• Tuberculosis and Respiratory Diseases
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• v.62 no.1
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• pp.5-10
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• 2007

Background: Korean national guidelines for examining contacts with active pulmonary tuberculosis (TB) are a tuberculin skin test (TST) and chest radiographs. The treatment of a latent TB infection as performed only in those younger than six years of age who test positive for TST. Although there is a high incidence of active TB in young Korean soldiers, the current national guidelines for controlling contacts with active TB in soldiers are insufficient. This study highlights the problems with the Korean guidelines for controlling a TB outbreak in a small military unit. Material and Methods: In December of 2005, there was a tuberculosis outbreak in a military unit with a total of 464 soldiers in Kyung Gi province. The chest radiographs were taken of all the soldiers, and TST were carried out on 408 candidates. Results: In the first screening of the chest radiographs, two active TB patients were detected. By August of 2006, four additional cases were detected, making a total of six cases after the outbreak. All the patients showed active pulmonary TB or TB pleuritis. When the results of TST in the close contacts and non-close contacts were compared, there was a significant difference in the absolute size of the induration($9.70{\pm}7.50mm$ vs. $6.26{\pm}7.02mm$, p<0.001) as well as the ratio of patients showing an induration > 10mm (50.0% vs. 32.0%, p<0.001) and 15mm (33.2% vs. 20.9%, p= 0.005). Conclusion: Although the national guidelines for managing a TB outbreak in a military unit were followed, there were continuous instances of new active TB cases. This highlights the need for new guidelines to prevent the spread of TB.

• Clean Technology
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• v.17 no.4
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• pp.379-388
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• 2011

The purpose of this study was to investigate the concentration levels, distribution characteristics and blood concentration of Polycyclic Aromatic Hydrocarbons (PAHs) at ambient air in Industrial Complex Area. The samples were collected at 4 sites in Industrial Complex Area and its vicinities. The result indicated that there was the difference of PAHs concentration as followed local characteristics. The level of average concentration of PAHs in the air in Industrial Complex Area was $14.52{\sim}193.48ng/m^3$. The level of average concentration of six materials with possibility of cancer creation was $1.65{\sim}13.44ng/m^3$. The concentrations of PAHs were generally low, but Jechul-dong is considered an area where consistent monitoring of PAHs is required. In addition, benzo(a)pyrene was detected in every atmospheric sample, however the concentration was not high. The level of concentration of benzo(a)pyrene in the air in the Jechul-dong was $2.89ng/m^3$. But, the concentration of the PAHs in Jechul-dong showed that the Benzo(a)pyrene concentration is above $1ng/m^3$ of air quality standard(EU). The results of the concentration level of PAHs in the blood from 240 persons who were exposed directly were surveyed, it was $1.12{\sim}11.45ng/m^3$ for man and $1.20{\sim}26.89ng/m^3$ for woman. It was indicated that the difference between the genders was very little. The accumulation inside human was anticipated as the PAHs concentration in the blood for the aged was very high. Industrial Complex Area and its vicinities are an area which has been greatly influenced by PAHs and environmental contaminants. It is necessary to control the emission sources of PAHs and to construct an observation system at Industrial Complex Area from now on. It is time to reduce the risk factors for health and environmental disease to protect the health of resident in Industrial Complex Area and its vicinities.

• Clean Technology
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• v.18 no.2
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• pp.200-208
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• 2012

This study was performed to prevent the health damage of environmental contaminants in Industrial Complex Area. And, this study aimed to identify the concentration levels and distribution characteristics of environmental contaminants and Polycyclic Aromatic Hydrocarbons (PAHs) at soil in Industrial Complex Area and control area. The concentration of the soil pollution standard such as the heavy metals in the soil, VOCs, PAHs, and PCB were measured and analyzed using the soil specimens in the Industrial Complex Area and control area. Soil specimens from the Industrial Complex Area (the direct exposure area) and the control area were surveyed. Songdo-dong, Haedo-dong and Jechul-dong, which are in the direct exposure area and near the emission source, showed relatively high concentrations of contaminant materials when compared with Jangki-myeon, which is far off and in the control area. The concentration of zinc was 20.8-58.9% of the level of concern (300 mg/kg) in the 1st region, which is a relatively high concentration. The concentration of fluoride was under the standard in every region, but it was about 74% of the level of concern (400 mg/kg) in the 1st region. It is recommended that controlling fluoride emissions is necessary. Levels of organic phosphate, phenol, and VOCs like benzene, toluene, ethylbenzene and xylene were under the detection limit of the analysis instruments. The concentration of TPH was high in Songdo-dong. The concentration of contaminants in Jechul-dong was high. In addition, it was observed that the level of soil contamination changed depending on the distance from the emission source. The concentration of PAH compounds in the soil was 18.71-1744.59 ng/g, and the concentration of six potential cancer-causing PAH materials was 6.54-695.94 ng/g. The highest concentration was in Songdo-dong. The PAH concentration in the direct exposure area near the complex was relatively high compared to the indirect exposure area.

