• Journal of the Korean Society of School Health
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• v.32 no.1
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• pp.41-49
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• 2019

Purpose: The purpose of the this study was to examine the mediating effect of resilience on the relationship between social capital - family, school, and community - and self-rated health in adolescents. Methods: The study is a secondary data analysis based on a cross-sectional design, using the data of 2016 Korean Children and Youth Panel Survey (KCYPS). The study analyzed the data of 2,001 adolescents by descriptive analysis, t-test, ANOVA, Pearson's correlation coefficients and structural equation modeling, using the SPSS and AMOS program. Results: The model's fit was adequate ($x^2/df=4.51$, CFI=.98, RMSEA=.04, SRMR=.02). The adolescents' social capital - family, school and community - had direct effects on their self-rated health. Resilience was found to play a partially mediating role in accounting for self-rated health. Conclusion: Resilience partially mediated the relationship between social capital and self-rated health in adolescents. Based on the results of this study, nursing strategies to build and strengthen social capital at the family, school and community level and to promote resilience are needed to improve the health of adolescents.

• Journal of Preventive Medicine and Public Health
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• v.52 no.4
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• pp.234-241
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• 2019

Objectives: To identify simultaneous behavioral changes in alcohol consumption, smoking, and weight using a fixed-effect model and to characterize their associations with disease status. Methods: This study included 7 000 529 individuals who participated in the national biennial health-screening program every 2 years from 2009 to 2016 and were aged 40 or more. We reconstructed the data into an individual-level panel dataset with 4 waves. We used a fixed-effect model for smoking, heavy alcohol drinking, and overweight. The independent variables were sex, age, lifestyle factors, insurance contribution, employment status, and disease status. Results: Becoming a high-risk drinker and losing weight were associated with initiation or resumption of smoking. Initiation or resumption of smoking and weight gain were associated with non-high-risk drinkers becoming high-risk drinkers. Smoking cessation and becoming a high-risk drinker were associated with normal-weight participants becoming overweight. Participants with newly acquired diabetes mellitus, ischemic heart disease, stroke, and cancer tended to stop smoking, discontinue high-risk drinking, and return to a normal weight. Conclusions: These results obtained using a large-scale population-based database documented interactions among lifestyle factors over time.

• Health Policy and Management
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• v.29 no.3
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• pp.312-322
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• 2019

Background: Since 2003, Korea has consistently shown the highest suicide rate among the Organization for Economic Cooperation and Development countries, and suicide remains the major cause of death. In particular, men are 2-3 times more likely to commit suicide than women, which called the 'gender paradox of suicide.' The areas with frequent suicide have spatially clustered patterns because suicide with a social contagion spreads around the neighborhood. The purpose of this study was twofold. The first was to estimate the hotspot areas of age-standardized male suicide mortality from 2008 to 2015. The second was to analyze the relationship between the hotspot areas and the regional characteristics for study years. Methods: The data was collected through the Korean Statistical Information Service. The study areas were 227 si gun gu administrative districts in Korea. The hotspot area was used as a dependent variable. Socio-demographic variables (number of marriages per 1,000 population, number of divorces per 1,000 population, and urbanization rate), financial variables (financial independence and social security budget), and health behaviors (EuroQol-5 dimension [EQ-5D], and depression experience rate) were used as independents variables. Results: The hotspot areas were commonly located in Gangwon-do, Chungcheongnam-do, Gyeongsangbuk-do, and Chungceongbuk-do. According to the results of panel logit regression, the number of divorces per 1,000 population, social security budget, and EQ-5D were statistically significant variables. Conclusion: The results of hotspot analysis showed the need for establishing a prevention zone of suicide using hotspot areas. Also, medical resources could be considered to be preferentially placed in the prevention zone of suicide. This study could be used as basic data for health policymakers to establish a suicide-related policy.

