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Background@#F-18 Fluorodeoxyglucose positron emission tomography (F-18 FDG PET), which can cover the body from the skull base to the thigh in one scan, is beneficial for evaluating distant metastasis. F-18 FDG PET has interested policymakers because of its relatively high cost. This study investigated the effect of the F-18 FDG PET reimbursement criteria amendment on healthcare behavior in breast cancer using an interrupted time series (ITS) analysis. @*Methods@#We retrospectively analyzed the inpatient and outpatient data from Korea’s Health Insurance Review and Assessment Service (HIRA) from January 1, 2013 to December 31, 2018. ITS analysis was performed for the number of each medical imaging modality and the total medical imaging cost of the breast cancer patients. @*Results@#The annual number of breast cancer patients has been increasing steadily since 2013. The trend of F-18 FDG PET increased before the reimbursement criteria was amended, but intensely decreased immediately thereafter. The chest and abdomen computed tomography scans showed a statistically significant increase immediately after the amendment and kept steadily increasing. A change in the total medical imaging cost for the breast cancer patient claimed every month showed an increasing trend before the amendment (β = 5,475, standard error [SE] = 1,992, P = 0.008) and rapid change immediately after (β = −103,317, SE = 16,152, P < 0.001). However, there was no significant change in the total medical imaging cost at the long-term follow-up (β = −912, SE = 1,981, P = 0.647). @*Conclusion@#Restriction of health insurance coverage for cancer may affect healthcare behaviors. To compensate for it, the policymakers must consider this and anticipate the impact following implementation.
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Background@#The purpose of this study is to investigate association between harms from the alcohol consumption of others and depression measured by Patient Health Questionnaire-9, perceived stress among Korean adults. @*Methods@#This study used data from the 7th Korea National Health and Nutrition Examination Survey (2016-2018; n=9,668). We used multivariate survey logistic regression analysis in order to investigate the association. @*Results@#Among participants, 5.55% had experience for harms from the alcohol consumption of others. Among them, 15.25% had depression and 8.97% had perceived stress. Multivariate survey logistic regressions revealed that objective depression and perceived stress were associated with harms from the alcohol consumption of others (objective depression: odds ratio [OR], 3.30; 95% confidence interval [CI], 2.32–4.70; perceived stress: OR, 2.04; 95% CI, 1.62-2.56). @*Conclusion@#Objective depression and perceived stress was significantly associated with harms from the alcohol consumption of others. This study suggests that government agencies and policy makers should recognize current status, further, develop a plan to identify the causes of harms from the alcohol consumption of others and protect vulnerable groups.
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Purpose@#Nutritional intervention by an interdisciplinary nutrition support team (NST) can potentially improve postnatal growth outcomes in preterm infants. This study aimed to measure the growth impact of a nutritional intervention package performed by an NST in a quality improvement effort in a neonatal intensive care unit (NICU). @*Methods@#Fifty-two infants born below 2,000 g and admitted to NICU participated in the Quality Improvement (QI) program between March 2016 and February 2017. The nutritional intervention was applied according to newly established nutritional guidelines on parenteral and enteral nutrition, and an NST performed a weekly nutritional assessment. The Z-scores of weight, height, and head circumference were calculated according to the gestational age and sex. The clinical impact on postnatal growth was compared between the QI and pre-QI groups. The pre-QI group included 69 infants admitted in the same NICU between 2014 and 2015. @*Results@#The time to the initiation of enteral nutrition decreased significantly (P＜0.001). Changes in weight (P=0.027), head circumference (P=0.003), Z-scores between birth, and 40 weeks postconceptional age (PCA) were significantly larger in the QI than the pre-QI group. The percentage of infants weighing below the 10th percentile at one month after birth and at 40 weeks PCA was higher in the pre-QI than the QI group. @*Conclusion@#The implementation of evidence-based best practices for preterm nutrition resulted in significant improvements in the growth outcomes in preterm infants.
