• 제목/요약/키워드: Quartile

검색결과 346건 처리시간 0.026초

패널 자료를 이용한 미충족 의료의 추세와 관련요인 (Trend of Unmet Medical Need and Related Factors Using Panel Data)

  • 김은수;은상준
    • 융합정보논문지
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    • 제10권9호
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    • pp.229-236
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    • 2020
  • 본 연구는 2009년부터 2013년까지(2010년 제외)의 한국 의료패널 자료를 활용하여 미충족 의료의 추세 및 현황을 알아보고, 미충족 의료와 관련된 요인을 분석하고자 하였다. 연구 대상자는 2009년 11,598명, 2011년 11,035명, 2012년 10,584명, 2013년 10,099명 그리고 7,144명의 패널 자료를 활용하여 빈도분석, 교차분석, 일반화 추정방정식 모형을 시행하였다. 연도별로 교차분석 결과, 여성, 중학교 졸업 이하의 학력, 의료보장 형태가 의료급여인 경우, 최저 분위의 가구소득, 주관적 건강상태 점수가 낮을 때 미충족 의료 경험률이 높은 것으로 나타났다. 일반화 추정방정식 모형을 통한 분석 결과, 여성, 40세 미만 연령대, 초등학교 졸업 이하, 최저 분위의 가구소득, 주관적 건강상태 20점 미만, 활동 제한이 있는 경우 미충족 의료를 경험할 가능성이 높은 것으로 나타났다. 이 결과를 바탕으로, 의료서비스 이용의 정책을 수립하는데 기초자료를 제공하고자 한다.

Nutrient-derived Dietary Patterns and Risk of Colorectal Cancer: a Factor Analysis in Uruguay

  • Stefani, Eduardo De;Ronco, Alvaro L.;Boffetta, Paolo;Deneo-Pellegrini, Hugo;Correa, Pelayo;Acosta, Gisele;Mendilaharsu, Maria
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권1호
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    • pp.231-235
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    • 2012
  • In order to explore the role of nutrients and bioactive related substances in colorectal cancer, we conducted a case-control in Uruguay, which is the country with the highest production of beef in the world. Six hundred and eleven (611) cases afflicted with colorectal cancer and 1,362 controls drawn from the same hospitals in the same time period were analyzed through unconditional multiple logistic regression. This base population was submitted to a principal components factor analysis and three factors were retained. They were labeled as the meat-based, plant-based, and carbohydrates patterns. They were rotated using orthogonal varimax method. The highest risk was positively associated with the meat-based pattern (OR for the highest quartile versus the lowest one 1.63, 95 % CI 1.22-2.18, P value for trend = 0.001), whereas the plant-based pattern was strongly protective (OR 0.60, 95 % CI 0.45-0.81, P value for trend <0.0001. The carbohydrates pattern was only positively associated with colon cancer risk (OR 1.46, 95 % CI 1.02-2.09). The meat-based pattern was rich in saturated fat, animal protein, cholesterol, and phosphorus, nutrients originated in red meat. Since herocyclic amines are formed in the well-done red meat through the action of amino acids and creatine, it is suggestive that this pattern could be an important etiologic agent for colorectal cancer.

A Study on Acute Effects of Fine Particles on Pulmonary Function of Schoolchildren in Beijing, China

  • Kim, Dae-Seon;Yu, Seung-Do;Cha, Jung-Hoon;Ahn, Seung-Chul
    • 한국환경보건학회:학술대회논문집
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    • 한국환경보건학회 2004년도 International Conference Global Environmental Problems and their Health Consequences
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    • pp.193-196
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    • 2004
  • To evaluate the acute effects of fine particles on pulmonary function, a longitudinal study was conducted. This study was carried out for the schoolchildren (3rd and 6th grades) living in Beijing, China. Children were asked to record their daily levels of peak expiratory flow rate using portable peak flow meter (mini-Wright) for 40 days. The relationship between daily PEFR and fine particle levels was analyzed using a mixed linear regression models including gender, height, the presence of respiratory symptoms, and daily average temperature and relative humidity as extraneous variables. The total number of students participating in this longitudinal study was 87. Daily measured PEFR was in the range of $253{\sim}501L/min$. On the daily basis, a PEFR measured in the morning was shown to be lower than that measured in the evening (or afternoon). The daily mean concentrations of $PM_{10}$ and $PM_{2.5}$ over the study period were $180.2\;{\mu}g/m^3$ and $103.2\;{\mu}g/m^3$, respectively. The IQR (inter-quartile range) of $PM_{10}$ and $PM_{2.5}$ were $91.8\;{\mu}g/m^3$ and $58.0\;{\mu}g/m^3$. Daily mean PEFR was regressed with the 24-hour average $PM_{10}$ (or $PM_{2.5}$) levels, weather information such as air temperature and relative humidity, and individual characteristics including gender, height, and respiratory symptoms. The analysis showed that the increase of fine particle concentrations was negatively associated with the variability in PEFR. The IQR increments of $PM_{10}$ or $PM_{2.5}$ (at 1-day time lag) were also shown to be related with 1.54L/min (95% Confidence intervals -2.14, -0.94) and 1.56L/min (95% CI -2.16, -0.95) decline in PEFR.

