• Journal of Preventive Medicine and Public Health
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• v.22 no.1 s.25
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• pp.29-44
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• 1989

A household survey was conducted to determine the utilization rate of medical facilities and to identify the factors related with the utilization in the South District of Taegu from July 3 to July 15, 1988. Study population included 1,723 family members of 431 households which were selected by one-stage simple cluster random sampling. Well trained medical college students interviewed mainly housewives with a structurized questionnaire. Morbidity rate of acute illness during the 2-week period was 101 per 1,000 persons and it was highest in the age group of 9 years below. The rate for chronic illness was 77 per 1,000 persons, increasing with age, low income and medicaid benefit. During the 2-week period, 689 of 1,000 persons utilized the medical facilities. Of the facilities, most number, 294, used hospital and clinic, and the order ran as pharmacy, health center, and herb medical clinic. The utilization rate was higher in the female, 70-year and older group, medicaid group, the lowest income class and self-employed group than other groups. The average number of visits among users of medical facilities during the 2-week period was 3.25. those who visited medical facilities most frequently were females, the 70-year and older group, the lowest income class and blue collar worker group. During one-year period, admission rate of 1,000 persons was 27.6 and that of female was 38.9, higher than that of male. the eldest group had the highest admission rate. Admission rate of medical insurance beneficiaries was twice or higher than non-beneficiaries. The higher the family monthly income, the more frequently they admitted. During one-year period, average admission days of the persons hospitalized were 22.5 days and males were hospitalized longer than females. The groups which were hospitalized longest were those between the ages of 40 and 49, medical insurance beneficiaries, the lowest income group and unemployed group. During one-year period, average admission days of 1,000 persons were 560 days and those of female were 661 days, more than those of male. The guoups which had the longest admission days were those above 70 years of age, the lowest income and unemployed groups. The medical insurance beneficiaries were three times or longer than non-beneficiaries. In logistic regression analysis of utilization of physician significant independent variables were the 9-year and younger group(+), the 70-year and older group(+), acute illness episode(+), chronic illness episode(+), medical insurance beneficiary(+) and white collar workers(-). Acute and chronic illness episode(+), and medical insurance for government employees and private school teacher(-) were significant variables in analysis of utilization of pharmacy. In multiple regression analysis of the number of physician visits, siginificant variables were acute illnes episode(+), chronic illness episode(+), industrial, occupational and regional medical insurance beneficiary(+), white collar workers(-). Acute and chronic illness episode(+), and medical insurance beneficiary(-) were significant variables in analysis of the number of pharmacy visits. In logistic regression analysis of admission event, significant independent variables were the 9-year and younger group(+), the 70-year and older group(+) , chronic illness episode(+), and medical insurance beneficiary(+).

• Journal of Preventive Medicine and Public Health
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• v.31 no.1 s.60
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• pp.59-71
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• 1998

To examine the association of hypertension with cluster of obesity, abnormal glucose and dyslipidemia in Korean urban population, we conducted this cross-sectional study among 3027 men and 2127 women age 20-85 years who visited a prevention center between May 1991 and June 1995 for a multiphasic health check at St. Mary's Hospital, Seoul. By the self-administered questionnaire, the informations of educational attainments, monthly income, alcohol consumption, cigarette smoking, and physical excercise level were obtained. Height, weight, and blood pressure were measured by a trained nurse. The fasting blood sugar (FBS), total cholesterol, high density lipoprotein (HDL) cholesterol and triglyceride were tested by enzyme method. Low density lipoprotein (LDL) cholesterol was calculated by 'total cholesterol - HDL cholesterol - triglyceride/5'. For testing the differences of cardiovascular risk factors between hypertension and normotension group, 1-test and $\chi^2$-test were performed. For the age adjusted odds ratios of hypertension in persons with obesity, abnormal glucose, and dyslipidemia compared with normal, logistic regression was performed by using SAS pakageprograme. The results obtained were as follows: 1. Age, weight, body mass index(BMI), blood glucose, total cholesterol, LDL cholesterol, and triglyceride of hypertension group in men and women were significantly higher than normotension group, but height and HDL cholesterol of hypertension group only in women significantly lower than normotension group. The frequency of obesity $(BMI\geq25kg/m^2)$, abnormal glucose $(\geq\;120mg/dl)$, hypercholesterolemia $(\geq\;240mg/dl)$, lower HDL cholesterol (<45 mg/dl in women only), higher LDL cholesterol $(\geq\;160mg/dl)$, and hyper hypertriglyceridemia $(\geq\;250mg/dl)$ in hypertension group of men and women were significantly higher than normotension group. 2. Systolic and diastolic blood pressure were negatively correlated with hight, but positively with age, weight, BMI, total cholesterol, LDL cholesterol, and triglyceride in men and women. BMI was positively correlated with fasting blood sugar, total cholesterol, LDL cholesterol and triglyceride but negatively with HDL cholesterol. 3. The age adjusted odds ratios of hypertension were as follows in men and women : among persons who were obese compared with those nonobese, 2.53 (95% Confidence Intervals [C.I.] 2.08-3.07) and 2.22 (95%C.I. 1.71-2.87): among persons who were abnormal glucose compared with those normoglycemic, 1.43 (95%C.I 1.13-1.82) and 2.01 (95%C.I 1.36-2.94): and among persons who were dyslipidemia (hypercholesterolemia or lower HDL cholesterol or higher LDL cholesterol or hypertriglyceridemia) compared with those normal lipid, 1.59 (95%C.I 1.30-1.95) and 1.51 (95%C.I 1.16-1.96). After combined more than one risk factor, the odds ratios were increased. Among persons with cluster of obesity, abnormal glucose, and dyslipidemia, the odds ratio of hypertension was 2.25 (95%C.I 1.47-3.37) in men and 3.02 (95%C.I 1.71-5.30) in women. In conclusion, it was suggested that hypertension was associated with cluster of obesity, abnormal glucose, dyslipidemia in this Korean urban population.

