• Journal of Preventive Medicine and Public Health
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• v.41 no.5
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• pp.287-294
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• 2008

Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.37-43
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• 2016

Background: While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. Methods: After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected. Results: The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040-an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309-an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario. Conclusion: Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time, effort, and resources; therefore, by analyzing the various factors affecting the supply of cardiovascular surgeons, an active intervention of policies can be prescribed for the areas that have failed to meet the appropriate market distributions.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.8
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• pp.513-523
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• 2018

This study was to examine the effects of depression, avoidance coping and quality of life on suicidal ideation of elders living at home. A descriptive survey study was conducted with a survey of 509 older people in person 50 senior center at G city from November 30, 2017 to 1. The data were analyzed with t-test, ANOVA, Pearson's correlation coefficients and stepwise multiple regression using IBM SPSS WIN 24.0 program. The mean score of the was depression $8.50{\pm}3.51$, avoidance coping style $12.36{\pm}3.41$, quality of life $7.26{\pm}1.97$ and suicidal ideation $6.16{\pm}1.78$. Suicidal ideation was had a negative correlation with Depression(r=-.219, p<.001) and a positive correlation with avoidance coping style(r=.277, p<.001). The result of the regression indicated that depression, avoidance coping style and gender explained 12.1% of variance in suicidal ideation. The results suggest that depression, avoidance coping style and gender were associated with suicidal ideation. Therefore it is necessary to develop strategies to reduce the depression, avoidance coping style and improve quality of life for community dwelling elders to reduce suicidal ideation.

• Environmental Analysis Health and Toxicology
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• v.30
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• pp.2.1-2.9
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• 2015

Objectives This study aimed to evaluate the association between presence of depression symptoms and the exposure level to insecticides among aged population in rural area, determined via measured levels of urinary 3-phenoxybenzoic acid (3-PBA), after controlling for socioeconomic confounding factors. Methods Using a cross-sectional study design, we randomly recruited participants for our study (161 male and 239 female) from rural areas of Asan, Chungnam, Korea. Environmental risk factor exposure was assessed using a questionnaire, and gas chromatography-mass spectrometry was used to analyze urinary 3-PBA levels. We used a logistic regression analysis to assess the association of urinary 3-PBA levels with the presence of self-reported depression symptoms. Results After controlling for creatinine levels, the median (interquartile range) concentration of 3-PBA was approximately 1.5 times (p<0.05) higher among female (1.54 [0.90 to 2.35]) ${\mu}g/g$) than among male (1.06 [0.64 to 1.81] ${\mu}g/g$). Our study found that among female participants, the unit increase in 3-PBA levels exhibited a likely positive association (odds ratio, 1.12; 95% confidence interval, 1.00 to 1.25) with an increased risk of presence of self-reported depression symptoms, after adjusting for socioeconomic insurance type, daily physical condition, marital status, smoking status, and age. Conclusions Given our finding of a potential association between the presence of self-reported depression symptoms and 3-PBA levels, precautions should be considered to minimize exposure to insecticides and thus protect the health of aged residents in rural areas.

• The Journal of the Korea Contents Association
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• v.20 no.10
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• pp.308-325
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• 2020

This study examines factual facilites safety of long-term care facilities for eldery, for improvement of Korean policy. So, This study reviewed policies of facilites safety of long-term care facilities on main OECD countries. We analyzed factual survey of facilites safety of long-term care facilities in Seoul metropolitan area. The results of the study were as follows: First, There were differences of law and rule of facilites safety of long-term care facilities in comparison with those of social welfare facilities, child day-care center, hospital. Second, it was the result of location condition analysis. Long-term care facilities in the Seoul metropolitan area were located on more than six floors of buildings. The location conditions of private facilities are weak compared to those of corporations and local governments. Third, there were the result of internal structure of facilities. Overall, the placement status was insufficient. For instance, there are smokeproof masks/fireproof blankets, smoke windows(fire safety windows), smoke smothering. In addition, there were places where legal essential installation structures were insufficient. Private facilities were generally insufficient in facility structures compared to those of local governments and welfare corporations. Fourth, there were the result of safety management. It was confirmed that private facilities were insufficient compared to local government facilities. For instance, there are safety management analysis, response manuals, fire preparedness training, etc. Finally, implications and future directions policies of facilites safety of long-term care facilities were discussed based on the finding of the study.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.6
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• pp.3751-3758
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• 2014

