• Title/Summary/Keyword: rural hospital

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Colorectal Cancer Incidence and Mortality in China, 2010

  • Zheng, Zhao-Xu;Zheng, Rong-Shou;Zhang, Si-Wei;Chen, Wan-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8455-8460
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    • 2014
  • Background: The National Central Cancer Registry of China (NCCR) affiliated to the Bureau of Disease Control, National Health and Family Planning Commission of China is responsible for cancer surveillance in the entire country. Cancer registration data from each local registry located in each province are collected by NCCR annually to be analyzed and published to provide useful information for policy makers and cancer researchers. Materials and Methods: Until 1st June, 2013, 219 population-based cancer registries submitted data of 2010 to the National Central Cancer Registry of China covering about 207,229,403 population, and 145 cancer registries were selected after quality evaluation for this study. Colorectal cancer cases were selected from the database according to ICD-10 coded as "C18-C20". We calculated the crude incidence and mortality rates by sex, age groups and location (urban/rural). The China population in 2000 and Segi's population were used as standardized populations for the calculation of age-standardized rates. The 6th National Population Census data of China was used to combined with the cancer registries' data to estimate the colorectal cancer burden in China in 2010. Results: Colorectal cancer was the sixth most common cancer in China. It was estimated that there were 274,841 new cases diagnosed in 2010 (157,355 in males and 117,486 in females), with the crude incidence rate of 20.1/100,000, highest in males in urban areas. Age-standardized rates by China standard population of 2000 (ASRcn) and World standard population (Segi's population, ASRwld) for incidence were 16.1/100,000 and 15.9/100,000 respectively. There were 132,110 cases estimated to have died from colorectal cancer in China in 2010 (76,646 men and 55,464 women) with the crude mortality rate of 10.1/100,000. The ASRcn and ASRwld for mortality were 7.55/100,000 and 7.44/100,000 respectively, higher in males and urban areas than in females and rural areas. The incidence and mortality rates increased with age, reaching peaksin the 80-84 year old, and oldest age groups, respectively. Conclusions: Colorectal cancer is one of the most common incident cancers and cause of cancer death in China. Primary and secondary prevention, with attention to a health lifestyle, physical activity and screening should be enhanced in the general population.

Survey on the Status of C. sinensis Infection in Rural Inhabitants (Yeoju Eup, Kyunggi Do) (농촌지역 주민(여주읍)에 있어서 간흡충 감염현황 조사 - 학생을 통한 대변수집 방안 및 결과 -)

  • Chung, Myung-Sook;Lee, Joon-Sang;Rim, Han-Jong;Yum, Yong-Tae;Cha, Chul-Whan;Koo, Bum-Hwan
    • Journal of agricultural medicine and community health
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    • v.11 no.1
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    • pp.3-11
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    • 1986
  • In order to observe the infestation rate and intensity of C. sinensis in Yeoju Eup, Kyung-gi Do, 9,512 stool specimens were collected from the inhabitants through student's helps. The specimens were examined by cellophane thick smear technique and Stoll's egg dilution technique. The epidemiological status was analysed statistically by the regession equation and catalytic curve with the results obtained from this area. The results are as follows: 1) Collection rate oft he stool samples was 66.5%, 9.512 out of 14,300 inhabintants complied with our survey. 2) The infestation rate of C.sinensis was 5.0%, and for male 7.8%, for female 2.3%. 3) Average E.P.G. by Stoll's egg dilution technique in this area was 1,572, and for male 1,853, for female 676. 4) The degree of the intensity of C. sinensis infection by E.P.G. count was distributed as 65.2% in light infection, 32.0 % in moderate infection, 2.8% in heavy infection and none in very heavy infection. 5) The intensity of endemicity in this area was represented with the regression equation calculated with cumulative percentages of E.P.G. counts. Regression equation was y=3.887+1.695 log x and Cs. $D_{50}$ was 4.54. 6) The two-stage catalytic model was applied and the calculation lead to the equation $y=0.267(e^{-0.004t}-e^{-0.019t})$; a=0.004 < b=0.019. 7) Other helminthic infection rate in this area was 1.4% in A.lumbricoides 2.7% in T. trichiura, 1.6% in M. yokogawai md 0.2% in Taenia sp. respectively.

