• 제목/요약/키워드: Health statistics

검색결과 4,629건 처리시간 0.031초

인구구조의 변화를 반영한 건강보험 진료비 추계 (A Financial Projection of Health Insurance Expenditures Reflecting Changes in Demographic Structure)

  • 이창수;권혁성;채정미
    • 한국보건간호학회지
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    • 제31권1호
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    • pp.5-18
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    • 2017
  • Purpose: This study was conducted to suggest a method for financial projection of health insurance expenditures that reflects future changes in demographic structure. Methods: Using data associated with the number of patients and health insurance cost per patient, generalized linear models (GLM) were fitted with demographic explanatory variables. Models were constructed separately for individual medical departments, types of medical service, and types of public health insurance. Goodness-of-fit of most of the applied GLM models was quite satisfactory. By combining estimates of frequency and severity from the constructed models and results of the population projection, total annual health insurance expenditures were projected through year 2060. Results: Expenditures for medical departments associated with diseases that are more frequent in elderly peoples are expected to increase steeply, leading to considerable increases in overall health insurance expenditures. The suggested method can contribute to improvement of the accuracy of financial projection. Conclusion: The overall demands for medical service, medical personnel, and relevant facilities in the future are expected to increase as the proportion of elderly people increases. Application of a more reasonable estimation method reflecting changes in demographic structure will help develop health policies relevant to above mentioned resources.

Association of Single Nucleotide Polymorphisms in the Prostaglandin-endoperoxide Synthase 2 (PTGS2) and Phospholipase A2 Group IIA (PLA2G2A) Genes with Susceptibility to Esophageal Squamous Cell Carcinoma

  • Liu, Fen;Wei, Wen-Qiang;Cormier, Robert T.;Zhang, Shu-Tian;Qiao, You-Lin;Li, Xin-Qing;Zhu, Sheng-Tao;Zhai, Yan-Chun;Peng, Xiao-Xia;Yan, Yu-Xiang;Wu, Li-Juan;He, Dian;He, Yan
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권4호
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    • pp.1797-1802
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    • 2014
  • Background: The prostaglandin-endoperoxide synthase 2 (PTGS2) and phospholipase A2 group IIA (PLA2G2A) genes encode enzymes that are involved in arachidonic acid and prostaglandin biosynthesis. Dysregulation of both genes is associated with inflammation and carcinogenesis, including esophageal squamous cell carcinoma (ESCC). We therefore hypothesized that there is an association between single nucleotide polymorphisms (SNPs) in these genes and susceptibility to ESCC. Methods: We performed a gene-wide tag SNP-based association study to examine the association of SNPs in PTGS2 and PLA2G2A with ESCC in 269 patients and 269 healthy controls from Taihangshan Mountain, Henan and Hebei Provinces, the rural area of China which has the highest incidence of esophageal cancer in the world. Thirteen tag SNPs in PLA2G2A and 4 functional SNPs in PTGS2 were selected and genotyped using a high-throughput Mass Array genotyping platform. Results: We found a modest increased risk of ESCC in subjects with the PTGS2 rs12042763 AA genotype (OR=1.23; 95% CI, 1.00-3.04) compared with genotype GG. For PLA2G2A, a decreased risk of ESCC was observed in subjects with the rs11677 CT (OR=0.51, 95%CI, 0.29-0.85) or TT genotype (OR=0.51, 95%CI, 0.17-0.96) or the T carriers (CT+TT) (OR=0.52, 95%CI, 0.31-0.85) when compared with the CC genotype. Also for PLA2G2A, rs2236771 C allele carriers were more frequent in the control group (P=0.02). Subjects with the GC (OR=0.55, 95%CI, 0.33-0.93) or CC genotype (OR=0.38, 95% CI, 0.16-0.94) or the C carriers (GC+CC) (OR=0.52, 95%CI, 0.32-0.85) showed a negative association with ESCC susceptibility. Conclusions: Our results suggest that PTGS2 and PLA2G2A gene polymorphisms may modify the risk of ESCC development.

