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고혈압약 투약을 시작한 장애인의 투약 순응도와 이에 영향을 미치는 요인
박종혁,신영수,이상이,박재현,Park, Jong-Hyock,Shin, Young-Soo,Lee, Sang-Yi,Park, Jae-Hyun 대한예방의학회 2007 예방의학회지 Vol.40 No.3
Objectives : The aims of this study were to estimate the antihypertensive medication adherence in people with a disability and a history of taking antihypertensive medication, and to identify the factors affecting medication adherence. Methods : The National Health Insurance claims data were linked with the National Disability Registry. People with a disability, who received a prescription of antihypertensives, were identified from a total of 85,098 cases. Cumulative medication adherence (CMA) was used as an indicator of medication adherence. A CMA > 80% was defined as appropriate medication adherence. Multiple logistic regression analysis was used to identify the factors affecting medication adherence. Results : The average CMA in a total of 85,098 patients was 79.5%. The appropriate adherence $(CMA{\geq}80%)$ rate was 54.5% and 20.5% of patients had a CMA < 50%. Multiple logistic regression analysis revealed that the probability of appropriate adherence decreased with decreasing number of prescription days per visit, increasing number of providers, the patients' residential area moving from urban to rural areas, and when patients have an internal organ disability, auditory impairment, mobility impairment. Conclusions : The adherence to antihypertensive medication in people with a disability is influenced by various socio-economic, clinical and regional factors. In particular, the disabled who have locomotive and communication disabilities and internal organ impairments have a higher probability of under-adherence to antihypertensive medication adherence in Korea.
박종혁,이진석,장혜정,김윤,Park, Jong-Hyock,Lee, Jin-Seok,Jang, Hye-Jung,Kim, Yoon 대한예방의학회 2008 예방의학회지 Vol.41 No.4
Objectives: The purpose of the study was to identify a gap between consumer characteristics and utilization of health information on the Internet. Methods: A telephone survey of nationally representative samples was conducted using structured questionnaires, and 1,000 of the 1,189 responses obtained were included in our analysis. The following variables were included in the analysis as potential predictors of health information use on the Internet: predisposing factors such as gender, age, and education status; enabling factors such as region and monthly household income; consumer need for health information; and attitude to health. Multiple logistic regression analysis was used to evaluate the association between utilization rate and the potential predictors. Results: Thirty-nine percent of consumers had obtained health information on the Internet over a one-year period. The utilization rates were higher for consumers who were young, educated, worked in the office setting, had higher incomes, wanted health information, and were able to use the Internet. The utilization rate was 5.35 times higher in the younger group (20-30 years) than in the elderly group (95% CI=2.21-12.97); 2.21 times higher for office workers than for manual workers (95% CI=1.16-4.20); 3.61 times higher for college graduates than for middle school graduates and below (95% CI=1.07-11.59); 1.99 times higher for people with monthly household incomes over 3,000,000 won than for those with monthly household incomes below 1,500,000 won (95% CI=1.01-3.92). Conclusions: There needs to be a paradigm shift, with consideration of not only Internet accessibility in the digital age, but also consumer ability and attitudes toward utilization of health information.
장애인의 국민건강보험 건강검진 수검에 영향을 미치는 요인
박종혁,이진석,이진용,홍지영,김소영,김성옥,조병희,김용익,신영수,김윤,Park, Jong-Hyock,Lee, Jin-Seok,Lee, Jin-Yong,Hong, Ji-Young,Kim, So-Young,Kim, Seong-Ok,Cho, Byong-Hee,Kim, Yong-Ik,Shin, Young-Soo,Kim, Yoon 대한예방의학회 2006 예방의학회지 Vol.39 No.6
Objectives : As the disabled have higher prevalence rates and earlier onsets of chronic diseases than the non-disabled, their participation in mass screening is important for the early detection and intervention of chronic diseases. Nevertheless, in Korea, the disabled have lower participation rates in mass screening services than the non-disabled. The purpose of the study was to find determinants for the participation in the National Health Insurance (NHI) mass screening program among the disabled. Methods : In this study, the NHI mass screening data of 423,076 disabled people, which were identified using the National Disability Registry (2003), were analyzed. Of the factors affecting the participation rates in mass screenings, the following variables were included for the analysis: socioeconomic stati, such as sex, age, category of health insurance program, region and income, disability characteristics, such as disability type, and severity. A multiple logistic regression analysis was used to evaluate the association between the participation rates, disability characteristics variables and demographic variables. Results : The participation rate in mass screening of the disabled was 41.3%, but was lower in females, an age of more than 70 years, self-employed and for those with an average monthly insurance premium over 133,500 Won and in metropolitan legions. The participation rate was 1.31 times lower in females than males (95% CI=1.29-1.33); 3.50 times lower in the elderly (more than 70 years) than the younger (95% CI=3.33-3.67); 1.43 times lower in those who live in metropolitan areas (95% CI=1.40-1.46); 2.59 times lower for those in a health Insurance program for the self-employed than for employees (95% CI=2.56-2.63), 1.19 times lower for the higher income (more than 133,500) than the lower income group (4,400-22,000) for the average monthly insurance premium (95% CI=1.15-1.23): 2.04 times lower for those with brain palsy and stroke disabilities than with auditory impairments (95% CI: 1.97-2.11) and 3.27 times for those with severe compared to mild disabilities (95% CI=3.15-3.40). Conclusions : The disabled with high severity, and locomotive and communication disabilities have lower participation rates in mass screening services in Korea.
