• Title/Summary/Keyword: multiple logistic regression

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Differences in Medical Care Utilization Rates of the Disabled and the Non-disabled with Ambulatory Care Sensitive Conditions (외래진료 민감질환 유질환자 중 장애인과 비장애인의 의료이용률 차이)

  • Eun, Sang-Jun;Hong, Jee-Young;Lee, Jin-Yong;Lee, Jin-Seok;Kim, Yong-Ik;Shin, Young-Soo;Kim, Yoon
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.5
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    • pp.411-418
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    • 2006
  • Objectives: The purpose of this study was to determine whether the disabled have worse access to primary care than the non-disabled. Methods: We used the National Disability Registry data and the National Health Insurance data for the calendar year 2003, and we analyzed 807,380 disabled persons who had been registered until December 2001 and we also analyzed 1,614,760 non-disabled persons for nine ambulatory care sensitive conditions (ACSCs). The rates of physician visits and hospitalizations for the patients with ACSCs were compared between the disabled and the nondisabled. Multiple logistic regression analysis was used to evaluate the association between medical care utilization and disability and to assess the association between hospitalization and the number of physician visits while controlling for potential confounders. Results: The numbers of physician visits per 100 patients were $0.78{\sim}0.97$ times lower for the disabled than that for the non-disabled with five of nine ACSCs. The numbers of hospitalizations per 100 patients were $1.16{\sim}1.77$ times higher for the disabled than that for the non-disabled with all the ACSCs. While the ORs of a physician visit for the disabled were significantly lower than that for the non-disabled with all the ACSCs (OR: $0.44{\sim}0.70$), and the ORs of hospitalization for the disabled were significantly higher (OR: $1.16{\sim}1.89$). The lower physician visit group (number of physician visits ${\leq}$1) was more likely to be hospitalized than the higher physician visit group (number of physician visits ${\geq}$2) (OR: $1.69{\sim}19.77$). The effect of the physician visit rate on hospitalization was larger than the effect of disability on hospitalization. Conclusions: The results suggest that the disabled were more likely to be hospitalized for ACSCs due to their lower access to primary care.

A Study on the Weight Length Index and Dental Caries of Elementary School Students (초등학생들의 체중신장지수(WLI)와 치아우식증에 관한 연구)

  • Lee, Sun-Mi;Kim, Song-Chon
    • Journal of Korean society of Dental Hygiene
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    • v.3 no.1
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    • pp.25-43
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    • 2003
  • In Korea, changes in children's diet patterns accelerate their physical growth and development: frequent snacking has been presumed to be a major cause of increasing dental caries. The present study attempts to clarify the relationship between the physical development of growing children and their tooth decay. For this purpose, 632 six-grade children in 4 elementary school located in Urban(Seoul) and Rural(Po-gok, Yang-In) were classified into three groups based on the Weight Length Index(WLI), known to reflect the nutritional conditions of school-age children, and the relationship was analyzed between each group and the variables considered to be related with dental caries. The result is as follows: The average weight and height of the male is $44.88{\pm}10.89$ kg, $148.49{\pm}7.33$ cm and female is $43.35{\pm}9.60$ kg, $149.23{\pm}6.73$ cm, respectively, which are in the similar level with the Korean Physical Standard. The classification of the children by the WLI reveals a relatively high distribution of over-weighted child ren - 212 persons, 335% of the entire population. The DMFT Index was a little high in the rural area(3.15 teeth in urban and 3.31, in rural). Among the groups of children classified by the WLI, the over-weight group have the highest DMFT index(3.69 teeth). The relationship between the frequency of taking in basic nutrients and the DMFT index is also found: the relationship is not evident in case of the foods containing rich calcium, protein, as well as fruits and vegetables. But, in the protein-rich food, higher frequency of its intake means significantly lower DMFT index in the normal-weight group of the urban children. In case of carbohydrate, higher frequency of its intake means significantly higher DMFT index in all the groups of the rural children. The DMFT index has some correlations with the relevant variables: the index has a positive correlation with the frequency of snacking, and a negative correlation with the economic status. That is, the higher the frequency of snacking is, and the lower the economic status is, the higher the DMFT index may be. In the logistic multiple regression analysis conducted with the presence of DMFT as a dependent variable, only the frequency of tooth brushing is turned to be a variable affecting the presence of either decayed, missing, or filled teeth. Based on the above result, the variables affecting the DMFT index are a time spent on eating, frequency of intake of protein and carbohydrate for a week, frequency of snacking, regular dental check-ups, preventive behaviors for oral health(fluoride gargling, tooth brusing after each meal, proper tooth brushing method). These variables have a relationship with the DMFT index, but the degree is somewhat different between the groups classified either by the region or by the WLI. Therefore, appropriate nutrition management should be conducted according to the individual's nutritional conditions when the services like nutritional education are provided based on the closely-examined characteristics of each target group. And, at the same time, oral health education should be strengthened, and its importance should also be emphasized so that people can pay attention to their own oral health.

