• 보건행정학회지
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• 제29권3호
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• pp.342-356
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• 2019

Background: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization. Methods: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data. Results: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014. Conclusion: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.

• 한국콘텐츠학회논문지
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• 제19권1호
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• pp.339-349
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• 2019

본 연구는 노인가구 노인의 삶의 만족도 변화에 미치는 영향 요인을 분석하는데 연구 목적이 있다. 연구를 위해 노인 1인가구와 노인 부부가구를 노인 가구라고 정의하여, 한국고용정보원이 제공하고 있는 고령화 연구패널자료(Korean Longitudinal Survey of Ageing: KLoSA)의 2, 3, 4차 자료를 활용 했으며, 65세 이상 3차시 모두 설문에 응답한 677명을 최종 분석대상으로 활용하였다. 노인가구의 삶의 만족도 수준의 종단적 연구에서 시간이 지날수록 개인별 만족도 수준이 낮아지고 있음을 확인하였고, 잠재성장모형의 조건부 모형을 통해 노인가구의 삶의 만족도 수준의 종단 변화에 영향을 미치는 요인을 분석하였다. 분석 결과, 가구유형, 주택소유유무, 주관적 건강상태 등이 노인가구의 삶의 만족도 초기값에 영향을 미치는 것으로 나타났으며, 가구유형, 생활수준 기대감 등이 노인가구의 삶의 만족도 변화율에 영향을 미치는 요인으로 나타났다. 이러한 연구 결과를 통해 노인가구의 자아실현 기회를 높여 노년 시대의 삶의 만족도 향상이 필요하며, 정책적 접근에 있어 다양한 유형을 고려한 선별적 접근이 필요함 등을 제언하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5077-5083
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• 2013

Background: Breast cancer is the most frequent cancer in women globally and represents the second leading cause of cancer death among women (after lung cancer). India is going through epidemiologic transition. It is reported that the incidence of breast cancer is rising rapidly as a result of changes in reproductive risk factors, dietary habits and increasing life expectancy, acting in concert with genetic factors. Materials and Methods: In order to understand the existing epidemiological correlates of breast cancer in South India, a systematic review of evidence available on epidemiologic correlates of breast cancer addressing incidence, prevalence, and associated factors like age, reproductive factors, cultural and religious factors was performed with specific focus on screening procedures in southern India. Results: An increase in breast cancer incidence due to various modifiable risk factors was noted, especially in women over 40 years of age, with late stage of presentation, lack of awareness about screening, costs, fear and stigma associated with the disease serving as major barriers for early presentation. Conclusions: Educational strategies should be aimed at modifying the life style, early planning of pregnancy, promoting breast feeding and physical activity. It is very important to obtain reliable data for planning policies, decision-making and setting up the priorities.

• Journal of Preventive Medicine and Public Health
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• 제33권2호
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• pp.231-238
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• 2000

Objective : To estimate the burden of diseases in Korea especially caused by major cancers using the YLL(years of life lost due to premature death) measurement. Methods : First, we determined the parameters: such as age-specific standard life expectancy, age on death, sex, cause of death by analyzing the national death certificate data and life table collected during 1996 provided by the National Statistical Office. Secondly, we estimated the age group-specific YLL by employing standard expected years of life lost(SEYLL). Thirdly, final burden of disease due to premature death was estimated by using YLLs measurement which developed by global burden of disease study group. Results : The burden of premature death by cancer for male was attributed mainly to liver cancer(514.5 person-year), stomach cancer(436.4 person-year), and lung cancer(367.7 person-year). Each of these cancers was responsible for the loss of over 100 person-year based on our YLL measurement. The burden of premature death by cancer for female was attributed mainly to liver cancer(135.1 person-year), stomach cancer(252.1 person-year), and lung cancer(121.8 person-year). Each of these cancers was responsible for the loss of over 100 person year based on our YLL measurement. Conclusion : We found the YLL method employed in this study was appropriate to quantify the burden of premature death. Thereby, it would provide a rational bases to plan a national health policy regarding premature death caused by cancer.

