• 보건행정학회지
• /
• 제25권3호
• /
• pp.197-206
• /
• 2015

Background: The purpose of this study was to propose a method for developing a measure of hospital-wide all-cause risk-standardized readmissions using administrative claims data in Korea and to discuss further considerations in the refinement and implementation of the readmission measure. Methods: By adapting the methodology of the United States Center for Medicare & Medicaid Services for creating a 30-day readmission measure, we developed a 6-step approach for generating a comparable measure using Korean datasets. Using the 2010 Korean National Health Insurance (NHI) claims data as the development dataset, hierarchical regression models were fitted to calculate a hospital-wide all-cause risk-standardized readmission measure. Six regression models were fitted to calculate the readmission rates of six clinical condition groups, respectively and a single, weighted, overall readmission rate was calculated from the readmission rates of these subgroups. Lastly, the case mix differences among hospitals were risk-adjusted using patient-level comorbidity variables. The model was validated using the 2009 NHI claims data as the validation dataset. Results: The unadjusted, hospital-wide all-cause readmission rate was 13.37%, and the adjusted risk-standardized rate was 10.90%, varying by hospital type. The highest risk-standardized readmission rate was in hospitals (11.43%), followed by general hospitals (9.40%) and tertiary hospitals (7.04%). Conclusion: The newly developed, hospital-wide all-cause readmission measure can be used in quality and performance evaluations of hospitals in Korea. Needed are further methodological refinements of the readmission measures and also strategies to implement the measure as a hospital performance indicator.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제32권4호
• /
• pp.144-153
• /
• 2021

Objectives: Anxiety disorders are the most common psychiatric disorders in adolescents and seem to occur the earliest among all forms of psychopathology. The aim of this study was to investigate the association of anxiety severity with health risk behaviors and mental health in adolescents. Methods: Data from the 2020 Korean Youth Risk Behavior Web-Based Survey were analyzed. A total of 54948 adolescents responded to the 7-item Generalized Anxiety Disorder Scale (GAD-7) for the assessment of their anxiety severity as well as to the mental health and health risk behavior survey. Logistic regression analysis, t tests, and variance analysis of a complex sample general linear model were used to examine the association of anxiety severity with health behaviors and mental health. Results: After statistical adjustment for sociodemographic characteristics, the subjects in the severe anxiety group were significantly more likely to be current smokers (odds ratio [OR]: 2.08, 95% confidence interval [CI]: 1.72-2.50), current drinkers (OR: 1.91, 95% CI: 1.67-2.19), experience habitual substance use (OR: 10.89, 95% CI: 8.22-14.42), have sexual intercourse (OR: 2.10, 95% CI: 1.76-2.51), and have unprotected intercourse (OR: 2.21, 95% CI: 1.67-2.92) than those in the normal group. Anxiety severity negatively correlated with sleep satisfaction and happiness, but positively correlated with stress perception, loneliness, depressive symptoms, and suicidality. Conclusion: Adolescent anxiety is associated with health risk behaviors and poor mental health. Thus, early screening and intervention for anxiety in adolescents could contribute to the management and coping of youth health risk behaviors in the community.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권6호
• /
• pp.2917-2922
• /
• 2014

Background: The p53-binding protein 1 (TP53BP1) gene may be involved in the development of cancer through disrupting DNA repair. However, investigation of associations between TP53BP1 rs2602141 A/C polymorphism and cancer have yielded contradictory and inconclusive outcomes. We therefore performed a meta-analysis to evaluate the association between the TP53BP1 rs2602141 A/C polymorphism and cancer susceptibility. Materials and Methods: Published literature from PubMed, Medline, the Cochrane Library, EMbase, Web of Science, Google (scholar), CBMDisc, Chongqing VIP database, and CNKI database were retrieved. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using fixed or random-effects models. Publication bias was estimated using funnel plots, Begg's and Egger's test. Results: A total of seven studies (3,018 cases and 5,548 controls) were included in the meta-analysis. Our results showed that the genotype distribution of TP53BP1 rs2602141 A/C was not associated with cancer risk overall. However, on subgroup analysis, we found that TP53BP1 rs2602141 A/C was associated with cancer risk within an allele model (A vs C, OR=1.14, 95%CI: 1.01-1.29) and a codominant model (AA vs CC, OR=1.36, 95%CI: 1.06-1.74) in Asians rather than in Caucasians. Subgroup analysis by cancer type, genotype, and with or without adjustment for controls showed no significant association. Conclusions: The findings suggested an association between rs2602141 A/C polymorphism in TP53BP1 gene and increased risk of cancer in Asians.

