• Journal of Korean Academy of Nursing
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• v.50 no.3
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• pp.401-410
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• 2020

Purpose: This study was performed to identify the prevalence of menstrual disorders in Korean women based on body mass index (BMI) and lifestyle factors, by utilizing the Korean National Health Insurance Database. Methods: A retrospective observational study design was used for the secondary data analysis. Data of women aged 15 to 49 years who were diagnosed with menstrual disorders were extracted from The National Health Insurance Service-National Health Screening Cohort in Korea from 2009 to 2016. The age-standardized prevalence rate of menstrual disorders was calculated using SAS version 9.4, and a Chi-square test and Cochran-Armitage test were performed. Results: In total, 2,219,445 cases were extracted from the database. The prevalence of menstrual disorders significantly increased from 8.6% to 11.6% (Z=135.16, p for trend <.001) over the past eight years. In particular, it was higher in underweight women than in women with normal weight across all years (Z=-4.18~-14.72, p<.001). Moreover, statistically significant differences in the prevalence of menstrual disorders were found to be associated with drinking and smoking in all years and with physical activity levels in part (p<.05~.001). Conclusion: These findings present compelling evidence on the prevalence of menstrual disorders based on a national database. Since the prevalence of menstrual disorders has steadily increased and differs based on BMI and lifestyle factors, educational and clinical interventions are necessary to promote risk awareness and appropriate behavioral changes among Korean women.

• Health Policy and Management
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• v.13 no.3
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• pp.104-128
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• 2003

Equity in health care has taken priority in the Korean government's policy agenda after the government-led national health insurance achieved universal coverage in 1989 along with the final inclusion of the self-employed as beneficiary. The purpose of this study is to examine the extent to which there exists difference or inequality in the utilization of health care, especially cancer inpatient services among income classes. We analysed the utilization of cancer inpatient services of residents in Jeju Island for a year of 2000, using the national health insurance data for qualification of beneficiaries and utilization of health care. The independent variable are 10 income classes based on the national health insurance fee imposed on each household for a year of 2000. The dependent variables of this study are an amount of cancer inpatient health care utilization measured by cancer admission days and cancer treatment costs. Also, cancer inpatient health care utilization is analysed by three categories divided into utilization in medical care institutions (1) within Jeju Island, (2) outside Jeju Island, and (3) all within and outside Jeju Island. We measured concentration index of cancer inpatient health care utilization. This analysis showed negative concentration index within Jeju Island and positive outside Jeju Island, and positive in all within and outside Jeju Island. This results suggest inequality against the relatively poor income groups in utilization of cancer inpatient health care services. Especially, inequity of cancer inpatient health care would be more serious in Jeju Island of Korea, considering that lower income groups reportedly have higher incidence rates in most of cancer and thus use more health services.

• Health Policy and Management
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• v.14 no.2
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• pp.17-33
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• 2004

The present study attempts to examine the progressivity of health care financial sources based on the income approach, for which it decomposes redistributive effects into vertical, horizontal, and re-ranking components. The study data include Korean Household Expenditure Survey (2000) conducted every 5 year by Korea National Statistical Office. The data were sampled from the national population by the multistage probabilistic sampling method, and amounts to 23,270 households. For the better application of the income approach, the study employs household total expenditure in Korea instead of total income, because the former data source is more reliable and less fluctuated over time. Progressivity of health care financing was measured by Kakwani index. Aronson's decomposition equation was used in case of the analysis where differential treatment of health care expenditure needs to be considered. Despite the progressivity of Korea's governmental contributions, total expenditure of health care showed regressive pattern, which may largely be attributable to the higher regressivity in out-of-pocket money. With the result of negative Kakwani index, differential treatment increased income redistribution biased for better-off. It is worth to note that social insurance displays not only negative Kakwani index, but also horizontal inequality, suggesting that the first step of health care financing reform should be the revision of social insurance premium rates toward effective and equable way.

