Computed Tomography Spending and Utilization for Inpatients with Cerebral Infarction in South Korea / 보건행정학회지

BACKGROUND: Computed tomography (CT) is one of the most efficient diagnostic methods for stroke patients. The number of CT scanners in South Korea, however, is higher than in other countries, and may cause the overuse of this tool in healthcare. We aim to study the relationship between using CT and various patient and hospital characteristics among patients with cerebral infarction. METHODS: We analyzed nationwide health insurance claims data for patients due to cerebral infarction during the second half of 2013 for up to 3 months. We performed multilevel analysis, including both inpatient and hospital-level variables, to determine how factors affect CT spending and utilization. RESULTS: The data used in our study consisted of 17,046 hospitalizations at 583 hospitals. Inpatients who visited more than one hospital had higher CT utilization numbers and cost (number: ≥3 hospitals: β, 2.27; p <0.05; 2 hospitals: β, 0.70; p <0.05; cost: ≥3 hospitals: β, 251,108; p <0.05; 2 hospitals: β, 77,299; p <0.05). People who visited a general hospital had higher numbers and cost of CT utilization than people who visited a smaller hospital. CONCLUSION: Increased sharing of records and improved continuity of care between hospitals are needed to help curb the overuse of CT.

The Effects of a Nutrition and Body Shape Education Program as Part of Health Promoting Projects in an Elementary School

The purpose of this study was to evaluate the effects of a nutrition education program as part of health promoting projects in an elementary school. A total of 168 students in the 4th grade were enrolled in the program for 6 months. A self-administered questionnaire was developed to assess nutrition knowledge and dietary habit. Nutrient intakes and body shape perceptions were measured using 24-hour recall method and self-ratings of body shape figures, respectively. The education program was conducted in various ways, focused on healthy dietary behavior, nutrients' roles and sources, and proper body shape perceptions, etc. After the education program, nutrition knowledge and dietary habit were significantly improved. Dietary habit scores were significantly and positively related to nutrition knowledge levels. Body shape perceptions were significantly and properly changed after the program. Dissatisfaction with perceived current body shape and discrepancy between shapes desired and considered healthy were significantly decreased. But girls still indicated a desire to be leaner than shapes which were perceived current and considered healthy. Nutrient intakes were partly improved by the program, but some nutrients, such as calcium, folate, zinc, sodium and niacin, were still remained deficient or excessive. These findings indicate that enhancement of nutrition knowledge is extended to the improvement of dietary habit. In addition, establishment of proper body shape perception is closely related to healthy dietary habits and is required to good nutrition and health.

Hospital Staff and Patient Recognition Toward Opening of Medical Services Market, and Factors in Selecting a Foreign Hospital

PURPOSE: The objectives of this study are to compare the hospital employees' and patients' recognition and attitudes toward the opening of the medical services market, to analyze the differences between hospital employees and patients on the factors in selecting a foreign hospital. MATERIALS AND METHODS: This study collected and analyzed data using systematic questionnaires that were self-administered by employees and outpatients to compare their recognition of the opening of the medical services market and the factors involved in selecting a foreign hospital. RESUTLS: Employees exhibited a higher level of recognition than the patients. Reasons for agreement were to ensure the right of selection for both the employees and patients. Reasons for disagreement, however, were split between the two groups: degraded public characteristics of medical services, for employees; and expensive medical fees, for patients. The most urgent task to prepare for the opening of the medical services market is the improvement of the diagnosis and treatment technologies for employees, and improvement of the services provided by hospital staff for patients. CONCLUSION: Korean hospitals shall need to improve their diagnosis and treatment technologies and provide medical services of high quality in order to compete with foreign hospitals.