이정아,이선희,박종혁,박재현,김성경,서주현,Lee, Jung-A,Lee, Sun-Hee,Park, Jong-Hyock,Park, Jae-Hyun,Kim, Sung-Gyeong,Seo, Ju-Hyun 대한예방의학회 2010 예방의학회지 Vol.43 No.3
Objectives: Limited research has investigated the specific needs of patients with cancer. This study was performed to explore patients needs and the related factors. Methods: The data were collected by 1 National Cancer Center and 9 regional cancer centers in Korea. An interview survey was performed with using a structured questionnaire for the subjects(2661 patients who gave written informed consent to particiate) survey 4 months after diagnosis and review of medical records. Data were analyzed using t-test, ANOVA and multiple regression analysis. Results: When comparing the relating factors related with patient needs to the sociodemographic characteristics, the female group showed a higher level of recognition for physical symptoms, social support needs. The younger group showed a significantly higher level of recognition for health care staff, psychological problems, information and education, social support, hospital services needs. In addition, the higher educated group showed a higher level of recognition for health care staff, physical symptoms, social support needs. The higher income and office workers group showed a higher level of recognition for hospital services needs. When comparing the relating factors related with patient needs to the cancer, the breast cancer group showed a higher level of recognition for all needs excluding physical symptoms, accessibility and financial support needs. The combined radiotherapy with surgery and chemotherapy group showed a higher level of recognition for psychological problems, information and education, social support needs. Conclusions: This study showed that needs on patient with cancer was significantly influenced by female, higher educagion, lower income, having religion, office worker, liver cancer, breast cancer, colon cancer, chemotherapy, and combined therapy.
암 환자의 발생 초기 의료비와 이에 영향을 미치는 요인
김소영,김성경,박종혁,박은철,Kim, So-Young,Kim, Sung-Gyeong,Park, Jong-Hyock,Park, Eun-Cheol 대한예방의학회 2009 예방의학회지 Vol.42 No.4
Objectives : The purposes of this study is to estimate the cost of cancer care after its diagnosis and to identify factors that can influence the cost of cancer care. Methods : The study subjects were patients with an initial diagnosis one of four selected tumors and had their first two-years of cancer care at a national cancer center. The data were obtained from medical records and patient surveys. We classified cancer care costs into medical and nonmedical costs, and each cost was analyzed for burden type, medical service, and cancer stage according to cancer types. Factors affecting cancer care costs for the initial phase included demographic variables, socioeconomic status and clinical variables. Results : Cancer care costs for the initial year following diagnosis were higher than the costs for the following successive year after diagnosis. Lung cancer (25,648,000 won) had higher costs than the other three cancer types. Of the total costs, patent burden was more than 50% and medical costs accounted for more than 60%. Inpatient costs accounted for more than 60% of the medical costs for stomach and liver cancer in the initial phase. Care for latestage cancer was more expensive than care for early-stage cancer. Nonmedical costs were estimated to be between 4,500,000 to 6,000,000 won with expenses for the caregiver being the highest. The factors affecting cancer care costs were treatment type and cancer stage. Conclusions : The cancer care costs after diagnosis are substantial and vary by cancer site, cancer stage and treatment type. It is useful for policy makers and researchers to identify tumor-specific medical and nonmedical costs. The effort to reduce cancer costs and early detection for cancer can reduce the burden to society and improve quality of life for the cancer patients.
