Cho, Jaelim;Lee, Won Joon;Moon, Ki Tae;Suh, Mina;Sohn, Jungwoo;Ha, Kyoung Hwa;Kim, Changsoo;Shin, Dong Chun;Jung, Sang Hyuk
Journal of Preventive Medicine and Public Health
/
v.46
no.3
/
pp.147-154
/
2013
Objectives: Many epidemiological studies have suggested that a variety of medical illnesses are associated with suicide. Investigating the time-varying pattern of medical care utilization prior to death in suicides motivated by physical illnesses would be helpful for developing suicide prevention programs for patients with physical illnesses. Methods: Suicides motivated by physical illnesses were identified by the investigator's note from the National Police Agency, which was linked to the data from the Health Insurance Review and Assessment. We investigated the time-varying patterns of medical care utilization during 1 year prior to suicide using repeated-measures data analysis after adjustment for age, gender, area of residence, and socioeconomic status. Results: Among 1994 suicides for physical illness, 1893 (94.9%) suicides contacted any medical care services and 445 (22.3%) suicides contacted mental health care during 1 year prior to suicide. The number of medical care visits and individual medical expenditures increased as the date of suicide approached (p<0.001). The number of medical care visits for psychiatric disorders prior to suicide significantly increased only in 40- to 64-year-old men (p=0.002), women <40 years old (p=0.011) and women 40 to 64 years old (p= 0.021) after adjustment for residence, socioeconomic status, and morbidity. Conclusions: Most of the suicides motivated by physical illnesses contacted medical care during 1 year prior to suicide, but many of them did not undergo psychiatric evaluation. This underscores the need for programs to provide psychosocial support to patients with physical illnesses.
Objectives: The objective of the study was to investigate oral health index between adequate and inadequate dental care following preventive scaling in regular dental check-up and management. Methods: The subjects in Busan were assigned to two groups including inadequate dental care (140 patients) and adequate dental care (88 patients) after preventive scaling from January 2014 to June 2015. The study instruments included oral health knowledge, awareness, practice, and community periodontal index of treatment needs (CPITN). Results: CPITN was significantly different between the two groups (p<0.05). Positive correlations were found in oral heath knowledge and awareness (r=0.462, p<0.05) before application of preventive scaling. There was a close correlation in oral health awareness and practice (r=0.205, p<0.05) before application of preventive scaling. After application of preventive scaling, oral health knowledge and awareness showed positive correlation (r=0.643, p<0.05). After application of preventive scaling, there was also a close correlation between oral health knowledge and practice (r=0.453, p<0.05). Oral health awareness and practice (r=0.512, p<0.05) showed positive correlation after the application of preventive scaling. However, oral health practice and CPITN (r=-0.189, p<0.05) showed a negative correlation. Conclusions: Practice made periodontal condition improve. To promote oral health practice in the group without adequate dental care, it is necessary to pay attention to adequate dental care and preventive scaling through education by dental hygienists.
The Affordable Care Act (ACA) was signed into law on March 23, 2010 and will fundamentally alter health care in the United States for years to come. The US is currently one of the only industrialized countries without universal health insurance. The new law expands existing public insurance for the poor. It also provides financial credits to low income individuals and some small businesses to purchase health insurance. By government estimates, the law will bring insurance to 30 million people. The law also provides for a significant new investment in prevention and wellness. It appropriates an unprecedented $15 billion in a prevention and public health fund, to be disbursed over 10 years, as well as creates a national prevention council to oversee the government's prevention efforts. This paper discusses 3 major prevention provisions in the legislation: 1) the waiving of cost-sharing for clinical preventive services, 2) new funding for community preventive services, and 3) new funding for workplace wellness programs. The paper examines the scientific evidence behind these provisions as well as provides examples of some model programs. Taken together, these provisions represent a significant advancement for prevention in the US health care system, including a shift towards healthier environments. However, in this turbulent economic and political environment, there is a real threat that much of the law, including the prevention provisions, will not receive adequate funding.
This study was conducted on 236 dental hygienists to find ways to improve patient education by identifying their concern in preventive care, their level of prevention management knowledge, and their impact on patient education by mediating their prevention-related knowledge. It was found that the prevention care concern, prevention knowledge and patient education of dental hygienists have a significant correlation, the higher the prevention care concern, the better the patient education, the better the prevention care knowledge, the better the prevention management knowledge, the better the patient education. The regression analysis and Sobel verification were conducted in order to identify a mediating effect of the preventive care knowledge on the influence that the level of concern on preventive dental care affects the patient education. Therefore, it was confirmed that the level of concern on preventive dental care has not only a direct effect and an indirect effect. Based on the results of this study, it is believed that the preventive education effect of patients will be even higher if institutional support is supported along with the attention of dental hygienists on preventive work and education for preventive knowledge content.
Sohn, Jungwoo;Cho, Jaelim;Moon, Ki Tae;Suh, Mina;Ha, Kyoung Hwa;Kim, Changsoo;Shin, Dong Chun;Jung, Sang Hyuk
Journal of Preventive Medicine and Public Health
/
v.47
no.6
/
pp.327-335
/
2014
Objectives: Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. Methods: Suicides motivated by non-illness-related factors were identified using the investigator's note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. Results: Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. Conclusions: Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.
