Hospital Admission Rates for Ambulatory Care Sensitive Conditions in South Korea: Could It Be Used as an Indicator for Measuring Efficiency of Healthcare Utilization? / 보건행정학회지

BACKGROUND: Hospital admissions for ambulatory care sensitive conditions (ACSCs), which are widely used as an indicator of poor access to primary care, can be used as an efficiency indicator of healthcare use in countries providing good access to health care. Korea, which has a national health insurance (NHI) system and a good supply of health care resources, is one such country. To quantify admission rates of ACSC and identify characteristics influencing variation in Korean health care institutions. METHODS: By using NHI claims data, we computed the mean ACSC admission rate for all institutions with ACSC admissions. RESULTS: The average ACSC admission rate for 4,461 institutions was 1.45%. Hospitals and clinics with inpatient beds showed larger variations in the ACSC admission rate (0%-87.9% and 0-99.6%, respectively) and a higher coefficient of variation (7.96 and 2.29) than general/tertiary care hospitals (0%-19.1%, 0.85). The regression analysis results indicate that the ACSC admission rate was significantly higher for hospitals than for clinics (β=0.986, p<0.05), and for private corporate institutions than public institutions (β=0.271, p<0.05). CONCLUSION: Substantial variations in ACSC admission rates could suggest the potential problem of inefficient use of healthcare resources. Since hospitals and private corporate institutions tend to increase ACSC admission rates, future health policy should focus on these types of institutions.

Effects of d-alpha-tocopherol supplements on lipid metabolism in a high-fat diet-fed animal model

High-fat diet up-regulates either insulin resistance or triglycerides, which is assumed to be related to the expression of peroxisome proliferator-activated receptor (PPAR)-alpha and PPAR-gamma. The beneficial effects of vitamin E on insulin resistance are well known; however, it is not clear if vitamin E with a high-fat diet alters the expression of PPAR-alpha and PPAR-gamma. We investigated the effects of d-alpha-tocopherol supplementation on insulin sensitivity, blood lipid profiles, lipid peroxidation, and the expression of PPAR-alpha and PPAR-gamma in a high-fat (HF) diet-fed male C57BL/6J model of insulin resistance. The animals were given a regular diet (CON; 10% fat), a HF diet containing 45% fat, or a HF diet plus d-alpha-tocopherol (HF-E) for a period of 20 weeks. The results showed that the HF diet induced insulin resistance and altered the lipid profile, specifically the triglyceride (TG) and total cholesterol (TC) levels (P < 0.05). In this animal model, supplementation with d-alpha-tocopherol improved insulin resistance as well as the serum levels of TG and very-low-density lipoprotein-cholesterol (VLDL-C) (P < 0.05). Moreover, the treatment decreased the levels of malondialdehyde (MDA) in the serum and liver while increasing hepatic PPAR-alpha expression and decreasing PPAR-gamma expression. In conclusion, the oral administration of d-alpha-tocopherol with a high-fat diet had positive effects on insulin resistance, lipid profiles, and oxidative stress through the expression of PPAR-alpha and PPAR-gamma in a high-fat diet-fed male mice.

Patient satisfaction versus political support: Korea's drug-dispensing law revisited

In 2000, Korea enacted a controversial law prohibiting doctors from dispensing drugs. Doctors have opposed this law, and in theory, the law inconveniences patients. We assessed the relationship between patients' satisfaction with drug dispensation and their overall support for the law by using a logit model to determine the effects of the law on patients and which patients are likely to support the law. We employed random digit dialing and obtained a sample of 540 adults who had used drugs since the law was enacted. We collected the data through phone interviews. The results indicate that the respondents were generally dissatisfied with the law regardless of sociodemographic or regional characteristics. However, with other factors controlled for, those respondents from the same region as the ruling political party were significantly more likely to support the law. This implies that regional politics influenced the policymaking process through which the law was crafted and enacted.

Nutritional Status, Quality of Diet and Quality of Life in Postmenopausal Women with Mild Climacteric Symptoms Based on Food Group Intake Patterns / 대한지역사회영양학회지

This study was conducted to examine the nutritional status, quality of diet and quality of life in postmenopausal women with mild climacteric symptoms based on their food group intake patterns. The data for nutritional status were obtained using 3-day records. Quality of diet was assessed by INQ, NAR, MAR, DDS, DVS, DQI-I. Climacteric symptoms were analyzed by the questionnaire of Kupperman's index and MENoL. The subjects were classified into the five groups, GMVDF, GMVdF, GMVDf, GMVdf, GmVDF according to their food group intake patterns. Analysis of nutrient intakes showed that the GMVDF group took significantly higher levels of kcal, carbohydrate, protein, fat, vitamin A, thiamin, riboflavin, folate, vitamin C, vitamin E, calcium, phosphorous, sodium, iron, zinc and fiber than GMVdf group did (p < 0.05). INQ of Ca and Fe appeared to be higher in GMVDF than in GMVdf groups (p < 0.05). Analysis of NARs showed that missing milk groups took lower riboflavin, Ca and P than other groups did as the same result with MAR (p < 0.05). Analysis of DDS and DQI showed that GMVdf group had the lowest quality of diet (p < 0.05); however, no difference was found on DVS. The GMVdf group showed the worst climacteric symptoms compared with those of the other groups (p < 0.05). However, we couldn't observe any differences in menopause-specific quality of life among the groups. In conclusion, it would be beneficial to meet all five food groups to increase the quality of diet and to reduce the climacteric symptoms in postmenopausal women.