A Study on the Association Between Ginseng Intake and Incidences of Cancer: Kangwha Cohort Study / 예방의학회지

OBJECTIVES: There are many concerns about ginseng as a cancer chemopreventive substance, but there have been few epidemiological studies on ginseng. This study sought to examine the relationships between ginseng intake and cancer incidence in the Kangwha cohort. METHODS: Between March 1985 and December 1999, 2697 males, aged 55 or over, as of 1985, were followed up for their cancer incidence. The cancer incidence rate, standardized incidence ratio and risk ratios were calculated according to ginseng intake. A Cox proportional hazard model was used to adjust for age at entry, smoking, alcohol intake, hypertension, and body mass index. RESULTS & CONCLUSIONS: The ginseng intake group had the same cancer (C00-C97) incidences (Standardized Incidence Ratio: SIR=1.11, 95% Confidence Interval = 0.97-1.27) and the same risk ratio (RR=1.09, 95% Confidence Interval = 0.85-1.41) as the no-intake group. Analyzing the subjects that had followed up from 1990, however, the ginseng intake group had lower cancer incidences at all sites (RR = 0.79, 95% Confidence Interval = 0.58-1.09). This was a cohort study to try and evaluate the association between ginseng intake and the incidences of cancer. The results of this study provide no clear conclusions on the cancer preventive effects of ginseng. Therefore, further study is needed in the future.

Association between Quality of Life and Sexual Adjustment for Spinal Cord Injury Couples

OBJECTIVE: To examine the association between sexual adjustment and quality of life and to evaluate the difference of sexual adjustment between small group counselling program and simple sexual rehabilitation program for spinal cord injury couples. METHOD: Fifteen subjects who had participated in 4 weeks small group counselling and twenty subjects, who had participated in simple sexual rehabilitation education were enrolled among among spinal cord injury couples. Direct interview was conducted. Visual analogue scale, Time trade off, Hospital anxiety and depression, and Beck depression inventory were used as quality of life indexes. Sexual Interest, Activity and Satisfaction was used as a sexualadjustment measure. RESULTS: The sexual adjustment index was very significantly positively correlated with all 4 indexes of the quality of life. The couples of the small group counselling had significantly higher sexual adjustment index than the simple education group. Satisfaction for small group counselling was also higher. CONCLUSION: To improve the quality of life for spianl cord injury couples, sexual adjustment level must be improved. Systematic sexual rehabilitation program such as small group counselling may be better solution than simple sexual rehabilitation education program.

Pesticides and Cancer Incidence: The Kangwha Cohort Study / 예방의학회지

OBJECTIVE: Few studies have examined the relationship between the risk of cancer and exposure to pesticides in Korea or in other East Asian that have until recently used chlorophenoxy herbicides. The aim of this study was to evaluate the relationship between the exposure to pesticides and cancer incidence. METHODS: We conducted a prospective cohort study with a follow-up period of 13 years (1985-1998). The subjects included 2,687 male and 3,589 female Kangwha Island residents, Koreans aged fifty-five or more as of March 1985, who received a personal health interview and completed a health examination survey. A Cox proportional hazards models were used to estimate relative risks (RR). RESULTS: At baseline, the mean age of the study participants in 1985 was 66.4 for males and 67.1 for females. During the 13 years follow-up, a total of 300 incidents of cancer in males and 146 in females developed. In males, the total cancer incidence in the highest group was RR, 1.4 (95% CI=1.0-1.9), p for trend=0.041, for digestive organ cancer incidence in the highest group, RR, 1.5 (95% CI=1.0-2.3), p for trend=0.057, for stomach cancer incidence in the highest group, RR, 1.6 (95% CI=0.9-2.8), p for trend=0.094, for gallbladder cancer incidence in the highest group, RR, 9.1 (95% CI=1.1-77.0), p for trend=0.014 were elevated according to the higher frequency of pesticide use per year. In particular, the risk of gallbladder cancer was very high. Although not significant, the risk of liver cancer was higher than in the non-exposed group (in the highest group, RR, 2.0 (95% CI=0.7-5.9)). In females, although not significant, breast cancer incidence in the highest exposure group was higher than in the non-exposed group (in the highest group, RR, 4.7 (95% CI=0.8-27.9)). CONCLUSIONS: This study demonstrates that Korean farmers who use pesticides, particularly males, have a significantly higher total cancer incidence, particularly from digestive organ cancers such as, stomach, gallbladder, and liver cancer. In particular, the risk of gallbladder cancer was very high.

