폐경 연령과 사망력과의 관계에 대한 코호트 연구 - 강화 코호트 연구 -

홍재석,이상욱,지선하,손태용,오희철,Hong, Jae-Seok,Yi, Sang-Wook,Jee, Sun-Ha,Sohn, Tae-Yong,Ohrr, Hee-Choul 대한예방의학회 2001 예방의학회지 Vol.34 No.4

Objective : To examine the association between age at menopause and mortality in a population-based sample of women in Kangwha, Korea. Methods : From the Kangwha Cohort, followed-up from 1985 to 1999, the data of the over 55 year old female group(n=3,596) was used in this study to examine the association between age at menopause and mortality. We calculated the all causes mortality risk ratio and the cancer mortality risk ratio by age at menopause grouping using the Cox Proportional Hazards Model with adjustments for age, BMI, smoking, education, chronic disease, self-rated health status, alcohol consumption and age at first birth. Result and conclusion : Compared to women who had menopause at 45-49 years, the all causes mortality risk ratio was 1.24 for women with menopause at less than 40 years(95% CI=1.01-1.53) and 1.05 for women with menopause at over 50 years(95% CI=0.92-1.20). Also, compared to women who had menopause at 45-49 years, the cancer mortality risk ratio was 1.53 for women with menopause at less than 40 years(95% CI=0.78-2.98) and 1.17 for women with menopause at over 50 years(95% CI=0.77-1.80).

우리나라 외래서비스 이용 당뇨환자의 특성에 따른 당화혈색소(HbA1c)검사 시행률 변이 분석

홍재석 ( Jae Seok Hong ),강희정 ( Hee Chung Kang ),김재용 ( Jai Yong Kim ) 한국보건행정학회 2009 보건행정학회지 Vol.19 No.1

Background: The appropriate management of diabetes mellitus(DM) can help reduce its relapse and economic burden, but the level of management of DM in Korea is reported to be insufficient. This study aims to identify the management level of DM by figuring out the HbA1c examination performance rate of the diabetics and analyzing the variation according to the characteristic of a diabetic. Methods: This study used the Korean National Health Insurance Database which includes E10-14(ICD-10 code) as a primary or secondary disease as of 2006. Study population is 1,892,062 diabetics excluding 393,784 patients with the first attack of DM in 2006, 33,440 diabetics who died in 2006, and 21,299 patients with DM having no record of ambulatory care among the 2,340,585 DM patients in total. Results: The HbA1c examination performance rate of all DM patients in our country is estimated to be 41.5% as of 2006 and shows variation according to the characteristic of individual DM patients. The highest performance odds was shown by the patients who were below 19 of age, insured for health insurance, attended more than 3 ambulatory care providers, made ambulatory care visits more than 10 times annually, attended a specialized general hospital as their main attending medical institution, had a record of hospitalization or had co-morbidity. Conclusion: This study propose that is necessary to make politic preparations for the appropriate management of diabetes at a national level, and particularly, the patients with advanced age, the ones dependent on Medical Aid, and the ones using hospitals or clinics, whose appropriate management seems vulnerable, demand a careful management.

우리나라 고혈압 환자의 투약 순응도 연구

홍재석 ( Jae-seok Hong ) 한국보건행정학회 2021 보건행정학회지 Vol.31 No.3

Background: Medication adherence in hypertension is the most important to control blood pressure and prevent major complications. The purpose of this study was to identify factors affecting medication adherence and to examine the relationship between medication adherence and blood pressure control in Korea. Methods: This study used data from the 7th Korea national health and nutrition examination survey (2016-2018) of the Korea Disease Control and Prevention Agency. We selected 4,063 hypertensive patients from the data. And we choose socio-demographic, health behavior, healthcare utilization, and severity characteristics as hypertensive patient characteristics. Results: Of the patients with hypertension, 92.3% had shown adherence to medication as of 2016-2018 and shows variation according to the characteristic of patients. The cases with male, under 50 years old, urban area, single household, unmet medical services, less than 5 years of hypertension duration, no comorbidities (diabetes mellitus, myocardial infarction) showed significantly low medication adherence. After adjusting for confounders, adherent patients tended to have lower current systolic blood pressure (β=-10.846, p<0.001) and diastolic blood pressure (β=-5.018, p<0.001) than nonadherent patients. And, adherent patients increased the control odds of blood pressure compared with nonadherent patients (odds ratio, 3.02; 95% confidence interval, 2.21-4.12). Conclusion: This study confirmed that adherence to antihypertensive drugs was effective in controlling blood pressure. In order to more actively manage hypertensive patients at the national level, it is necessary to make an effort to improve the medication compliance of nonadherent groups, such as early-diagnosis patients, young patients under 50 years of age, and patients living alone.

