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A Review of Relationship Between Level of Fertility and Contraceptive Prevalence in Korea: Some Implication for Policy Suggestion (최근의 피임실천수준과 출산력추이에 관한 고찰 -몇가지 정책적 제언을 중심으로-)

  • 고갑석
    • Korea journal of population studies
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    • v.8 no.2
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    • pp.79-92
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    • 1985
  • Fertility has been declined since 1966 (see Table 1). This fertility reduction was duely caused by age at first marriage, induced abortion and contraceptive practice which has been largely increased in recent years. Although tbe proximate determinant such as induced abortion, age at marriage and breastfeeding can and do have an effect on fertility, the principal cause of the reduction in fertility in Korea during the fertility transition can be supported by correlation between level of fertility and contraceptive prevalence (See Fig. 4). Taking a regression equation between fertility (TER. Y) and prevalence level (X), the total fertility rate in 1984 was estimated as 1.9 and 2.1 based on lenear and expotential function shown as follow; $Y_1$=5.709-0.0549 X and $Y_2$_______80________ 1+e2.433+0.017X ($R^2$=O. 93) ($R^2$=0. 96) Where $Y_1$ and $Y_2$ denote total fertility rates obtained through two equations respectivelly. The peak of contraceptive prevalence was assumdd as 80 percent which is almost upper limit in human society. On the other hand, an observed value of 1984 fertility level obtained from five month period shows 2.1 which is coincident with logistic fitting after the adjustment of response error assumed around 10 to 20 percent, At any rate, fertility of Korean women will have been reached replacement level (2.1) by 1985.Thus policy for family planning program must be reviewed toward the direction of integrated approach particularly with MCH program inasmuch as fertility in Korea has already shown population replacement level that require more good quality of service in family planning and their There must be an advanced level of fertility in Korea because wide use of contraception and induced life abortion and age at marriage will effect modern fertility which shows up and down trend between 2.1 and 1.5 in general.

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Development of Performance Measures Based on Nursing Process for Admission and Discharge Care (간호과정 적용 평가도구 개발 -입원 및 퇴원 시 간호를 중심으로-)

  • Kim, Keum Soon;Kim, Jin A;Choi, Yun Kyoung;Kim, Eun Man;Kim, Yu Jeong;Kim, Mi Ae;Kim, Kyoung Ok;Kim, Eul Soon
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.2
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    • pp.123-137
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    • 2011
  • Purpose: This study was conducted to develop standards ensuring nursing process-based care of patient admission and discharge, to develop a performance measurement tool evaluating the care applied according to the standards, and finally to determine validity of the standards and the tool. Methods: The standards and the tool were reviewed by a panel of experts and refined based on the panel's suggestions. Validity of the standards and the tool were examined through surveying a total of 302 hospital nurses. Results: The mean validity scores of the performance measurement standards and the tool were 4.11 and 4.09, respectively, out of 5.00. So the performance measurement standards and the tool in this study were found to be acceptable in evaluating quality of nursing care provided at patient admission and discharge. Conclusion: This result indicates that the performance measurement standards and the tool developed in this study are valid instruments to monitor and improve quality of nursing care for patient admission and discharge.

A Study on Application of Risk Based Aviation Safety Oversight Approach for Approved Maintenance Organization System (위험기반 항공안전감독 시스템 적용을 통한 정비조직 제도 개선방안 연구)

  • Nam, Seungju;Park, Yurim;Kwon, Sang Wook;Hwang, Yu Shin;Yoon, Heekweon
    • Journal of Aerospace System Engineering
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    • v.15 no.5
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    • pp.50-59
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    • 2021
  • The need for risk based safety management has been highlighted in accordance with the growth of aviation industry and public interest in aviation safety. Maintenance, Repair and Overhaul (MRO) in aviation industry is defined to guarantee the safety and reliability. Therefore, state's Civil Airworthiness Authority (CAA) has established safety oversight system dedicated for the development of a healthy MRO industry. The study proposed a risk based oversight system considering Korean environment. Based on literature review including analysis of International Civil Aviation Organization guidance and advance system, we identified two organization risks. Organization complexity can be evaluated in accordance with how large the organization is and how complicated the service they provide are. Organization profile is the organization's characteristic related with safety. This study contributes to improving the process of identifying risk of organization and focusing surveillance capabilities on risk areas for efficient management of CAA's resources.