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Background@#Although Korean government have been adopting several policies to expand coverage of National Health Insurance (NHI) program, the coverage rate is still below average across Organization for Economic Cooperation and Development countries.This study was to identify public perception on appropriateness of coinsurance rate and factors associated with coinsurance rate in National Health Insurance. @*Methods@#For this cross-sectional study, 507 participants over aged 20 years were recruited from telephone surveys. Respondents experienced at least one and more visiting medical facilities due to medical problems in last 12 months. Demographic factors, socioeconomic positions, and experiences on medical utilization were measured in order to identify factors associated with perception appropriateness of coinsurance rate. @*Results@#The 49.9% (n=209) of the public responded that the coinsurance rate of NHI program was appropriate. There were no differences in positive perception according to socio-demographic factors and experiences on medical utilization except for gender, residential area, and felt expensive when using medical services. People who felt burden of medical expenditure were more likely to perceive coinsurance rate inappropriate (odds ratio, 2.33; 95% confidence interval, 1.52–3.58) @*Conclusion@#In spite of the relatively low coverage rate of NHI, this study identified that 49.9% of the public perceived the current coinsurance rate was adequate. However, people who felt the burden of medical expenditure were still had a negative perception of the coinsurance rate needed to decrease the coinsurance rate.
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Purpose@#Nutritional intervention by an interdisciplinary nutrition support team (NST) can potentially improve postnatal growth outcomes in preterm infants. This study aimed to measure the growth impact of a nutritional intervention package performed by an NST in a quality improvement effort in a neonatal intensive care unit (NICU). @*Methods@#Fifty-two infants born below 2,000 g and admitted to NICU participated in the Quality Improvement (QI) program between March 2016 and February 2017. The nutritional intervention was applied according to newly established nutritional guidelines on parenteral and enteral nutrition, and an NST performed a weekly nutritional assessment. The Z-scores of weight, height, and head circumference were calculated according to the gestational age and sex. The clinical impact on postnatal growth was compared between the QI and pre-QI groups. The pre-QI group included 69 infants admitted in the same NICU between 2014 and 2015. @*Results@#The time to the initiation of enteral nutrition decreased significantly (P＜0.001). Changes in weight (P=0.027), head circumference (P=0.003), Z-scores between birth, and 40 weeks postconceptional age (PCA) were significantly larger in the QI than the pre-QI group. The percentage of infants weighing below the 10th percentile at one month after birth and at 40 weeks PCA was higher in the pre-QI than the QI group. @*Conclusion@#The implementation of evidence-based best practices for preterm nutrition resulted in significant improvements in the growth outcomes in preterm infants.
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Background@#Although Korean government have been adopting several policies to expand coverage of National Health Insurance (NHI) program, the coverage rate is still below average across Organization for Economic Cooperation and Development countries.This study was to identify public perception on appropriateness of coinsurance rate and factors associated with coinsurance rate in National Health Insurance. @*Methods@#For this cross-sectional study, 507 participants over aged 20 years were recruited from telephone surveys. Respondents experienced at least one and more visiting medical facilities due to medical problems in last 12 months. Demographic factors, socioeconomic positions, and experiences on medical utilization were measured in order to identify factors associated with perception appropriateness of coinsurance rate. @*Results@#The 49.9% (n=209) of the public responded that the coinsurance rate of NHI program was appropriate. There were no differences in positive perception according to socio-demographic factors and experiences on medical utilization except for gender, residential area, and felt expensive when using medical services. People who felt burden of medical expenditure were more likely to perceive coinsurance rate inappropriate (odds ratio, 2.33; 95% confidence interval, 1.52–3.58) @*Conclusion@#In spite of the relatively low coverage rate of NHI, this study identified that 49.9% of the public perceived the current coinsurance rate was adequate. However, people who felt the burden of medical expenditure were still had a negative perception of the coinsurance rate needed to decrease the coinsurance rate.
