Analysis of New Patient's Willingness to Pay Additional Costs for Securing Satisfactory Consultation Time / 보건행정학회지

BACKGROUND: We evaluated new patient's satisfactory consultation time (SCT) and their willingness to pay additional costs (WPAC) for their SCT. METHODS: We surveyed medical service satisfaction, SCT, WPAC for their SCT, and payable amount to 612 new patients of single general hospital and measured their real consultation time (RCT). To compare WPAC and payable amount, we divided RCT into 4 groups (≤3 minutes, 3–5 minutes, 5–10 minutes, and >10 minutes), and SCT into 3 groups (≤5 minutes, 5–10 minutes, and >10 minutes). On the basis of WPAC, we estimated new patient's SCT. RESULTS: RCT was 6.2 minutes, SCT was 8.9 minutes, and medical service satisfaction score was 4.3 (out of 5). The number of patients having WPAC (payable group) was 381 (62.3%) and the amount was 5,853 Korean won. Their RCT and SCT were longer than non-payable group (6.4 minutes vs. 5.7 minutes, 9.3 minutes vs. 8.2 minutes). From multiple logistic regression analysis, WPAC of RCT 5–10 minutes was higher than that RCT ≤3 minutes (odds ratio=1.78). Payable amount was highest in RCT >10 minutes (6,950 Korea won) and SCT >10 minutes (7,458 Korean won). Intuitively we suggest 10 minutes as SCT, based on payable group's SCT (9.3 minutes) and cut-off time differentiating payable group with non-payable group (10 minutes). CONCLUSION: We found that new patient had WPAC for their SCT and the longer the SCT, the greater the amount. From this, we hope that current simplified new patient consultation fee calculating system should be modified combining the consultation time factor.

Dependence of RIG-I Nucleic Acid-Binding and ATP Hydrolysis on Activation of Type I Interferon Response

Exogenous nucleic acids induce an innate immune response in mammalian host cells through activation of the retinoic acid-inducible gene I (RIG-I). We evaluated RIG-I protein for RNA binding and ATPase stimulation with RNA ligands to investigate the correlation with the extent of immune response through RIG-I activation in cells. RIG-I protein favored blunt-ended, double-stranded RNA (dsRNA) ligands over sticky-ended dsRNA. Moreover, the presence of the 5'-triphosphate (5'-ppp) moiety in dsRNA further enhanced binding affinity to RIG-I. Two structural motifs in RNA, blunt ends in dsRNA and 5'-ppp, stimulated the ATP hydrolysis activity of RIG-I. These structural motifs also strongly induced IFN expression as an innate immune response in cells. Therefore, we suggest that IFN induction through RIG-I activation is mainly determined by structural motifs in dsRNA that increase its affinity for RIG-I protein and stimulate ATPase activity in RIG-I.

The Status of Home-Based Hospice Care in Korea / 한국호스피스완화의료학회지

PURPOSE: This study was conducted to investigate how home-based hospice care is provided in Korea. METHODS: From July 2011 through August 2011, 29 hospice facilities that provide home-based hospice care were surveyed using a questionnaire. Items included in the questionnaire were general characteristics of the organization, staff members, service programs, difficulties. RESULTS: Among the surveyed, hospice care was hospital-based for 11 (37.9%) facilities, hospital-independent center-based care for four (13.8%) and home-based care only for 10 (34.5%). Near half the participants were located in Seoul and Gyeonggi-do. Caregivers included nurses for 62.1% of the participants, volunteers 62.0%, pastors 44.8%, social workers 37.9%, coordinators 31.0% and doctors 31.0%. The facilities offered service programs such as family counseling (96.6%), transfer to other facilities (93.1%), psychological support (89.7%), bereavement support (86.2%), dying care (79.3%), clinical care (75.9%) and spiritual support (75.9%). The major obstacles were financial issues (24.1%), lack of trained staff (20.7%) and staff members' lack of awareness of home-based hospice care (13.8%). CONCLUSION: In Korea, home-based hospice care is provided by an insufficient number of facilities. Moreover, the service providers are experiencing difficulties such as lack of trained staff, insufficient financial resource and staff's lack of awareness of home-based hospice care. It is necessary to increase the number of home-based hospice care facilities with consideration of even distribution across regions and standard staffing and service programs and develop related insurance policies.

Socioeconomic Inequity in Self-Rated Health Status and Contribution of Health Behavioral Factors in Korea / 예방의학회지

OBJECTIVES: The study is investigated socioeconomic variations in self-rated health status and contribution of health behavioral factors in Korea. METHODS: A nationally representative sample (2,800 men and 3,230 women aged 20-64 years) from the 2005 Korea National Health and Nutrition Surveys was analyzed using logistic regression. RESULTS: Self-rated health was lower among lower socioeconomic groups compared with higher socioeconomic groups, with gender being irrelevant. This association was attenuated when health behavioral and socio-demographic factors were adjusted. When each health behavioral factor was considered separately, mediators such as smoking in men, and stress or exercise in women explained a large part of the decreased socioeconomic health inequalities. CONCLUSIONS: In Korea, subjective health inequalities arise from different socioeconomic status, but this difference is decreased by health behavioral factors. Therefore, socioeconomic inequity in self-rated health status can be corrected more effectively by promotional health behaviors.