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.

소비자의 인터넷 건강정보 활용에 영향을 미치는 요인

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.

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.

암 진료 영역의 임상질지표 현황과 추진방향

이은정,박종혁,Lee, Eun Jung,Park, Jong Hyock 한국의료질향상학회 2010 한국의료질향상학회지 Vol.16 No.1

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.

암 환자의 치료에 대한 요구도와 관련된 요인분석

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.

고도음주로 인한 우리나라 국민의 질병부담 측정

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.

일개 상급종합병원 직원들의 흡연 지식 및 태도에 영향을 미치는 요인

박보희(Bo Hui Park),엽경은(Kyoung Eun Yeob),박보람(Bo Ram Park),김소영(So Young Kim),최강현(Kang Hyeon Choe),박종혁(Jong Hyock Park) 한국보건교육건강증진학회 2017 보건교육건강증진학회지 Vol.34 No.3

Hadoop기반의 공개의료정보 빅 데이터 분석을 통한 한국여성암 검진 요인분석 서비스

박민희,조영복,김소영,박종배,박종혁,Park, Min-hee,Cho, Young-bok,Kim, So Young,Park, Jong-bae,Park, Jong-hyock 한국정보통신학회 2018 한국정보통신학회논문지 Vol.22 No.10

본 논문에서는 공개의료정보 빅데이터 분석을 위해 클라우드 환경에서 아파치 하둡 기반의 클라우드 환경을 도입하여 컴퓨팅 자원의 유연한 확장성을 제공하고 실제로, 로그데이터가 장기간 축적되거나 급격하게 증가하는 상황에서 스토리지, 메모리 등의 자원을 신속성 있고 유연하게 확장을 할 수 있는 기능을 포함했다. 또한, 축적된 비정형 로그데이터의 실시간 분석이 요구되어질 때 기존의 분석도구의 처리한계를 극복하기 위해 본 시스템은 하둡 (Hadoop) 기반의 분석모듈을 도입함으로써 대용량의 로그데이터를 빠르고 신뢰성 있게 병렬 분산 처리할 수 있는 기능을 제공한다. 빅데이터 분석을 위해 빈도분석과 카이제곱검정을 수행하고 유의 수준 0.05를 기준으로 단변량 로지스틱 회귀분석과 모델별 의미 있는 변수들의 다변량 로지스틱 회귀분석을 시행 하였다. (p<0.05) 의미 있는 변수들을 모델별로 나누어 다변량 로지스틱 회귀 분석한 결과 Model 3으로 갈수록 적합도가 높아졌다. In this paper, we provide flexible scalability of computing resources in cloud environment and Apache Hadoop based cloud environment for analysis of public medical information big data. In fact, it includes the ability to quickly and flexibly extend storage, memory, and other resources in a situation where log data accumulates or grows over time. In addition, when real-time analysis of accumulated unstructured log data is required, the system adopts Hadoop-based analysis module to overcome the processing limit of existing analysis tools. Therefore, it provides a function to perform parallel distributed processing of a large amount of log data quickly and reliably. Perform frequency analysis and chi-square test for big data analysis. In addition, multivariate logistic regression analysis of significance level 0.05 and multivariate logistic regression analysis of meaningful variables (p<0.05) were performed. Multivariate logistic regression analysis was performed for each model 3.

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.