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Appropriateness of Admissions in the Emergency Room of a Tertiary Hospital (응급실 방문 환자의 입원의 적절성에 영향을 미치는 요인)

  • Cho, Hong-Jun;Lee, Sang-Il
    • Quality Improvement in Health Care
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    • v.2 no.1
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    • pp.58-67
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    • 1995
  • Background: This paper describes an effort to provide baseline informations for appropriate utilization of emergency room in a tertiary hospital. Methods: Authors have evaluated that the admissions in the emergency room were medically necessary by objective criteria, Appropriateness Evaluation Protocol(AEP), for one month in a tertiary hospital. Data were analysed by chi-square test and multiple logistic regression to exmaine statistical significances at the level of 0.05. Results: The prevalence of inappropriate decisions for admission was found to be 47.8%(154/322). Whether the physician decided the patient to admit or not was affected by type of services, number of departments involved, patients' medical condition, route of visit, and a day of the week visited. Level of appropriateness of admission is significantly related to patients' age, type of services, and a day of the week visited. Conclusion: We found that substantial proportion of admissions through emergency room are medically unnecessary and that non-medical factors are related to physician's for admission decisions and level of appropriateness of admission. This suggests that policy measures be required to relieve the overcrowding problem and to reduce non-emergent utilization of emergency room in a tertiary hospital.

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Association Between Transport Accident Type And Mortality In Elderly Inpatients : Using Korean National Hospital Discharge In-depth Injury Survey Dataset (퇴원손상심층조사자료를 이용한 노인 입원 환자의 운수사고 유형과 사망 사이의 연관성)

  • Ryu, Han-Jun;Kang, Sun-Hee;Boo, Yoo-Kyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.7
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    • pp.616-624
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    • 2020
  • This study analyzed the association between the type of transport accident and the associated mortality of elderly inpatients. The findings will contribute to the development and establishment of a systematic and effective policy according to the type of transport accident to reduce the mortality of inpatients. The data on elderly inpatients with transport accidents was extracted from the 2013-2017 Korean National Hospital Discharge In-depth Survey dataset. The data was analyzed by descriptive statistics analysis, chi-square tests and multiple logistic regression analysis. After adjustment for sociodemographic, disease, injury and policy factors, the elderly inpatient deaths due to transport accidents were significantly higher for pedestrian accidents (OR: 2.522 95%, CI: 1.291-4.972), bicycle/cart accidents (OR: 2.809, 95% CI: 1.328-5.942) and motorcycle accidents (OR: 2.330, 95% CI: 1.226-4.819) rather than that for car accidents. Likewise, elderly inpatients have a higher risk of death from other types of transport accidents than those caused by car accidents. However, Korean policies related to transport accidents of elderly inpatients are concentrated on car accidents. Effective policy is needed according to the characteristics of each type of transport accident to reduce the transport accident mortality of elderly inpatients.

Effect of severe neonatal morbidities on long term outcome in extremely low birthweight infants

