• Health Policy and Management
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• v.20 no.1
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• pp.125-136
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• 2010

Objectives: The purpose of this study is to analyze the proportion of fundus examination of DM patients for preventing microvascular complication and to examine the factors related to fundus examination in DM patients. Methods: This study used 2005 Korean national health and nutrition survey data. We selected all 1,129 diabetes mellitus patients from the data. And we choose 8 factors related to diabetes mellitus patients. These are sex, age group, type of residential area(rural or urban), education level, income level, comorbidity with hypertension, current insulin use, and duration of suffering from DM. We have analysed these factors by whether he had been examined fundus or no through Chi-square and logistic regression analysis. Results: Female DM patients have tendency to get more fundus examination than Male DM patients. And Young patients, patients who live in urban area, well educated patients, high income patients, comorbidity with hypertension, patients have got the insulin injection, patients have long duration of suffering from DM are to get more fundus examination. According to multivariate logistic regression analysis, sex and education level, income level, and duration of suffering from DM, comorbidity with hypertension, patients have got the insulin injection are significant factors on fundus examination for prevent microvascular diabetes mellitus complications. Conclusions and Discussion: We have concluded that physicians and policy makers should consider to fundus examination especially of man and DM patients who have more shorter disease period and low educated patients and low incomed patients and patients who have taken insulin therapy.

• Journal of Korean Physical Therapy Science
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• v.11 no.4
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• pp.11-19
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• 2004

Muscle stiffness, pain discomfort in daily activities are cardinal symtoms on arthritis. To reduce these symtoms, a nonequivalent one-group pre & posttest experiment was carried out at a rural community health post area in kwangju province during eight weeks(from 25th of January to 20th of March, 2002) The subjects were sixteen old (60-80) with osteoarthritis. And to reduce the level of pain, discomfort in daily living and to increase that of life satisfaction, 25-30minutes of muscle-joint exercise followed by 25-30minutes of local heat therapy were done three times a week. The total experimental period extended at 12 weeks and the total 36 times it executed 1. The retrogression characteristic osteoarthritis elderly with local heat and a muscle joint exercise was the telegram which it receives and after receiving, the score of the paindaily activity function appeared to the lead, there was a difference which considers statistically, this constriction was supported.(Z=4.947, p<0.0001) 2. The retrogression characteristic osteoarthritis elderly with local heat and a muscle joint exercise was the telegram which it receives and after receiving, the score of daily activity function appeared lowly, there was a difference which considers statistically, this construction was supported.(Z=2.7226, p<0.0279) 3. The retrogression characteristic osteoarthritis elderly with local heat and a muscle joint exercise was the telegram which it receives and after receiving, there was not a difference where the quality of life considers statistically, this construction was rejected.(Z=-1.2087, p>0.2171)

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7257-7260
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• 2013

To determine the pattern of disease in patients presenting with breast lumps and to determine the sensitivity and specificity of fine needle aspiration cytology of benign and malignant diseases as a diagnostic tool by correlating with histopathology findings. This retrospective study was carried out in the Department of Pathology, Maharaja Agrasen Medical College, Agroha, from Jan 2008 to April 2012. Fine needle aspiration cytology was performed on 370 cases and out of these 52 cases were received in the Department for histopathological examination. Fibroadenoma was the most common disease encountered, in 88 (24%), with a peak incidence in second and third decade of life. Fibrocystic disease was second, being common in the third and fourth decades of life. Peak incidences of duct ectasia, granulomatous and tubercular mastitis were seen in the third decade. Gynaecomastia showed two peak incidences in second and sixth decades of life. Out of total 370 cases undergoing fine needle aspiration, benign cases were 316 (85.4%), malignant and suspicious were 54 (14.6%) and 10 (2.70%) respectively. Out of total 22 histological confirmed malignant lesions 19 were interpreted as malignant cytologically while two as suspicious and one as benign. All thirty histologically confirmed benign cases were diagnosed as benign cytologically. The sensitivity, specificity, positive and negative predictive values were 98%, 100%, 100% and 96.4% respectively. FNA cytology is highly accurate for diagnosis of breast masses. However, the clinician should correlate FNA cytological results with physical examination and imaging findings to prevent false negative and false positive events and to obtain optimal management of their patients.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.3721-3725
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• 2016