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한국 농촌지역의 임신효율 (Reproductive Efficiency)에 관한 연구 : 충남 서산지역을 중심으로

  • An, Mun-Yeong
    • Journal of agricultural medicine and community health
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    • v.7 no.1
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    • pp.74-79
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    • 1982
  • Recently in Korea, integration of F.P. & MCH programs for effective and efficient implementation of the health programs has been discussed actively. In fact, categorical health workers in fields have been trained and changed as an integrated health workers by government. But one of the most important problems that had to be solved for successful integration of F.P. and MCH programs, is that there must be a common indicator for the evaluation of the two health services (integrated indicator). We regarded reproductive efficiency (=R.E.) that had been proposed by Charlotter M$\ddot{u}$ller et al, as the good integrated indicator. The object of this brief article is to introduce the meaning of reproductive efficiency and to illustrate the usefulnesses of R.E. as the integrated health indicator by applying this indicator to the data from preliminary survey of Seosan demonstration project for integration of F.P. & MCH service supported by WHO. The results and conclusions are as follows 1) Definition of R.E. is the percentage of pregnancies that succeed in production normal, surving children after taking into account the frequency of all measurable types of adverse outcomes (End point for evaluation of survival is one year of age). 2) On the basis of the past pregnant history, reproductive efficiency of the 2,484 eligible women (15-44 years) was roughly 75% (But, in the concept of good births, it is not regarded whether the survived infant is normal health or not). 3) Compared with the results of the other two surveys of the rural area in Korea, reproductive efficiency has been slightly decreased than before, in spite of family planning and MCH services for past 20 years. Because the quantity of increased abortion rate overwhelmed that of the decreased infant mortality rate. 4) Reproductive efficiency has the object for measure many events during the period from the conception (Wanted pregnancy) to an normal surviving children as an 1 year of age. So these heterogenous adversities, ie, induced abortion, still births, spontaneous abortion, neonate & infant death, are aggregated as R.E. However, if the information of these important events and reproductive efficiency were given, R.E. is used as the comprehensive evaluation indicator for F.P. and M.C.H. after meticulous analysis the various components of R.E. 5) Economic loss for adverse outcomes of preg were pregnancy were calculated applying the medical cost at the relatively small sized hospital of small city. Economic loss for 100 cases of adverse outcome is 10,420,000 won, and economic loss for infant death is 46.1% of the total loss. So, it is rational to invest much more effort and than before to MCH programs.

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Management of Diabetic Mellitus in Low-income Rural Patients (일개 농촌지역 저소득층 당뇨병환자의 관리 상태)

  • Kim, Hye-Yeon;Yun, Woo-Jun;Shin, Min-Ho;Kweon, Sun-Seong;Ahn, Hye-Ran;Choi, Seong-Woo;Lee, Young-Hoon;Cho, Dong-Hyeok;Rhee, Jung-Ae
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.5
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    • pp.315-322
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    • 2009
  • Objectives : Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. Methods : We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. anklebrachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. Results : The age of diabetic subjects was 68.7$\pm$8.7 years and the duration of diabetes was 8.9$\pm$8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. Conclusions : DM management in low income patients is very poor and requires further work to improve.

