• Journal of Preventive Medicine and Public Health
• /
• v.46 no.6
• /
• pp.300-308
• /
• 2013

Objectives: The purpose of this study was to classify determinants of cost increases into two categories, negotiable factors and non-negotiable factors, in order to identify the determinants of health care expenditure increases and to clarify the contribution of associated factors selected based on a literature review. Methods: The data in this analysis was from the statistical yearbooks of National Health Insurance Service, the Economic Index from Statistics Korea and regional statistical yearbooks. The unit of analysis was the annual growth rate of variables of 16 cities and provinces from 2003 to 2010. First, multiple regression was used to identify the determinants of health care expenditures. We then used hierarchical multiple regression to calculate the contribution of associated factors. The changes of coefficients ($R^2$) of predictors, which were entered into this analysis step by step based on the empirical evidence of the investigator could explain the contribution of predictors to increased medical cost. Results: Health spending was mainly associated with the proportion of the elderly population, but the Medicare Economic Index (MEI) showed an inverse association. The contribution of predictors was as follows: the proportion of elderly in the population (22.4%), gross domestic product (GDP) per capita (4.5%), MEI (-12%), and other predictors (less than 1%). Conclusions: As Baby Boomers enter retirement, an increasing proportion of the population aged 65 and over and the GDP will continue to increase, thus accelerating the inflation of health care expenditures and precipitating a crisis in the health insurance system. Policy makers should consider providing comprehensive health services by an accountable care organization to achieve cost savings while ensuring high-quality care.

• Journal of Preventive Medicine and Public Health
• /
• v.48 no.1
• /
• pp.28-37
• /
• 2015

Objectives: Among the Korean elderly (those 65 years of age and older), the suicide rate is 80.3/100 000 people, which is ten times higher than the Organization for Economic Cooperation and Development average. Because South Korea is rapidly becoming an aging population, this high elderly suicidal rate will only get worse. Although the size of the elderly suicide problem is quite large, previous research in South Korea has surveyed restricted areas and not the entire country. Even though the factors that affect elderly suicide are complicated, there has been little research into these influencing factors. Thus, this research uses the national survey data (Community Health Survey) that was obtained in 2009. Additionally, we analyze factors affecting elderly suicidal ideation and attempts as well as the paths of these effects. Methods: Community Health Survey data obtained by the Korea Centers for Disease Control and Prevention in 2009 was used for this study. We additionally examined the factors that affect suicide with chi-squared tests, t-tests, Pearson's correlation test, and path analysis. Results: Depressive symptoms and suicidal ideation are the only factors that directly affect suicidal attempts. Demographic, behavioral, and physical activity factors have indirect effects on suicidal attempts. Conclusions: Depression has the strongest influence on suicidal ideation and attempts. Demographic, behavioral, and physical activity factors affect suicidal attempts mostly through depressive symptoms. In addition, there is a path that suggests that demographic, behavioral, and physical activity factors affect suicidal attempts not through depression symptoms but only through suicidal ideation. This means that the elderly who do not have depression symptoms attempt suicide according to their own situations and characteristics.

• Journal of the Korean Society of School Health
• /
• v.7 no.1
• /
• pp.9-28
• /
• 1994

This study is to investigate the status and problems in the anual physical examination in elementary & secondary schools. The study helps the introduction of health assessment. Two hundreds and forty nurse teachers of elementary & seconcary school in Seoul received in-service traomong fpr 20 daus frp, September 7 to September 27, 1992. Questionnaires were given to the 240 teachers and the number of collected questionnaire is 112. The result of the questionnaire analysis is like the following. First, the answered teachers aged 35~39, 36.6%; experience 6~10 years 37.5%; the number of class 31~40, 28.6%. Among the answered of the school doctors is practicioners. The doctors major subjects are 26.8% of internal medicine and 35.7% of surgery. Second, in elementary & secondary school nurse teachers received in-service training for the primary health assessment. And then 37.5% of schools practiced the health assessment. The term of the health assessment is largely a-year-length, occurately its rate of schools have practiced the assessment reaches 81.0%. The number of health assessment are consist of eyes, nose, ear, throat, skin, spine, heart and other abnormal regions and diseases all over the body. And 83.3% of the rate of the health assessment includes all these contents. The period of the health assessment is 7 to 28 days. Third, the physical examination conducted by school doctors is 91.0%. The method is various; one is 56.6% of the students who checked first by he nurse teacher. The number of 15.1% of the schools is directly checked by the school doctor. The invited medical doctors are divided into two categories. The number of general physician is 61.9%. Contrary to that school doctors are 38.1%. The contents of the medical examination is all the items printed on the medical examination sheet. To follow the medical examination sheet the number of school is 59.6%. Eyes, throat, skin and heart etc. partly medical examination is 40.4%. The rate of schools that used only stethoscope, tongue pressor as the medical instruments reaches 53.4% and 87.1% of elementary & secondary school give the invited doctors the allowance a nurse teachers conference decided. The number of 8.9% schools pay the doctors independent allowance. The medical examomatopm allowance is 200 to 250 won per capita. The rate is 56.1%. Forth, after the medical examination 72.1% of school sends letter to the parents to notice the result of the examination. The number of response from parent is 12.5%. The observation record in secondary school is 70.6% for junior, and 80.0% for senior respectively, and 65.5% is for the elementary school children. To conclude the regular physical examination in elementary & secondary school is very important. Because the students are in the stage of rapid growth and development. Early finding of the students diseases can help to cure with ease. In the light of public health the management of health program in the elementary & secondary school is of consequence.