Prognostic Evaluation of Categorical Platelet-based Indices Using Clustering Methods Based on the Monte Carlo Comparison for Hepatocellular Carcinoma

  • Guo, Pi;Shen, Shun-Li;Zhang, Qin;Zeng, Fang-Fang;Zhang, Wang-Jian;Hu, Xiao-Min;Zhang, Ding-Mei;Peng, Bao-Gang;Hao, Yuan-Tao
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권14호
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    • pp.5721-5727
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    • 2014
  • Objectives: To evaluate the performance of clustering methods used in the prognostic assessment of categorical clinical data for hepatocellular carcinoma (HCC) patients in China, and establish a predictable prognostic nomogram for clinical decisions. Materials and Methods: A total of 332 newly diagnosed HCC patients treated with hepatic resection during 2006-2009 were enrolled. Patients were regularly followed up at outpatient clinics. Clustering methods including the Average linkage, k-modes, fuzzy k-modes, PAM, CLARA, protocluster, and ROCK were compared by Monte Carlo simulation, and the optimal method was applied to investigate the clustering pattern of the indices including platelet count, platelet/lymphocyte ratio (PLR) and serum aspartate aminotransferase activity/platelet count ratio index (APRI). Then the clustering variable, age group, tumor size, number of tumor and vascular invasion were studied in a multivariable Cox regression model. A prognostic nomogram was constructed for clinical decisions. Results: The ROCK was best in both the overlapping and non-overlapping cases performed to assess the prognostic value of platelet-based indices. Patients with categorical platelet-based indices significantly split across two clusters, and those with high values, had a high risk of HCC recurrence (hazard ratio [HR] 1.42, 95% CI 1.09-1.86; p<0.01). Tumor size, number of tumor and blood vessel invasion were also associated with high risk of HCC recurrence (all p< 0.01). The nomogram well predicted HCC patient survival at 3 and 5 years. Conclusions: A cluster of platelet-based indices combined with other clinical covariates could be used for prognosis evaluation in HCC.

손상감시를 위한 핵심데이터 선정과 보완 (The Selection and Supplementation of Core Data for Injury Surveillance)

  • 임준규;김한결;이현실
    • 디지털융복합연구
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    • 제18권9호
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    • pp.265-275
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    • 2020
  • 손상부담은 우리사회에서 매우 심각한 것으로 널리 인식되고 있다. 그럼에도 불구하고 손상감시에 필요한 데이터가 충분하지 않다. 이 연구의 목적은 손상감시를 위해 핵심 데이터를 선택하고 보완하는 것이다. 이를 위해 본 연구에서는 통계품질 6가지 차원에 따라 '사망원인통계', '건강보험통계', '퇴원손상조사'에 대한 품질평가보고서 등의 문헌을 분석 하였다. 분석결과는 '사망원인통계'와 '건강보험통계'가 손상감시를 위한 핵심데이터로서 유용성이 있다는 것이다. 그러나 '건강보험통계'에는 손상외인에 대한 데이터가 부족하다는 단점이 있다. 단점을 보완하기 위해, 본 연구에서는 국민건강보험 의료비 청구 시 의료기관이 손상외인을 의무적으로 신고하도록 하는 제도를 제안한다. 이 제도의 결과로서 우리는 '손상 피라미드 구축', '국민연금과의 데이터 연계', '손상 데이터의 시의성 향상'을 기대할 수 있다. 그리고 이 제도 실현을 위한 후속 연구를 기대한다.

치과위생사의 직무스트레스, 감정노동이 지각된 건강상태에 미치는 영향 (The effects of job stress and emotional labor on Perceptive health status of dental hygienist's)

  • 이명선;임희정
    • 한국학교ㆍ지역보건교육학회지
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    • 제20권3호
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    • pp.43-52
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    • 2019
  • Objectives: This study aims to understand the effects of job stress and emotional labor on perceptive health status of dental hygienist's. And provide basic data by for establishing the plan for the effective management of job stress and emotional labor and the promotion of health. Methods: Self-evaluation questionnaires were surveyed for 441 dental hygienist's who agreed to participate in the survey, using questionnaires used in the preceding study were modified and complemented. We analyzed the data with frequency analysis, descriptive statistics, t-test, chi-square test와 ANOVA, Spearman correlation coefficient by using IBM SPSS Statistics 21.0 (IBM Co., Armonk, NY, USA). The significance level for significance was set at 0.05. Results: health status were job stress, emotional labor significant negative correlation. The factors having significant effects on health problem were physical health status, the job culture of job stress, lack of job autonomy, organizational instability, and workplace culture. In addition, social health status was affected by emotional expressionism, relationship conflict, organizational instability, organizational system, and workplace culture. Conclusion: Recognizing the importance of the management of job stress and emotional labor in the working environment to dental clinic and hospital managers and managerial dental hygienists, a dental hygienist health promotion intervention program is needed to mitigate and cope with job stress and emotional labor.

