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사회경제적 위치와 유방암 수술 후 총 사망위험과의 관련성
박미진,정우진,이선미,박종혁,장후선,Park, Mi-Jin,Chung, Woo-Jin,Lee, Sun-Mi,Park, Jong-Hyock,Chang, Hoo-Sun 대한예방의학회 2010 예방의학회지 Vol.43 No.4
Objectives: This study aims to evaluate and explain the socioeconomic inequalities of all-cause mortality after breast cancer surgery in South Korea. Methods: This population based study included all 8868 females who underwent radical mastectomy for breast cancer between January 2002 and June 2003. Follow-up for mortality continued from January 2002 to June 2006. The patients were divided into 4 socioeconomic classes according to their socioeconomic status as defined by the National Health Insurance contribution rate. The relationship between socioeconomic status and all-cause mortality after breast cancer surgery was assessed using the Cox proportional hazards model with adjusting for age, the Charlson’s index score, emergency hospitalization, the type of hospital and the hospital ownership. Results: Those in the lowest socioeconomic status group had a significantly higher hazard ratio of 2.09 (95% CI =1.50 - 2.91) compared with those in the highest socioeconomic group after controlling for all the identifiable confounding variables. For allcause mortality after radical mastectomy, all the other income groups showed significantly higher 3-year mortality rates than did the highest income group. Conclusions: The socioeconomic status of breast cancer patients should be considered as an independent prognostic factor that affects all-cause mortality after radical mastectomy, and this is possibly due to a delayed diagnosis, limited access or minimal treatment leading to higher mortality. This study may provide tangible support to intensify surveillance and treatment for breast cancer among low socioeconomic class women.
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젊은 성인에서 교정 QT간격과 심혈관질환 위험요인의 관련성: 강화연구
안성복,김현창,허남욱,하경수,장후선,김진배,서일,Ahn, Song-Vogue,Kim, Hyeon-Chang,Hur, Nam-Wook,Ha, Kyoung-Soo,Jang, Hoo-Sun,Kim, Jin-Bae,Suh, Il 대한예방의학회 2006 예방의학회지 Vol.39 No.6
Objectives : Prolongation of the heart rate-corrected QT (QTc) interval has been reported to be associated with cardiovascular morbidity and mortality. However, few studies have examined the relationship between the QTc interval and cardiovascular risk factors in young healthy people, The aim of this study was to examine the associations between the QTc interval and cardiovascular risk factors in young healthy adults. Methods : This study was performed as part of the Kangwha study, which started in 1986, and is an on-going follow-up study on blood pressure and related cardiovascular risk factors. In follow-up examinations during 2005, cardiovascular risk factors, including anthropometrics, blood pressure, blood chemistry and carotid ultrasonography, were measured, and questionnaires on health behaviors completed by 127 men and 149 women aged 25 years. The QTc interval was measured on the resting 12-lead electrocardiogram using an automatic analysis program. Results : The mean QTc interval was significantly longer in women $(419{\pm}17ms)$ than in men $(405{\pm}17ms)$ (p<0.001). A significant positive correlation was found between the QTc interval and waist-hip ratio (p=0.030) in men. Women showed a positive correlation between the QTc interval and systolic blood pressure (p=0.017). On a multiple regression analysis, the QTc interval was positively associated with the waist-hip ratio in men (p=0.012) and with the systolic blood pressure (p=0.020) in women. Conclusions : In young healthy Korean adults, the QTc interval was independently associated with the waist-hip ratio in men and with the systolic blood pressure in women.
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건강보험 청구자료를 이용한 우리나라 뇌졸증 환자의 사회경제적 비용 추계
임승지,김한중,남정모,장후선,장영화,김세라,강혜영,Lim, Seung-Ji,Kim, Han-Joong,Nam, Chung-Mo,Chang, Hoo-Sun,Jang, Young-Hwa,Kim, Se-Ra,Kang, Hye-Young 대한예방의학회 2009 예방의학회지 Vol.42 No.4
Objectives : To estimate the annual socioeconomic costs of stroke in Korea in 2005 from a societal perspective. Methods : We identified those 20 years or older who had at least one national health insurance (NHI) claims record with a primary or a secondary diagnosis of stroke (ICD-10 codes: I60-I69, G45) in 2005. Direct medical costs of the stroke were measured from the NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting the hospitals. Indirect costs were defined as patients and caregivers productivity loss associated with office visits or hospitalization. Also, the costs of productivity loss due to premature death from stroke were calculated. Results : A total of 882,143 stroke patients were identified with prevalence for treatment of stroke at 2.44%. The total cost for the treatment of stroke in the nation was estimated to be 3,737 billion Korean won (KRW) which included direct costs at 1,130 billion KRW and indirect costs at 2,606 billion KRW. The per-capita cost of stroke was 3 million KRW for men and 2 million KRW for women. The total national spending for hemorrhagic and ischemic stroke was 1,323 billion KRW and 1,553 billion KRW, respectively, which together consisted of 77.0% of the total cost for stroke. Costs per patient for hemorrhagic and ischemic stroke were estimated at 6 million KRW and 2 million KRW, respectively. Conclusions : Stroke is a leading public health problem in Korea in terms of the economic burden. The indirect costs were identified as the largest component of the overall cost.
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퇴원환자 요약정보를 이용한 이탈환자 특성과 관련 요인 연구: 일개 대학병원 사례
김영옥 ( Young Ok Kim ),김태현 ( Tae Hyun Kim ),박소희 ( So Hee Park ),장후선 ( Hoo Sun Chang ) 한국보건정보통계학회(구 한국보건통계학회) 2013 보건정보통계학회지 Vol.38 No.2
Objectives: Patients who are discharged from hospital prematurely have become strategically important for hospital customer relationship management. The purpose of this study was to investigate the characteristics of patients who were discharged prematurely and the associated factors using patient discharge data. Methods: This study used a retrospective, cross-sectional design. Primary data source comes from medical records of patients who were discharged from a university medical center during 2011. Data were analyzed using chi-square test, T-test, Mann-Whitney U test, and multivariate logistic regression to find significant patient characteristics and factors associated with premature discharge. Results: Final research subjects were 18,104 patients after excluding duplicated discharge patients, death patients, and discharges against medical advice. Male sex, older age, and living further away from Seoul were positively associated with premature discharge. Patients who were admitted via emergency room, due to car accident, and referred by other medical providers were more likely to discharge prematurely. Those who were diagnosed with neoplasm or circulatory system illness, and having comorbidities or complications were related to premature discharge. Other factors, such as having consultation treatment, non-favorable treatment outcome, and staying in intensive care unit had higher odds of premature discharge. Conclusions: It is suggested that hospitals monitor patients who would be more likely to be discharged prematurely, and need to address any quality issues during hospitalization if they lead patients to discharge early.
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