• Korea Journal of Hospital Management
• /
• v.24 no.4
• /
• pp.1-12
• /
• 2019

Purposes: The purpose of this study, was to identify similar factors between reasons for unscreening and unmet health care needs through prior research, and based on this, we wanted to figure out the relevance between the medical screening and unmet health care needs. Methodology: The analysis was conducted using data from 9,640 adults aged 19 or older who don't have a missing value from 16,277 participants in the 7th, 1st&2nd Year (2016&2017) of the National Health and Nutrition Examination Survey (KNHANES). Unmet health care needs were investigated as a self-reported questionnaire of whether medical service was required but not received. And the analysis was performed through the Chi-Square Test and Multi-logistic Regression analysis. Findings: As a result of the analysis, unmet healthcare needs were higher who received only one type of screening comparative to who screened both. and were highest who screened neither. Practical Implications: Unmet health care needs are the center of a vicious cycle, such as morbidity and mortality, which is detrimental to the quality of life, and continues to increase. Therefore, it is necessary to find ways of realizing health care that guarantees the health rights of all citizens by policy guarantee and support for the subjects to recognize the importance of thorough education of screenings rather than only health screening or cancer screening.

• Journal of Korean society of Dental Hygiene
• /
• v.13 no.2
• /
• pp.297-303
• /
• 2013

Objectives : The purpose of this study was to evaluate the oral health status of the disabled people in Ulsan. Methods : Two dentists taken a calibration training for national oral health survey examined the Oral health status on 110 disabled people in Ulsan, in 2009. The surveyed disabled people, 6 to 19 years old, have been supplied with the oral health care services by dentists, oral hygienists and volunteers at dental clinics of schools and a dental clinic supported from Ulsan Metropolitan City Nam-Gu Health Center since 1997. The obtained data from these surveys were analyzed with the SPSS statistical package. Results : Among subjects aged 12-14 years, DMF rate was 38.2%; Active D rate, 17.6%; DMFT index, 1.15; DT rate, 33.33%; MT rate, 0.00%; FT rate, 66.67%. Oral heath status of disabled people in Ulsan were evaluated to be a similar level to the Ulsan non-disabled citizens from 2010 Korean National Survey. Conclusions : The oral health care programs for disabled people using voluntary dentists, oral hygienists and other workers in Ulsan are evaluated to be effective for the disabled people.

• Journal of Preventive Medicine and Public Health
• /
• v.50 no.4
• /
• pp.240-250
• /
• 2017

Objectives: Subjective life expectancy (SLE) has been found to show a significant association with mortality. In this study, we aimed to investigate the major factors affecting SLE. We also examined whether any differences existed between SLE and actuarial life expectancy (LE) in Korea. Methods: A cross-sectional survey of 1000 individuals in Korea aged 20-59 was conducted. Participants were asked about SLE via a self-reported questionnaire. LE from the National Health Insurance database in Korea was used to evaluate differences between SLE and actuarial LE. Age-adjusted least-squares means, correlations, and regression analyses were used to test the relationship of SLE with four categories of predictors: demographic factors, socioeconomic factors, health behaviors, and psychosocial factors. Results: Among the 1000 participants, women (mean SLE, 83.43 years; 95% confidence interval, 82.41 to 84.46 years; 48% of the total sample) had an expected LE 1.59 years longer than that of men. The socioeconomic factors of household income and housing arrangements were related to SLE. Among the health behaviors, smoking status, alcohol status, and physical activity were associated with SLE. Among the psychosocial factors, stress, self-rated health, and social connectedness were related to SLE. SLE had a positive correlation with actuarial estimates (r=0.61, p<0.001). Gender, household income, history of smoking, and distress were related to the presence of a gap between SLE and actuarial LE. Conclusions: Demographic factors, socioeconomic factors, health behaviors, and psychosocial factors showed significant associations with SLE, in the expected directions. Further studies are needed to determine the reasons for these results.