우리나라 당뇨병 환자의 특성에 따른 안저검사 시행률 변이에 관한 연구

홍재석 ( Jae-seok Hong ) 대한보건협회 2020 대한보건연구 Vol.46 No.1

목적: 이번 연구는 최근 우리나라 당뇨병 환자에서의 안저검사 시행률을 파악해 보고, 안저검사 시행률에 차이가 발생하는 환자특성을 살펴보고자 하였다. 방법: 이번 연구는 질병관리본부의 국민건강영양조사 제7기(2016-2017년) 자료를 이용하여, 당뇨병 환자(n=1,100)를 대상으로 여러 가지 환자특성(인구사회학적, 의료이용, 중증도)에 따라 안저검사 시행률에 차이가 있는지를 살펴본 단면연구이다. 결과: 우리나라 당뇨병 환자들의 안저검사 시행률은 30.6%이었고, 환자특성에 따라 안저검사 시행률에 차이가 있었다. 여성 환자, 50-59세와 60-69세 환자, 소득수준이 ‘중상’인 환자, 인슐린 치료를 받는 환자에서 안저검사를 시행할 오즈가 높았다. 또한, 교육수준이 높을수록, 그리고 당뇨병 유병기간에 길어질수록 안저검사를 시행할 오즈가 높았다. 결론: 우리나라 당뇨병 환자에 대한 안저검사 시행률은 다른 국가들에 비해 매우 낮은 수준을 보이고 있어 안저검사 시행률을 향상시키기 위한 노력이 필요해 보인다. 특히 안저검사 시행률이 낮은 남성과 사회경제적 수준이 낮은 환자군, 그리고 젊은 환자군에 대한 각별한 관심이 필요하다. 향후 알림 메시지나 행동 코치, 재정적 인센티브 등과 같은 안저검사 시행률 향상을 위한 정책이 마련될 필요가 있어 보인다. Purpose: This study aims to identify the management level of diabetic retinopathy by figuring out the fundus examination performance rate of the diabetics and analyzing the variation according to the characteristic of a diabetic. Methods: This study used data from the 7th Korea national health and nutrition examination survey (2016-2017) of the Korea center for disease control and prevention(KCDC). We selected 1,100 diabetic patients from the data. And we choose socio-demographic, healthcare utilization, and severity characteristics as diabetic patient characteristics. Results: The Fundus examination performance rate of diabetic patients in our study is estimated to be 30.6% as of 2016-2017 and shows variation according to the characteristic of diabetic patients. The higher performance odds was shown by the patients who were female, 50-59 and 60-69 years old, middle-high income, and insulin treatment. And, the higher the level of education and the longer the duration of diabetes mellitus, the higher the odds of fundus examination performance. Conclusion: The fundus examination performance rate for diabetic patients in Korea is low compared to other countries, so efforts to improve the fundus examination performance rate are needed. Particularly, the male patients, patients with low socio-economic status, or younger patients, whose appropriate management seems vulnerable, demand a careful management. It is necessary to establish policies to improve the fundus examination rate such as reminder message, behavioral coaching, and financial incentives.

우리나라 성인 2형 당뇨환자의 외래진료 지속성과 관련요인 분석

홍재석 ( Jae Seok Hong ),김재용 ( Jai Yong Kim ),강희정 ( Hee Chung Kang ) 한국보건행정학회 2009 보건행정학회지 Vol.19 No.2

Background: Previous studies have reported that enhanced continuity of care prevented a sudden worsening in progress among chronic disease patients, and as a result was favorable for efficient spending of health care funds. This study aims to estimate the continuity of care of Korean with diabetes and to identify factors affecting the continuity of care. Methods: This study used the Korean National Health Insurance Claims Database which includes E11 (ICD-10) as a primary or secondary disease as of 2006. Study population is 1,160,725 type 2 diabetics (20-84 years). Continuity of Care Index (COC), Modified, Modified Continuity Index (MMCI), and Most Frequent Provider Continuity (MFPC) were used as indexes of continuity of care. Results: The continuity of care in the study population was 0.94±0.10 as calculated by MMCI, 0.91±0.16 as calculated by MFPC and 0.86±0.23 as calculated by COC. The lower continuity of care was shown in the patients who were female, 65 and over years old, Medical Aid recipients, 13 times or more visitors, hospital users as main attending medical institution, patients experienced hospitalizations or comorbidities. Conclusion: The continuity of care for adult patients with type 2 diabetes was high in Korea, and showed variation according to patients` characteristics. This result provides empirical evidence for policymakers to develop or strengthen programs for managing patients showing low continuity of care.