• Korea Journal of Hospital Management
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• v.22 no.3
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• pp.1-17
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• 2017

Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.

• Journal of agricultural medicine and community health
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• v.31 no.3
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• pp.263-273
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• 2006

Objectives: This study was conducted to investigate the trend of health statue of the elderly living in rural area according to drinking patterns. Methods: This study was conducted with 2,421 elderly people (male 1,273 and female 1,148) residing in the selected 25 villages, with exclusion of a few elderly people who were in hospital, out for a long time or had an unknown address. This study were carried out, face-to-face interviews with the subjects were made from January to March 2002. Results: The investigation of drinking state showed that for male subjects, drinkers accounted for 48.8%, nondrinkers 35.1% and abstainers from drinking 16.1%, whereas for female subjects, drinkers accounted 15.3%, nondrinkers 80.2% and abstainers from drinking 4.5%. The health status was analyzed according to drinking pattern. For elderly men, abstainers from drinking showed worse health state than nondrinkers and drinkers. Elderly women showed the same result. It is widely known that drinking are the important causes of chronic diseases. Therefore, it is needed to provide the elderly with education on control of preventable health risk factors and effect of living state on health, in order to prevent aggravation of health level of the elder population aged 65 and over. This will also help them promote their health. It will be desirable that for the elderly, the objective will focus on health promotion rather than treatment of diseases. Conclusions: Carry out health plan for rural communities and health maintenance programs and health promotion of the elderly in those communities shall be developed. In addition, preventive education and health examination shall be conducted more frequently with the elderly who drink but are still healthy.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.10
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• pp.6234-6241
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• 2014

The purpose of this study was to examine the status of medical staff stress and accommodating manners on the death of patients in a hospital setting for serving the basic information to develop a death education program of medical personnel from April 1 to April 30, 2014. A survey was performed on 353 medical personnel at K university hospital, located in Daejeon metropolitan city. Frequency analysis, chi-square test, and independent t-test were used to analyze the data. The results showed that 'to understand the value of the time and preparedness of a meaningful future' were the most important perspectives on the contents of death education (p<0.05), 'in order to change perceptions and attitudes toward death positively' was the most important reason why they required death education'(p<0.05), 'case-based teaching and problem-based learning' was the most effective way of death education (p<0.05), 'negative or hostile response of a patient's guardian to medical personnel' was the largest stress that medical personnel confront upon witnessing a death'(p<0.05). An understanding of the death of patients by medical personnel and an awareness of the need for death education will help improve the understanding of the patient, their guardian, and medical personnel themselves. The main findings will contribute to the development of a specific death education program on the medical personnel in a hospital setting.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.9
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• pp.6080-6088
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• 2015

The purpose of study is to find difference in the quality of life and related factors according to the employment status. Using data from the fifth National Health and Nutrition Survey, economically active population of 20-69 years old 3,429 participants who said to questions of 'economic activity status' were finally used as analysis subjects in Korea. According to economic activity status, individuals were divided by the six different employment status and their quality of life was inspected using the EQ-5D dimensions and index score as well as analyzing the factors affecting the quality of life. As a result, unemployed compared to full-time workers, had significantly higher needs of four dimensions and Unpaid family workers had in the dimensions of Mobility, Self-care and Usual activities and temporary job had in the dimensions of Self-care and Usual activities. After figuring out life quality factors according to employment status, it was found that compared to full-time workers greater age(${\beta}=-0.089$, p<0.001), more stress(${\beta}=-0.143$, p<0.0001), hyperlipidemia(${\beta}=-0.064$, p<0.0001), stroke, arthritis(${\beta}=-0.160$, p<0.0001), respiratory diseases(${\beta}=-0.055$, p<0.001) and chronic health conditions were more influential to low quality of life for temporary job(${\beta}=-0.034$, p<0.05), day workers(${\beta}=-0.078$, p<0.0001) and unemplyed(${\beta}=-0.052$, p<0.01). The study is reported that it is to find difference in the quality of life and related factors according to the employment status and it is considered to provide basis for health evaluation of utilization in the same field of study.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.5 no.2
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• pp.174-180
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• 2002

Purpose: Ursodeoxycholic acid (UDCA) is known to decrease hepatic injury by promoting the biliary secretion of retained toxic endogenous bile acids in hepatobiliary diseases complicated by total parenteral nutrition (TPN). However, most studies have focused on treatment for complications after TPN. We investigated the preventive role of early administration of UDCA in TPN-induced hepatobiliary complications by a randomized, double-blind, placebo-controlled trial. Methods: Between May 2000 and May 2002, thirteen patients, who were given TPN more than 10 days in the hospital, were assigned randomly to two groups. One was the case group (7 patients) who were given UDCA simultaneously with TPN regimen, and the other, the control group (6 patients) who were given placebo. Their age ranged from 1 day to 13 years. They were affected with diseases impossible for enteral nutrition, such as prematurity, cerebral palsy, chronic diarrhea, anorexia nervosa, pancreatitis, and cyclic vomiting. The duration of TPN ranged from 10 to 70 days. Hematologic parameters including liver function test were measured at regular intervals, and the duration, composition, administration rate, total calorie of TPN were recorded. The serum levels of total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase were compared between groups after cessation of the study. Results: The autoregressive coefficient of the control group was 0.4419 (p=0.0651) in bilirubin, -0.0431 (p=0.7923) in AST, 0.2398 (p=0.2416) in ALT, and 0.2459 (p=0.1922) in alkaline phosphatase by mixed procedure model when the parameters were referred to the case group. Conclusion: The serum level of total bilirubin did not increase in comparison with that of the control group, but statistically insignificant, when both TPN and UDCA were administered simultaneously from the beginning.

