A cohort study on the relationship between pesticide use and mortality, and cancer mortality / 예방의학회지

The purpose of this study is to examine the relationship between pesticide use and mortality, and cancer mortality which are recognized as health hazards of pesticides. Data were analyzed from a cohort of 6,066 people aged fifty-five or over and who have been residing in the main island of Kangwha county. Death certificates, computerized citizenship registers searches, and household interview survey lead to get more than ninety-seven percents follow-up rate for the first five year observation period. Important findings are as follows: 1. Age specific mortality rates of pesticide users are significantly lower than those of pesticides nonusers. The SMR of male is 0.80, and 0.58 for females respectively probably due to healthy worker effects. But, age specific cancer mortality rates are significantly higher than those of pesticide nonusers (SMR=1.59) in males. this finding is not observed in females (SMR=0.85), however. 2. Logistic regression analyses showed that self-reported health status, drinking, and smoking histories in male are significantly associated with total mortality rate. The histories of pesticide use are also calculated to be highly associated with cancer mortality as in univariate analyses in males. In female, self-reported health status, age of first delivery are found to be significantly related to total mortality rate. Only drinking history is calculated to be associated with cancer mortalities in females. Data from further observation of 'Kangwha cohort' and indepth analyses of these are highly expected.

A Study on the Efficient Management of Long-term Inpatient Flow in a General Hospital / 예방의학회지

This study refers to the problem of long-term inpatient flow in a general hospital. In this study, a queueing simulation model was developed for the two departments in the hospital with a homogenous case mix and relatively many long-term inpatients in order to increase the tumover rate and hospital charges. Before the simulation run, the model was verified by the Kolmogorov-Smirmov test. The following results were generated by three alternative models of the special bed policies. 1. Alternative I: When long term inpatients were admitted to the wards belonging to departments A and B without transfer to other departments and special beds, the average turn-over rate decreased by 2-4% and the average hospital charges decreased by 70 million won. 2. Alternative II: When long-term inpatients were transferred to department C but the transfer of wards was determined by department C in order of clinical need, the average turnover rate increased by 4-13% but the average hospital charges decreased by 30 million won. This result was not greatly different from the present state. 3. Alternative III: When long-term inpatients were transferred to the special wards and department C simultaneously, the increase in the average turnover rate and hospital charges was equivalent to the increase of two beds in the special wards. When the special wards were allocated 16 beds, the average turnover rate of departments A and B increased by about 55% and 20% respectively. Also, the hospital charges increased by about 0.44 billion won. As a result, trasfer to department C and the use of 16 beds in the special wards for long-term inpatients of departments A and B is expected to maximize the hospital revenue. However, as the above special bed policy can not increase the turnover rate above 60%, there is a need for a more comprehensive policy to further increase the rate. The development of an elaborate model should include the number of long-term inpatients in all clinical departments, the special wards system or an increase of hospital beds to handle admission needs, and the resources of the hospital by department. When the alternative are evaluated, a cost-benefit analysis in addition to the turnover rate and the hospital charges should be considered.

The Change of Children's Blood Pressure and Factors Affecting the Level of Blood Pressure In Children / 예방의학회지

To show the distribution and change of blood pressure according to age and find factors affecting the level of blood pressure in primary school children, a follow-up study was conducted from 1986 to 1989 on 401 first grade children attending primary school in Kangwha county in 1986 and their parents. The blood pressure of the children was significantly increased according to age. The average annual increase was 1.8mmHg in systolic blood pressure and 2.5mmHg in diastolic blood pressure. The level of blood pressure did not show any significant difference in both sexes. Among children who were at or above the 80th percentile of blood pressure in the first grade, 35 and 30% of them have remained at the same level of systolic and diastolic blood pressure respectively in the fourth grade. But we could not find any significance in the tracking of blood pressure of children who were at or above the 90th percentile of blood pressure in the first grade. Weight and pulse rate were shown to significant factors affecting systolic blood pressure in children of both sexes and mother's blood pressure and skinfolds thickness were also affected systolic blood pressure in girls. The variables significantly affecting diastolic blood pressure were arm circumference and pulse rate for boys and height and pulse rate for girls.

Korean Nationwide Blood Pressure Study

A nationwide arterial blood pressure survey in Korea was conducted for the first time with 9,790 persons selected as a probability sample. The survey was done from March to September 1980. The objectives of the survey were to measure the distribution of arterial blood pressures and the magnitude of hypertension by demographic and socioeconomic variable characteristics in the Korean cultural setting. To examine more critically the local notions, beliefs and hypotheses related to hypertension, as well as the relation between salt intake and blood pressure, were also part of the objectives of the study. General patterns of distributions of blood pressures by age and sex were found to be very similar to that of other countries. However, remarkably lower mean systolic blood pressures found at all ages in females, consistently low prevalence rates for hypertension in both sexes, low rates for systolic hypertension in females and remarkably higher rates for diastolic hypertension in both sexes were found. The more educated, those with higher incomes, the more mental work done and dwellers of the larger cities had the higher blood pressures. These findings are compatible with beliefs long held by Koreans. A negative correlation was also observed indirectly, however, between salt intake and blood pressure.

Medical Accessibility and Its Effects on Medical Care Utilization: Experiences from Yonsei Health Insurance Cooperatives / 예방의학회지

Accessibility to medical facilities and personnels has been known as one of important determinants of medical care utilization. This study attempted to identify the effects of medical accessibility in terms of geographical distance and occupational opportunity to the medical utilizations. Two-year-experiences of Yonsei University Health Insurance Cooperatives were used as the sources of data. Out patient utilization patterns of 713 members sampled from 4,352 members of Health Insurance Cooperatives were analyzed in order to identify the effects of medical accessibilities. Findings: 1. Average clinic visit rate of Yonsei Health Insurance is 1.66 per person per year. 2. The utilization rates of geographically more accessible group were 33% higher than that of less accessible group. 3. No marked difference in clinic visit rate were observed between medical and non-medical personnel and their family members. 4. Clinic visit rates among occupationally accessible group were slightly higher than those of less accessible. The utilization rate was more sensitively changed by the insurance policy changes in occupationally accessible group.