• Journal of Preventive Medicine and Public Health
• /
• 제34권1호
• /
• pp.21-27
• /
• 2001

Objectives : To develop a model that will predict the mortality of patients undergoing Coronary Artery Bypass Graft (CABG) and evaluate the perfermance of hospitals. Methods : Data from 564 CABGs peformed in six general hospitals were collected through medical record abstraction by registered nurses. Variables studied involved risk factors determined by severity measures. Risk modeling was performed through logistic repression and validated with cross-validation. The statistical performance of the developed model was evaluated using c-statistic, $R^2$, and Hosmer-Lemeshow statistic. Hospital performance was assessed by severity-adjusted mortalities. Results : The developed model included age, sex, BUN, EKG rhythm, Congestive Heart Failure at admission. acute mental change within 24 hours, and previous angina pectoris history. The c-statistic and $R^2$ were 0.791 and 0.001, respectively. Hosmer-Lemeshow statistic was 10.3(p value=0.2415). One hospital had a significantly higher mortality rate than the average mortality rate, while others were net significantly different. Conclusion : Comparing the quality of service by severity adjusted mortality rates, there were significant differences in hospital performance. The severity adjusted mortality rate of CABG surgery may He an indicator for evaluating hospital performance in Korea.

• KDI Journal of Economic Policy
• /
• 제33권1호
• /
• pp.93-124
• /
• 2011

본고에서는 Tversky and Kahneman(1974)의 기준점 효과와 Kahneman and Tversky(1979)의 전망이론으로 해석이 가능한 현상이 우리나라 자산시장에 동시에 나타나는지를 주가 및 부동산 가격을 대상으로 검증하였다. 전망이론의 경우 위험 회피 성향 투자자가 가격 상승 시 매각을 선호하는 것으로 예측하는데, 본고는 이런 성향이 자산가격 수익의 변동성이 증가하는 경우 더 강화되는 것으로 보았다. 1990년대 이후 우리나라 자료를 바탕으로 실증분석한 결과, 과거 수익률이 양(+)인 경우, 주가수익률은 과거 20 또는 30 영업일 자료(window)를 이용하여 산출한 변동성에, 아파트를 제외한 주택가격 수익률은 과거 24~36개월의 자료를 이용하여 산출한 변동성에 각각 통계적으로 유의한 영향을 받는 것으로 나타났다.

• Journal of Preventive Medicine and Public Health
• /
• 제53권5호
• /
• pp.342-352
• /
• 2020

Objectives: The aim of this retrospective cohort study was to investigate whether non-alcoholic fatty liver disease (NAFLD) was associated with incident bone mineral density (BMD) decrease. Methods: This study included 4536 subjects with normal BMD at baseline. NAFLD was defined as the presence of fatty liver on abdominal ultrasonography without significant alcohol consumption or other causes. Decreased BMD was defined as a diagnosis of osteopenia, osteoporosis, or BMD below the expected range for the patient's age based on dual-energy X-ray absorptiometry. Cox proportional hazards models were used to estimate the hazard ratio of incident BMD decrease in subjects with or without NAFLD. Subgroup analyses were conducted according to the relevant factors. Results: Across 13 354 person-years of total follow-up, decreased BMD was observed in 606 subjects, corresponding to an incidence of 45.4 cases per 1000 person-years (median follow-up duration, 2.1 years). In the model adjusted for age and sex, the hazard ratio was 0.65 (95% confidence interval, 0.51 to 0.82), and statistical significance disappeared after adjustment for body mass index (BMI) and cardiometabolic factors. In the subgroup analyses, NAFLD was associated with a lower risk of incident BMD decrease in females even after adjustment for confounders. The direction of the effect of NAFLD on the risk of BMD decrease changed depending on BMI category and body fat percentage, although the impact was statistically insignificant. Conclusions: NAFLD had a significant protective effect on BMD in females. However, the effects may vary depending on BMI category or body fat percentage.