• Journal of Preventive Medicine and Public Health
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• v.21 no.2 s.24
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• pp.431-441
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• 1988

The purpose of this study was to compare the difference of two survey methods for health services research. Data were collected by means of two types of household survey conducted from March 11 to September 19, 1985. A probability sample of 30,613 persons was taken from 180 Enumerated Districts designated by the Economic Planning Board. The sample was divided into two groups systematically. One group was surveyed by the self-administered questionnaire and the other group was interviewed. Response rates were 81.4% and 90.6% respectively. The data were analysed by the ratio of the results of the self-administered survey to those of the interview survey. No difference was observed in sex, age, residence, or occupation between the two groups. However the respondents' characteristics were statistically different between the two groups. The major findings of this study are as follows : 1. The morbidity rate was 142.5 per 1,000 persons during the two week period by the self-administered questionnaire survey and 74.3 per 1,000 persons with the interview survey method. The ratio of the morbidity rate by the self-administered questionnaire to that by the interview was 1.92, and the difference between the two rates were due to the personal characteristics. 2. The out-patient utilization rate was 10.2 visits per person per year by the self-administered questionnaire survey and 5.4 by the interview survey, and the ratio was 1.89; the admission rate was 3.2 times per 100 persons per year by the self-administered questionnaire survey and 1.9 times by the interview survey, and the ratio was 1.68. Differences due to the sociodemographic characteristics were greater in the out-patient utilization rates than in the adimssion rates. 3. Percentages of effective medical care demand were 90.2% in the self-administered survey and 92.3% in the interview survey; the ratio was 0.98 which was less than that of the morbidity rate and medical care utilization. But, differences of effective medical care demand occurred in persons with no occupation, and aged or low educated respondents. 4. Respiratory illness had the highest frequency in the two survey methods. But there was a slight difference between the two survey methods in morbidity composition. 5. It was concluded that data collected by the interview survey were inclined to be underestimated and this problem can be corrected by a modified self-administered survey.

• Korean Journal of Social Welfare
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• v.48
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• pp.150-178
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• 2002

The elderly have higher potential for contracting chronic diseases and suffering from development of a complication. Also, the extended old age period leads the elderly to demand more medical services. All those facts indicate that the elderly need more medical services than any other age groups. Consequently, medical care for the elderly with chronic diseases causes high costs burden. However, there is few studies researching the financial burden of chronic illness of the elderly. This study aimed to 1) understand how much the elderly with chronic diseases pay for medical expenses; 2) find out some specific factors related to health care financial burden; 3) suggest the alternative policies to decrease excessive financial burden of caring for the elderly with chronic illness. National Health and Nutrition Survey, which was surveyed by the Korea Institute for Health and Social Affairs in 1998, was used in this study. 4,707 persons with chronic diseases out of 5385 persons over age 60 were selectively sampled. Using SPSSWIN, correlation analysis, T-test, ANOVA and Regression were used as statistical methods in this study. Stepwise multiple regression was employed to analyze the data with a ratio of health care expenditure to income(financial burden) as a dependent variable. Out of Korean old people, 87% had the chronic diseases and their health care financial burden rate showed the average of 17.9%, which meaned they expended almost 20% income to buy medical services. The variables having a great influence on financial burden were monthly income, activity, limitation and single household of an old person. The excessive financial burden was experienced by people who had more than 4 activity limitations(37.1%) and were in the lowest Income level(32.6%), and single household of an old person(31.4%). The new policies should be considered to 1) reduce the financial burden in these groups and to develop the sliced medical cost system considering the characteristics of chronic illness and income level; and 2) develop the medical management system to care for the elderly with chronic illness.