• Journal of Periodontal and Implant Science
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• v.48 no.2
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• pp.92-102
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• 2018

Purpose: This study investigated the validity of the Charlson comorbidity index (CCI) as a predictor of periodontal disease (PD) over a 12-year period. Methods: Nationwide representative samples of 149,785 adults aged ${\geq}60$ years with PD (International Classification of Disease, 10th revision [ICD-10], K052-K056) were derived from the National Health Insurance Service-Elderly Cohort during 2002-2013. The degree of comorbidity was measured using the CCI (grade 0-6), including 17 diseases weighted on the basis of their association with mortality, and data were analyzed using multivariate Cox proportional-hazards regression in order to investigate the associations of comorbid diseases (CDs) with PD. Results: The multivariate Cox regression analysis with adjustment for sociodemographic factors (sex, age, household income, insurance status, residence area, and health status) and CDs (acute myocardial infarction, congestive heart failure, peripheral vascular disease, cerebral vascular accident, dementia, pulmonary disease, connective tissue disorders, peptic ulcer, liver disease, diabetes, diabetes complications, paraplegia, renal disease, cancer, metastatic cancer, severe liver disease, and human immunodeficiency virus [HIV]) showed that the CCI in elderly comorbid participants was significantly and positively correlated with the presence of PD (grade 1: hazard ratio [HR], 1.11; P<0.001; grade ${\geq}2$: HR, 1.12, P<0.001). Conclusions: We demonstrated that a higher CCI was a significant predictor of greater risk for PD in the South Korean elderly population.

• The Journal of the Korean life insurance medical association
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• v.3 no.1
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• pp.103-141
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• 1986

The present study was undertaken to establish the decision standard of builds for the insured by using the ratio of weight-for-height as build index. Materials being examined were the ratio of weight-for-height being calculated from the actually measured heights and weights of a total of 15,838 insured persons who were examined medically at Honam Medical Department of Dong Bang Life Insurance Company, Ltd. from June, 1979 to September, 1985. The ratio of weight-for-height is calculated by the following formula. The ratio of weight-for-height(%)=$\frac{weight(kg){\times}100}{\{height(cm)-100\}{\times}0.9(kg)$ The results were as follows: 1. The distribution of the ratio of weight. for-height of the 15,838 insureds follows Log normal distribution being skewed to the left(the direction of underweight). 2. The ratio of weight-for-height were Log transformed to lead to a sym metrical pattern of distribution in which statistical rules are known to be applied more exactly. Thereafter, the establishment of dicision standard of builds was undertaken by using the log of the ratio of weight-for-height as build index. Through all ages in male, the ratio of weight-for-height indicating the range of standard lives including slight overweighted and underweighted lives besides normal lives is 80-130%, and corresponds to $"M-2{\delta}"-"M+1.5{\delta}"$ and to $M{\pm}20%$ ; in female, 85-135%, and corresponds to $"M-2{\delta}"-"M+1.5{\delta}"$ and to $M{\pm}20%$. Through all ages in male, the ratio of weight-for-height indicating the initial level of super-overweighted and super-underweighted lives is 130-150% and 75-80%,and corresponds to $M+3{\delta}\;and\;M-3{\delta}$ and to M+40% and M-25% respectively;in female, 140-160% and 75-80%, and corresponds to $M+3{\delta}\;and\;M-3{\delta}$ and to M+40%-+50% and M-25% respectively. 3. Author's rating table model for builds(a table of weight per height) is proposed. On the table, the ratings for builds, i. e. standard, super-weighted and super-underweighted lives, are listed.

• Korean Journal of Acupuncture
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• v.36 no.1
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• pp.81-91
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• 2019

Objectives : Symptoms caused by traffic accidents can be divided into localized pain and systemic symptoms. Edema and pain can be increased due to obesity. During hospitalization of obese patients after traffic accident injury, obesity and systemic symptoms such as edema, dizziness, abdominal fullness and heavy body feeling might increase more by decreased physical activity due to pain. Methods : This report details on two cases of obese female inpatients with systemic symptoms after a car accident who were treated with wild ginseng complex (WGC) pharmacopuncture combined with Korean Medicine (KM) automobile insurance treatment. The Numeric Rating Scale (NRS), Neck Disablility Index (NDI) and the Oswestry Disablility Index (ODI) were evaluated before and after treatment for comparison. Body composition was also measured. Results : Localized pain improved with a decrease in patients' NRS, NDI and ODI scores. Systemic symptoms increased during hospitalization were also improved with changes of body composition. Conclusions : Combining WGC pharmacopuncture with KM automobile insurance treatment may be synergistically effective for the treatment of obese patients with systemic symptoms such as edema, heavy body feeling and abdominal fullness.