  • Koo, Kyo-Yeon;Kim, Jeong-Eun;Lee, Soon-Min;NamGung, Ran;Park, Min-Soo;Park, Kook-In;Lee, Chul
    • Clinical and Experimental Pediatrics
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    • v.53 no.6
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    • pp.694-700
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    • 2010
  • Purpose: To assess the validity of individual and combined prognostic effects of severe bronchopulmonary dysplasia (BPD), brain injury, retinopathy of prematurity (ROP), and parenteral nutrition associated cholestasis(PNAC). Methods: We retrospectively analyzed the medical records of 80 extremely low birthweight (ELBW) infants admitted to the neonatal intensive care unit (NICU) of the Severance Children's Hospital, and who survived to a postmenstrual age of 36 weeks. We analyzed the relationship between 4 neonatal morbidities (severe BPD, severe brain injury, severe ROP, and severe PNAC) and poor outcome. Poor outcome indicated death after a postmenstrual age of 36 weeks or survival with neurosensory impairment (cerebral palsy, delayed development, hearing loss, or blindness) between 18 and 24 months of corrected age. Results: Each neonatal morbidity correlated with poor outcome on univariate analysis. Multiple logistic regression analysis revealed that the odds ratios (OR) were 4.9 (95% confidence interval [CI], 1.0-22.6; $P$=0.044) for severe BPD, 13.2 (3.0-57.3; $P$<.001) for severe brain injury, 5.3 (1.6-18.1; $P$=0.007) for severe ROP, and 3.4 (0.5-22.7; $P$=0.215) for severe PNAC. Severe BPD, brain injury, and ROP were significantly correlated with poor outcome, but not severe PNAC. By increasing the morbidity count, the rate of poor outcome was significantly increased (OR 5.2; 95% CI, 2.2-11.9; $P$<.001). In infants free of the above-mentioned morbidities, the rate of poor outcome was 9%, while the corresponding rates in infants with 1, 2, and more than 3 neonatal morbidities were 46%, 69%, and 100%, respectively. Conclusion: In ELBW infants 3 common neonatal mornidifies, severe BPD, brain injury and ROP, strongly predicts the risk of poor outcome.

Level of Obstructive Sleep Apnea of Patients with Ischemic Cardio-cerebrovascular Disease and Affecting Factors (허혈성 심뇌혈관질환자에서 폐쇄성 수면무호흡증 정도 및 영향요인)

  • Kim, Sun Hwa;Hwang, Seon Young
    • The Journal of the Korea Contents Association
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    • v.18 no.4
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    • pp.114-127
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    • 2018
  • This study aimed to investigate the levels of Obstructive Sleep Apnea (OSA), health behavior and sleep quality and to examine the predictors of OSA in patients with ischemic cardio-cerebrovascular disease. 141 patients who were admitted to the vascular unit were recruited and surveyed using structured questionnaires. Saturation of Peripheral Oxygen (SpO2) was measured at three time points using a pulse oximeter. Data were analyzed using SPSS/WIN 20.0. The mean age of the subjects was $64.4{\pm}11.1$ years and 61% was men. The 21.3%(n=30) of the subjects were classified as high-risk for OSA by the cut point and 71.6%(n=101) had low sleep quality. OSA high-risk group showed significant difference in SpO2 in the middle of sleep (p=.006) and at the end of sleep (p=.004) compared to the low-risk group. Multiple logistic regression analysis showed that perceived frequent snoring, smoking, obesity, lack of exercise among health behavior were found as predicting factors on OSA. OSA or persistent snoring should be recognized as a cardiovascular risk factor in the cardiovascular nursing practice. In addition to early treatment of OSA, education and counseling should be provided to patients and their family for prevention of secondary recurrence.

Parent-related factors affecting obesity and overweight in school-aged children (학령기 아동의 비만에 영향을 미치는 부모관련 요인)

  • Ryu, Hyun-Sook;Cho, In-Sook
    • Journal of the Korean Applied Science and Technology
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    • v.35 no.1
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    • pp.223-234
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    • 2018
  • The purpose of this study was to analyze the parent-related factors affecting obesity and overweight in school-aged children. The subjects of this study were 408 students of 4th~6th grade and their parents and examined the degree of obesity, obesity-related characteristics, eating habits and exercise habits of children and their parents. The data were analyzed using $x^2-test$, t-test, ANOVA and multiple logistic regression analysis. The results of this study were as follows: father's BMI OR=1.265(95% CI: 1.133-1.412, p<.001), mother's BMI OR=1.214(95% CI: 1.077-1.368, CI: 1.113-1.725, p= .001), the child's eating habit OR=0.953(95% CI: .909- .998, p= .042), the TV watching time OR=1.385(95% CI: 1.113-1.725, p= .004), the economic state OR=0.132(95% CI: .026- .676, p= .015) were factors related affecting obesity and overweight in school-aged children. Children's obesity was influenced by parent's genetic factors, eating habits and living environment factors. Therefore, it is important to motivate the children as well as the their parents and induce the active participation of the program in order to manage the child's obesity.

