• 한국노년학
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• v.39 no.2
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• pp.325-345
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• 2019

The purpose of this study is a exploratory study for understanding the process of the social isolation of the socially isolated elderly through the approach to their life history. The research was analyzed by one of the methods of qualitative research on life history, the conceptual framework of 'Dimensions, turning, and adaptation' of Mandelbaum(1973). According to the results of this study, the socially isolated elderly people were found to be socially isolated by experiencing complex difficulties such as family disconnection, poverty, poor job and health deterioration. Specifically, in the area of life, there was experience of poor relationship with parent, absence of family, poverty of family and unfavorable relationship with surrounding people in life with original family before isolation. They had bad jobs in the labor market, such as hard labor, delivery, business, and chores. In the area of turning point, we experienced family break due to the separation of the original family and the spouse due to various reasons such as financial crisis, parental divorce and death, spouse affair, economic difficulty. In a transitional stage in the life, many reasons such as the financial crisis, the death of parents, the extramarital affair and economic difficulties led to the disconnection from their original family and their spouses. In an adaptive phase, participants accepted the changed life at each turning point in their lives, carrying out their roles, compromising and trying to adapt properly. He said that their current life, which has entered the social safety net system of the people's basic recipients, has led him to live a more stable life and is adapting to personal hobbies and vicarious satisfaction through networks. This result is somewhat different from previous studies in which isolated elderly people were severely exposed to the risk of depression and loneliness. However, we should also consider the characteristics of this study that interviewed elderly people with relatively low isolation. Based on the results of this research, he presented various practical policy implications.

• Health Policy and Management
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• v.24 no.1
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• pp.56-70
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• 2014

Background: Korea shows rapid population aging and increase in healthcare service use and expenditure. Also, this would be accelerated because of the baby boomers who will be 65 years old and more in 2020. Chronic disease is another reason that increases the use of healthcare service and expenditure of the middle- and old-aged households. Catastrophic health expenditure (CHE) is the index which can indicate the households' burden of health spending. Despite the importance, there are few studies on CHE of middle- and old-aged households and especially no panel study yet. This is the reason that this study is carried out. Methods: This study used 3-year data from the Korea Welfare Panel Study conducted from 2009 to 2011. We defined CHE if a household's health expenditure is equal or greater than the threshold value if income remaining after subsistence needs has been met. We used 4 different threshold values which are 10%, 20%, 30%, and 40%. In order to look at the households which experienced CHE, we conducted panel logit analysis after correspondence analysis and conditional transition probability analysis. Results: This study showed three notable results. First, there has been a difference among age groups, which implies that the older people are, the more easily they can experience CHE. Second, the households with no private insurance are shown to have a higher CHE occurrence rate. Lastly, there has been a significant difference among the kinds of chronic diseases. The households which have cancer, cerebrovascular disease, and heart disease have a higher CHE occurrence rate. However, the households with diabetes have no significant effects to CHE occurrence. Also, hypertension has a negative effect to the occurrence. Conclusion: With the results, it can be implied that elderly people with chronic disease are more needed in medical coverage and healthcare. Also, private insurance can play its role in protecting households from CHE. Therefore, it needs to conduct studies on CHE especially about different age groups, private insurance, and chronic disease.

• Journal of Digital Convergence
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• v.15 no.4
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• pp.327-337
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• 2017

The purpose of this study is to identify the current state of paid care services and to identify the factors that affect the utilization of private nursing services. This study constructed and utilized the Korean Health Panel data (2011-2014) in the form of panel data, and selected 5,110 patients who had experience using one or more hospitalization services per year. STATA 12.0 SE was used for data processing and analysis of this study. Frequency analysis was performed to confirm basic characteristics of hospitalized patients. Cross-analysis and t-test were conducted to confirm the status of paid care services according to characteristics. Respectively. Finally, panel logistic regression was performed by applying a hierarchical method to stepwise modeling the three categories of Andersen's Behavioral Model to identify factors affecting the use of paid care services for inpatients. The results showed that the use of paid nursing services was higher in women, elderly, long - term hospitalized and disabled. On the other hand, significant household income variables in private employment did not show significant results. The results of this study are expected to be used as basic data for the selection of the nursing care integrated services under discussion. In addition, detailed discussions on the selection of subjects should be made in the future.