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투시 조영 검사 시 환자 선량 관리를 위한 진단참고선량 구축에 관한 연구 (UGI, Esophagography 기준) (Fluoroscopy examinations for the management of patient dose study on the establishment of diagnostic reference level (UGI, Esophagography standards))

  • 홍선숙;박은성;조준영;성민숙;양한준
    • 대한디지털의료영상학회논문지
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    • 제14권1호
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    • pp.1-6
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    • 2012
  • This round of tests in patients with UGI and Esophagography data collected by national and international reference levels based on the original set of guidelines and fluoroscopy, through the provision of medical radiation exposure reduction and further optimization of Defense to realize that is intended. 359 names in our hospital underwent Esophagography 302 patients who underwent UGI average fluoroscopy time and number of images to calculate the average 21 cm Acryl phantom dose for 10 seconds and 20 seconds, average area dose and the area dose of 1 spot image, 5 spot consecutive images by measuring the patient dose and third quartile of the mean area dose was set seonryangin reference dose. Esophagography average patient dose was set to 30.05 $Gy{\cdot}cm^2$, DRL was set at a 25.37 $Gy{\cdot}cm^2$. Average dose of UGI patients were selected as 45.33 $Gy{\cdot}cm^2$, DRL was set at a 34 $Gy{\cdot}cm^2$. UGI patients with established average dose recommended in the 2008 national recommendation from the UGI examination with a dose of less than 49.7 $Gy{\cdot}cm^2$ seonryangin is evaluated. This Note examines the dose of self-aware through education recognizes the importance of dose reduction and examine if their efforts and further reduce patient dose could achieve optimization of the medical exposure is considered.

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농촌 지역 일부 노인에서 신체 기능 정도에 따른 활동 제한도, 비만도 및 영양소 섭취 수준의 변화 양상 비교 (Comparison of Self-living Ability, Obesity Indices and Nutrient Intake according to Physical Fitness among the Elderly in Rural Areas)

  • 서희재;김복희
    • 한국식품영양학회지
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    • 제22권4호
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    • pp.577-586
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    • 2009
  • Aging is associated with decreased energy expenditure, thermogenesis and energy requirements. Maintenance of physical fitness of the elderly has been reported to reduce the rate at which the basal metabolic rate, muscle strength, skeletal muscle mass and bone density deteriorate. Skeletal muscle disease is known to increase the risk of physical disability and psychological problems. This study was conducted to investigate changes in disability, emotional problems, body compositions, obesity indices and nutrient intake levels according to physical fitness with the elderly in rural areas. According to the results, physical fitness was negatively related with Activities of Daily Living(ADL, p<0.05), Instrumental Activities of Daily Living(IADL, p<0.001), Body Mass Index(BMI, p<0.001) and abdominal obesity(p<0.05), while it showed a positive correlation with the General Self Efficacy Scale(GSES)(p<0.001) and nutrient intake(p<0.05). When changes in these factors were compared according to the range of quartile of the Fullerton Advanced Balance Scale(FAB Scale), GSES(Q1=35.3, Q2=43.5, Q3=53.2, Q4=51.9, p<0.001), BMI(Q1=36.1%, Q2=34.7%, Q3=33.2%, Q4=28.6%, p<0.01), abdominal obesity(Q1=1.02, Q2=0.99, Q3=0.97, Q4=0.94, p<0.001) and nutrient intake(Q1=71.1%, Q2=75.4%, Q3=80.6%, Q4=80.2%, p<0.05) differed significantly. Taken together, these results suggested that better physical fitness would lead to a reduction in negative factors including physical disability and obesity indices, but to an increase in positive factors such as GSES and nutrient intake. The results of this study are expected to be used as basic data for the development of programs to promote the health of the elderly in a local society.