The Influence of Metabolic Syndrome and its Components on the Impaired Health-related Quality of Life by Gender in Korean Adults: The 2016-2018 Korea National Health and Nutrition Examination Survey (한국 성인의 대사증후군 및 그 구성요소가 성별에 따른 건강관련 삶의 질 손상에 미치는 영향: 2016-2018 국민건강영양조사)

  • Eum, Mi-Jung;Jung, Hye-Sun
    • The Journal of the Korea Contents Association
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    • v.20 no.10
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    • pp.411-423
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    • 2020
  • The purpose of this study was to examine the association between metabolic syndrome and its components and health-related quality of life in Korean adults. Metabolic syndrome defined in accordance with NCEP-ATP III, and HRQOL was evaluated using EQ-5D. Data on 16,657 adult, extracted from Korean National Health and Nutrition Examination Surveys in 2016-2018, were analyzed and showed that 34.3% of subjects were metabolic syndrome, with males higher than females. The average score of HRQOL was 96.7 for men and 94.5 for women. Multiple logistic regression analysis was results, The OR of impaired HRQOL in women who metabolic syndrome was 1.27(95% CI: 1.09-1.46) compared to who women without metabolic syndrome. Among the components of metabolic syndrome, abdominal obesity (OR=1.72, 95% CI: 1.50-1.97) and high blood pressure (OR=1.26, 95% CI: 1.06-1.50) were associated to impaired HRQOL. But, there were no significant in men. In conclusion, In order to improve women's HRQOL, it suggests that an approach strategy is necessary to reduce the risk factors of metabolic syndrome, which take into account women's characteristics.

Effects of Dental Hygienist's Musculoskeletal Pain Resolution and Self-Efficacy on Musculoskeletal Disorders (치과위생사의 근골격계 통증 해결 방법과 자기효능감이 근골격계 질환에 미치는 영향)

  • Moon, Ae-Eun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.2
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    • pp.329-338
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    • 2018
  • This study was conducted to examine musculoskeletal disorder and analyze the effects of musculoskeletal pain control and self-efficacy on musculoskeletal disorders in dental hygienists. Material and Methods; 483 dental hygienists residing in Gwangju were collected by the convenience sampling method and the self-administered questionnaire survey was conducted. Frequency analysis, crosstab analysis, t-test, and multiple logistic regression analysis were used for analysis. Results: the prevalence of musculoskeletal pain among subjects was 83.9% for the prior year, with 29.8% of patients being afflicted by musculoskeletal disorders. The factors influencing musculoskeletal disorders were musculoskeletal pain resolution. For pain resolution, the odds ratio of musculoskeletal disorders of the group who answered treatment in a hospital, an Oriental medicine clinic, or a pharmacy was 0.22 (95% confidence interval, 0.14-0.34) compared with the group who answered sick leave or task change, suggesting a negative relationship. These findings indicate that people with musculoskeletal disorders were not treated in the hospital, Oriental medicine clinic, or pharmacy. Therefore, it is necessary to improve medical management (oriental medicine, intravenous injection or medication, heat therapy or cryotherapy, steroid treatment, counseling, endovascular treatment using spinal cord stimulation, physical therapy, stretching, rehabilitation, and manual therapy) and job environment and to make a good approach to the prevention of musculoskeletal disorders to control dental hygienists' musculoskeletal pain.

Relating Factors on Mental Health Status (Depression, Cognitive Impairment and Dementia) among the Admitted from Long-term Care Insurance (노인장기요양보험 인정자의 정신적 건강상태(우울, 인지기능장애 및 치매) 및 그의 관련요인)

  • Song, Young-Su;Kim, Tae-Baek;Bae, Nam-Kyou;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.2
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    • pp.247-260
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    • 2018
  • This study examined the mental health status (depression, cognitive impairment and dementia) and its association with the related factors in the elderly people who were admitted from long-term care insurance. The study subjects were 1,488 people (male 740, female 748) aged over 70 years of age who had been recognized for long-term care insurance services in the years 2011~2014 from the National Health Insurance Corporation. The data collected from the National Health Insurance Corporation set forth a lifestyle questionnaire, itemized health screening tests, and long-term care as recognition data for research purposes. As a result, depression, cognitive impairment, and dementia of subjects increased significantly with age. As a multiple logistic regression result, the risk ratios of depression, cognitive impairment, and dementia, which indicated the mental health status, were significantly higher in women than in men, in the lower body weight group than in the overweight group, in the smoking group than in the non-smoking group, and in the drinking group than in the non-drinking group. These results suggest that the mental health status (depression, cognitive impairment, and dementia) of subjects decreased with increasing age, particularly the group with poor health related behaviors, such as smoking, drinking, and regular exercise, indicating that the mental health condition is lower than in the good group.