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BACKGROUND/AIM: We aimed to evaluate the efficacy of sending educational video clips via smartphone mobile messenger (SMM) on enhancing bowel preparation before colonoscopy. METHODS: This was a prospective, endoscopist-blinded, randomized controlled study. Patients in the SMM group received two video clips sent via SMM that explained the diet and regimen for bowel preparation, whereas those in the control group did not receive any video clips. We compared the quality of bowel preparation between the two groups, which was assessed by an endoscopist using the Ottawa scale. RESULTS: Between August and November 2014, 140 patients in the SMM group and 141 patients in the control group underwent colonoscopic examination. The total Ottawa score of the SMM group was significantly lower than that of the control group (5.47±1.74 vs. 5.97±1.78, p=0.018). These results were particularly prominent in the younger age group; the total Ottawa score of patents in the SMM group aged <40 years was significantly lower than that of patients in the control group aged <40 years (5.10±1.55 vs. 6.22±2.33, p=0.034). CONCLUSIONS: We demonstrated that sending educational video clips via SMM could result in better bowel preparation, especially in the younger age group.
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Humans , Colonoscopy , Diet , Education , Prospective Studies , SmartphoneABSTRACT
The purpose of this study was to identify the effects of simulation education using team-based on problem solving process, communication ability and communication confidence of nursing students. The study used a one group, pre-post test design. The subjects of this study were 88 nursing college students. self-reported questionnaires were collected between March 3 and June 21, 2019. As a result, There was a statistically significant difference in the problem-solving process: 3.37 points beforehand, 3.53 points after death, 3.36 points after communication, 3.54 points after the fact, and communication confidence increased from 6.39 points before to 7.64 points. After team-based simulation training, problem solving process is a communication ability, communicator confidence. The results of this study show that team-based simulation training has been effective in improving problem resolution, communication skills and communication confidence, so it can be used as a basis for future standardized program development.
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Humans , Communication , Education , Evaluation Studies as Topic , Nursing , Problem Solving , Program Development , Simulation Training , Students, NursingABSTRACT
PURPOSE: Early detection of Mycoplasma pneumoniae is important for appropriate antimicrobial therapy in children with pneumonia. This study aimed to evaluate the diagnostic value of a rapid antigen test kit in detecting M. pneumoniae from respiratory specimens in children with lower respiratory tract infection (LRTI). METHODS: A total of 215 nasopharyngeal aspirates (NPAs) were selected from a pool of NPAs that had been obtained from children admitted for LRTI from August 2010 to August 2018. The specimens had been tested for M. pneumoniae by culture and stored at −70°C until use. Tests with Ribotest Mycoplasma® were performed and interpreted independently by two investigators who were blinded to the culture results. RESULTS: Among the 215 NPAs, 119 were culture positive for M. pneumoniae and 96 were culture negative. Of the culture-positive specimens, 74 (62.2%) were positive for M. pneumoniae by Ribotest Mycoplasma®, and 92 of the 96 (95.8%) culture-negative specimens were negative for M. pneumoniae by Ribotest Mycoplasma®. When culture was used as the standard test, the sensitivity and specificity of Ribotest Mycoplasma® were 62.2% and 95.8%, respectively. Additionally, the positive predictive value, negative predictive value, and overall agreement rates with Ribotest Mycoplasma® were 94.9%, 67.2%, and 77.2%, respectively. CONCLUSIONS: A positive test result of Ribotest Mycoplasma® suggests a high likelihood of culture-positive M. pneumoniae infection. However, a negative test result should be interpreted with caution because nearly one-third of negative test results reveal culture-positive M. pneumoniae infections.