The Association Between Serum Albumin Levels and Metabolic Syndrome in a Rural Population of Korea

  • Cho, Hye-Min;Kim, Hyeon-Chang;Lee, Ju-Mi;Oh, Sun-Min;Choi, Dong-Phil;Suh, Il
    • Journal of Preventive Medicine and Public Health
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    • 제45권2호
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    • pp.98-104
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    • 2012
  • Objectives: A positive association between serum albumin levels and metabolic syndrome has been reported in observation studies, but it has not been established in the Korean population. The purpose of this study was to evaluate the association between serum albumin levels and the presence of metabolic syndrome among a sample of apparently healthy Korean adults. Methods: This cross-sectional study analyzed data of 3189 community-dwelling people (1189 men and 2000 women) who were aged 40 to 87 years and were living in a rural area in Korea. Serum albumin levels were classified into quartile groups for each sex. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III guidelines with an adjusted waist circumference cut-off value ${\geq}90\;cm$ for men and${\geq}85\;cm$ for women). An independent association between serum albumin levels and metabolic syndrome was assessed by multiple logistic regression analysis. Results: Higher serum albumin levels were associated with increased prevalence of metabolic syndrome. The odds ratio (95% confidence interval) of the prevalence of metabolic syndrome for the highest versus the lowest serum albumin quartiles was 2.81 (1.91 to 4.14) in men and 1.96 (1.52 to 2.52) in women, after adjusting for age, smoking status, alcohol consumption, and physical activity. When each metabolic abnormality was analyzed separately, higher serum albumin levels were significantly associated with hypertriglyceridemia and hyperglycemia in both sexes, and with abdominal obesity in men. Conclusions: These results suggest that higher serum albumin levels are positively associated with an increased risk of metabolic syndrome in Korean adults.

Improving the Performance of Risk-adjusted Mortality Modeling for Colorectal Cancer Surgery by Combining Claims Data and Clinical Data

  • Jang, Won Mo;Park, Jae-Hyun;Park, Jong-Hyock;Oh, Jae Hwan;Kim, Yoon
    • Journal of Preventive Medicine and Public Health
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    • 제46권2호
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    • pp.74-81
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    • 2013
  • Objectives: The objective of this study was to evaluate the performance of risk-adjusted mortality models for colorectal cancer surgery. Methods: We investigated patients (n=652) who had undergone colorectal cancer surgery (colectomy, colectomy of the rectum and sigmoid colon, total colectomy, total proctectomy) at five teaching hospitals during 2008. Mortality was defined as 30-day or in-hospital surgical mortality. Risk-adjusted mortality models were constructed using claims data (basic model) with the addition of TNM staging (TNM model), physiological data (physiological model), surgical data (surgical model), or all clinical data (composite model). Multiple logistic regression analysis was performed to develop the risk-adjustment models. To compare the performance of the models, both c-statistics using Hanley-McNeil pair-wise testing and the ratio of the observed to the expected mortality within quartiles of mortality risk were evaluated to assess the abilities of discrimination and calibration. Results: The physiological model (c=0.92), surgical model (c=0.92), and composite model (c=0.93) displayed a similar improvement in discrimination, whereas the TNM model (c=0.87) displayed little improvement over the basic model (c=0.86). The discriminatory power of the models did not differ by the Hanley-McNeil test (p>0.05). Within each quartile of mortality, the composite and surgical models displayed an expected mortality ratio close to 1. Conclusions: The addition of clinical data to claims data efficiently enhances the performance of the risk-adjusted postoperative mortality models in colorectal cancer surgery. We recommended that the performance of models should be evaluated through both discrimination and calibration.