Cohort Study on Age at Menopause and Mortality- Kangwha Cohort Study - / 예방의학회지

OBJECTIVE: To examine the association between age at menopause and mortality in a population-based sample of women in Kangwha, Korea. METHODS: From the Kangwha Cohort, followed-up from 1985 to 1999, the data of the over 55 year old female group(n=3,596) was used in this study to examine the association between age at menopause and mortality. We calculated the all causes mortality risk ratio and the cancer mortality risk ratio by age at menopause grouping using the Cox Proportional Hazards Model with adjustments for age, BMI, smoking, education, chronic disease, self-rated health status, alcohol consumption and age at first birth. RESULT AND CONCLUSION: Compared to women who had menopause at 45-49 years, the all causes mortality risk ratio was 1.24 for women with menopause at less than 40 years(95% CI=1.01-1.53) and 1.05 for women with menopause at over 50 years(95% CI=0.92-1.20). Also, compared to women who had menopause at 45-49 years, the cancer mortality risk ratio was 1.53 for women with menopause at less than 40 years(95% CI=0.78-2.98) and 1.17 for women with menopause at over 50 years(95% CI=0.77-1.80).

Association between BMI and Mortality: Kangwha cohort study / 예방의학회지

OBJECTIVES: To investigate the association between BMI and Mortality. METHODS: This study was based on the analysis and assembly of the 'Kangwha Cohort Study', previously conducted by the Department of Preventive Medicine, Yonsei University. A total of 2,696 males and 3,595 females were followed for almost ten years and ten months from March 1985 to January 1996, a total of whom 2,420 died during this period. The Cox's proportional hazards regression model was used to analyze this data. RESULTS: We found a U-shaped relationship between BMI and mortality among the aged men in the Kangwha cohort. The hazard ratio of dying was adjusted for age, marital status, occupation, self cognitive health level, chronic disease, smoking, and alcohol frequency, then sorted by body mass index into the following groups; less than 18.5, 18.5 to less than 21.0, 21.0 to less than 23.5, 23.5 to less than 26.0 and greater than or equal to 26. The corresponding ratios for men were 1.81(1.50-2.19, 95%CI), 1.31(1.14-1.51, 95%CI), 1.0(referent), 1.05(0.87-1.26, 95%CI) and 1.39(1.09-1.76, 95%CI), respectively. And for women, 1.46(1.19-1.78), 1.12(0.95-1.31, 95%CI), 1.0(referent), 1.00(0.84-1.20, 95%CI) and 1.09(0.89-1.34, 95%CI), respectively. CONCLUSIONS: The risk of death among aged men in Kangwha increased in the under and overweight groups. The relationship between BMI and mortality has been well studied in Western populations, but little is known about the association between BMI and mortality in our country. So, on the basis of this study, it is apparent that more studies of the relationship between BMI and mortality will be needed for future work.

Potential for Integrated Medical School and Oriental Medical School Curriculum / 한국의학교육

This study aims to suggest potential steps required for the integration of medical and oriental medical school by comparing the curriculum and its content between the two. The analysis was based on the specific behavioral objectives(SBOS) of the Korean Medical Association and Oriental Medical School Association. We used the school's catalog as well to get information on courses that are offered, hours, and credits. Major findings were as follows. 1. Clinical courses that are taught in oriental medical schools cover about 75% of the courses offered in medical schools on the basis of SBOS. This suggests that western medical knowledge is required for training oriental medical doctors in Korea. 2. If the SBOS of clinical medicine is taught for another 1 year at the oriental medical school, it will cover the entire content of the medical school. Also if 1.5 years of oriental medicine content is taught at medical school, it will include the whole SBOS offered in orienta medical school. Including a 1 year of clinical practicum, the extra years of required education would be 2 years for oriental medical students and 2.5 years for the medical students. Planning for an integrated for medical and oriental medicine requires close cooperation between all parties in practice and academics. A newly developed level of medicine will emerge from this if the plan takes into account the establishment of medical and oriental medical graduate schools and KMA's movement to reduce the number of SBOS to be taught in medical schools.