The liver fluke Opisthorchis viverrini is a serious health problem in Thailand. Infection is associated with cholangiocarcinoma (CCA), endemic among human populations in northeast and north Thailand where raw fish containing fluke metacercariae are frequently consumed. Recently, Thailand public health authorities have been organized to reduce morbidity and mortality particularly in the northeast through O. viverrini and CCA screening projects. Health modification is one of activities included in this campaign, but systemic guidelines of modifying and developing health behavior among liver fluke and CCA prevention in communities towards health belief and social support theory are still various and unclear. Here we review the guidelines for modifying and developing health behavior among populations in rural communities to strengthen understanding regarding perceived susceptibility, severity, benefits, and barriers to liver fluke and CCA prevention. This model may be useful for public health officers and related organizations to further health behavior change in endemic areas.

• Korean Journal of Health Education and Promotion
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• v.7 no.1
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• pp.54-63
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• 1990

This study aims to find out the prevalence of smoking, and to analyze the effect of smoking for health status, and then to emphasize the necessity of stop smoking. The data used in this study are obtained from periodic health care programe at Health Care Center in a suburban hospital, and selected 435 males who have occupation. The independent varibles chosen for the analysis are general charactersitic variables and smoking habit. The dependent variables are designed to cover the health status of individual cases, and include blood pressure, blood cholesterol level with HDL-cholesterol and blood triglyceride level, recent symptoms and recently being managed diseases. The result of this study are summarized as follows. 1) Percentage of smoker by the age groups is highest in 4th decade, being 71.1%. The second and third ranks are 6th and 7th decades, being 53.5% and 44.4%, respectively. 2) In the view of socio-economic levels, smoking rate is higher in the groups who live at rural area and whoes occupation is labor or merchant. Smoking rate is significantly higher in the heavy drinking group. 3) Among the atherosclerotic risk factors, which include hypertension, HDL-cholesterol by total cholesterol ratio lower than 0.2 and triglyceride level higher than 200gm/dl, hypertension was not statistically associated with smoking, but others revealed statistically high association with smoking. 4) The groups who have the symptoms of severe fatigue, gastrointestinal symptoms, pulmonary symptoms, palpitation and chest tightness havepositive association with smoking. 5) The groups who have hypertension with cardiovascular diseases and gastrointestinal diseases showed highly significant association with non-smoking. 6) In relation of the smoking habit to the atherosclerotic risk factor index, smokers have more atherosclerotic risk factors, but that is not statistically significant. 7) In relation of the smoking habit to the recent symptom index, smokers have more symptoms than non-smokers with statistical significance. In conclusion, smokers have worse health status than non-smokers especially in the atherosclerotic risk factors such as hypertension or abnormal blood lipid status and have more symptoms such as severe fatigue, gastrointestinal symptoms, pulmonary symptoms, palpitation and chest tightness. And the campaingn against smoking should direct for the male in 4th decade because they have highest smoking rate.

• The Journal of Internal Korean Medicine
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• v.37 no.1
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• pp.1-7
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• 2016

Objectives: This study aimed to investigate the sociodemographic factors of stroke patients.Methods: Patients were hospitalized at Korean medical hospitals with cerebral hemorrhage and infarction and then discharged between September 2013 and August 2014. We investigated the patients’ general character and risk factors, then the patients were classified according to the regions where they reside.Results: The results indicated that having hypertension and diabetes mellitus as an underlying disease was more common in stroke patients from the country. No other statistical significance was noted among the indexes of any other results.Conclusions: Based on these results, hypertension, and diabetes mellitus were more important risk factors in patients from the country than they were for city residents. Further large-scale studies are needed to generalize the findings of this study.

• Journal of Preventive Medicine and Public Health
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• v.40 no.1
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• pp.51-58
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• 2007

Objectives : The objectives of this study were to estimate the continuity of care for all Koreans with diabetes and to identify factors affecting the continuity of care. Methods : We obtained National Health Insurance claims data for patients with diabetes who visited health-care providers during the year 2004. A total of 1,498,327 patients were included as study subjects. Most Frequent Provider Continuity (MFPC) and Modified, Modified Continuity Index (MMCI) were used as indexes of continuity of care. A multiple linear regression analysis was used to identify factors affecting continuity of care. Results : The average continuity of care in the entire population of 1,498,327 patients was $0.89{\pm}0.17$ as calculated by MFPC and $0.92{\pm}0.16$ by MMCI. In a multiple linear regression analysis, both MFPC and MMCI were lower for females than males, disabled than non-disabled, Medicaid beneficiaries than health insurance beneficiaries, patients with low monthly insurance contributions, patients in rural residential areas, and patients whose most frequently visited provider is the hospital. Conclusions : The continuity of care for patients with diabetes is high in Korea. However, women, the disabled and people of low socio-economic status have relatively low continuity of care. Therefore, our first priority is to promote a diabetes management program for these patients.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4373-4377
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• 2013