• International Journal of Human Ecology
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• 제6권1호
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• pp.1-16
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• 2005

Due to increasing life expectancy, Americans live nearly 20 years after retirement. During this period, elderly persons have to stretch finances to manage the level of living without earnings. However, decision making ability decreases with age. One coping strategy for this problem would be seeking help from others. We examine factors affecting elderly persons' assistance use with respect to financial management using the 2000 Health and Retirement Study (N=3,823). It was found that age, education, health status, and ethnicity significantly affect elderly persons' financial management assistance use. The older-olds, those with lower educational attainment and poorer health status were more likely to use financial management assistance. However, Hispanic elderly were less likely to use financial management assistance.

• Journal of Preventive Medicine and Public Health
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• 제34권3호
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• pp.191-199
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• 2001

Objective : In this study, we focused on estimating the burden of premature death in Korea caused by smoking using the YLL(years of life lost due to premature death) measurement. Methods : First, we determined parameters: such as age-specific standard life expectancy, age on death, sex, and cause of death by analyzing the national death certificate data and life table collected during 1997. These were provided by the National Statistical Office. Secondly, we estimated the age group- specific years of life lost due to premature death by employing the standard expected years of life lost(SEYLL) measurement. Thirdly, the burden of premature death caused by smoking was estimated using the YLLs measurement which was developed by the global burden of disease study group. Fourthly, We calculated the risk related to smoking using the population attributable risk. Results : The following results were obtained in this study: 1) Premature death that is attributable to smoking in males could be prevented in 60.9%(513,582 person-year) by non-smoking. 2) The burden of premature death by smoking for female was prevented to 17.7%(513,582 person-year) by non-smoking. Conclusion : We found that the YLL method employed in this study was appropriate in quantifying the burden of premature death. This provides a rational basis for planning a national health policy regarding premature deaths caused by smoking and other related risk factors.

• Journal of Preventive Medicine and Public Health
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• 제34권4호
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• pp.354-362
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• 2001

Objectives : The aim of this study was to estimate the burden of disease through an analysis of Years of Life Lost due to premature deaths, one component of the Disability-Adjusted Life years (DALY). In addition, the cause of death statistics were adjusted to improve validity, and the results were compared with those of the Global Burden of Disease (GBD). Methods : In closely fellowing the approach taken in the original GBD study, most of the explicit assumptions and the value judgments were not changed. However, the statistics for some problematic concerns such as deaths of infants or those due to senility, were adjusted. Deaths, standard expected years of life lost (SEYLL), and potential years of life lost (PYLL) were computed using vital registration data compiled by the National Statistical Office. Results : The burden for males is 1.8 and 2.3 times higher than that for females, according to SEYLL and PYLL, respectively. The proportions of deaths due to Group I, II, and III causes are 5.4%, 80.4%, and 14.3%, respectively, for PYLL, but in a major shift from Group II to III they are 6.3%, 66.2%, and 27.5%, respectively, for SEYLL. The proportion of Group III causes in Korea, 27.5%, is extremely high when compared to 10.1% for the world, 7.6% for developed countries, and 10.7% for developing countries. Conclusions : Estimation results showed that the total burden due to premature deaths is smaller than that for the entire world but larger than that for developed countries. The disease structure of Korea has changed to resemble that of developed countries. Also, an overly large portion of the total burden in Korea stems from injuries arising from car accidents.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1845-1850
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• 2015