General Radiography Usage and Exposure Dose of Korean Elderly: Based on Data from Aged Patients in 2016 (한국 노인의 일반촬영 이용량 및 피폭선량: 2016년 고령환자데이터 기반)

  • Gil, Jong-Won;Yoo, Se-Jong;Lee, Won-Jeong
    • Journal of radiological science and technology
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    • v.44 no.5
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    • pp.495-502
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    • 2021
  • This study aims to provide basic data for elderly health insurance policy and medical radiation safety management by analyzing the general radiography usage and exposure dose of the elderly in Korea. The effective dose for each general radiography was calculated using the ALARA-GR program for 260 general radiography codes selected from 'National Health Insurance Care Benefit Cost'. The usage of general radiography was analyzed in the 2016 elderly patient data of the Health Insurance Review and Assessment Service, and the effective dose for each general radiography was applied. The general radiography usage and exposure dose per person aged 65 years and over was 6.47 cases and 0.56 mSv. Females showed higher value than males as 7.15 cases and 0.66 mSv(p<.001). By age, those between 75 and 79 showed the highest number as 6.97 cases and 0.62 mSv(p<.001). Those who were supported by Medical Aid showed higher value than those who were insured by National Health Insurance as 8.82 cases and 0.76 mSv(p<.001). In addition, the ratio by radiography was in the order of Chest 20.85%, Knee Joint 15.58%, and L-spine 14.67%, and the exposure dose was L-spine 29.40%, Chest 15.82%, Abdomen 7.97%, and Entire Spine 7.20%. General radiography, which is widely used due to the high frequency of diseases in the elderly population should be taken into consideration when establishing health insurance policies. In addition, it is necessary to check whether the general radiography with high exposure dose is performed as a routine examination without considering medical necessity.

Atherosclerotic Cardiovascular Disease Risk and Statin Prescription Status in Korean Adult Patients (국내 성인환자에서 죽상동맥경화성 심혈관질환 위험도와 스타틴 처방 현황)

  • Kim, Jong Yoon;Rhew, Kiyon
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.3
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    • pp.198-204
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    • 2021
  • Background: Cardiovascular (CV) disease is known as one of the major causes of death from disease worldwide. Statin therapy plays a pivotal role in atherosclerotic cardiovascular disease (ASCVD) lowering the LDL-cholesterol level effectively. The purpose of this study was to evaluate the association of the intensity of statin therapy in adult patients of Korea and the risk of ASCVD of the patient group. Methods: We used data from sample of patients from the Health Insurance Review and Assessment Service (HIRA-NPS-2018). We analyzed the patterns of prescribing statins including types of statin, statin intensity, and number of patients with ASCVD or risk of ASCVD. Results: 155,512 patients were included in the analysis, and 27,950 patients (18.0%) was over 75 years. High-intensity statin usage was increased in ASCVD patients compared with the low-intensity statin use. The OR (odds ratio) of high-intensity statin were increased in myocardial infarction patients compared with low-intensity statin use showing the highest OR; 12.40 (95% CI; 9.48-16.22). At patient groups of angina, ischemic heart disease and carotid disease, high-intensity statin prescription rate was increased compared with low-intensity statin. However, there was no statistical significance between both statin prescription rates in patients of peripheral arterial disease, abdominal aneurysm, diabetic mellitus and atherosclerosis. Conclusion: The statin prescription rate showed intensity increasing tendency according to the risk of ASCVD. More aggressive statin therapy might be beneficial for the ASCVD patients based on the recent guidelines of dyslipidemia.

Comparative Study on the National Health Screening Programs according to the Health Insurance System (국가별 건강보험체계에 따른 국가건강검진제도 비교 연구)

  • Lee, Yeji;Kim, Eunyoung;Lee, Donghyun
    • Health Policy and Management
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    • v.31 no.3
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    • pp.272-279
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    • 2021
  • Background: Korea's health screening program has been faced the need for changes as the population and diseases structure are changing. In addition to Korea, many countries operate state-led health check-up programs to improve the health level of the people, and the operating methods of the program appear in various forms according to each country's health insurance system. This study examines other state-led health screening programs and proposes a direction for the development of Korea's health screening program. Methods: The study was conducted using the literature review method, and the "country" was set as a unit for the case analysis. The operating method of the health screening programs and the financial resources were compared according to the health insurance system. Five countries were selected as Korea, the United States, the United Kingdom, Japan, and Taiwan. Results: The analyzed countries mainly operate the health screening program as a management method for chronic diseases, but there were differences in the operating method, financing, and targeted subjects and examination items. In most countries, a risk assessment was performed prior to the examination (screening), and the subjects who needed the examination were first selected, and a follow-up management service was provided in accordance with the risk each individual exposed. Conclusion: Rather than applying the same screening method to populations with different risk levels, a health screening program will be constructed in consideration of the individual's health level and exposure risk, and the healthcare delivery system will be reorganized so that screening and treatment services can be linked.