The Threshold of 0.5% Salt-water Taste and Risk of Stomach Cancer (0.5% 소금물에 대한 역치와 위암발생의 위험도)

  • Ohrr, Hee-Chul;Lee, Kang-Hee;Yi, Sang-Wook
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.293-302
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    • 2000
  • The relationship between sodium intake and stomach cancer risk has been studied much in Japan but a great portions still remain controversial. There has been few studies on relationship between sodium intake and stomach cancer in Korea. The goal of this nested case-control study is to investigate the association between sodium intake and stomach cancer risk in a rural county of Korea We estimated sodium intake indirectly by the threshold of salt-water taste of patients. This study was based on both of the data from 'Kangwha Cohort Study' which had been conducted from March 1985 and 'Kangwha Community Cancer Registry' which had been launched on July in 1982 by the College of Medicine, Department of Preventive Medicine. Yonsei University. A total of 145 patients who developed stomach cancer in Kangwha County were initially recruited as the case group. We tried to get two community-controls per stomach cancer case by matching age and gender. Finally we got information from 90 cases and 146 controls about the threshold of the salt taste and preference of salty food and so on. Some 79% of the information about ease group came from proxy respondents and 56% among controls. Risk ratios of developing stomach cancer adjusted for smoking, body mass index and self-stated health level were estimated. No statistically significant association between the threshold of salt taste and stomach cancer risk found in this study. We recommend some further studies utilizing urinary salt excretion, diet record method for better estimating of salt intake with a paticular emphasis on interaction effect between salty and spicy food in hospital-based case-control study designs.

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Trends of Health Care Utilization and Relevance Index of Stroke Inpatients among The Self-Employed Insured and Their Dependents of National Health Insurance (1998-2005) (국민건강보험 지역가입자 중 뇌졸중 입원환자의 의료이용 양상 및 지역친화도 추이 (1998-2005))

  • Kim, Ji-Hyun;Cho, Byung-Mann;Hwang, In-Kyung;Son, Min-Jeong;Yoon, Tae-Ho
    • Health Policy and Management
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    • v.18 no.4
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    • pp.66-84
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    • 2008
  • Objectives: This study aimed to. offer some fundamental evidences for the stroke management policy by investigating the trends of medical care utilization and regionalization in stroke inpatients. Methods: We used the National Health Insurance claims and registry data for stroke inpatients from 1998 to 2005. Among all stroke inpatient claims data, self-employed insured and their dependents were only included in this study. The classification of stroke was based on ICD-10(I60-I69) and its subtype was divided by hemorrhage(I60-I62) and infarction(I63-I64) type. To evaluate regionalization of medical care utilization, relevance index was calculated by regions. The regions were classified 8 large catchment areas and 163 self authorized areas. Results: The overall medical care utilization rate of stroke inpatient has been increased, especially infarction subtype. Among medical care institutions, the utilization of hospital has been the most rapidly increased. Although considered annual rate of interest, total medical cost of stroke inpatients has been increased, Totally, more than 84% of stroke inpatient were admitted to medical care institutions in their own large catchment area during 1998-2005. The relevance indices in their own large catchment area (self sufficiency rates) were more than 70% in most areas regardless of stroke subtype except Chungbuk catchment area. Self sufficiency rates of stroke inpatients among 163 self authorized areas in 1998 and 2005 were 84.2% and 83.1% in metropolitan, 46.7% and 45.5% in urban, and 19.5% and 22.6% in rural areas, respectively. Conclusion: Stroke management policy for improvement of distribution at the district level, especially in rural areas, may be helpful for reducing regional inequality in stroke.

Intestinal Parasitic Infections and Environmental Water Contamination in a Rural Village of Northern Lao PDR