• Journal of Nutrition and Health
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• v.56 no.2
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• pp.155-167
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• 2023

Purpose: This study investigates the association between seafood consumption and frailty according to gender in the Korean elderly. Methods: Cross-sectional data from the Seventh (2016-2018) Korea National Health and Nutrition Examination Survey was procured for this study. Data from 3,675 subjects (1,643 men and 2,032 women) aged ≥ 65 years were analyzed. Levels of seafood intake were assessed by a one-day 24-hour dietary recall, and subjects were classified into three tertiles by gender according to frailty phenotype: robust, pre-frail, and frail. Multinomial logistic regression analysis was performed to clarify the association between seafood consumption and frailty for each gender. Results: The prevalence of frailty was determined as 13.4% for men and 29.7% for women. Participants with a higher seafood intake had higher intakes of grains, fruits, and vegetables, while the intake of meat was significantly lower. In both men and women, the group with higher seafood intake showed higher energy and micronutrient intakes. The frail prevalence and frailty score were significantly low in the highest tertiles of seafood consumption compared to the lowest tertile in men and women (p < 0.001). After adjusting for confounder, the highest tertile of seafood consumption showed a decreased risk of frailty compared to the lowest tertile only in women (hazard ratio [HR], 0.50; 95% confidence interval [CI], 0.32-0.78; p-trend = 0.008 vs. HR, 0.52; 95% CI, 0.32-0.83; p-trend = 0.008; respectively). Conclusion: Results of this study suggest that seafood consumption potentially decreases the risk of frailty in the elderly.

• 한국노년학
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• v.29 no.4
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• pp.1383-1396
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• 2009

In this study, we investigated the effects of perceived health and ageism experience of the elderly on successful aging, which were respectively presumed as predictors of biomedical model and psychosocial model of the successful aging. As important research results, firstly, negligence among ageism experience constructs appeared higher than other discriminatory experiences. Secondly, male showed significantly higher discriminatory experience than female in the area of 3 constructs such as property, negligence and employment ageism. Also there were some different discriminative experiences in the area of perceived health and ageism in terms of age, wealth and education. Finally, the results of hierarchical multiple regression hired to find out factors influencing successful aging showed that the factors such as sex, wealth, perceived health and property discrimination of ageism affected successful ageing. Based on the analytic results, we verified that perceived health, i.e., predictor of biomedical model had higher effect on successful aging than ageism experience, i.e., predictor of psychosocial model of successful aging. Thus, it was suggested that health promotion policy should be considered with priority and also combating ageism as well for successful aging.

• 한국노년학
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• v.29 no.2
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• pp.629-643
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• 2009

The purpose of this study is, by using the demographic variables, to identify self-efficacy, social support, and quality of life of the elderly with depression and to assess the impacts of these factors upon their quality of life. By analyzing the factors which have an impact upon the life quality of the elderly with depression, this study aims to provide important information which help understand them, and to find out what kind of care is necessary for their happy and satisfactory life. The study took purposive sampling and survey of 215 people among the elderly with depression who were under care of the outpatient clinics, day hospitals, and mental health clinics located in Seoul and Kyunggi Province, Korea. This study was conducted from November 10th to 20th, 2008 and the data were collected using the questionnaires of self-efficacy, social support, and quality of life scales. Using a SPSS/WIN 15.0 program, the analysis of the data showed the following results. First, among the demographic characteristics, the elderly with depression who were male, had spouse, higher education, no public assistance, shorter period of depression, and were healthy turned out to have higher self-efficacy. In terms of social support, the participants who had higher education, no public assistance, and were healthy turned out to have more social support. Further, in terms of quality of life, the variables of spouse, public assistance, period of depression, and health condition were statistically significant. Second, as a result of hierarchical regression, it appeared that the elderly with depression, who had higher self-efficacy, more social support, spouse, good health, no public assistance, and shorter period of depression, turned out to have higher quality of life. Based on the study findings, the implications of social work practice, policy, and future research were discussed.

• Korea Journal of Hospital Management
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• v.25 no.3
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• pp.67-77
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• 2020

Background: As of 2016, average Koreans sleep 7 hours and 42 minutes, the lowest figure among Organization for Economic Cooperation and Development(OECD) countries, and the number of people with sleep disorders reached 561,000. Accordingly, the government has promoted the provision of 'Multiple Sleep Test' to strengthen the diagnosis service for patients with 'sleep disorder' in july 2018. As a result, healthcare costs for patients with sleep disorder is on the rise every year. In this study, we utilized 'Appropriate Sleep' criteria of United States's National Sleep Foundation(NSF) then investigated Korean's sleep pertinence using ｢7th National Health and Nutrition Survey for 2016-2018」 by different occupational type, demographic characteristics, socio-economic characteristics, and health behaviors. Methods: We performed descriptive analysis to examine differences of sleep appropriateness by various sample characteristics. Multivariate logistic regression models were used to examine sleep appropriateness by occupational type and other variables. We also analyzed subgroup models to investigate. Results: As a result, a total of 1,948 (18.37%) study subjects experienced in-appropriate sleep. Results of the Multivariate logistic regression analysis revealed that blue color group had a higher odds ratio (OR) for experiencing in-appropriate sleep (OR=1.179). In addition, the odds ratio of experienced in-appropriate sleep among the elderly aged 70 and over was 2.698, and the odds ratio of the overstressed group was 1.299. Furthermore, sub-group analysis showed that blue color job of female(Or=1.334), high school or below(OR=1.404), divorce/death/separation(OR=2.039), 25%ile-50%lie income group(OR=1.411) more likely experienced in-appropriate sleep. Conclusion: Growing sleep disorder patients and related health care costs are expected. Government should apply detailed 'total periodic sleep disorder management policy' including pre-consultation, examination, diagnosis, treatment, post-consultation, self-management especially to vulnerable population that this study found.

