• Health Policy and Management
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• v.34 no.1
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• pp.78-86
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• 2024

Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

• Journal of dental hygiene science
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• v.16 no.1
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• pp.26-36
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• 2016

The purpose of this study was to examine how oral health literacy of mothers affect the oral health status of their preschool children. The subjects were 233 mothers and their preschool children who are between 5 and 6 years old. They were selected according to the convenience sampling method. The individual self-administered questionnaire was used for the mother's survey while the children were interviewed using structured questionnaire to examine their oral health status and behavior. According to study results, the number of decayed primary teeth and the number of decayed and filled primary teeth had a statistically significant negative correlation with the oral health literacy of the mother, the children's oral health knowledge, attitude and behavior (COHKAB), and the mother's oral health management behavior. Hierarchical multiple regression analysis was performed after including general characteristics variables, the COHKAB and the mother's oral health management behavior. Meanwhile, mother's oral health literacy had a statistically influence on children's oral health status. The higher the mother's oral health literacy level, the lower the number of decayed and filled primary teeth were. The findings suggest that efforts to improve the oral health status of preschool children should consider mother's oral health literacy as an important factor. Therefore, the effective intervention and education programs are necessary to enhance mother's oral health literacy.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.239-254
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• 1996

Health services on industrial noisy environment have been provided only for noise-induced hearing loss management until now. But gradually, modem diseases and death have come to be related to stress and mental health deeply, therefore noise-induced mental disorder, like a stress became very important. In this point, the purpose of this study was to analyze the relationship between noise exposure level in worksite and workers' stress symptoms. This study included a survey of 786 manual workers selected from 89 worksites in 21 factories in Puchon. The results were as follows: 1. For demographic characteristics, most of the workers were males(80.8%), the $20\sim29years$ old were 34.5% and those who graduated from high school were 65.3%. The workers whose monthly income ranged from 100,000 to 800,000 won were 37.5% and who have a religion were 47.9%. 2. For occupational characteristics, workers who had worked $1\sim5$ years in the factories were 33.0%. Those who were much for them workload were 43.9% and who worked more than 8 hours a day were 73.9%. Those who were disatisfied with their job and pay were 31.9% and 50.6%. The workers who responsed ventilation condition of their worksites were bad were 51.9% and the dissatisfed with working environment of their worksites were 45.9%. 3. Workers who were suffering from tinnitus were 53.3% and those who perceived hearing loss were 50.1%. Persons who reported they always wore earplugs at work were 35.4%. Those who felt earplugs bigger than their ears were 30.6% and those who experienced eardiseases caused by earplugs were 25.6%. 4. For the noise exposure level in worksite, workers who were exposed to $80\sim90dB$ were 30.3%, $90\sim100dB$ were 26.4% and $50\sim70dB$ were 19.2%. 5. Workers' stress symptoms were significantly related to marital status and their monthly income(p<0.05). Workers who were single and had lower monthly income showed higher PSI (Psychiatric Symptom Index) scores than those who were married and had higher monthly income. Higher PSI scores were also significantly related to $1\sim2$ days hight-work per week, much for them workload, dissatisfaction with their job, and bad relationship with their bosses and coworkers. 6. Higher PSI scores were significantly related to severe tinnitus and perceived hearing losso(p<0.001). Workers who felt the earplugs they use did not fit their ears showed significantly higher PSI scores(p<0.01). Workers who reported that they did not feel they need earplugs showed. significantly higher PSI scores (p<0.05). Increased experience of eardisease caused by earplugs that did not fit were also significantly related to higher PSI scores(p<0.01). 7. The higher noise exposure level in worksite from 80dB was, the more severe stress symptoms including PSI subparts were reported; Anxiety, Anger, Depression, and Cognitive disorder(p<0.001). 5. According to the results of stepwise multiple regression analysis, factors affecting workers' PSI scores were perceived hearing loss$(R^2=0.160)$, noise exposure level in worksite$(R^2=0.110)$, realtionship with coworkers, amount of workload, monthly income and relationship with bosses orderly and the total $R^2$ of this 6 factors was 0.371. 9. The most significant factors that have impact on manual workers' stress symptoms were perceived hearing loss and noise exposure level in worksite, especially noise exposure level in the worksite was the most affective factor on the depression symptom.