• Journal of Society of Preventive Korean Medicine
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• v.4 no.1
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• pp.1-16
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• 2000

From 1998, Oriental Medical Physicians(OMP) is distributed in Public Health Sector. but long term plan for Oriental Medicine in Public Health is not existed. So, this study is designed for the activation of OMP Subjects in this study were comprised 3 groups of oriental medicine related persons, the group of which are Students of 11 Oriental Medical Schools, Oriental Medical Physicians in Public Health Sector, Specialist Croup of Oriental medicine Policy(total 1,458 persons). Data were collected from July 1st to November 30, 1999. Direct interview with key persons, systematic interview by using of interview protocol, e-mail and facsimile have been conducted. The results of survey were coded by Excel 5.0, and analysed with SAS 6.12 statistical package. Inter-group difference determined by T-test, and descriptive statistics have been examined. Major findings can be epitomized as follows. 1) OMP disposition to multifarious organizations and institutes such as Public Health Centers, Public Health Sub-centers, Public Hospitals, Private Hospitals in Remote-Vulnerable Area, Community Social Welfare Centers, Institutes for Heath Policy Research, etc, will promise an effective use of Oriental Medical Physician. 2) Average number of patients treated by OMP was 22.8, average budget for oriental medical department, in which OMP were affiliated, was 39.6 million Won per year. Direct cost per every patient visit was 7,210.9 Won, which is considered expensive for public health service. Therefore, development and transformation for Oriental Medical Service in Public Health Sector is desirable in economic and political aspects. 3) It is recommended that ${\ulcorner}Advisory\;Committee{\lrcorner},{\ulcorner}Planning\;Commission\;for\; Public\;Health\;in\;Oriental\;Medicine{\lrcorner}$ should be established for the activation and for the support of Oriental Medical Physician in Public Health Sector, 4) Most effective programmes for oriental public health doctor are health service programmes for the elderly, Home health visit, chronic degenerative disease control services(p<0.001). 5) Standard guideline for facilities and equipments of Oriental Medicine Department in Public Health Center is needed for optimal supply of resources and activation of public health activity.

• Journal of Physiology & Pathology in Korean Medicine
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• v.16 no.6
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• pp.1201-1206
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• 2002

In oriental medicine, human being is classified into four groups according to their body constitution status (;tae-yang, tae-eum, so-yang, and so-eum persons) considering the differences in function of internal organs and characteristics. Four body constitution, called 'sa-sang' has been recognized as an important factor for diagnosing the patients before madical teratment. Yet, the criteria to divide body constitutions or its scientific principle are not clearly defined. As an initial effort to elucidate biological priciples underlying four body constitution groups, we studied genetic variations among three constitution groups (tae-eum, so-yang, and so-eum persons). Noting distinct responses to ingested food and administered drugs among three groups, SNPs and haplotype experiments were performed in 2D6, 2C9, and 1A2 DNA regions of the cytochrome P450 gene. Significant variability in SNPs types was found in 2D6 region. Moreover, haplotyping in 2D6 region showed relatively high occurrences of haplotype 3 and 5 in so-eum person, haplotype 6 in tae-eum person, and hyplotype 1 in so-yang person. These results indicate that individuals with different body constitutions respond differently to ingested food and drugs, which might reflect constitution-specific genetic background. The genetic approach would therefore be useful to reveal intrinsic differences among four constitution body groups in the responsiveness to various drugs and external stimulations to human body.

• Journal of Oriental Neuropsychiatry
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• v.15 no.2
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• pp.45-51
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• 2004

Hwabyung is a Korean culture bound syndrome and translated as anger syndrome at DSM-IV. And it is caused by the suppression of anger and has characteristics of chest discomfort, burning up as physical symptoms, and mortification, chagrin as psychological symptoms. It is very common in the field of psychiatry in Korea with Major Depressive Disorder (MDD). * Objective : 95 patients with MDD or Hwabyung, who visited the department of psychiatry in Korea University Medical Center or oriental medical hospital of Kyunghee Medical Center from May 2003 to August 2003, were selected for the study to compare between Major Depressive Disorder and Hwabyung. * Methods : The Structured Clinical Interview Schedule for DSM-IV (SCID) and Hwa-Byung Diagnostic Interview Schedule (HBDIS) were conducted for diagnosis. And Symptom Check List-90-Revised (SCL-90-R) was carried out for comparison between MDD and Hwabyung. * Result : Among the 95 patients, MDD group was 23 persons, Hwabyung group was 36 persons, and MDD plus Hwabyung group was 36 persons and it occupied 37.9%. MDD plus Hwabyung group had higher scores than any other groups in the whole dimensions of SCL-90-R. Hwabyung group had higher scores than MDD group in somatization, anxiety, hostility, Global Severity Index(GSI) and positive symptom total (p<.05) of SCL-90-R, but two groups had no difference in obsessive-compulsive, interpersonal-sensitivity, depression, phobic anxiety, paranoid ideation, psychoticism, positive symptom distress index of SCL-90-R. * Conclusion : These result showed that Hwabyung is similar to MDD at the point of depression and psychoticism but more severe at somatization, anxiety and anger than MDD.