계속조사에서 상대표준오차를 이용한 표본크기 결정에 관한 고찰 (A Note on the Decision of Sample Size by Relative Standard Error in Successive Occasions)

  • 한근식;이기성
    • 응용통계연구
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    • 제28권3호
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    • pp.477-483
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    • 2015
  • 본 연구에서는 계속조사에서 과거의 조사결과에서 얻은 추정값의 상대표준오차를 이용한 표본크기 결정 문제에 대하여 실제 사업체 조사자료를 활용하여 살펴보았다. 통계청 사업체 조사결과 중 건설업을 모집단으로 이용하여 표본크기를 500에서 3,000까지 500씩 증가시켜가면서 표본을 1,000개씩 단순임의추출 또는 층화추출하여 추출된 각 표본으로부터 상대표준오차들의 사분위수를 계산하였다. 그리고 이들 값들을 토대로 계속조사에서 시점 (t-1)에서의 상대표준오차를 이용한 시점 t에서의 표본크기를 추출법에 따라 구하였다. 그 결과 단순임의추출의 경우는 층화추출의 경우보다 시점 (t-1)에서의 상대표준오차들의 크기에 따라 표본크기가 매우 크게 차이가 나타남을 알 수 있었으며, 층화추출의 경우도 어떻게 층화를 하느냐에 따라 표본크기에 차이가 있을 수 있음을 알 수 있었다. 따라서 계속 조사에서 과거의 조사결과에서 얻은 추정값의 상대표준오차를 이용한 표본크기 식을 활용하는데 있어서 세심한 주의가 필요함을 확인할 수 있었다.

섬진강댐 상류 유역의 강우시 비점오염물질 유출 특성 (Characteristics of Non-point Pollutant Discharge from Upper Watershed of Seomjin Dam during Rainy Season)

  • 곽동희;유승준;김지훈;임익현;권지영;정팔진
    • 상하수도학회지
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    • 제22권1호
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    • pp.39-48
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    • 2008
  • This study was carried out to investigate the characteristics of the pollutant discharge from non-point source and to estimate the unit loads of the pollutant discharge from the upper watershed of Seomjin Dam during rainy season. The upper watershed of Seomjin Dam is located in the middle of Jeonbuk province is formed two tributaries mainly. A sub-branch stream of those tributaries is Imsil stream of which flow rate is about 13% of the main stream of Seomjin reservoir normally. On the basis of measurement result in this study, the water quality of Imsil stream was fluctuated highly and the quantity of measured pollutant discharge was higher than the value calculated with the proportion of flow rate during dry season. On the contrary, during rainy season the mean values of flow rate and water quality were higher than the quartile according to the statistical analysis. That means rainfall can influence strongly on the water quality of the upper watershed of Seomjin reservoir. Among the several criteria of water quality, SS discharge was most sensitive to the flow rate variation of stream, which was fluctuated in proportion of rainfall, basically. It was evaluated the event mean concentration (EMC) of non-point source pollutants depending on rainfall events as well. Though the pollutant discharge unit of Imsil stream was lower than the main stream of Seomjin reservoir, the EMC value of Imsil stream was higher than the main stream of Seomjin reservoir.

강우의 개념적 시간분포와 설계홍수량 산정에 관한 연구 (The Estimations of A Conceptual Time Distribution of Rainfall and Design Flood)

  • 이병운;장대원;김형수;서병하
    • 한국수자원학회:학술대회논문집
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    • 한국수자원학회 2005년도 학술발표회 논문집
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    • pp.937-942
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    • 2005
  • It is necessary to estimate the runoff hydrograph and peak flood discharge using law of probability for synthetic flood control policy and design of hydraulic structures. Rainfall analysis is needed in the process of peak flood discharge estimation and the time distribution of a design rainfall is a very important process in the analysis. In this study, we estimate design flood for a small urban basin and a rural basin of medium scale which have different travel times. The Huff method is widely used in Korea for the time distribution of design rainfall to estimate design flood. So, we use Huff method and a conceptual method which is suggested in this study for the comparative purpose. The 100-year frequency rainfall is used to estimate design flood for each basin and the design flood is compared with the existing design flood. As the result, the design flood is overestimated $14.6m^3/sec$ by Huff method and is underestimated $70.9m^3/sec$ by a conceptual method for the rural basin. For the small urban basin, the design flood is excessively overestimated $294.65m^3/sec$ by Huff method and is overestimated $173m^3/sec$ by a conceptual method. The reason of excessive overestimation by Huff method in the small urban basin is that the increased rate of rainfall intensity according to the decrease of duration is large and the duration exceeds the time of concentration when the increased rainfall intensity is concentrated in a quartile. Therefore, we suggested a conceptual method for the time distribution of design rainfall by considering the rainless period and duration. Especially, the conceptual method might be useful for the small urban basin with short concentration time which the design flood is overestimated by Huff method.

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