• Korean Journal of Adult Nursing
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• v.12 no.2
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• pp.184-195
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• 2000

It has been believed that cancer is an omnious factor threatening the future and life itself. Patients having the disease experience anxiety, fear, feeling of weakness, depression and feelings of uncertainty and hopelessness. Most cancer patients, however, have expectations of possible recovery and a better future, very different from the patients who feel hopeless. Therefore. hope allows people to respond effectively to the fatal disease they have and prevents them from detoriorating physically and spiritually, positively influencing their survival, response to treatment and sense of security. Studies previously performed showed that hope is positively correlated with social and family supports, self-esteem, spiritual well-being, responsive action, health promotion behavior and quality of life. Thus, the study attempted to provide basic information on nursing cancer patients by investigating their levels of hope and determining predictive factors which influence hope. For the study 200 cancer patients in two university hospitals located in Pusan were sampled as subjects. Data were collected for twenty nine days from Feburary 1, 1999 to March 1. Instrumets for the study included 10 items from the self-esteem scale by Rosenberg (1965), 39 hope measurements by Kim and Lee(1965), 16 of the social support scale by Tae(1986) and 16 of the general characteristics scale, all of which totaled 81 items. The data were analyzed using the SPSS program. General characteristics of the investigated based on numbers and percentage. Hope, self-esteem and social support were analyzed using means, minimum, maximum and standard deviation. Relations among the foregoing three factors were analyzed using Pearson' correlation coefficient. Levels of hope in cancer patients were determined using t-test, ANOVA and Scheffe test. Predictive factors influencing hope were investigated using multiple stepwise regression analysis. Results of the study are summarized as follows: 1. An average level of hope was $185.55{\pm}23.39$ points(96 min. and 234 max.) 2. Levels of hope showed a significant difference among them according to sex (t=-3.69, P=.000), age(F=4.714, P=.000), job(F=3.247, P=.008), monthly income (F=6.113, P=.003), treatment charge (F=3.796, P=.011), supportive resources (F=10.554, P=.000), diagnosis(F=2.287, P=.029), perceived health status(F=22.184, P=.000), level of pain(F=3.334, P=.021), religion (F=4.911, P=.001) and religion's effect in life (F=11.706, P=.000), 3. For the subjects, self-esteem and social support were $38.32{\pm}7.21$(13 min, and 50 max.) and $52.97{\pm}8.49$points(28 min, 80 max.). Concerning social support, average levels of family support and medical support were found $35.95{\pm}6.05$(18 min, and 40 max) and $27.02{\pm}4.99$ points(20 min and 40 max). The hope the cancer patients showed significant correlations with self-esteem (r=.588, P=.000), family support(r=.224, p=.001) and medical support(r=.221, P=.002). 4. The five variables related to hope (self-esteem, religion's effect in life, perceived health status, social support and age) accounted for 54.2 percent of the hope level; especially, self-esteem was the highest at 34.6%. As shown in the above results, predictive factors which most influence hope in cancer patients were self-esteem and religion's effect of life. Therefore, nursing interventions to increase self-esteem should be developed. Regarding religion's effects, studies on spiritual aspects should be carried out in a way that contributes to promotion of hope.

• Journal of agricultural medicine and community health
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• v.38 no.3
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• pp.182-194
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• 2013

Objectives: To identify and compare the health behaviors and health status of the elderly between urban and rural areas using the data of the Korean National Health and Nutrition Examination Survey (KNHANES). Methods: The study population comprised 3,823 elderly people aged 65 years or older who participated in the $4^{th}$ KNHANES (2007-2009). The areas were classified into "large cities," "cities," and "rural areas" using the administrative and residential areas. The health behaviors and health status of the elderly between the rural and urban areas were compared using a complex sample design with the Rao-Scott chi-square test and weighted multiple logistic regression analysis. Results: Compared to large cities, the odds ratios (ORs) (95% confidence interval [CI]) of rural areas were as high as 1.58 (1.25-2.01) for the influenza vaccination and as low as 0.47 (0.37-0.59) for flexibility exercises, 0.56 (0.38-0.81) for muscular exercises, and 0.76 (0.62-0.92) for obesity. The ORs (CI) for osteoarthritis and diabetes mellitus were as low as 0.81 (0.66-0.99) and 0.70 (0.55-0.89), respectively. Conclusions: The health behaviors and health status of the elderly are better in rural areas than in urban areas despite the fact that the socioeconomic conditions in rural areas are poorer that those in urban areas. These findings suggest that programs suitable for residential areas should be developed and that studies to explain the differences in residential areas are needed.

