This study aims to provide basic data for elderly health insurance policy and medical radiation safety management by analyzing the general radiography usage and exposure dose of the elderly in Korea. The effective dose for each general radiography was calculated using the ALARA-GR program for 260 general radiography codes selected from 'National Health Insurance Care Benefit Cost'. The usage of general radiography was analyzed in the 2016 elderly patient data of the Health Insurance Review and Assessment Service, and the effective dose for each general radiography was applied. The general radiography usage and exposure dose per person aged 65 years and over was 6.47 cases and 0.56 mSv. Females showed higher value than males as 7.15 cases and 0.66 mSv(p<.001). By age, those between 75 and 79 showed the highest number as 6.97 cases and 0.62 mSv(p<.001). Those who were supported by Medical Aid showed higher value than those who were insured by National Health Insurance as 8.82 cases and 0.76 mSv(p<.001). In addition, the ratio by radiography was in the order of Chest 20.85%, Knee Joint 15.58%, and L-spine 14.67%, and the exposure dose was L-spine 29.40%, Chest 15.82%, Abdomen 7.97%, and Entire Spine 7.20%. General radiography, which is widely used due to the high frequency of diseases in the elderly population should be taken into consideration when establishing health insurance policies. In addition, it is necessary to check whether the general radiography with high exposure dose is performed as a routine examination without considering medical necessity.
In this study, we analyzed the use of general radiography imaging and effective dose in inpatients. Our aim is to help reduce national medical radiation exposure doses and develop rational health-care financial policies. The effective dose for each general radiography was calculated using the ALARA-GR program for 53 types (total: 260 codes) general radiography codes selected from 'National Health Insurance Care Benefit Cost'. The usage of general radiography was analyzed in the 2018 inpatient patient data of the Health Insurance Review and Assessment Service, and the effective dose for each general radiography was analyzed. 89.00% of inpatients undergo general radiography imaging at least once, with an average of 12.63 scans per person and an effective dose of 1.00 mSv. Those who received support from Medical Aid showed a higher value compared to those who were insured by National Health Insurance, with 17.39 cases and 1.43 mSv (p<.001). Chest had the highest usage rate at 23.12% for general radiography imaging, while L-spine had the highest effective dose at 24.53%. It is estimated that 420 inpatients patients undergo 121 to 820 general radiography imaging procedures per year, and 233 inpatients are estimated to have an annual effective dose of >20.00~58.25 mSv. Rational use of health-care finances and the practice of medical radiation safety management are essential for the well-being of individuals, the enhancement of quality of life, and the improvement of health-care quality.
Background: This study was purposed to analyze the effect of spatial accessibility to the psychiatry department in general hospital on the outpatient visit of mental patients. Methods: Data was provided from the Statistics Korea and Statistical Geographic Information Service, National Health Insurance Service, Health Insurance Review and Assessment Service, and Korea Transport Institute in 2015. The study regions were 103 administrative regions such as Si and Gu. The 103 regions had at least one general hospitals with a psychiatry department. The number of outpatient visit of mental patients in regions was used as the dependent variable. Spatial accessibility to mental general hospital was used as the independent variable. Control variables included such as demographic, economic, and health medical factors. This study used network analysis and multi-variate regression analysis. Network analysis by ArcGIS ver. 10.0 (ESRI, Redlands, CA, USA) was used to evaluate the average travel time and travel distance in Korea. Multi-variate regression analysis was conducted by SAS ver. 9.4 (SAS Institute Inc., Cary, NC, USA). Results: Travel distance and time had significant effects on the number of outpatient visits in mental patients in general hospital. Average travel time and travel distance had negative effects on the number of visits. Variables such as (number of total population, percentage of aged population over 65, and number of mental general hospital) had significant effects on the number of visit in mental patients. Conclusion: Health policy makers will need to consider the spatial accessibility to the mental healthcare organization in conducting regional health planning.
Reconstruction of defects around the knee region requires thin and pliable skin. The superior lateral genicular artery (SLGA) flap provides an excellent alternative to muscle-based flaps. The anatomy and the surgical techniques of the SLGA flap were reviewed and the results of cases using the SLGA flap for coverage of knee and proximal leg defects were analyzed. SLGA flaps were performed in two cases and followed up for at least 6 months. Twelve articles on the use of the SLGA flap were also identified. A review of 39 cases showed that the mean diameter of the perforator supplying the skin of the flap was 1.04 mm, while the mean diameter of the SLGA at its origin was 1.78 mm. The mean length of the pedicle measured from the origin of the popliteal artery was 7.44 cm. The average dimensions of the flap were 14.8×6.6 cm with primary closure of the donor site in 61.5% of cases. Of these cases, 38.5% were due to trauma, 23.1% were post-burn complications, 12.8% were defects after resection of tumors, and 10.3% were for ulcers post-bursectomy. The most common complication was flap tip necrosis. All studies reported favorable outcomes with complete wound healing.
The purpose of this study was to examine association between oral health status and perceived general health symptom. We analyzed 14,231 subjects who participated in Korea National Health and Nutrition Examination Survey (2007~2009). All individuals were examined by a questionnaire about socioeconomic history, smoking and drinking habit, the frequency of daily tooth brushing, the presence of regular dental visit, and EuroQol-5D. Dental survey was conducted to find the decayed, missing, and filled teeth (DMFT) index and community periodontal index. Subjects with perceived problem with mobility had higher DMFT index (odds ratio, 1.18, p<0.001). Subjects with with perceived problem with pain/discomfort had higher DMFT index (odds ratio, 1.16, p<0.001). Self-rating general health symptom was not associated with periodontitis (p>0.05). Perceived general health was associated with DMFT index. It is recommendable that we can use the perceived general health to predict oral health status.