An Attitude Among Personnels About Operation of Computer System in a New Hospitals / 대한의료정보학회지

The purpose of this study is to grasp the attitude among personnels and to investigate the factors influencing the attitude about the operation of computer system in a new hospitals. Data was collected from 234 employees of two general hospital located in Seoul and Kyung-Ki Do, Korea, using a self-administered questionnaire. Self-administered questionnaire were given to study socioeconomic characteristics, the level of knowledge, aptitude, attitude and behavior of computerization about the operation of computer system in a new hospitals. The major findings were as follows; 1. Job position had not statistically significant relationship with the attitude about the operation of computer system. But according to age, sex, aptitude, the level of attitude about the operation of computer system was statistically significant relationships. 2. Generally, those who were had higher period of computer usage and frequency of computer education showed a higher positive attitude about the operation of computer system. Also, those who answers to improve of efficiency and satisfaction of computer system showed a higher positive attitude about the operation of computer system. 3. In the results of multiple regression, the period of computer usage, satisfaction of computer system and sex were significantly related to attitude about the operation of computer system. Also, those with good aptitude were significantly related to attitude about the operation of computer system. However, job position and duration of work was not statistically significant relationship with attitude about the operation of computer system.

An Attitude Among Personnels About Operation of Computer System in a New Hospitals / 대한의료정보학회지

The purpose of this study is to grasp the attitude among personnels and to investigate the factors influencing the attitude about the operation of computer system in a new hospitals. Data was collected from 234 employees of two general hospital located in Seoul and Kyung-Ki Do, Korea, using a self-administered questionnaire. Self-administered questionnaire were given to study socioeconomic characteristics, the level of knowledge, aptitude, attitude and behavior of computerization about the operation of computer system in a new hospitals. The major findings were as follows; 1. Job position had not statistically significant relationship with the attitude about the operation of computer system. But according to age, sex, aptitude, the level of attitude about the operation of computer system was statistically significant relationships. 2. Generally, those who were had higher period of computer usage and frequency of computer education showed a higher positive attitude about the operation of computer system. Also, those who answers to improve of efficiency and satisfaction of computer system showed a higher positive attitude about the operation of computer system. 3. In the results of multiple regression, the period of computer usage, satisfaction of computer system and sex were significantly related to attitude about the operation of computer system. Also, those with good aptitude were significantly related to attitude about the operation of computer system. However, job position and duration of work was not statistically significant relationship with attitude about the operation of computer system.

Relationship between structural characteristics and hospital mortality rates on tertiary referral hospitals in Korea / 예방의학회지

This study was to evaluate hospital characteristics as composition of manpower and facilities to the death rate of patient; and to earmark the factors affecting the overall hospital mortality rates. The data utilized were derived from survey material conducted by the Korean Hospital Association on 32 tertiary referral hospitals in Korea between 1986 and 1994. The findings are: 1. Those hospitals having the most capacity per bed had little difference to the mortality rates than the others. 2. Those hospitals having the most daily patients per specialist had significantly higher mortality rates than the others, but the number of daily patients per nurse had little effect on the mortality rates. 3. Those hospitals which had a relatively sufficient number of quality assurance activities revealed a lower mortality, and particularly in case where such effort was directed to the clinicians, the outcome was remarkable. we concluded that the major factor affecting the hospital mortality rates seems to be the number of specialists per number of beds, the degree of quality assurance assessment of the clinicians, the quality assurance activities of each hospital as a whole, and the number of daily patient per specialist. According to the findings of this study, the composition and quality of specialist and adequate quality assurance activities seemed to be the essential for the improvement of hospital care. Therefore, in this regard the proper implementation of policy and support is highly recommended. Due to lack of available research material, the personal characteristics of specialists haven't been considered in this study However, this longitudinal observation of 32 tertiary referral hospitals over a nine year period has significant merit alone.

Distribution af active physicians and their working areas after 10 years of graduation / 예방의학회지

The geographical distribution of active physicians who graduated from medical schools before 1985 were studied. Those who had emigrated, hold non-medical jobs, are in the military service, or work as public health physicians and resident staff were excluded from the study. A total of 27,728 physicians were analyzed. Our studies have shown a relationship between the location of the medical schools from the which the physicians have graduated and the geographical regions in which they practice. A statistically significant number of physicians are working near the medical colleges from which they have graduated. That is, those who had graduated from medical schools located in the southern area of the country are presently working in the same region. This relationship was shown to be especially significant for older physicians and female doctors, who work around the area of the medical colleges from which they graduated.

Smoking and female lung cancer by morphological types, a case-control study / 한국역학회지

No abstract available.