• Journal of Nutrition and Health
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• v.51 no.5
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• pp.400-413
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• 2018

Purpose: This study examined the association between the antioxidant vitamin intake and obesity in Korean women. Methods: Adult women aged ${\geq}19years$ who completed a health examination and nutrition survey from the Korea National Health and Nutrition Examination Survey between 2007 ~ 2016 were selected for the study (n = 30,425). A BMI ${\geq}25kg/m^2$ and waist circumference ${\geq}85cm$ were defined as obesity and abdominal obesity, respectively. The individual antioxidant vitamin intake was estimated by linking the antioxidant vitamin composition database of commonly consumed foods and the subjects' 24-hour recall food consumption data. Carotenoids, retinol, vitamin A (retinol activity equivalent), vitamin C, tocopherols, and vitamin E (${\alpha}$-tocopherol equivalent) were included in the analysis. Each vitamin intake was converted to the nutrient density per 1,000 kcal. Odds ratio (ORs) and 95% confidence interval (CI) for obesity according to each tertile of the nutrient density was obtained from multiple logistic regression adjusted for age, household income, education level, smoking, alcohol consumption, and physical activity. Results: The mean intake of ${\alpha}$-carotene, retinol, vitamin E, ${\alpha}$-tocopherol, and ${\gamma}$-tocopherol per 1,000 kcal was significantly lower in the obese group than in the normal group. A higher intake of lycopene was inversely associated with obesity (highest vs. lowest; OR = 0.89, 95% CI: 0.83-0.96) and abdominal obesity (highest vs. lowest; OR = 0.88, 95% CI: 0.81-0.95). Higher intakes of ${\alpha}$-carotene, total carotenoids, vitamin A, and ${\gamma}$-tocopherol also had a negative relationship with abdominal obesity. The antioxidant vitamin intakes from eggs, milk and dairy products, seasoning, and grains were significantly lower in the obese group than in the normal group. Conclusion: This study showed that the dietary intake of antioxidant vitamins was inversely associated with obesity and abdominal obesity among Korean women. Further study will be needed to examine the causal relationship between the antioxidant vitamin and obesity.

• Journal of dental hygiene science
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• v.16 no.1
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• pp.53-61
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• 2016

Eating supports to gain energy and nutrition and improves quality of life. Ageing affects the food intake ability due to loss of natural teeth and the progressive muscle degeneration. Our objective was to investigate how the food intake ability (FIA) and the remaining teeth could influence on oral health related quality of life in the elderly. This study was performed with 503 elderly subjects living in Daejeon, Korea. The questionnaire with the FIA with 30 Korean food and Oral Health Impact Profile 14 (OHIP-14) and oral examination were surveyed. The five groups according to cluster analysis of FIA had the different numbers of remaining teeth and functional posterior teeth with opposing teeth or prosthesis significantly: group 1, $21.78{\pm}8.27$ and $2.80{\pm}2.63$; group 2, $16.75{\pm}7.87$ and $2.16{\pm}2.44$; group 3, $14.68{\pm}9.77$ and $1.73{\pm}2.30$; group 4, $9.93{\pm}8.13$ and $0.78{\pm}1.68$; group 5, $10.18{\pm}8.37$ and $0.51{\pm}1.22$. The more foods the subjects could masticate, the better oral health related quality of life they had. The medium FIA, soft FIA and the number of remaining teeth could explain 46% of OHIP-14, but hard FIA could not in the multiple regression model. We suggested to develop the oral health program for the elderly to be able to eat the food with medium physical property at least be helpful to improve oral health related quality of life.