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Child , Humans , Diagnosis , Chromatography, Affinity , Mycoplasma pneumoniae , Mycoplasma , Pneumonia , Pneumonia, Mycoplasma , Point-of-Care Systems , Research Personnel , Respiratory Tract Infections , Sensitivity and SpecificityABSTRACT
BACKGROUND: To aim of this study was to examine the association between perceived possibility of purchasing cigarettes and e-cigarette experience among adolescents who currently smoke cigarettes. METHODS: Data were derived from the Korea Youth Risk Behavior Web-Based Survey; a total of 29,169 current smokers participated. The dependent variable was e-cigarette experience in the previous month. Analyses included χ2 test and survey logistic regression. RESULTS: A perceived easy possibility of purchasing cigarettes increased the odds of e-cigarette experience (odds ratio, 1.19; 95% confidence interval, 1.07–1.33) compared to when it was perceived as impossible. An easy possibility of purchasing cigarettes increased the odds of e-cigarettes experience among males aged 12–15 or 17 years compared to when it was impossible to purchase cigarettes. CONCLUSION: A perceived easy possibility of purchasing cigarettes was more likely to increase e-cigarette experience among adolescents. Laws restricting adolescents' access to e-cigarettes must be strengthened.
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Adolescent , Humans , Male , Electronic Nicotine Delivery Systems , Jurisprudence , Korea , Logistic Models , Risk-Taking , Smoke , Smoking , Tobacco ProductsABSTRACT
PURPOSE: Little is known regarding the extent to which dying patients with chronic obstructive pulmonary disease (COPD) receive life-sustaining procedures and palliative care in U.S. hospitals. We examine hospital cost trends and the impact of palliative care utilization on the use of life-sustaining procedures in this population. METHODS: Retrospective nationwide cohort analysis was performed using National Inpatient Sample (NIS) data from 2005 and 2014. We examined the receipt of both palliative care and intensive medical procedures, defined as systemic procedures, pulmonary procedures, or surgeries using the International Classification of Diseases, 9th revision (ICD-9-CM). RESULTS: We used compound annual growth rates (CAGR) to determine temporal trends and multilevel multivariate regressions to identify factors associated with hospital cost. Among 77,394,755 hospitalizations, 79,314 patients were examined. The CAGR of hospital cost was 5.83% (P < 0.001). The CAGRs of systemic procedures and palliative care were 5.98% and 19.89% respectively (each P < 0.001). Systemic procedures, pulmonary procedures, and surgeries were associated with increased hospital cost by 59.04%, 72.00%, 55.26%, respectively (each P < 0.001). Palliative care was associated with decreased hospital cost by 28.71% (P < 0.001). CONCLUSION: The volume of systemic procedures is the biggest driver of cost increase although there is a cost-saving effect from greater palliative care utilization.
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Humans , Cohort Studies , Costs and Cost Analysis , Health Policy , Hospital Costs , Hospitalization , Inpatients , International Classification of Diseases , Interrupted Time Series Analysis , Palliative Care , Pulmonary Disease, Chronic Obstructive , Retrospective StudiesABSTRACT
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.
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Humans , Cerebral Infarction , Continuity of Patient Care , Delivery of Health Care , Health Expenditures , Hospitalization , Hospitals, General , Inpatients , Insurance, Health , Korea , Multilevel Analysis , StrokeABSTRACT
BACKGROUND: The purpose of this study is to investigate impact of increased tobacco price in 2015 on the adult smoking rate in South Korea. METHODS: This study used 6th Korea National Health and Nutrition Examination Survey from 2013 to 2015. Total 14,860 adults were included in the analysis. The chi-square test, univariate- and multivariate survey logistic regressions, and subgroup analysis were conducted. RESULTS: Results show that adult smoking rate before price increase were 19.08% and after price increase were 16.69%. Adjusted by variables associated with smoking behavior and others, multivariate survey logistic regressions revealed that smoking rate decreased after introduction of increased tobacco price policy (odds ratio [OR], 0.745; 95% confidence interval [CI], 0.575 to 0.967) and the impact was different by various social status (male: OR, 0.688; 95% CI, 0.523 to 0.905; age over 60: OR, 0.487; 95% CI, 0.315 to 0.754; rural area: OR, 0.531; 95% CI, 0.309 to 0.912; household income Q1: OR, 0.593; 95% CI, 0.352 to 0.999; household income Q4, OR, 0.616; 95% CI, 0.386 to 0.983). CONCLUSION: The study revealed decreased smoking rate after increased tobacco price policy and different trend depending on various social characteristics. We recommend that government agencies and policy makers should pursue tobacco price control policy continuously and population specific manner and concurrently non-price policy should be implemented as well.