• Health Policy and Management
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• v.33 no.3
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• pp.253-263
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• 2023

Background: The purpose of this study was to explore the relationship between the local extinction index and total medical service utilization. Methods: A fixed effects model in panel analysis was performed for the 228 administrative districts in Korea. The statistical yearbook on the usage of medical services by region and Korean Statistical Information Service data were used from 2010 to 2019 for analysis. Medical service utilization was represented by the number of visits day, the number of inpatient days, and medical charges. Control variables were selected by using an Anderson model. The local extinction index was calculated using resident registration population data. Results: Descriptive statistics showed that the number of areas at risk of extinction increased from 61 to 95 for the study years. In addition, the number of visits, the number of inpatient days, and medical charges all increased during the study years. After controlling for variables affecting medical service utilization and doing a panel fixed effects model, the result suggested that a one-step increase in the local extinction index was significantly associated with a 12.29% decrease in medical charges of inpatients, a 7.33% decrease in medical charge of outpatient, a 5.21% decrease in the number of inpatient day, and a 5.54% decrease in the number of visits day. Conclusion: This study showed that the higher the region's extinction risks, the higher the region's total medical service utilization. The results of this study suggested that there was a disparity in medical service utilization between areas at risk of extinction and areas not at risk of extinction, so measures should be taken to address this disparity.

• Health Policy and Management
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• v.32 no.2
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• pp.228-236
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• 2022

The aim of this study was updating suicide-related indicators, including the number of suicidal deaths, suicide rate, and the prevalence of suicidal ideation and suicide attempts. We observed trends in suicide-related indicators based on up-to-date information. This study used five data sources to evaluate the trends of suicide-related indicators: Statistics Korea (1983-2020), Korean Wealth Panel Study (KOWEPS, 2012-2020), and Korea Health Panel Survey (KHP, 2010-2013, 2016-2018), Korean National Health and Nutrition Examination (KNHANES, 2007-2013, 2015-2020), and Korean Community Health Survey (KCHS, 2008-2009, 2013, 2017). The suicide rate per 100,000 population decrease from 26.9 in 2019 to 25.7 in 2020. Based on recently available data, the rates of suicidal ideation were 1.48% (KOWEPS, 2020), 2.61% (KHP, 2018), 4.62% (KNHANES, 2019), and 6.96% (KCHS, 2017). Those of suicide attempt as were 0.07% (KOWEPS, 2020), 0.44% (KNHANES, 2020), and 0.32% (KCHS, 2017). Annual percentage change (APC) of suicide rate was -1.87% (Statistics Korea, 2011-2020). APC of suicidal ideation was -10.7% (KOWEPS, 2012-2020), -11.5% (KHP, 2010-2013, 2016-2018), -14.7% (KNHANES, 2007-2013, 2015, 2017, 2019), and -2.5% (KCHS, 2008-2009, 2013, 2017). APC of suicide attempt was -11.3% (KOWEPS, 2012-2019), -5.2% (KNHANES, 2007-2013, 2015-2020), and -4.4% (KCHS, 2008-2009, 2013, 2017). Although the suicide rate in Korea has decreased compared to 10 years ago, it is still at a high level. Thus, continuous observation and appropriate suicide prevention policies are needed.

• Health Policy and Management
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• v.33 no.2
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• pp.194-292
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• 2023

Background: This study aimed to update suicide-related indicators, including the number of suicidal deaths, suicide rate, and the prevalence of suicidal ideation and suicide attempts. We observed trends in suicide-related indicators based on up-to-date information. Methods: This study used five data sources to evaluate the trends of suicide-related indicators: Statistics Korea (1983-2021), Korean Wealth Panel Study (KOWEPS, 2012-2021), and Korea Health Panel Survey (KHP, 2010-2013, 2016-2019), Korean National Health and Nutrition Examination (KNHANES, 2007-2013, 2015-2021), Korean Community Health Survey (KCHS, 2008-2009, 2013, 2017, 2021). Results: The suicide rate per 100,000 population increased from 25.7 in 2020 to 26.0 in 2021. The rates of suicidal ideation from recently available data were 4.28% (KNHANES, 2021), 6.52% (KCHS, 2021), 1.61% (KOWEPS) and 7.10% (KHP, 2019). The suicidal attempts rates were 0.46% (KNHANES, 2021) and 0.34% (KCHS, 2021). The annual percentage change (APC) of suicide rate showed that suicide rates increased in the younger population (APC=9.02% in <19 years, APC=5.13 in 20-39 years) although the rates decreased in the older population (APC=-3.37 in 60-79 years, APC=-2.25 in >80 years). Conclusion: The suicide rate and related indicators increased in 2021 compared to 2020. Thus, continuous observation and appropriate suicide prevention policies as well as studies about the factors that affected the increase in 2021 are needed.

