• 제목/요약/키워드: health outcome

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Adjusting for Confounders in Outcome Studies Using the Korea National Health Insurance Claim Database: A Review of Methods and Applications

  • Seung Jin Han;Kyoung Hoon Kim
    • Journal of Preventive Medicine and Public Health
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    • 제57권1호
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    • pp.1-7
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    • 2024
  • Objectives: Adjusting for potential confounders is crucial for producing valuable evidence in outcome studies. Although numerous studies have been published using the Korea National Health Insurance Claim Database, no study has critically reviewed the methods used to adjust for confounders. This study aimed to review these studies and suggest methods and applications to adjust for confounders. Methods: We conducted a literature search of electronic databases, including PubMed and Embase, from January 1, 2021 to December 31, 2022. In total, 278 studies were retrieved. Eligibility criteria were published in English and outcome studies. A literature search and article screening were independently performed by 2 authors and finally, 173 of 278 studies were included. Results: Thirty-nine studies used matching at the study design stage, and 171 adjusted for confounders using regression analysis or propensity scores at the analysis stage. Of these, 125 conducted regression analyses based on the study questions. Propensity score matching was the most common method involving propensity scores. A total of 171 studies included age and/or sex as confounders. Comorbidities and healthcare utilization, including medications and procedures, were used as confounders in 146 and 82 studies, respectively. Conclusions: This is the first review to address the methods and applications used to adjust for confounders in recently published studies. Our results indicate that all studies adjusted for confounders with appropriate study designs and statistical methodologies; however, a thorough understanding and careful application of confounding variables are required to avoid erroneous results.

영유아 영양의 제요인이 질병이환에 미치는 영향 (The Effect of Several Factors in Infant Nutrition on Disease Affection)

  • 장혜순
    • 한국식품영양과학회지
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    • 제23권5호
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    • pp.757-766
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    • 1994
  • The survey was conducted to investigate several factors affecting the disease outcome with 116 infants aged 10 to 24 months residing in Kunsan city, Cheonbuk province . General characteristics, weaning practice , nutrient intake and the actual state for affecting disease were studied. Among many factors, mother's educational status was found to be the most influencing factor for affecting the disease outcome analyzed by oneway ANOVA. The exposure index disease, cold and diarrrhea, against mother's education were analyzed to find out the major factors for disease outcome. The education group up to middle school graduates, mother's job , nutrients supplements, feeding method, sex of baby were the factors, for the high school graduates, job , nutrients supplements were the causes, and the group graduated from the college the above grade mother's health state was the most important factor for the baby exposing to the disease. The disease outcome decreased when the bottle feeding was replaced by breast feeding, sufficient nutrients supplementation was recommended , and health care for mother during pregnancy was strongly advised.

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간호시뮬레이션 실습교육이 간호대학생의 학습성과와 수업경험에 미치는 효과 (Effects of Nursing Simulation-Based Practice Education on Learning Outcome and Classes Experience in Nursing Students)

  • 한영인
    • 보건의료산업학회지
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    • 제8권1호
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    • pp.135-150
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    • 2014
  • The purpose of this study was to identify the effects of nursing simulation-based practice education on learning outcome and teaching experience in nursing students. Pretest-posttest design with nonequivalent control group was utilized to analyze the effects of nursing simulation-based practice education. The subjects were 96 students of a nursing college. All subjects participated in 6 week. The data were analyzed by the SPSS win 17.0 program. The results were as follows; There were statistically significant differences in learning outcome and teaching experience effects of nursing simulation-based practice education in nursing students. In conclusion, we required nursing simulation-based practice education and small group discussion analysis of factors are associated with goal-setting skills and self-presentation skills, goal setting skills. We required nursing simulation-based practice education training to strengthen the ability of self-directed learning program utilizing the repeated study.

족부족관절 분야의 환자 자가 보고 결과 평가법 (Patient-Reported Outcome Measures of the Foot and Ankle)

  • 김지연;김범수
    • 대한족부족관절학회지
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    • 제26권1호
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    • pp.1-8
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    • 2022
  • The patient-reported outcome measures (PROMs) are important in assessing the patient's overall health, lesion-specific outcomes, and condition-specific outcomes. PROMs are also known as "scoring systems" and are usually in questionnaires. There are almost a hundred different PROMs available in foot and ankle surgery. Each PROM has its merits, demerits, and validity. Selecting an appropriate PROM is important for adequately evaluating a patient's health status. This article summarizes the most frequently used PROMs in the literature on foot and ankle surgery and presents the authors' recommendations.