• Korean Journal of Clinical Pharmacy
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• v.16 no.2
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• pp.139-146
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• 2006

Objectives: Bio-equivalence(BE) test is important not only to ensure the quality of generic drugs, but also to promote drug substitution under the separation of prescribing and dispensing practice(SPD). This study was intended to investigate the perception of consumers, doctors, and pharmacists on the confidence of bio-equivalence(BE) assured drugs. Methods: Nation-wide telephone interview survey was conducted for 1,018 consumers, 800 doctors, and 806 pharmacists from September to October in 2003. Descriptive analysis and ${\chi}^2$ analysis were conducted. Results: Even though people showed higher confidence level for the Bioequivalent drugs compared with Bio-inequivalent drugs, the confidence was generally low. Among those asked about the therapeutic substitutability of original drugs by BE versions, 95.78% of pharmacists responded "positive", while only 39.33% of consumers and 31.13% of doctors said so. The elderly, the less educated, who takes chronic disease medicine, pays high cost of prescription drugs, and are in the low income responded less aware of that. Also most consumers got information such as effect of drugs from either media or doctors. Conclusions: In order for people to believe that BE drugs and original drugs are equivalent, we need to strengthen health education, and to clarify any misunderstanding. It is also necessary for the national policy to provide accurate information about drugs to the public.

• Journal of Korean Clinical Nursing Research
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• v.25 no.3
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• pp.275-284
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• 2019

Purpose: The purpose of this study was to analyze the current state of home health nursing (HHN) for elders and to provide basic data on policy alternatives for establishing home medical care in the advanced general hospital. Methods: This study was conducted as a secondary data analysis, using electronic medical record (EMR) data of older patients who received HHN more than once from the S advanced general hospital between January 2016 and December 2018. Results: A total of 1,790 patients received HHN visits, with 22,477 visits being made. The mean age was 76.8±7.3 years old, 96.0% of elders had health insurance and 24.6% had orthopedics problems. Of the 1,168 people who visited emergency rooms, the most frequent symptom was pain (23.4%) and all patients visited the hospital at least once and at most 163 times outpatient care during HHN. Causative diseases were degenerative knee joint osteoarthritis (0.6%), surgery for right knee replacement (4.0%), and for dressings (9.7%) in the HHN service content analysis. Conclusion: The progress towards an aging society and the introduction of community care are expected to further enhance the need for HHN which should be able to provide comprehensive and continuous visiting health care services to the older patients. The results of this study are expected to help doctors solve problems not solved by HHN, reduce unnecessary emergency room or outpatient visits, and readmission, while at the same time contributing to the improvement of patient quality of life through efficient patient health care.

• Hip & pelvis
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• v.36 no.2
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• pp.144-154
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• 2024

Purpose: The objective of this study was to assess postoperative direct medical expenses and medical utilization of elderly patients who underwent either hemiarthroplasty (HA) or internal fixation (IF) for treatment of a femoral intertrochanteric fracture and to analyze differences according to surgical methods and age groups. Materials and Methods: Data from the 2011 to 2018 Korean National Health Insurance Review & Assessment Service database were used. Risk-set matching was performed for selection of controls representing patients with the same sex, age, and year of surgery. A comparative interrupted time series analysis was performed for evaluation of differences in medical expenses and utilization between the two groups. Results: A total of 10,405 patients who underwent IF surgery and 10,405 control patients who underwent HA surgery were included. Medical expenses were 18% lower in the IF group compared to the HA group during the first year after the fracture (difference-in-difference [DID] estimate ratio 0.82, 95% confidence interval [CI] 0.77-0.87, P<0.001), and 9% lower in the second year (DID estimate ratio 0.91, 95% CI 0.85-0.99, P=0.018). Length of hospital stay was significantly shorter in the IF group compared to the HA group during the first two years after time zero in the age ≥80 group. Conclusion: A noticeable increase in medical expenses was observed for patients who underwent HA for treatment of intertrochanteric fractures compared to those who underwent IF over a two-year period after surgery. Therefore, consideration of such findings is critical when designing healthcare policy support for management of intertrochanteric fractures.