This study was designed to evaluate the effects of arthritis and comorbid chronic conditions on the health-related quality of life (HRQoL) in the Korean older population. The study subjects were 2,708 Korean adults aged 65 and older from the $3^{rd}$ Korea National Health and Nutrition Examination Surveys data: 1,357 persons with a single chronic condition, such as arthritis, herniations of the intervertebral disc, osteoporosis, asthma, peptic ulcers, stroke, or cataract; 886 persons with arthritis and a second chronic condition described above; and 465 persons with no chronic condition. An analysis of covariance was performed to compare the EQ-5D index among the groups. The effects of arthritis, second chronic condition and their interactions were analyzed by multiple linear regression analysis. The results are as follows. Compared to men with arthritis only, men with stroke only, stroke and arthritis, or cataract and arthritis had a lower age adjusted EQ-5D index. Women with a stroke only, asthma only, cataract only, osteoporosis and arthritis, peptic ulcer and arthritis, stroke and arthritis, or cataract and arthritis had a lower age adjusted EQ-5D index than women with arthritis only. Arthritis and comorbid conditions had additive effects on the HRQol in both genders except for arthritis and stroke in women. In conclusion, comorbid chronic medical conditions in older people with arthritis may reduce the HRQoL in an additive manner.

• Journal of Korean Academy of Nursing
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• v.30 no.1
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• pp.98-109
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• 2000

The purpose of this study was to identify the effect on improvement of the Activity of Daily Living (ADL) and decrease the cognitive function and agitation behaviors by reminiscence with audio-visual stimulation for senile dementia. The quasi-experimental design was used in this study. Subjects were 26 with mild senile dementia who were cared for at a Day Care Center for Dementia in Seoul. The data were collected from March to July, 1999. Subjects were divided into three groups : Control Igroup with 10 subjects, reminiscence group(Control II group with 8 subjects), and reminiscence with audio-visual stimulation group(experimental group with 8 subjects). The Control I group got routine care as usual. Control II group participated in reminiscence sessions for one hour a day, five times a week , for a period of 4 weeks. The experimental group participated in reminiscence with audio-visual stimulation sessions for one hour a day, five times a week, for a period of 4 weeks. Instruments of this study were color photography with sound that was developed through an open questionnaire about events, objects, humans in action and animals that 100 Korean elderly over 60 would like to memorize. This was referred from the Sensory Stimuli Package by Namazi and Haynes(1994). The effects of treatment was evaluated through MMSE-K by Kwon & Park(1989). Also the Brief Cognitive Rating Scale(BCRS) by Reisberg et al(1983) for the cognitive function, through Agitation Inventory by Cohen- Mansfield and Colleague(1989) for behavioral response and through the Rapid Disability Rating Scale-2(RDRS-2) by Linn & Linn(1982) for the activity of daily living respectively. Data analysis was done using SPSS for $\chi$2- test, ANOVA, repeated measures ANOVA. The results were as follows : 1. Reminiscence with audio-visual stimulation did not improve cognitive function for senile dementia, but significantly improved verbal expression, the subscale of cognitive function. 2. Reminiscence with audio-visual stimulation reduced agitation behavior of experimental group significantly, but there was no significant difference between groups. 3. Reminiscence with audio-visual stimulation did not significantly effect the activity of daily living after treatment. In conclusion, it was shown that the reminiscence with audio-visual stimulation was an effective therapy to improve verbal expression and to reduce agitation behaviors of senile dementia. Further research with more indepth approach is needed, considering characteristic and level individualized for each senile dementia.