Purpose: The purpose of this study was to identify needs of health education of the students, parents, general teachers, and health teacher of the elementary, middle, and high schools. Method: 279 schools of elementary, middle, and high school were sampled nonproportionally during the period from June 28 to July 26, 2004 The data were collected by the questionnaire from 1,888 students, 1,876 parents, 1,695 general teachers, 279 health teachers. A frequency, % and $x^2-test$ were used to analysis by SAS program. Result: 1. It showed that 98.1% of elementary school students, 92.3% of middle school students, 89.6% of high school students answered that they need health education. The most of students, parents, and general teachers had high interests in health education. 2. In the case of students, main causes of needs of health education was 'to prevent diseases or accidents'. But parents answered that it was 'to build up a healthier behavior'. General teachers answered that it was 'more effective systematic and continuous health education'. 3. Over 80% of students, parents, and general teachers about the question of who qualified person is to teach health education as a regular class responded that health teacher is available. Especially 93% of elementary school students answered like that. 4. The most of students, parents, and general teachers answered that health education in the classroom is favorable 1 to 2 hours per week. Conclusion: As results of the study, the majority of students, parents, general teachers agreed needs of health education. Therefore, on the basis of this study, systematic and continuous health education is necessary. Additionally the establishment of independent health subject is required certainly.
Journal of Korean Society of Occupational and Environmental Hygiene
/
v.28
no.3
/
pp.319-329
/
2018
Objectives: The object of this paper is to analyze difference of general and occupational characters, risk exposure and ill health symptom depending on the special type of employment. Methods: 50,007 participants from Fourth Korean Working Condition Survey conducted in 2014 was analyzed. Cross-tabulation analysis was conducted for deriving difference in general and occupational characters, mulitvariate logistic regression analysis was conducted after controlling general and occupational characters for deriving difference in risk exposure and ill health symptom depending on the special type of employment. Results: In the special type of employment, female, ages of 50, education levels of high school, monthly income of 2,000-3,000 thousand won, job types of sales person, enterprises of less than 100 workers, working duration of 2-10 years and long working hours worker's proportion was higher than general employment. Physical(OR: 0.84, 95% CI: 0.76-0.94) and ergonomic (OR: 0.48, 95% CI: 0.42-0.55) risk exposure was lower, psychological(OR: 1.77, 95% CI: 1.54-2.04) risk exposure was higher than general employment, and there was no significant difference between the special type of employment and general employment in chemical/biological risk exposure(OR: 1.06, 95% CI: 0.94-1.20) and ill health symptom(OR: 0.98, 95% CI: 0.89-1.09). Conclusions: This article offers the analysing difference between the special type of employment and general employment using huge size cross sectional data represent Korean employees.
Objectives : This study analyzed job performance in local area general hospitals to look for measurable effects from educational training and/or organizational communication. Methods : For the purposes of this study, a survey was conducted of general hospital employees from 29 hospitals in Gwangju and Jeonnam. The survey period was August 22 - September 30, 2016, and 1,004 responses were used in the final analysis. Results : This study revealed that certain aspects of communication (upward,downward,vertical,orinformal) had significant effects on job satisfaction, learning transfer, and general performance. Conclusions : To improve job performance in general hospitals, employers must improve overall satisfaction by improving upon job training and internal communication. Specifically, training should be better connected to learning transfer and organizational design must encourage active communication between employees.
Purpose: This study aims to determine the association between psychosocial work environment and self-rated health among general hospital nurses. Methods: A total of 195 nurses working in one general hospital were eligible for data analysis by multivariate logistic regression. The psychosocial work environment was measured with the Korean version of the Copenhagen Psycosocial Questionnaire version II (COPSOQ-K). Self-rated health was recoded as good (excellent/good) and not good (fair/poor/bad) to the question, "In general, how would you rate your health status?" Results: 40% of nurses rated their health positively. Commitment to the workplace (OR=1.27), predictability (OR=1.32), recognition and reward (OR=1.41), role clarity (OR=1.32), and social support from colleagues (OR=1.25) were positively associated with self-rated health of nurse participants. Work-family conflict (OR=0.82) was negatively associated with self-rated health. Conclusion: The findings suggest that psychological work environment predicts self-rated health of hospital nurses. Good psychological work environment may be helpful in improvement of nurses' health.
Purpose: This study aims to identify the types of health-related quality of life (QoL) based on the EuroQoL 5 Dimensions among community older people and predict the factors affecting these types. Methods: This study used data from the 2016 Korea Health Panel Survey, whose participants included 3,848 older people. The data were analyzed using the software jamovi 1.2.17 and Mplus 8.2 for latent class analysis. Results: The subgroups of the older people's health-related QoL were identified as three latent classes: General stable type (43.9%), pain-related low type (35.0%), and general low type (21.1%). The types and characteristics of health-related QoL among the latent classes differed. Comparing the difference between the general low type and general stable type, the subjects showed higher probability of belonging to the general stable type when they were men, younger, higher education level, employment, better subjective health, lower BMI and stress level, and no suicidal ideation. A comparison between the general low type and the pain-related low type showed that the subjects were more likely to be classified as the pain-related low type when they were younger, higher education, employment, and better subjective health. Conclusion: The results showed a significant heterogeneity in the types of health-related QoL among community older people, and the predictors for each type were not the same. These findings present basic data for cultivating nursing interventions that enhance health-related QoL.
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