• 대한영양사협회학술지
• /
• 제13권3호
• /
• pp.240-249
• /
• 2007

The objective of this study was to investigate the relation of serum calcium level, body mass index(BMI) with bone status expressed as broadband ultrasound attenuation(BUA) measured by quantitative ultrasound (QUS) and the occurrence of osteopenia among adult men and women. Two hundred eleven(63 male and 148 female) workers who worked in 4 different battery factories were recruited from March 2005 to October 2005. BUA was used as a surrogate of bone mineral density and measured at left calcaneous bone area. The BUA value transformed into T-score by WHO standard conversion criteria to determine osteopenia (-2.5

• Asian-Australasian Journal of Animal Sciences
• /
• 제30권6호
• /
• pp.765-772
• /
• 2017

Objective: This study examines the genetic factors influencing the phenotypes (four economic traits:oleic acid [C18:1], monounsaturated fatty acids, carcass weight, and marbling score) of Hanwoo. Methods: To enhance the accuracy of the genetic analysis, the study proposes a new statistical model that excludes environmental factors. A statistically adjusted, analysis of covariance model of environmental and genetic factors was developed, and estimated environmental effects (covariate effects of age and effects of calving farms) were excluded from the model. Results: The accuracy was compared before and after adjustment. The accuracy of the best single nucleotide polymorphism (SNP) in C18:1 increased from 60.16% to 74.26%, and that of the two-factor interaction increased from 58.69% to 87.19%. Also, superior SNPs and SNP interactions were identified using the multifactor dimensionality reduction method in Table 1 to 4. Finally, high- and low-risk genotypes were compared based on their mean scores for each trait. Conclusion: The proposed method significantly improved the analysis accuracy and identified superior gene-gene interactions and genotypes for each of the four economic traits of Hanwoo.

• 한국환경보건학회지
• /
• 제38권6호
• /
• pp.472-481
• /
• 2012

Objectives: This study aims to investigate the AD (allergic diseases: asthma, allergic rhinitis and atopic dermatitis) prevalence among elementary schoolchildren in an industrial city, Ulsan, and identify major environmental risk factors associated with AD prevalence. Methods: Data on the physician-diagnosed prevalence over the past 12 months and potential risk factors of AD were collected through a questionnaire from a 2009-2010 survey of 4,067 schoolchildren living in different urban environments. The logistic regression analysis was performed to assess differences in AD prevalence among the areas and to determine which environmental factors impacted AD. Results: Our survey results showed that the AD prevalence rate ranged between 26.2% and 35.9%. Children living in polluted areas (near industrial and central urban areas) had about a 10% higher prevalence of AD than did those living in coastal or suburban residences. The Chi-Square test demonstrated that this local difference was statistically significant before and after adjustment of major confounders such as parental AD history and parental education. The results of the logistic regression analysis showed a statistically significant association between several environmental factors (ventilation in winter, odor conditions and exposure to traffic smoke, and outdoor $PM_{10}/O_3$ pollution) and the prevalence of AD found by multivariate model after adjusting confounders. Conclusion: These results suggest that local differences in AD prevalence are significantly associated with outdoor environmental factors. Although there are likely to be other risk factors for AD, living in a polluted area and exposure to high levels of air pollutants can contribute to an increased risk of childhood AD.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권8호
• /
• pp.3629-3633
• /
• 2014

Background: Glioblastoma (GBM) is an immunosuppressive tumor whose median survival time is only 12-15 months, and patients with GBM have a uniformly poor prognosis. It is known that heredity contributes to formation of glioma, but there are few genetic studies concerning GBM. Materials and Methods: We genotyped six tagging SNPs (tSNP) in Han Chinese GBM and control patients. We used Microsoft Excel and SPSS 16.0 statistical package for statistical analysis and SNP Stats to test for associations between certain tSNPs and risk of GBM in five different models. ORs and 95%CIs were calculated for unconditional logistic-regression analysis with adjustment for age and gender. The SHEsis software platform was applied for analysis of linkage disequilibrium, haplotype construction, and genetic associations at polymorphism loci. Results: We found rs891835 in CCDC26 to be associated with GBM susceptibility at a level of p=0.009. The following genotypes of rs891835 were found to be associated with GBM risk in four different models of gene action: i) genotype GT (OR=2.26; 95%CI, 1.29-3.97; p=0.019) or GG (OR=1.33; 95%CI, 0.23-7.81; p=0.019) in the codominant model; ii) genotypes GT and GG (OR=2.18; 95%CI, 1.26-3.78; p=0.0061) in the dominant model; iii) GT (OR=2.24; 95%CI, 1.28-3.92; p=0.0053) in the overdominant model; iv) the allele G of rs891835 (OR=1.85; 95%CI, 1.14-3.00; p=0.015) in the additive model. In addition, "CG" and "CGGAG" were found by haplotype analysis to be associated with increased GBM risk. In contrast, genotype GG of CCDC26 rs6470745 was associated with decreased GBM risk (OR=0.34; 95%CI, 0.12-1.01; p=0.029) in the recessive model. Conclusions: Our results, combined with those from previous studies, suggest a potential genetic contribution of CCDC26 to GBM progression among Han Chinese.