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Adult , Humans , Administrative Personnel , Family Characteristics , Government Agencies , Korea , Logistic Models , Nutrition Surveys , Smoke , Smoking , Sociological Factors , TobaccoABSTRACT
BACKGROUND: The purpose of this study is to investigate impact of increased tobacco price in 2015 on the adult smoking rate in South Korea. METHODS: This study used 6th Korea National Health and Nutrition Examination Survey from 2013 to 2015. Total 14,860 adults were included in the analysis. The chi-square test, univariate- and multivariate survey logistic regressions, and subgroup analysis were conducted. RESULTS: Results show that adult smoking rate before price increase were 19.08% and after price increase were 16.69%. Adjusted by variables associated with smoking behavior and others, multivariate survey logistic regressions revealed that smoking rate decreased after introduction of increased tobacco price policy (odds ratio [OR], 0.745; 95% confidence interval [CI], 0.575 to 0.967) and the impact was different by various social status (male: OR, 0.688; 95% CI, 0.523 to 0.905; age over 60: OR, 0.487; 95% CI, 0.315 to 0.754; rural area: OR, 0.531; 95% CI, 0.309 to 0.912; household income Q1: OR, 0.593; 95% CI, 0.352 to 0.999; household income Q4, OR, 0.616; 95% CI, 0.386 to 0.983). CONCLUSION: The study revealed decreased smoking rate after increased tobacco price policy and different trend depending on various social characteristics. We recommend that government agencies and policy makers should pursue tobacco price control policy continuously and population specific manner and concurrently non-price policy should be implemented as well.
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Adult , Humans , Administrative Personnel , Family Characteristics , Government Agencies , Korea , Logistic Models , Nutrition Surveys , Smoke , Smoking , Sociological Factors , TobaccoABSTRACT
A 30-year-old female patient, 18 weeks gestational age, with no prior medical history was admitted to hospital complaining severe right upper quadrant pain. The patient was admitted to intensive care unit (ICU) after emergency surgery to treat intraperitoneal hemorrhage caused by rupture of liver hematoma. Despite the absence of high blood pressure, the patient was diagnosed with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome on the basis of abnormal levels of blood aspartate aminotransferase/alanine aminotransferase, lactate dehydrogenase, total bilirubin, direct bilirubin, C-reactive protein (CRP) and platelet along with liver damage and proteinuria. While in ICU, the patient was given total parenteral nutrition (TPN) and enteral nutrition (EN) for –20 days because oral feeding was impractical. In the early stage, TPN supply was not sufficient to meet the elevated nutritional demand induced by disease and surgery. Nevertheless, continuous care of nutrition support team enabled satisfactory EN and, subsequently, oral feeding which led to improvement in patient outcome.