• Journal of agricultural medicine and community health
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• v.30 no.1
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• pp.75-88
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• 2005

Objectives: This survey was intended to provide basic data which can be available as a baseline in the set up of dietary guidelines for assuring community-based self-support of the rural elderly, through investigation of the relationship of the various dietary consumptions with their ADL and IADL. Methods: The study subjects, 439 rural residents(male: 196, female:243) aged over 65 in Kumsan Kun and Chongyang Kun, Chungchongnamdo Province were interviewed, in June of 2004, about their sociodemographic characteristics, daily life styles, the variety of dietary consumption, ADL and IADL with the following major findings: Results: In terms of the scores' distribution to show variety of food consumption among all subjects, 68.3% got 1~3 points, 23.2% 4~6 points, and 8.4% 7~10 points with a decreasing proportion of subjects in higher points. In terms of their functional status, normal-range groups showed 93.2% of ADL and 72.9% of IADL whereas, impaired ADL group 6.8% of ADL and 27.1% of IADL, respectively. Concerning the relation of ADL and IADL with the variety of their consumed food, the greater scores for food variety was associated with the significantly higher proportion of normal ADL group and the lower proportion of impaired ADL group. Multiple logistic regression analysis with ADL and IADL as dependent variables, and food variety scores as explanatory variables, the relative risk of impaired-ADL group was 0.84 in the food variety group of 4~6 points, 0.63 in 7~10 points with no statistical significance. The relative risk of impaired- IADL group was 0.52(p<0.01) in the food variety group of 4~6 points, 0.41(p<0.05) in 7~10 points with statistical significance. Conclusions: These study results suggest that the lower dietary variety, the lower functional capacity of daily living, and the variety of dietary is associated with the functional capacity of daily living in rural elderly.

• Journal of agricultural medicine and community health
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• v.36 no.4
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• pp.227-237
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• 2011

Objectives: This study was conducted to investigate the utilization and its determinants of rehabilitation services of people with disabilities in a rural area. Methods: From March 2 to April 1, 2011, we interviewed 101 disabled people with either physical disabilities or brain lesions. The subjects completed questionnaires about the utilization of rehabilitation services, general characteristics (age, sex, marital status, education level, economic status, health insurance, housing, and employment) and disability characteristics (type, level, comorbidity, reason for the occurrence of the disability, self-rated degree of disability, and daily life care giver). Frequency, Pearson's chi-square test, and a multiple logistic regression were used for statistical analysis. Results: This study showed that 70.3% of the people in this rural area with disabilities were using rehabilitation services. The two most common reasons for not using the services were "doubt about the effectiveness of the service" and "no facilities nearby." The facilities that the disabled people were currently using, in the order of most used to least, were general hospitals or clinics, rehabilitation centers, oriental medicine clinics, and public health centers. Only 19.7% of those who received rehabilitation responded that they were satisfied with the service. Significant factors in the utilization of rehabilitation services were sex, employment, self-rated economic status, and the reason for the occurrence of the disability. Women, people who were currently working, people who were of middle or higher economic status, or people who had acquired a disability were significantly more likely to use the services. Conclusions: A large number of people with disabilities in a rural area use rehabilitation services at present, but accessibility and satisfaction were low. Quantitatively and qualitatively, rehabilitation services for disabled people in a rural area should be centered around Community-based Rehabilitation (CBR). Effective strategies, for example reaching those who have not used the rehabilitation services, will be needed to improve services in rural areas.

• The korean journal of orthodontics
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• v.38 no.3
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• pp.202-213
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• 2008

Objective: The purpose of this study was to compare the cephalometric measurements of obese and non-obese Korean male patients with obstructive sleep apnea syndrome (OSA). Methods: Eighty-seven adults who had visited the Sleep Disorder Clinic Center in Keimyung University, Daegu, Korea were examined and evaluated with polysomnography (PSG) and lateral cephalogram. They were divided into 4 groups (non-obese simple snorers, obese simple snorers, non-obese OSA patients, obese OSA patients) according to AHI (Apnea-Hypopnea Index) and BMI (Body Mass Index). Results: The obese OSA group had the highest AHI among the 4 groups. The non-obese OSA group had a significantly steeper mandibular angle and shorter tongue length than the obese OSA group. The hyoid bone of the obese OSA group was positioned anterior and inferior as compared with the non-obese OSA group. Multiple regression analysis showed that tongue length in the obese OSA group and retroposition of hyoid bone in the non-obese OSA group were significant determinants for the severity of AHI. Conclusions: From a cephalometric point of view, the obese and non-obese pateints with OSA may be characterized by different pathogeneses. Therefore, they have to be managed by individualized treatment. For the obese OSA patients, weight control must be advised as a first choice and for the non-obese OSA patients, oral appliance, nasal CPAP, UPPP and others could be chosen according to the obstructive sites.