Analysis of behavioral management for dental treatment in patients with dementia using the Korean National Health Insurance data

  • Kim, Taeksu;Chi, Seong In;Kim, Hyuk;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.5
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    • pp.461-469
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    • 2021
  • Background: The global population is aging rapidly, and accordingly, the number of patients with dementia is increasing every year. Although the need for dental treatment increases for various reasons in patients with dementia, they cannot cooperate during dental treatment. Therefore, behavioral management, including sedation (SED) or general anesthesia (GA), is required for patients with dementia. Thus, this study aimed to investigate the trends and effects of SED or GA in patients with dementia undergoing dental treatment in South Korea based on the Korean National Health Insurance claims data. Methods: This study utilized customized health information data provided by the Health Insurance Review and Assessment Service. Among patients with records of using sedative drugs during dental treatment from January 2007 to September 2019, patients with the International Classification of Diseases-10 code for dementia (F00, F01, F02, F03, and G30) were selected. We then analyzed the full insurance claims data for dental care. Age, sex, sedative use, and dental treatment of patients were analyzed yearly. In addition, the number of cases of GA or SED per year was analyzed, and changes in behavioral management methods with increasing age were investigated. Results: Between January 2007 and September 2019, a total of 4,383 (male, 1,454; female, 2,929) patients with dementia received dental treatment under SED or GA. The total number of SED and GA cases were 1,515 (male, 528 ; female, 987 ) and 3,396 (male, 1,119 ; female, 2,277) cases, respectively. The total number of cases of dental treatment for 4,383 patients with dementia was 153,051 cases, of which 2.22% were under GA and 0.98% were under SED. Midazolam was the most commonly used drug for SED. Conclusion: Although gingivitis and pulpitis were the most common reasons for patients with dementia to visit the dentist, GA or SED for patients with dementia was frequently used in oral and maxillofacial or periodontal surgery.

A Methodological and Reporting Quality Assessment of the Systematic Reviews in the Journal of Korean Obstetrics and Gynecology (대한한방부인과학회지에 게재된 체계적 문헌고찰의 방법론 및 보고의 질 평가)

  • Seo, Ji-Hye;Kang, So-Hyeon;Hur, Da-Hee;Lee, Dong-Nyung;Kim, Hyeong-Jun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.2
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    • pp.108-123
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    • 2021
  • Objectives: The purpose of this study is to assess the methodological and reporting quality of the systematic reviews in the Journal of Korean obstetrics and gynecology. Methods: Systematic reviews in the Journal of Korean obstetrics and gynecology were selected from January 1987 to February 2021, by searching Koreanstudies Information Service System (KISS) and the search system of the Society of Korean medicine obstetrics and gynecology. The methodological and reporting quality was assessed using A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2) tool and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Results: Total of 19 systematic reviews were finally included for this study. The levels of methodological quality were low in 63.2% and very low in 36.8%. As a result of evaluating the reporting quality, 22 to 15 (average 18.6) items out of 27 items (81.5 to 55.6%) were reported. Conclusions: The results of a systematic review are helpful in giving a high level of evidence. In order to improve the quality of systematic reviews published in the Journal of Korean Obstetrics and Gynecology, it is necessary to perform and report according to the the PRISMA checklist and AMSTAR 2.

A Study on complex Differences of Community Spirits and Tourism Development Supports based on Segemented Groups of Residents' Attitude of Tourism Development (지역주민의 관광개발태도에 따른 공동체 의식과 관광개발 지지도 복합차이연구)

  • Song, Rae Heun;Yoon, Yoo Shik
    • Korea Science and Art Forum
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    • v.37 no.3
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    • pp.213-224
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    • 2019
  • This study was to investigate if there are any segmented groups of residents' attitude toward tourism development and also to examin if there are significant differences among such segmented groups in terms of community spirits and touridms development supports. From the literature review, the survey questionaries was developed and a total of 358 useful sample were collected and analyzed in SPSS. The results from cluster and MANOVA showed that there are some significant differences among the segmented groups. the higher residents have positive attitude toward tourism development the stronger residents have community spirits and tourism development support, More insight implication and discussion was provide in conclusion.

The Severity of COVID-19 in Patients with Nonalcoholic Fatty Liver Disease in Korea

  • Park, Hyeki;Joe, Hyun
    • Health Policy and Management
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    • v.31 no.4
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    • pp.472-478
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    • 2021
  • Background: Early identification of patients who are highly likely to develop severe illness among confirmed cases of coronavirus disease 19 (COVID-19) can be expected to lead to effective treatment. This study therefore aimed to determine whether the presence of nonalcoholic fatty liver disease (NAFLD) has an impact on the exacerbation of COVID-19 symptoms. Methods: The study used the Korean National Health Insurance claim data for treatment of COVID-19 patients in 2020. NAFLD includes nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). The outcome variables used were hospitalization and the use of medical devices. Hospitalization was defined by a length of stay exceeding one day and the use of medical devices was defined as one or more uses of a ventilator or extracorporeal membrane oxygenation. Multivariable logistic regression analysis was performed to determine if there was a difference in the hospitalization and use of medical devices of COVID-19 patients depending on the presence of NAFLD. Results: The odds ratio of hospitalization was 1.059, indicating slightly higher odds of hospitalization for patients with NAFL or NASH compared to those without the conditions, but it was not statistically significant (0.969-1.156). On the other hand, the odds ratio of use of medical devices was high at 1.667 and was statistically significant (1.111-2.501). Conclusion: The study results found NAFLD to be a risk factor that can exacerbate symptoms in COVID-19 patients. Accordingly, it is necessary to identify NAFLD patients through preemptive screening and provide them with appropriate treatments.