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Adult , Female , Humans , Pregnancy , Aspartic Acid , Bilirubin , Blood Platelets , C-Reactive Protein , Emergencies , Enteral Nutrition , Gestational Age , HELLP Syndrome , Hematoma , Hemolysis , Hemorrhage , Hypertension , Intensive Care Units , L-Lactate Dehydrogenase , Liver , Parenteral Nutrition , Parenteral Nutrition, Total , Platelet Count , Proteinuria , RuptureABSTRACT
This study investigated the serotype distribution and antimicrobial resistance of 3,820 nasopharyngeal Streptococcus pneumoniae isolates from infants and children who presented with respiratory symptoms at Seoul National University Children's Hospital from July 2010 to June 2015 after the introduction of the extended-valency pneumococcal conjugate vaccines (PCVs). Serotypes and antimicrobial susceptibility were determined using the Quellung reaction and E-test, respectively. S. pneumoniae was isolated from 397 (10.4%) specimens. The most common serotypes were 19A (14.0%), 23A (12.8%), 15B/C (10.7%), 11A (10.1%), 6C (7.8%), and 6A (6.3%) among the typeable pneumococci (n = 335). The PCV serotype proportions significantly decreased (59.1% in 2010/11 to 17.0% in 2014/15, P < 0.001), whereas the non-PCV serotype proportions significantly increased (40.9% in 2010/11 to 83.0% in 2014/15, P < 0.001). The non-susceptibility rates for penicillin (oral), penicillin (parenteral, non-meningitis), cefotaxime, and erythromycin were 97.8%, 22.8%, 27.7%, and 95.5%, respectively. The proportions of PCV serotypes responsible for non-susceptibility to penicillin (parenteral, non-meningitis) and multidrug resistance significantly decreased (80.8% to 21.1%, P < 0.001 and 64.3% to 12.3%, P < 0.001, respectively), whereas the non-PCV serotype proportions significantly increased (19.2% to 78.9%, P < 0.001 and 35.7% to 87.7%, P < 0.001, respectively). Serotypes 23A and 15B/C demonstrated significant proportional increase among the antibiotics resistant strains. Thus, the PCV serotype proportions decreased and the non-PCV serotype proportions increased among nasopharyngeal carriage pneumococci after the introduction of extended-valency PCVs in Korea. Antimicrobial non-susceptibility rates for penicillin and erythromycin remain high despite the decrease in the proportion of PCV serotypes responsible for antimicrobial resistance over time.
Subject(s)
Child , Humans , Infant , Anti-Bacterial Agents , Cefotaxime , Drug Resistance, Multiple , Erythromycin , Korea , Penicillins , Pneumonia , Seoul , Serogroup , Streptococcus pneumoniae , Streptococcus , Vaccines, ConjugateABSTRACT
PURPOSE: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity in many countries, and it has high rate of hospital readmissions due to recurrent exacerbations of the disease. Many previous studies have suggested further examination of the factors that contribute to hospital readmissions of COPD patients. However, evidence on the effects of nurse staffing by registered nurses (RNs) on the readmission of COPD patients is lacking in Korea. The aim of our study was to evaluate the effects of nurse staffing on hospital readmissions of COPD patients. METHODS: We used National Health Insurance claim data from 2002 to 2012. A total of 1,070 hospitals and 339,379 hospitalization cases were included in the analysis. We divided the number of RNs per 100 beds and the proportion of RNs on staff to one of three groups (Q1: low; Q2: moderate; Q3: high). A generalized estimating equation model was used to evaluate the associations between readmission and nurse staffing. RESULTS: A higher number of RNs was associated with lower readmission rates of 8.9% (Q2) and 7.9% (Q3) respectively. A similar effect was observed as the proportion of RNs among the total nursing staff gradually increased, resulting in lower readmission rates of 7.7% (Q2) and 8.3% (Q3). CONCLUSIONS: Our results suggest notable positive effects of nurse staffing by RNs on patient outcomes. In addition, the magnitude of impact differed between different sizes of hospitals. Thus, human resource planning to solve staffing shortages should carefully consider the qualitative aspects of the nursing staff composition.
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Aged , Female , Humans , Male , Health Facility Size/statistics & numerical data , Hospitals, General/statistics & numerical data , Nurses/supply & distribution , Nursing Staff, Hospital/supply & distribution , Patient Outcome Assessment , Patient Readmission/statistics & numerical data , Personnel Staffing and Scheduling , Pulmonary Disease, Chronic Obstructive/nursing , Quality of Health Care , Recurrence , Republic of Korea , Retrospective StudiesABSTRACT
PURPOSE: The purpose of this study was to explain the health promotion behavior of Chinese international students in Korea using a structural equation model including acculturation factors. METHOD: A survey using self-administered questionnaires was employed. Data were collected from 272 Chinese students who have resided in Korea for longer than 6 months. The data were analyzed using structural equation modeling. RESULTS: The p value of final model is .31. The fitness parameters of the final model such as goodness of fit index, adjusted goodness of fit index, normed fit index, non-normed fit index, and comparative fit index were more than .95. Root mean square of residual and root mean square error of approximation also met the criteria. Self-esteem, perceived health status, acculturative stress and acculturation level had direct effects on health promotion behavior of the participants and the model explained 30.0% of variance. CONCLUSIONS: The Chinese students in Korea with higher self-esteem, perceived health status, acculturation level, and lower acculturative stress reported higher health promotion behavior. The findings can be applied to develop health promotion strategies for this population.