Background: The majority of cervical cancers, the most prevalent cancer among Nepali women, are diagnosed in advanced stage leading to high mortality in Nepal. The present study explored factors associated with late diagnosis. Materials and Methods: A cross-sectional study was carried out in two specialized cancer hospitals of Nepal from August 12 to October 12, 2012. Randomly selected 110 cervical cancer patients were interviewed and their medical records were reviewed. Multivariate logistic regression analysis was performed to predict associations. Results: Mean age of patients was 52.7years (SD=10.6), 66% were illiterate and 77% were rural inhabitants. Medical shops (33.6%) and private hospitals (31%) were major first contact points of patients with health care providers (HCP). There was no cervical/per-speculum examination (78.2%) and symptoms misinterpretation (90%) of patients occurred in initial consultation with HCP. Four in every five cases (80.9%) of cervical cancer had late diagnosis. Literate women (adjusted OR=0.121, CI: 0.030-0.482) and women having abnormal vaginal bleeding as early symptom (adjusted OR=0.160, CI: 0.035-0.741) were less likely to suffer late diagnosis. Women who shared their symptoms late (adjusted OR=4.272, CI: 1.110-16.440) and did so with people other than their husband (adjusted OR=12.701, CI: 1.132-142.55) were more likely for late diagnosis. Conclusions: High level of illiteracy among women and their problematic health seeking behavior for gynecological symptoms are responsible for late diagnosis of cervical cancer in Nepal. In the absence of a routine screening program, prevention interventions should be focused on raising awareness of gynecological symptoms and improving health seeking behavior of women for such symptoms.

• Health Policy and Management
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• v.19 no.4
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• pp.66-77
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• 2009

This study aims to examine the effect of socioeconomic status (hereafter, SES) on healthcare utilization of the patients with rare and incurable diseases. Information of 2,973 patients who were self-employed insured and utilized healthcare service in 2007 was drawn from the National Health Insurance (hereafter, NHI) claim data. SES was set as four groups based on the monthly contribution. Outcome variable was the expense for outpatient and in-hospital services, which was log-transformed and square-rooted in oder to obtain normal distribution. Covariates included age, gender, residence and diagnosis. To examine the effects after controlling for covariates, we employed generalized estimating equation model, since patients with the same diagnosis are likely to have similar characteristics of demographics and healthcare utilization. Univariate statistics showed that lower SES was associated with less utilization of healthcare services. After controlling for covariates, a significantly smaller amount of money was expended for the lowest SES group compared to the highest one. Rural residence was associated with less utilization, except that residents in Seoul significantly more utilized outpatient services in tertiary hospitals. Considering that there is a subsidy program for the low income patients, such differences in healthcare utilization according to SES seems to result from the burden of out-of-pocket payments for uncovered services of the NHI.

• Korean Journal of Health Education and Promotion
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• v.32 no.3
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• pp.11-22
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• 2015

Objectives: This study was to examine the influences of community characteristics on the mortality rates. Community characteristics included socioeconomic environmental characteristics, health care resources, and health lifestyle practice. Methods: This study used secondary data whose units of analyses were 249 administrative districts. Mortality rates were estimated with hierarchical regression models entered in the order of (1) socioeconomic environmental characteristics, (2) health care resources, and (3) health lifestyle practice. Results: About 70% of mortality rate was explained by socioeconomic environmental characteristics, health care resources, and health lifestyle practice. In particular, socioeconomic environmental characteristics showed the strongest impact on mortality rate. Among socioeconomic characteristics, community with lower rate of households headed with college or more, lower number of inhabitants per on-premise license, higher rate of population in poverty, and rural region showed higher mortality rate. Among health care resources, community with higher number of inhabitants per doctor and lower number of inhabitants per hospital bed showed higher mortality rate. Among health lifestyle practice, community with higher current smoking rate and lower moderate physical activity practice rate showed higher mortality rate. Conclusions: The results suggest that policy makers should take into account socioeconomic environmental characteristics of community in developing community-based health promotion rather than focusing on lifestyle changes of residents.