Kim, Won-Sool;Hong, Young-Seoub;Kim, Yang-Seak;Lee, Sang-Ju;Park, Kyung-Il;Jung, Kap-Yull;Kim, Joon-Youn
Journal of Preventive Medicine and Public Health
/
v.27
no.2
s.46
/
pp.286-298
/
1994
For the purpose of presenting the basic data for the establishment of control measures on the long-term noise exposed workers, this study was carried out on the relationship between personal noise exposed dose and hearing loss on the 67 male workers whose hearing threshold had exceeded 40 dB in 4,000 Hz, from 1990 to 1992. Conclusively, the level of hearing loss was significantly related to personal noise exposed dose in follow-up period. We considered that personal noise exposed dose which was measured by the personal noise dosemeter was more efficient rather than the noise level of workplace for the evaluating the long-term change of hearing acuity. And although in the case of not-diagnosed as noise induced hearing loss. it was suspected that the active control programs such as improvement of noisy environment or early transfer to proper workplace were needed on the workers who exposed with over 90 dB in personal noise exposed dose.
The increase of health care expenditures is an important problem in the almost countries. Also, suppression of the health care expenditures is an important problem in the health field of Korea since the national health insurance for total people in 1989. Thus, it is very important to grasp the change of the health care expenditures of family and proportions of the health care expenditures to total expenditures of family, because they are the basis of national health care expenditures in Korea. While the health care expenditures of urban family were increased during 1980-1993 by 12.8% annually, the total expenditures of urban family were increased by 14.8% annually. Consequently, the proportions of health care expenditures to total expenditures were decreased from 5.98% to 4.76%. The proportions of health care expenditure for 3 years to come were predicted to 4.75% in 1994, 4.67% in 1995, and 4.63% in 1996 by the time-series analysis. That is, it was predicted that they would be decreasing slowly. The product elasticity of health care expenditure was less than 1 in the multiple regression analysis. so the health care is normal good rather than superior good. Therefore, it seems that the household economy is able to bear the expense pursuing the improvement of quality of health care by actualizing the medical insurance fee.
Kim, Chun-Bae;Lee, Do-Sung;Kim, Han-Joong;Sohn, Myong-Sei
Journal of Preventive Medicine and Public Health
/
v.28
no.2
s.50
/
pp.450-461
/
1995
This paper tested by using Micro TSP, an empirical econometric analysis to approve officially a hypothesis of price elasticity of the demand for medical care services in Korean national medical insurance and the economic effect of health care delivery system with time-series datas of Medical Insurance Statistical Yearbook$(1981\sim1993)$. The results suggest that the Korean medical insurance system shows moral hazard due to the change of coinsurance and the economic effect according to intervention of the health care delivery system, but it is different by insurers regardless of the same structure of the medical insurance scheme.
Objectives: The goal of this study was to identify association between the continuity of ambulatory care of diabetes patients in South Korea (hereafter Korea) and the incidence of macrovascular complications of diabetes, using claims data compiled by the National Health Insurance Services of Korea. Methods: This study was conducted retrospectively. The subjects of the study were 43 002 patients diagnosed with diabetes in 2007, who were over 30 years of age, and had insurance claim data from 2008. The macrovascular complications of diabetes mellitus were limited to ischemic heart disease and ischemic stroke. We compared the characteristics of the patients in whom macrovascular complications occurred from 2009 to 2012 to the characteristics of the patients who had no such complications. Multiple logistic regression was used to assess the effects of continuity of ambulatory care on diabetic macrovascular complications. The continuity of ambulatory diabetes care was estimated by metrics such as the medication possession ratio, the quarterly continuity of care and the number of clinics that were visited. Results: Patients with macrovascular complications showed statistically significant differences regarding sex, age, comorbidities, hypertension, dyslipidemia and continuity of ambulatory diabetes care. Visiting a lower number of clinics reduced the odds ratio for macrovascular complications of diabetes. A medication possession ratio below 80% was associated with an increased odds ratio for macrovascular complications, but this result was of borderline statistical significance. Conclusions: Diabetes care by regular health care providers was found to be associated with a lower occurrence of diabetic macrovascular complications. This result has policy implications for the Korean health care system, in which the delivery system does not work properly.
Purpose: The purpose of this study was to identify the risk perception, safety climate and preventive behaviors of COVID-19 infections, and to verify the factors influencing the adoption of preventive behaviors by health care workers. Methods: A mixed-method approach was used based on a survey carried out in a general hospital. Quantitative data (N=181) were collected through a questionnaire and analyzed using multiple regression. Qualitative data (N=8) were collected through individual interviews and analyzed through Colaizzi's phenomological research method. Results: The factors influencing adoption of preventive behaviors by health care workers were safety climate (β=.41, p<.001), education (β=-.20, p=.025), work unit (β=-.16, p=.032), and risk perception (β=.15, p=.020). The explanatory power was 28.3%, and they have shown that these health care workers felt 'the threat of a pandemic like a battlefield', experienced 'struggle with quarantine rules' and realized 'the reality of infection control and the reorganization for change'. Conclusion: The findings of this study indicate that to increase the adoption of infection control preventive behaviors by health care workers when faced with new infectious diseases in the future, it is necessary to establish organizational support and a safe climate. This study confirms the need for preemptive support and education.
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