• Health Policy and Management
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• v.29 no.1
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• pp.27-39
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• 2019

Background: This study is designed to estimate the factors that affect the level of three different performance (publicity, efficiency, profitability) among regional public hospitals. Methods: The units of analysis are the regional 30 hospitals, which have the operating data during 22 years (from 1933 to 2014). The research method is used by fixed panel analysis. The publicity is measured by medicaid outpatient proportion and medicaid inpatient proportion. The efficiency is measured by two types of efficient score by DEA (data envelopment analysis). The profitability is measured by medical income to medical revenue and ROA (return on total asset). Results: At first, the increase of bed gives negative affect to the publicity but give positive effect to the efficiency and profitability. Because it means the increase of the region population, it gives more profitability compare to hospital with small number of beds. The more the operating period is the higher effect to the publicity and efficiency because of it's refutation. The debt ratio gives negative effect to publicity, but positive effect to profitability. It is the normal belief that there is inverse relationship between publicity and profitability. The turnover rate of bed gives the negative affect to the publicity, but positive affect to the efficiency and profitability. That give us the implication that type of the inpatient make different effect the hospital performance. The ratio of labor cost give negative effect to all kind of performance. That means that the higher labor cost don't mean the higher publicity and labor cost control is very important factors to hospital performance. So the region hospital have to focus the labor factors more to make higher performance. Conclusion: As the conclusion, the independent variables give similar effect to the efficiency and the profitability, but give inverse effect to the publicity. That means that if an region hospital want to make the more publicity, it loss the higher efficiency and profitability. Specially publicity is higher negative relation with the profitability.

• 한국노년학
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• v.29 no.4
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• pp.1611-1628
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• 2009

It is well known that health and psychosocial factors are closely associated with depressive symptoms. Due to limitations in available data and analysis methods, however, little is known about the effects of health and psychosocial factors on depression trajectory. In order to address the limitations, this study examines the predictors of depression trajectory using latent growth curve modeling involving individuals aged 60 and over who participated in the Korean Welfare Panel Study (N=4,919). Controlling for socioeconomic variables, health and psychosocial variables were cross-sectionally associated with depressive symptoms, which is consistent with previous findings. However, the effects of health and psychosocial variables on the rate of depressive symptom change varied. Health variables were significantly associated with the levels of depressive symptoms at wave 1, but these were not significantly associated with the rate of depressive symptoms change. By contrast, although psychosocial variables were significantly associated with depressive symptoms at wave 1, the effects of psychosocial variables on the rate of depressive symptom change varied. Specifically, while self-esteem and family relationship were positively associated with the rate of depressive symptom change, social relationship was negatively associated with the rate of depressive symptom change. Based on the findings, this study discussed implications for intervention and future research.

• Research in Community and Public Health Nursing
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• v.26 no.1
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• pp.31-41
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• 2015

Purpose: The purpose of this study was to compare the use of health services and health expenditures between non-exercise and exercise groups of diabetic patients and among three groups divided according to exercise intensity. Methods: Data were obtained from the Korean Health Panel Survey of 2011. The participants of this study were 864 diabetic patients who did exercise (walk, moderate exercise, or vigorous exercise) or not. Data were subsequently analyzed using the SPSS 21 Program. Results: The exercise group showed higher percentages of medication compliance, non-smokers, and regular diet than the non-exercise group. The hospitalization percentage, the number of outpatient hospital visits, and health expenditures were higher in the non-exercise group than in the exercise group. There was no difference among the three groups divided according to exercise intensity in the use of health services and health expenditures. Conclusion: These results show that exercise is a way to reduce diabetic patients' use of health services and their health expenditures.

• Journal of Preventive Medicine and Public Health
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• v.56 no.1
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• pp.88-94
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• 2023

Objectives: This study examined how deprivation differed by region and the effect those differences had on suicidal ideation among the local population. Methods: Data collected over 10 years (2012-2021) in the Korea Welfare Panel Study were organized into 3 categories: metropolitan, city, and rural. A panel analysis was conducted on the impact of deprivation indices, socio-demographic characteristics, and life satisfaction on suicidal ideation in each category. Results: Income, divorce status, family relationship satisfaction, and medical deprivation had a significant impact on suicidal ideation in metropolitan areas, whereas these variables did not have significant effects in rural areas. In other words, income, family, and medical support were more impactful in city areas. Conclusions: Although the deprivation index was higher in rural areas than in city areas due to an aging population and reduced income levels, the mental health of rural residents was found to be generally better than that of city residents. The possibility that this is related to the strength of relationships within the respective communities should be considered in light of recent discussions on relational welfare.