• Journal of Korean society of Dental Hygiene
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• v.7 no.2
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• pp.123-133
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• 2007

This document is about immigrant worker who use counseling office for human rights in the Daegu Gumin Church. We researched their oral health state so that we can understand their situation and support them properly. General characteristics of study subjects, habits related to oral health, the oral examination and treatment clinic, participated in oral heath education program were studied by designed administered questionaire. And decay, filling(treatment teeth), missing tooth(lost teeth by dental-caries)was counted by oral examination, and calculated DMFT-index. This study was done from the July, 9, 2006 to Aug. 8, 2006. In a total of 289 immigrant worker, 77.9% of them were men and 22.1% of them were women. 55.7% of their salary was from 1,000,000 won to 1,500,000 won and most of them were working for a fiber industry. Many of them are living in korea for more then three years. DMFT index for men was 2.77 and for women was 4.06 so average of DMFT index was 3.06. 46.7% of them said that they are healthy in oral health state. The question for having difficulty using dental clinic in korea, 65.1% of them said "it is difficult". First reason was a communication problem and second was time. Most of them didn't have a oral health education but 85.1% of them said that they are looking forward to attending oral health education. Immigrant worker had better DMFT index then that of korean blue color worker. But still it is quite difficult for them using dental clinic in korea also cost. It is necessary to support them properly that medical insurance system, medical facilities of quality, medical insurance subscriber beside, made by their language, manual for them. At once, medical service improvement a policy is necessary for immigrant worker in korea.

• Korea Journal of Hospital Management
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• v.14 no.1
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• pp.23-35
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• 2009

The objectives of the present study is to examine the validity of Charlson Comorbidity Index(CCI) based on medical record data; to utilize the index to determine outcome indexes such as mortality, length of stay and cost for the domestic patients whose have received total hip arthroplasty. Based on medical record date, 1-year Mortality was analyzed to be 0.664 of C statistic. The $R^2$ for the predictability for length of stay and the cost was about 0.0181, 0.1842. Fee of national health insurance and total cost including the cost not covered by insurance, also had statistically significance above 3 points of Charlson point score(p=0.0290, 0.0472; $p.{\le}0.05$). The 1-year mortality index, length of stay and cost of the total hip arthroplasty patients which was obtained utilizing CCI have a limitative prediction power and therefore should be carefully analyzed for use.

• Dementia and Neurocognitive Disorders
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• v.22 no.2
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• pp.49-60
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• 2023

Background and Purpose: The National Responsibility Policy for Dementia Care was implemented in September 2017 in Korea. This study aimed to compare dementia incidence in Seoul and Gangwon-do before and after the implementation of this policy. Methods: We extracted insurance claim data from the Korean Health Insurance Review and Assessment Service for people diagnosed with diabetes, hypertension, or dyslipidemia for the first time in Seoul and Gangwon-do, Korea. We defined two enrollment groups based on the policy implementation date: 1) January 1, 2015 to December 31, 2016 (Index 1, pre-implementation), and 2) January 1, 2017 to December 31, 2018 (Index 2, post-implementation). Each group was followed up for 1 year from the time of enrollment. Then, we calculated hazard ratios to compare the incidence of dementia between the two groups, and between Seoul and Gangwon-do. Results: In Seoul, the incidence of dementia was significantly lower in Index 2 than in Index 1 (hazard ratio [HR], 0.926; 95% confidence interval [CI], 0.875-0.979). However, the incidence rate did not differ between the 2 groups (HR, 1.113; 95% CI, 0.966-1.281) in Gangwon-do. In Index 1, the incidence of dementia did not differ between Seoul and Gangwon-do (HR, 1.043; 95% CI, 0.941-1.156), but in Index 2, was significantly higher in Gangwon-do than in Seoul (HR, 1.240; 95% CI, 1.109-1.386). Conclusions: After implementing the National Responsibility Policy for Dementia Care, the dementia incidence rate decreased significantly in Seoul, consistent with other studies, but not in Gangwon-do.

• The Journal of the Korean life insurance medical association
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• v.7 no.1
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• pp.170-179
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• 1988

A study on the change of cardiothoracic ratio by age calculated from photofluorography film of chest in a total of the 8,115 insureds was undertaken. The results were as follows: 1. The incidence of cardiothoracic ratio of high value increased gradually with age. 2. At the same build, the average cardiothoracic ratio increased gradually with age. 3. Larger the build index was, the incidence of higher cardiothoracic ratio increased. 4. It seemed that the change of cardiothoracic ratio by age was influenced mainly by age and build(the change of build by age) from $18{\sim}19$ to $40{\sim}49$ age group and by age itself in $50{\sim}59$ age group and over. 5. The average cardiothoracic ratio of $30{\sim}39$ age group in male or female was approximate to that of all ages group respectively.