Background: Cancer is recently one of the major concerns of the public health both in the world and Iran. To inform priorities for cancer control, this study estimated years of potential life lost (YPLL) and productivity losses due to cancer-related premature mortality in Iran in 2012. Materials and Methods: The number of cancer deaths by sex for all cancers and the ten leading causes of cancer deaths in Iran in 2012 were obtained from the GLOBOCAN database. The life expectancy method and the human capital approach were used to estimate the YPLL and the value of productivity lost due to cancer-related premature mortality. Results: There were 53,350 cancer-related deaths in Iran. We estimated that these cancer deaths resulted in 1,112,680 YPLL in total, 563,332 (50.6%) in males and 549,348 (49.4%) in females. The top 10 ranked cancers accounted for 75% of total death and 70% of total YPLL in the males and 69% for both death and YPLL in the females. The largest contributors for YPLL in the two genders were stomach and breast cancers, respectively. The total cost of lost productivity due to cancer-related premature mortality discounted at 3% rate in Iran, was US$ 1.93 billion. The most costly cancer for the males was stomach, while for the females it was breast cancer. The percentage of the total costs that were attributable to the top 10 cancers was 67% in the males and 71% in the females. Conclusions: The YPLL and productivity losses due to cancer-related premature mortality are substantial in Iran. Setting resource allocation priorities to cancers that occur in younger working-age individuals (such as brain and central nervous system) and/or cancers with high incidence and mortality rates (such as stomach and breast) could potentially decrease the productivity losses and the YPLL to a great extent in Iran.

• 보건행정학회지
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• 제21권4호
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• pp.511-526
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• 2011

This study aims at surveying how Koreans look upon and prepare for the age of longevity("age of 100 years") drawing near at hand, analyzing factors affecting such a perception and behavior. To this end, a telephone survey was launched for 1200 persons sampled to evenly comprise the young, middle-aged, and elderly groups. Our findings indicate that more Koreans looked upon the upcoming "age of 100 years" as a 'disaster' rather than a 'blessing.' The sense of combined uneasiness over the aged life being further elongated while they are unprepared for it, anxiety over maintaining health and so forth came into play. However, the better a person is prepared by way of health management, savings for retirement, preparation for leisure activities and employment for the later life, the more positively he or she looked upon the "age of 100 years". An analysis by group indicates that women rather than men, the elderly rather than the young, the less educated rather than the highly educated, the low-income bracket rather than the high-income bracket looked upon the "age of 100 years" more negatively. Under such circumstances, it is suggested that the nation's social system tailored to a life expectancy of 80 years should be readjusted, tailored to a 'longevity paradigm' and that to this end social systems should be reoriented toward the direction where 'healthy aging' and 'active aging' are fully supported.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2131-2136
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• 2016

Background: Cancer is currently one of the main public health problems all over the world and its economic burden is substantial both for health systems and for society as a whole. To inform priorities for cancer control, we here estimated years of potential life lost (YPLL) and productivity losses due to cancer-related premature mortality in Iran from 2006 to 2010. Materials and Methods: The number of cancer deaths by sex and age groups for top ten leading cancers in Iran were obtained from the Ministry of Health and Medical Education. To estimate the YPLL and the cost of productivity loss due to cancer-related premature mortality, the life expectancy method and the human capital approach were used, respectively. Results: There were 138,228 cancer-related deaths in Iran (without Tehran province) of which 76 % (106,954) were attributable to the top 10 ranked cancers. Some 63 % of total cancer-related deaths were of males. The top 10 ranked cancers resulted in 106,766,942 YPLL in total, 64,171,529 (60 %) in males and 42,595,412 (40%) in females. The estimated YPPLL due to top 10 ranked cancers was 58,581,737 during the period studied of which 32,214,524 (54%) was accounted for in males. The total cost of lost productivity caused by premature deaths because of top 10 cancers was 1.68 billion dollars (US$) from 2006 to 2010, ranging from 251 million dollars in 2006 to 283 million dollars in 2010. Conclusions: This study showed that the economic burden of premature mortality attributable to cancer is significant for Iranian society. The findings provide useful information about the economic impact of cancer for health system policy/decision makers and should facilitate planning of preventive intervention and effective resource allocation.