  • Ribas, Alexis;Jollivet, Chloe;Morand, Serge;Thongmalayvong, Boupha;Somphavong, Silaphet;Siew, Chern-Chiang;Ting, Pei-Jun;Suputtamongkol, Saipin;Saensombath, Viengsaene;Sanguankiat, Surapol;Tan, Boon-Huan;Paboriboune, Phimpha;Akkhavong, Kongsap;Chaisiri, Kittipong
    • Parasites, Hosts and Diseases
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    • v.55 no.5
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    • pp.523-532
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    • 2017
  • A field survey studying intestinal parasites in humans and microbial pathogen contamination at environment was performed in a Laotian rural village to identify potential risks for disease outbreaks. A parasitological investigation was conducted in Ban Lak Sip village, Luang Prabang, Lao PDR involving fecal samples from 305 inhabitants as well as water samples taken from 3 sites of the local stream. Water analysis indicated the presence of several enteric pathogens, i.e., Aeromonas spp., Vibrio spp., E. coli H7, E. coli O157: H7, verocytotoxin-producing E. coli (VTEC), Shigella spp., and enteric adenovirus. The level of microbial pathogens contamination was associated with human activity, with greater levels of contamination found at the downstream site compared to the site at the village and upstream, respectively. Regarding intestinal parasites, the prevalence of helminth and protozoan infections were 68.9% and 27.2%, respectively. Eight helminth taxa were identified in fecal samples, i.e., 2 tapeworm species (Taenia sp. and Hymenolepis diminuta), 1 trematode (Opisthorchis sp.), and 5 nematodes (Ascaris lumbricoides, Trichuris trichiura, Strongyloides stercoralis, trichostrongylids, and hookworms). Six species of intestinal protists were identified, i.e., Blastocystis hominis, Cyclospora spp., Endolimax nana, Entamoeba histolytica/E. dispar, Entamoeba coli, and Giardia lamblia. Questionnaires and interviews were also conducted to determine risk factors of infection. These analyses together with a prevailing infection level suggested that most of villagers were exposed to parasites in a similar degree due to limited socio-economic differences and sharing of similar practices. Limited access to effective public health facilities is also a significant contributing factor.

Clinical Features of Clonorchiasis (간흡충증의 임상 양상)

  • Kim, Kook-Hyun;Jang, Byung-Ik;Kim, Tae-Nyeun
    • Journal of Yeungnam Medical Science
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    • v.23 no.2
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    • pp.171-181
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    • 2006
  • Background: $Clonorchis$ $sinensis$ is an important human parasite that is usually found in the biliary tract. It is widely distributed in East Asia in Taiwan, Japan, China and Korea. About 2 million people are estimated to be infected with $C.$ $sinensis$ in Korea. This study was conducted to evaluate the state of infestation and clinical aspects of $C.$ $sinensis$. Material and Methods: We evaluate 1,063 patients with clonorchiasis retrospectively at Yeungnam University Hospital and Health Promotion Center from January 2001 to December 2003. All patients were diagnosed by a positive stool test for $C.$ $sinensis$ eggs. Clinical features, laboratory data and imaging studies were evaluated. Results: The ratio between affected males and females was 3.6 : 1. The highest infection rate was noted in the 40-60 age groups regardless of sex. The infection rate of $C.$ $sinensis$ among the residents of urban areas was higher than in rural areas. There were 813 (76.5%) patients who were asymptomatic. Common symptoms included right upper abdominal pain in 7.6% and epigastric pain in 7.2%. For the laboratory studies, serum ALP and GGT levels were within normal limits in 85.2% and 56.0% respectively. Peripheral eosinophilia was noted in 66.1% of cases. Of the 83 cases undergoing ERCP, 27 cases (32.5%) showed peripheral dilatation of the intrahepatic duct. Conclusion: This study suggests that $C.$ $sinensis$ infection is still endemic even in rural areas of Korea and that asymptomatic infections are common. Further work should be focused on the early diagnosis and treatment of patients with subclinical infection.