뇌졸중으로 인한 운동 관련 후유증의 한의 치료 연구에서 뇌졸중 시기 및 평가 척도에 대한 국내 문헌 고찰 (A Review of the Stroke Stage and Outcome Measures in Stroke Motor Sequelae Clinical Studies in Korea)

  • 이지은;천세은;전민결;신용진;임정태;신선호
    • 대한한방내과학회지
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    • 제43권4호
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    • pp.656-679
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    • 2022
  • Objectives: The aims of this study were to evaluate the fidelity of stroke stage reporting, the timeliness of the outcome measures, and the use of the core outcome set. Methods: We searched the literature using 6 domestic databases. We selected studies that used Korean medicine interventions and targeted stroke patients with motor sequelae. We examined whether the included studies reported the stroke stage and whether they used the outcome measures in the appropriate period based on the recommendations of the "Stroke Evidence Database to Guide Effectiveness". We also confirmed the use of the essential assessment tools suggested by the core outcome set. Results: Overall, 77 studies were finally selected, with 16 (21%), 55 (71%), and 6 (8%) published on the acute, subacute, and chronic phases, respectively. Only 11 of the studies directly mentioned the stroke stage. The most commonly used assessments were the National Institutes of Health Stroke Scale, Modified Barthel Index, and Manual Muscle Testing. Only 5 studies failed to apply the stage-related outcome measures at the recommended period. The outcome variables used inadequately were the National Institutes of Health Stroke Scale, Functional Ambulation Categories, 36-Item Short Form Health Survey, and Mini-Mental State Examination. Among the core outcome set items, some studies used liver and renal function tests, but no herbal medicine safety reporting was conducted. Conclusions: In future studies, we propose to ensure accurate reporting of the stroke stage with reliable outcome measures to deliver better clinical and research outcomes. Furthermore, in future clinical studies on stroke, a standard protocol that reflects the core outcome set should be developed.

지역사회치위생학 현장(보건소)실습 성과평가 내용분석 (Contents analysis of the community dental hygiene practice outcome evaluation)

  • 이가영;한양금;김영경;임현주;권양옥;김한미;박정란;김남희
    • 한국치위생학회지
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    • 제16권1호
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    • pp.37-43
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    • 2016
  • Objectives: The purpose of the study is to evaluate the contents analysis of the community dental hygiene practice in the dental hygiene students and suggest the outcome based evaluation index of community dental hygiene practice. This study will provide the basic data for the community nursing and social welfare practice. Methods: A self-reported questionnaire was completed by 82 dental hygiene professors and 254 dental hygienists in community health centers after receiving informed consent based on institutional review board from 5th Dec 2014 to 30th Jul 2015. A total of 49 professors and 134 dental hygienists gave the complete answers. The study instrument was adapted from the literature review. The questionnaire consisted of evaluation, purpose of evaluation, and evaluation format. Data were analyzed using SPSS 20.0 program. The contents analysis was carried out through input, process, output, and outcome. Results: The practice outcome evaluation was conducted in 62.9% of the dental hygiene departments and 32.9% of the community health centers. Most of the dental hygiene professors chose "To know what students learned(27.3%)" and "To ensure student's role and behavior in practice(27.3%)." as the purpose of evaluation. The public dental hygienists chose "To score the practice grade(42.1%)." The evaluation method was done anonymously. Conclusions: The outcome based evaluation in community dental hygiene practice was the best method to evaluate the practice education for the competency of the dental hygiene students.