• Journal of Home Health Care Nursing
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• v.8 no.2
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• pp.121-134
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• 2001

The purpose of this study were to analyze the home care services and to evaluate the client's satisfaction with the home care services provided by home care service center in the C hospital. The data were collected by reviewing charts of 128 home care clients who were receiving home care services at C hospital from October 1997 to September 2000. The subjects for satisfaction of home care service were 20 clients from July 10 to September 30, 2000. The tool for measurement of present condition of home care service was developed by the researchers. The satisfactions of the home care services were measured by using the instrument developed by Im(997). The data were analyzed by using the SPSS/PC+. The results of this study were as followings : 1. Majority of the subjects was female(61.7%). The average of age was 63.5 years. The service has been used mostly by the elderly 60 years of age or older(71.1%). The economic level of most of subjects was in middle class(94.5%). 2. Majority of the subject had a cancer(55.4%), following stroke(25.0%). The average duration of disease for the subjects was 31 months. The average time of hospitalization for the subjects was 3.3 times. The duration of hospitalization was 10$\sim$30 days(26.6%), 30$\sim$60 days(23.4%) and above of the 210 days(9.4%). 3. Most of the subjects used his/her doctor (47.7%), as a consultant, following his/her nurse (28.1%), other patients or their family (21.9%). Most of reasons for a consultation were supportive management(Infusion or medication, 60.94%), following tube management(L-tube or T-tube, 25%), Foley catheter management (15.63%) etc. 4. 28 types of nursing diagnoses were used by the home care service. The nursing diagnosis altered nutrition: less than body requirement were used mostly by the home care service, following risk for infection, impaired skin integrity, impaired swallowing, ineffective airway clearance altered comfort: pain, impaired physical mobility. By the human-response pattern, exchanging(63.2%), moving(7.5%), feeling(10.4%), knowing(5.2%), communicating (2.6%), relating(0.5%) perceiving(0.4%) and choosing(0.3%). There were 42 nursing intervention types were performed by the home care service. By the NIC(nursing intervention classification. McCloskey. Bulech. 1996). physiologic: complex (30.3%) was the most, safety(28.3%), behavioral(20.0%), physiologic: basic(10.8%) and health system(1.7%). Observation or assessment was the most nursing intervention performed by the home care service. following IV infusion. vital sign observation. infusion management and fluid-electrolyte balance management. 5. The level of client's satisfaction with provided home care services showed considerably high(2.67/ 3).

• Korean Journal of Clinical Pharmacy
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• v.22 no.4
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• pp.304-315
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• 2012

Today, suicide by self-poisoning of prescribed or non-prescribed drugs on purpose has been increasing and is a major cause of mortality. It is very important to treat promptly and properly for saving the lives from those suicides. There is neither an organization such as poison control center nor measurement in S. Korea, though. The object of this study was to evaluate information of frequently used substances for suicide attempt in S. Korea. Our results also can provide healthcare provider including pharmacists and doctors, etc and contribute to increasing health and welfare for Korean. From June $1^{st}$ 2006 to April $30^{th}$ 2012, we retrospectively studied patients visiting emergency room due to suicide attempt. We collected information of underlying disease, history of past medical condition and suicide attempt, ingredient and getting route of ingesting substances, emergency treatment, and outcome by reviewing electronic medical record. We also evaluated actual treatment of self-poisoning and made guide information about antidote medication for S. Korean healthcare provider. Among total 242 cases of suicidal attempts, cases ingesting substances including prescription, non-prescription drugs and agricultural chemicals were 86.4%. The most frequently used drugs for suicide attempt were sedatives-hypnotics (53.6%), followed by analgesics (16.7%) and antidepressants (12.4%). Analgesics including acetaminophen and aspirin were most in teenagers but sedatives-hypnotics including benzodiazepines, non-benzodiazepine (zolpidem) and antihistamine were most in other ages including elderly people. Most frequently used antidote was activated charcoal (62.7%) and specific antidotes for some substances (acetaminophen, aspirin, agricultural chemicals) were also treated properly, accompanying with medication for supportive care. In conclusion, the most used substances for suicide attempt were sedatives-hypnotics and treatments for self-poisoning in emergency room were appropriate based on existing references. Therefore, information of frequently used substances and antidote reflecting these results will be useful for South Korean healthcare provider.

• 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.