• Health Policy and Management
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• v.2 no.2
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• pp.221-237
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• 1992

The reasons for cost inflation in medical insurance expenditure are classified into demand pull inflation and cost push inflation. The former includes increase in the number of beneficiaries and utilization rate, while the latter includes increase in medical insurance fee and the charges per case. This study was conducted to analyze sources of increases of expenditure in medical insurance demonstration area by the period of 1982-1987 which was earlier than national health insurance and the period of national health insurance(1988-1990). The major findings were as follows: Medical expenditure in these areas increased by 9.4%(15.1%) annually between 1982 and 1990 on the basis of costant price(current price) and for this period, the yearly average increasing rate of expenses for outpatient care[10.5%(15.8%)] was higher than that of inpatient care [7.3%(12.6%)]. Medical expenditure increased by 6.3%(8.9%) annually between 1982 and 1987, the period of medical insurance demonstration, while it increased by 10.7%(18.9%) after implementing national health insurance(1988-1990). Medical expenditure increased by 35.9%(45.9%) between 1982 and 1987. Of this increase, 115.2%(92.1%) was attributable to the increase in the frequencies of utilization per beneficiary and 61.0%(68.1%) was due to the increase in the charges per case, but the expenditure decreased by 76.2%(60.2%) due to the reduction in the number of beneficiaries. Beteen 1988 and 1990, the period of national health insurance, medical expenditure increased by 21.2%(41.4%). Of this increase, 87.5%(46.4%) was attributable to the increase in the frequencies of utilization per beneficiary and 52.4%(73.4%) was due to the increase in the charges per case, and of the increase in the charges per case, 69.6%(40.8%) was attributable to the increase in the days of visit per case. Medical expenses per person in these areas increased by 78.2%(89.0%) between 1982 and 1987. Of this increase, 76.6%(69.1%) was attributable to the increase in the frequencies of utilization per beneficiary and 23.4%(30.9%) was due to the increase in the charges per case. For this period, demand-pull factor was the major cause of the increase in medical expenses and the expenses per treatment day was the major attributable factor in cost-push inflation. Betwee 1988 and 1990, medical expenditure per person increased by 31.2%(53.1%). Of this increase, 60.8%(37.2%) was attributable to the demand-pull factor and 39.2%(62.8%) was due to the increase in the charges per case which was one of cost-push factors. In current price, the attributalbe rate of the charges per case which was one of cost-push factors was higher than that of utilization rate in the period of national health insurance as compared to the period of medical insurance demonstration. In consideration of above findings, demand-pull factor led the increase in medical expenditure between 1982 and 1987, the period of medical insurance medel trial, but after implementing national health insurance, the attributable rate of cost-push factor was increasing gradually. Thus we may conclude that for medical cost containment, it is requested to examine the new reimbursement method to control cost-push factor and service-intensity factor.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.11
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• pp.4985-4994
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• 2011

The purpose of this study was to investigate the level of knowledge, health belief and sick role behavior, and the influencing factors on them among the patients with coronary artery disease. The study subjects were 168 patients diagnosed as having coronary artery disease at a university hospital during the period from July 1st, to August 31th, 2010. As a results, Based on the mean scores of knowledge about coronary artery disease according to the general characteristics, they were significantly higher in males than in females(p=0.033). The mean scores of health belief were significantly higher according to age decrease(p=0.043). The mean scores of sick role behaviors were significantly higher in females than in males(p=0.006), with their increasing tendency in the age range from 40's to 60's and decreasing tendency in the age over 70's(p=0.015), the group with religion were significantly higher than the one without(p=0.050). In terms of the mean scores of knowledge and sick role behaviors about coronary artery disease according to the related characteristics, there was a significant difference with the time period elapsed after diagnosed as coronary artery disease, frequency of admissions, perception about the disease, information gathering through mass com. but in terms of those of health belief, there was a not significant difference in all the variables. The significantly influencing factors on degree of knowledge by multivariate regression analysis included degree of perception about a disease, scores of sick role behavior, presence of coronary artery diseases in a family or friends, and the time period elapsed after diagnosed as having coronary artery disease. Those on health belief included age and scores of sick role behavior, and those on sick role behaviors included score of knowledge, perception about a disease, age, BMI, and religion. The results showed a significant difference with their general characteristics or coronary artery disease-related factors.