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Preliminary Report of Use-Effectiveness of Ovulation Method in Korea (자연피임법으로서의 배란법의 피임효과)

  • Bae, S.C.;Chung, Y.J.;Rha, J.G.;Oh, W.S.;Kim, S.J.
    • Clinical and Experimental Reproductive Medicine
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    • v.3 no.1
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    • pp.27-32
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    • 1976
  • In recent years, explosive increase in population has been damaging mankind in terms of deprivation of natural resources and more of economical demands. Therefore, we have thought about problems as to counter-balance the increasing population, and reached a resolution of artificial methods of controlling birth. In the past, though now used in some of contraceptive methods, extravaginal ejaculation, condom were commonly used. But recently, pills, IUD and several kinds of operative procedures are quite popular. Though the recent methods are known to be effective compared with the traditional methods, a certain unwanted side effects as well as limited value of usages now must be discussed. On this aspect, we are trying to research for a ideal methods such as symptom free, more of natural way of family planning and try to zero the failure rate. And also it has been suggested that only if those scientific methods of controlling birth can be base on religious concepts of moral being, it will be enlightened. At the Happy Family Planning Clinic of St. Mary's Hospital, we apply Billing's ovulation method to out-patients who want contraception and usually advise them to use it on a self-care basis. For a retrospective study of the presurvey data analysis and use-effectiveness of the ovulation method from April 1, 1975 to Nov., 30, 1975, we have dealt with a total of 1,383 women (urban areas 465, rural areas 918). The results of preliminary survey were as follows; 1) Among 465 women in Seoul areas, the failure rate was 10.3, which signified unplanned pregnancies of 32 women. 27 of the 32 women were pregnant due to the users own failure and the remaing 5 due to the failure of the method. Therefore, the failure of the method accounted for 1.6. 2) Among 918 women in rural areas, the failure rate was 15.2 signifing unplanned pregnancies in 93 women. The cause of the failure in 81 of the 93 women was attributable to the user's own mistake and that in the remaing 12 to the default of the method. Therefore, the failure attributable to the method accounted for 2.0.

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Changing Patterns of Ambulatory Care Utilization of a Rural Community in a Regional Medical Insurance Scheme (지역의료보험 가입자의 외래 의료이용 변화)

  • Yu, Seung-Hum;Cho, Woo-Hyun;Sohn, Myong-Sei;Park, Chong-Yon
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.2 s.24
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    • pp.419-430
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    • 1988
  • This study was performed in a rural community, Kanghwa county which was introduced to a regional medical insurance pilot program in 1982. The purposes of this study were, firstly, to observe the changes in ambulatory care utilization in the three years 1982, 1983 and 1987 : secondly, to analyse factors which convert perceived medical care needs to effective medical care demand. During the three periods, a serial interview survey was performed to determine the changes in medical utilization before and after the regional medical insurance program implementation. The number of subjects was 3,356 persons in the year 1982, 3,705 in 1983 and 2,745 in 1987. The results of the study were as follows : 1. Total ambulatory care utilization rates per 100 persons during a 2-week period were 23.6 in the year 1982, 21.8 in 1983, and 29.3 in 1987; and physician visit rates were 6.1 in 1982, 11.7 in 1983, and 14.9 in 1987. Thus, compared to the total utilization rate there was a definite increase in physician visit, and during the study periods there was a decrease in drug store visits whereas an increase in hospital or clinic visits was noticed. 2. The rates of effective demand for medical care need were 70.7% in 1982, 70.5% in 1983 and 75.9% in 1987 : and the rates of patients who visited physicians were 20.2% in 1982, 42.8% in 1983 and 35.6% in 1987. Thus, physician visits increased sharply by introducing the medical insurance program, but after the latent medical care demands were fulfilled, there was a slight decrease in the physician visits. 3. The number of acute symptoms and the number of chronic symptoms were common determinants of total ambulatory care utilization and physician visits. Besides the medical care need factors, age in 1982, sex and accessibility in 1983, and accessibility in 1987 were statistically significant determinants of the total utilization ; sex and accessibility in 1983, and education in 1987 were also statistically significant determinants of the physician visit. 4. For persons with perceived acute symptoms during the 2-week periods, accessibility in total utilization and age in physician visits were common discriminating factors of ambulatory care utilization in the three years, and education and income were also statistically significant variables. For persons with perceived chronic symptoms, occupation and income were statistically significant discriminating variables commonly observed in total utilization and physician visits.

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