50대 이상 장노년층의 구강건강 관련 삶의 질과 구강 건강 결과의 관련성 (Association between Oral Health Related Quality of Life(OHQoL) and Oral Health Outcome in Adults over 50 Years Old)

  • 조영식;임순연;황혜림
    • 치위생과학회지
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    • 제11권4호
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    • pp.305-310
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    • 2011
  • 50대 이상 장 노년층 성인들의 구강건강 관련 삶의 질(Oral-health related quality of life, OHRQoL)과 건강 결과(health outcome)의 관련성을 평가하기 위해 148명을 편의추출하여 구강검사와 면접조사를 통해 OHIP-14(Oral health impact profile-14)와 인지 건강 및 구강건강 상태를 측정하고, 독립표본 t 검정, 일원분산분석, 교차분석, 상관분석 등을 실시한 결과 다음과 같은 결론을 얻었다. 1. OHIP-14의 모든 문항에 대해 조사 대상자 중 9.5%가 전혀 문제나 불편감을 느끼지 않는다고 응답하였으며, 가장 문제를 많이 느끼는 차원은 '신체적 통증'(69,8%)과 '심리적 불편감'(63.5%)으로 나타났다. 2. 평가 구강건강 상태에 따른 구강건강 관련 삶의 질 수준을 비교한 결과 우식경험치아수, 잔존치아수에 따라 유의한 차이가 나타났으나(p=0.045), 치주상태와 틀니사용여부에 따른 차이는 나타나지 않았다. 3. 조사 대상자의 43.9%(N=65)가 자신이 '건강하지 않다'고 느끼고 있으며, 43.9%(N=65)가 자신의 구강건강상태가 '나쁘다'고 생각하고 있고, 54.7%(N=81)가 자신의 구강건강상태에 대해 '만족하지 않는다'고 응답했다. 4. 조사 대상자가 느끼는 인지 건강상태에 따른 구강건강 관련 삶의 질을 비교한 결과 인지 건강상태, 인지 구강건강상태, 구강건강 만족도에 따라 유의한 차이가 나타났다(p<0.001). 5. 조사 대상자의 인지 건강상태와 OHIP-14 점수는 유의한 상관관계가 있으나(r=0.326, p<0.01), 인지 건강상태와 우식경험치아수, 잔존치아수의 상관관계는 통계적으로 유의하지 않았다.

건강식당사업 효과평가를 위한 조사지 개발 (Developing a Questionnaire to Evaluate the Healthy Restaurant Program)

  • 홍경의;정효지
    • Journal of Nutrition and Health
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    • 제44권6호
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    • pp.562-576
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    • 2011
  • The purpose of this study was to develop a reliable questionnaire to assess the effectiveness of the healthy restaurant program, which was implemented by Seocho-gu District in Seoul. Evaluation indices were deduced from the logic model of the healthy restaurant program. The questionnaires consisted of three sections (process evaluation, outcome evaluation, and general characteristics) for restaurateurs and customers who were participating in the program or not. To validate the questionnaire, 133 restaurateurs and 246 customers were sampled using convenient methods. Data were collected by interviews. Reliability was tested by Cronbach's alpha coefficient. The alpha coefficient for restaurateurs was 0.75-0.99 for the process and 0.79-0.97 for the outcome evaluation questions. The alpha coefficients for customers were 0.76-0.92 for the outcome evaluation questions. Face and content validity were examined for all questions, and construct validity was tested for latent variables. We are confident that more accurate and significant information will be collected using this questionnaire.

간호결과 분류체계의 타당성 검증 - 지역사회 간호결과를 중심으로 - (Validation of the Nursing Outcomes Classification (NOC) to Nursing in Korea)

  • 이은주
    • 지역사회간호학회지
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    • 제13권3호
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    • pp.523-531
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    • 2002
  • Purpose: The purpose of this study was to assess the importance and sensitivity to nursing interventions of six sensitive nursing outcomes selected from the Nursing Outcomes Classification. The outcomes in this study were Self-Care: Activities of Daily Living, Self-Care: Instrumental Activities of Daily Living, Treatment Behavior: Illness or Injury, Knowledge: Health Promotion, Caregiver Performance: Direct Care, and Caregiver Physical Health. Method: Data were collected from 97 visiting nurses working in public health centers located in a province and a capital city. The Fehring method was used to estimate outcomes and indicators for content validity. Simultaneous multiple regression and stepwise regression were used to evaluate relationships between each outcome and its indicators. Results: Results confirmed the importance and nursing sensitivity of the outcomes and their indicators. Multiple regression revealed key indicators of each outcome. Self-Care: Instrumental Activity of Daily Living needed to be revised. Neither all of the indicators nor the indicators showing the highest importance and contribution ratio were selected as independent variables for the stepwise regression model. The R2 of the regression models ranged from 29 to 56% in importance by selected indicators and from 56 to 83% in contribution. Conclusion: Further research is needed for the revision of outcomes and their indicators.

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