Subject(s)
Adult , Female , Humans , Male , Young Adult , Acculturation , Asian People/psychology , Cross-Sectional Studies , Emigrants and Immigrants/psychology , Health Promotion/methods , Health Status , Models, Theoretical , Republic of Korea , Self Concept , Social Support , Students/psychology , Surveys and QuestionnairesABSTRACT
PURPOSE: This study was conducted to investigate the effect that detection of chronic disease via health screening programs has on health behaviors, particularly smoking. MATERIALS AND METHODS: We analyzed national health insurance data from 2007 and 2009. Subjects who were 40 years of age in 2007 and eligible for the life cycle-based national health screening program were included. The total study population comprised 153518 individuals who participated in the screening program in 2007 and follow-up screening in 2009. Multiple logistic regression analyses were conducted by sex, with adjustment for health insurance type, socioeconomic status, body mass index, diabetes, hypertension, hyperlipidemia, and family history of cardiovascular and/or neurovascular disease. RESULTS: Among men with smoking behavior changes, those newly diagnosed with hyperlipidemia were more likely to show a positive health behavior change, such as smoking cessation, and were less likely to have a negative behavior change (e.g., smoking initiation). Additionally, men newly diagnosed with diabetes showed lower rates of negative health behavior changes compared to those without disease. Body mass index (BMI)> or =25, compared to BMI<23, showed higher rates of positive health behavior changes and lower rates of negative health behavior changes. Newly diagnosed chronic disease did not influence smoking behavior in women. CONCLUSION: Smoking behavior changes were only detected in men who participated in health screening programs. In particular, those newly diagnosed with hyperlipidemia were more likely to stop smoking and less likely to start smoking.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Body Mass Index , Health Behavior , Health Surveys , Hyperlipidemias/diagnosis , Hypertension , Mass Screening/methods , Motivation , Regression Analysis , Smoking/epidemiology , Smoking Cessation/psychology , Social ClassABSTRACT
PURPOSE: Aim of this study is to investigate the characteristics and performance of colorectal-anal specialty vs. general hospitals for South Korean inpatients with colorectal-anal diseases, and assesses the short-term designation effect of the government's specialty hospital. MATERIALS AND METHODS: Nationwide all colorectal-anal disease inpatient claims (n=292158) for 2010-2012 were used to investigate length of stay and inpatient charges for surgical and medical procedures in specialty vs. general hospitals. The patients' claim data were matched to hospital data, and multi-level linear mixed models to account for clustering of patients within hospitals were performed. RESULTS: Inpatient charges at colorectal-anal specialty hospitals were 27% greater per case and 92% greater per day than those at small general hospitals, but the average length of stay was 49% shorter. Colorectal-anal specialty hospitals had shorter length of stay and a higher inpatient charges per day for both surgical and medical procedures, but per case charges were not significantly different. A "specialty" designation effect also found that the colorectal-anal specialty hospitals may have consciously attempted to reduce their length of stay and inpatient charges. Both hospital and patient level factors had significant roles in determining length of stay and inpatient charges. CONCLUSION: Colorectal-anal specialty hospitals have shorter length of stay and higher inpatient charges per day than small general hospitals. A "specialty" designation by government influence performance and healthcare spending of hospitals as well. In order to maintain prosperous specialty hospital system, investigation into additional factors that affect performance, such as quality of care and patient satisfaction should be carried out.