• Journal of Sasang Constitutional Medicine
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• v.27 no.2
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• pp.199-210
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• 2015

Objectives The aim of this study was to make an analysis of clinical characteristics and status of Sasang constitutional medicine of patients with gastrointestinal symptoms who visited a Korean medicine hospital. Methods We studied 287 patients with gastrointestinal symptoms who visited a Korean medicine hospital from March 1, 2010 to February 30, 2012. We retrospectively collected medical history and characteristics of subjects using data of EMR (electronic medical record). Results The proportion of female was higher than male. Most patients was suffered from chronic gastrointestinal disorder. And they were not under western medicine treatment. Among the 287 patients, 139 persons (48.43%) were Soyangin, 88 persons (30.66%) Taeeumin and 60 persons Soeumin (20.91%). The proportion of Soyangin was higher than other Sasang types. In the distribution of prescription according Sasang Constitutional Medicine symptomatology, the proportion of exterior disease's prescription was higher than interior disease in Soyangin (93.53%). And the proportion of interior disease's prescription was higher than exterior disease in Taeeumin (75.86%) and Soeumin (95.00%). The majority of disease were Gyolhyung-symptom (51.54%) and Mangeum-syndrome (46.15%) of exterior disease in Soyangin, Dry-febrile symptom (73.56%) of interior disease in Taeeumin, and Taeeum-syndrome (95.00%) of interior disease in Soeumin. Conclusions By analyzing on clinical characteristics and distribution of Sasang Constitutional Medicine symptomatology could contribute to the development of guideline for treatment of gastrointestinal disease of Sasang Constitutional Medicine.

• Physical Therapy Rehabilitation Science
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• v.8 no.3
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• pp.134-140
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• 2019

Objective: The purpose of this study was to investigate the effect of exercise therapy and bedside ergometer exercise on muscle strength, function level, and quality of life of persons in intensive care. Design: Randomized Controlled Trial Methods: Sixteen patients in the ICU were randomly assigned to either the exercise group (n=8) or the bedside cycle ergometer group (n=8). Activities in the ICU exercise group (rolling, sitting at the edge of the bed, transfer from sitting to standing, standing balance training, ambulation) and bedside cycle ergometer group were performed 5 times a week for 30 minutes during the ICU admission period. Medical Research Council (MRC) and Functional Status Scale-Intensive Care Unit (FSS-ICU) parameters were assessed at the time of admission to the ICU, and reevaluation was assessed on the day of ICU discharge. The Short Form-36 (SF-36) was assessed at the time of discharge from the ICU. Results: MRC and FSS-ICU were significantly increased before and after intervention in both the experimental and control groups (p<0.05). There was a significant difference between MRC and FSS-ICU in the comparison of the changes before and after the intervention (p<0.05). SF-36 was compared between groups after intervention and there was a significant difference between the experimental and the control group (p<0.05). Conclusions: Muscle strength and functional levels improved after intervention in both the experimental and control groups. The ICU exercise group was more effective than the bedside cycle ergometer group to improve muscle strength, functional level, and quality of life performance of persons in the ICU.

• Korean Journal of Adult Nursing
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• v.18 no.1
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• pp.41-49
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• 2006

Purpose: This study was conducted to understand the meaning of mind control as it is understood by elderly persons in Korea. Method: This study was conducted by engaging three elderly persons who are over the age of sixty five and presently residing in Seoul. Several in depth interviews were conducted with these individuals from March 2003 until November 2003. The contents of the interviews were analyzed using the Giorgi Method (1985), which places the emphasis on discovering meaning within the phenomenological context of an individual's experience. Results: The analysis of the contents revealed the following four components with regard to the meaning of mind control for elderly persons (1) Settling the mind (2) Gradual lowering of expectations and hope for the success of offspring, (3) Having good thoughts and acting accordingly, and (4) Making up one's mind to follow the 'natural flow of life'. Conclusion: By allowing a wider and deeper understanding of the meaning of mind control for elderly persons the results of this study provide a basis for improving the care of elderly with a holistic perspective.