중증 흡연자들의 금연 성공과 관련된 흡연행태와 심리상태
곽찬용(Chan-Yong Kwak),박종혁(Jong-Hyock Park),김소영(So Young Kim),이상익(Sang Ick Lee),신철진(Chul-Jin Shin),손정우(Jung-Woo Son),주가원(Gawon Ju),김시경(Siekyeong Kim) 한국중독정신의학회 2018 중독정신의학 Vol.22 No.2
Objectives : The purpose of this study was to determine the factors affecting smoking cessation rate of heavy smokers. Methods : Typically, 81 participants enrolled in the smoking cessation camp at Chungbuk National University Hospital from April 2016 to November 2016 were included in the present study. The psychological factors related to group classification and the factors related to the success of smoking cessation were analyzed. Results : After 24 weeks of leaving the camp, 57 out of 81 participants successfully quit smoking and 24 failed in doing so. In the successful group, depression scale, stress scale, and various smoking-related factors exhibited intercorrelation and in the failure group, no significant correlation was observed. However, a comparison of correlation coefficients showed no significant difference. In addition, smoking cessation success rate was low when exhaled CO concentration was high at the time of admission when the smoking initiation age was juvenile, and when the smoking type was A (stimulus seeking type). Conclusion : Exhaled CO concentration at the time of admission, smoking initiation age, and smoking type A (stimulus seeking type) were associated with smoking cessation success.
김진희,함명일,박은철,박재현,박종혁,김성은,김성경,Kim, Jin-Hee,Hahm, Myung-Il,Park, Eun-Cheol,Park, Jae-Hyun,Park, Jong-Hyock,Kim, Sung-Eun,Kim, Sung-Gyeong 대한예방의학회 2009 예방의학회지 Vol.42 No.3
Objectives : The objective of this study is to estimate the economic costs of cancer on society. Methods : We estimated the economic burden of people with cancer in South Korea. To perform the analysis, we reviewed the records of people who were cancer patients and those who were newly diagnosed with cancer. The data was compiled from the National Health Insurance Corporation, which included the insurance claims database, a list of cancer patients, a database that records the cancer rates, the Korea Central Cancer Registry Center s cancer patient registry database and the Korea National Statistical Office s causes of death database. We classified the costs as related to cancer into direct costs and indirect costs, and we estimated each cost. Direct costs included both medical and non-medical care expenses and the indirect costs consisted of morbidity, mortality and the caregiver's time costs. Results : The total economic costs of cancer in South Korea stood at 14.1 trillion won in 2005. The largest amount of the cost 7.4 trillion won, was the mortality costs. Following this were the morbidity costs (3.2 trillion won), the medical care costs (2.2 trillion won), the non-medical care costs (1.1 trillion won) and the costs related to the caregiver's time (100 billion won). As a result, the economic cost of cancer to South Korea is estimated to be between 11.6 trillion won to 14.1 trillion won for the year 2005. Conclusions : We need to reduce the cancer burden through encouraging people to undergo early screening for cancer and curing it in the early stage of cancer, as well as implementing policies to actively prevent cancer.
김용익,윤석준,이진용,이희영,박종혁,신영수,이중규,Kim, Yong-Ik,Yoon, Seok-Jun,Lee, Jin-Yong,Lee, Hee-Young,Park, Jong-Hyock,Shin, Young-Soo,Lee, Jung-Kyu 대한예방의학회 2005 예방의학회지 Vol.38 No.2
Objectives: This study estimated the burden of disease due to high alcohol consumption using DALY, a composite indicator recently developed by the Global Burden of Disease study group. The results were analyzed by age and sex. Methods: Firstly, high alcohol consumption-related diseases, and their relative risk (RR), were selected. Secondly, population attributable fractions (PAFs) were computed using formulae, including the relative risk (RR) and prevalence of exposure (Pe). Thirdly, the DALYs of high alcohol consumption-related diseases were estimated. Lastly, the attributable burdens of diseases due to high alcohol consumption wereconcluded as being the sum of the products that multiplied the DALYs of high alcohol consumption-related diseases by their population attributable fraction (PAF). Results : The burden of high alcohol consumption in Korea was 2992.3 person years (PYs) per 100,000 persons in men, and 1426.6 in women. For men, the high alcohol consumption-induced diseases with the five biggest burdens were liver cirrhosis, hypertensive disease, liver cancer, cerebral infarction and intracerebral hemorrhage. For women, these were cerebral infarction, intracerebral hemorrhage, hypertensive disease, liver cirrhosis and liver cancer. Conclusion: This study highlighted the attributable fraction of diseases due to exposure to high alcohol consumption, by quantifying the results of exposure to risk factors. Therefore, it is now possible to assess interventions for risk factors in quantifiable terms in each population. Finally, measuring the risk factor burdens was expected to contribute to priority setting and effective resource allocation in public health policy.