코로나19에서 고혈압 치료율의 지역 간 변이요인 분석 (Interregional Variant Factor Analysis of Hypertension Treatment Rate in COVID-19)

  • 박종호;김지혜
    • 디지털융복합연구
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    • 제20권4호
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    • pp.469-482
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    • 2022
  • 본 연구의 목적은 코로나19에서 고혈압 치료율의 지역 간 변이요인을 분석하는 것이다. 이를 위해 생태학적 분석에 적합한 데이터를 2020년 질병관리청 지역건강통계, 각 지자체 코로나19 확진자 현황 자료, 국민건강보험공단, 건강보험심사평가원의 건강보험통계, 한국사회보장정보원의 복지통계, 한국교통연구원의 교통접근성 지표 자료를 수집하였다. 고혈압 치료율의 지역 간 변이와 관련 요인을 SPSS Statistics 23을 활용하여 기술통계, 상관분석을 실시하였으며, 지역 간 변이 요인을 Arc GIS를 이용하여 지리적 가중회귀분석을 실시하였다. 연구결과로 지리적 가중회귀모형의 전반적인 설명력은 27.6%였으며, 지역별로는 23.1%에서 33.4%까지 분포하는 것으로 나타났고, 고혈압 치료율에 영향을 미치는 요인으로 기초생활보장 의료급여 수급자 비율, 당뇨병 치료율, 인구10만 명당 보건기관 수가 높을수록 고혈압 치료율이 높았으며, 코로나19 확진자수, 코로나19 유행으로 감소된 신체활동 비율, 코로나19 유행으로 감소된 음주 비율이 낮을수록 고혈압 치료율이 높은 것으로 분석되었다. 이러한 결과를 기반으로 코로나19에서 고혈압 치료율의 지역 간 변이요인 분석은 효과적인 고혈압 치료율 관리 사업을 기대할 수 있을 것이며, 더 나아가 지역사회 중심의 건강증진 정책 수립에 활용될 것으로 기대된다.

Risk of Treatment-related Mortality with Sorafenib in Patients with Cancer

  • Zhang, Xin-Ji;Zhang, Tian-Yi;Yu, Fei-Fei;Wei, Xin;Li, Ye-Sheng;Xu, Feng;Wei, Li-Xin;He, Jia
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6681-6686
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    • 2013
  • Background: Fatal adverse events (FAEs) have been reported with sorafenib, a vascular endothelial growth factor receptor kinase inhibitor (VEGFR TKI). We here performed an up-to-date and detailed meta-analysis to determine the overall risk of FAEs associated with sorafenib. Methods: Databases, including PubMed, Embase and Web of Science, and abstracts presented at the American Society of Clinical Oncology annual meetings were searched to identify relevant studies. Eligible studies included randomized controlled trials evaluating sorafenib effects in patients with all malignancies. Summary incidence rates, relative risks (RRs), and 95% confidence intervals (CIs) were calculated for FAEs. In addition, subgroup analyses were performed according to tumor type and therapy regimen. Results: 13 trials recruiting 5,546 patients were included in our analysis. The overall incidence of FAEs with sorafenib was 1.99% (95%CI, 0.98-4.02%). Patients treated with sorafenib had a significantly increased risk of FAEs compared with patients treated with control medication, with an RR of 1.77 (95%CI 1.25-2.52, P=0.001). Risk varied with tumour type, but appeared independent of therapy regimen. A significantly increased risk of FAEs was observed in patients with lung cancer (RR 2.26; 95% CI 1.03-4.99; P= 0.043) and renal cancer (RR 1.84; 95% CI 1.15-2.94; P= 0.011). The most common causes of FAEs were hemorrhage (8.6%) and thrombus or embolism (4.9%). Conclusions: It is important for health care practitioners to be aware of the risks of FAEs associated with sorafenib, especially in patients with renal and lung cancer.