• Journal of Nutrition and Health
• /
• v.38 no.10
• /
• pp.864-872
• /
• 2005

Various types of functional foods for health (FFH) are popularly used among adolescents. We surveyed 858 students, $15.0 \pm$ 1.6 (14-18) years of age, attending general junior or senior high schools in Korea for FFH use and significant variables for their FFH use including demographic characteristics, food consumption frequency and nutritional beliefs. The use prevalence of FFH was $47.8\%$, and among all types of FFH, nutritional supplements were taken most frequently, followed by red ginseng products > enzyme containing products > plant extract-fermented products. FFH use was higher in older aged-group, subjects lived in small or middle city, and those from families with a high socioeconomic status in comparison to each corresponding group. Health concern on offsprings by parents and usage ratio of FFH by family was higher in users than in nonusers of FFH. Total score of dietary assessment was higher in users than in nonusers of FFH, and users had a more positive view concerning the potential health benefit of FFH than did nonusers. Most users of FFH took FFH when they were healthy ($50.7\%$) , and they did not feel special effects through the FFH use ($57.1\%$) . Most users of FFH got the information on FFH through family and relatives ($61.5\%$) , and most of them purchased FFH at pharmacy or oriental medicine clinics ($55.1\%$) . FFH users preferred vitamin C-and Ca-supplements most among the vitamin mineral supplements belonged to FFH. Given the widespread use of FFH by adolescents, the reasonable use of these products for the contribution to their overall health and well-being is a subject that is emphasized in nutrition education for them. (Korean J Nutrition 38(10) : 864$\sim$872,2005)

• Journal of Digital Convergence
• /
• v.15 no.11
• /
• pp.471-484
• /
• 2017

The present study explored factors that influence consumers' benefit expectancy about telemedicine service. Responses from a national online survey of 927 adults (aged 19-59), collected in January 2016, were analyzed with multiple regression analysis. The results revealed: (1) Health consciousness positively influenced all three benefit expectancies (all ps < .05); (2) Doctor-patient communication efficacy positively influenced expectancy for convenience improvement (${\beta}=.107$, p < .01) and service quality improvement (${\beta}=.086$, p < .05); (3) Use of health-related smart applications contributed to positive expectancy for service quality improvement (${\beta}=.081$, p < .05) and cost-saving (${\beta}=.067$, p < .05). Some of the relationships were moderated by gender and residence. This convergence study, which examined public's perception about telemedicine from the perspectives of consumer psychology, media, and public health, provides practical implications to promote telemedicine service and educate consumers about it.

• Journal of the Ergonomics Society of Korea
• /
• v.31 no.1
• /
• pp.171-176
• /
• 2012

Objective: The goal of this study was to assess work ability of Korean workers in the shipbuilding industry. Background: Old age is associated with inevitable time-dependent losses in physical capabilities. However the maintenance of physical capabilities is essential for continuing independence in old age. The work ability index(WAI) was constructed to reveal how well a worker is able to perform his or her work. Method: The WAI is a kind of survey methods developed to estimate the work capacity of aged workers by the Finish Institute of Occupational Health(FIOH) in 1998. The difference of the WAI between groups in each category was tested using the Kruskal-Wallis test, and the relationship between the WAI and the workers' ages was tested by the Correlation test. Results: This study surveyed 2,709 persons working in the shipbuilding industry in Korea. The average WAI score for all workers was 40.0 denoting a Good Level. Also, workers in the shipbuilding industry had lower work ability, as compared to the results of other industries. The WAI was analyzed for different age groups(${\leq}29$; 30~34; 35~39; 40~44; 45~49; 50~54; ${\geq}55$). The results of Kruskal-Wallis test showed that significant difference was identified on the effect of aging(p<0.05). Conclusion: Advanced countries like the Finland showed decreasing tendency in good and excellent levels as aged, but there was no decreasing tendency in Korean population. The results may be attributable to the general characteristics of Korean society, such as poor social security and burden caused by role of the patriarch. It may bring forth higher work ability in aged population even their physical condition is getting worse. Application: This finding could be used for developing more accurate assessment tool of work ability for working environment.

• Health Policy and Management
• /
• v.22 no.4
• /
• pp.561-578
• /
• 2012

This study was performed in order to compare a change in pharmaceutical expenditures per outpatient of clinic and to analyze factors relevant to a systems as part of evaluating policies for the incentive scheme to reduce total prescribed drug expenditure and for the drug utilization review system("DUR system" hereafter). For this, it had finally analytical subjects as 21,320 clinics nationwide without a change in location, clinics symbol and signed subject during both terms of the first half of 2010 and the first half of 2011. As a result, the odds ratio with reduction in pharmaceutical expenditures of clinic was statistically higher significantly in the shorter year number of opening clinic, in the larger number of doctors, when the classification of establishment is other, not individual, and when the signed subject is surgical division. Also, the odds ratio was significantly higher in the less patient number of clinic and in the lower ratio of patients aged over 65. Finally, the odds ratio was significantly high when a clinic had been located in DUR system demonstrative project area. Through this, a case of policy for improvement in doctor's autonomous prescription behavior like DUR system can be known to be effective for reduction in pharmaceutical expenditures. A future research on evaluation of policy for pharmaceutical expenditure management system will need to be performed in-depth analysis in consideration of diverse characteristics on the participatory entities.