베트남 참전군인에서 우편으로 검진대상자를 모집하기 위한 예비조사

이상욱,홍재석,오희철,Yi, Sang-Wook,Hong, Jae-Seok,Ohrr, Hee-Choul 대한예방의학회 2003 Journal of Preventive Medicine and Public Health Vol.36 No.2

Objective : The aim of this study was to identify the validity of recruiting medical checkup participants of Vietnam veterans using a mail survey, and to identify the 'Vietnam service related characteristics' and 'general characteristics' of Vietnam veterans groups, Method : In this study, a total 900 veterans were randomly selected from the list of Vietnam veterans from f964 to 1973. The veterans were classified into 5 groups, taking into consideration their registered status in the Ministry of Patriots and Veterans Affairs: the VRD (veterans who have agent orange-related diseases), VSD (veterans who have agent orange-suspected disease), VM (veterans who peformed meritorious deeds during the war), VR (veterans who were registered with the Ministry of Patriots and Veterans Affair) and OV (other veterans) groups. By means of postal surveys, the veterans' intention to participate in the medical checkup for our research, and their socioeconomic and general characteristics were investigated. 52 surveys were returned due to the subjects not residing at the listed address, and were excluded from the analysis. Result : 699 of the 848 veterans (82.4%) responded to the survey, of which 619 (88.6%) intended to participate in the medical checkup for our research. The S veterans groups all had similar ages, Vietnam service period, Agent Orange exposure, troop characteristic and wartime class, with the exception of VM, who were older, and with a greater number of officers than the other 4 groups, There was a big difference in the health statius among the Vietnam veterans group. The VM and OV were much healthier than VRD, VSD and VR groups, The socioeconomic stati of the VRD, VSD and VR groups were lower than those of the VM and OV groups. Conclusion : Although there were some limitations, the recruitment, by mail, of medical checkup participants from Vietnam veterans is a valid and feasible method. The VM and OV groups were much healthier, and with higher socioeconomic stati, than the VRD, VSD, and VR groups.

고엽제의 건강위해성 평가를 위한 연구설계와 방법 제안

이상욱,원종욱,홍재석,오희철,Yi, Sang-Wook,Won, Jong-Uk,Hong, Jae-Seok,Ohrr, Hee-Choul 대한예방의학회 2001 Journal of Preventive Medicine and Public Health Vol.34 No.3

Objectives : To propose a feasible, valid and appropriate study designs and epidemiologic methods for evaluating the adverse health effects of Agent Orange-chemical defoliants used in Vietnam- in Korea. Methods : A literature study was peformed on Agent Orange, herbicides, pesticides and dioxins. The study subjects, study design, exposure assessment and health outcomes assessment were examined in each study. The potential data sources for the study subjects, study design, exposure assessment and health outcomes assessment in Korea were investigated. Results and Conclusion : In earlier Korean studies, research subjects for studying the effects of Agent Orange were identified from the patients or persons who claimed to have Agent Orange-related diseases due to the difficulties in identifying the entire population of Vietnam veterans in Korea. In this study, an attempt was made to identify the total number of Vietnam veterans in Korea. As a result, the addresses of 20,000 Vietnam veterans were obtained. It is proposed that a retrospective cohort design on a sample of the total number of Vietnam veterans is a feasible and appropriate study design. Self report questionnaires and military records were proposed to assess the exposure level. It is believed that measuring the plasma or tissue TCDD should be used only for a validation study assessing the level of exposure. For the health outcomes assessment, it is possible to obtain the mortality, cancer frequency, physical examination, screening and medical insurance record data.

인천지역 보건소의 민간의료기관에 대한 예방접종 실적 상세보고 권고사업의 효과

이현승 ( Hyun Seung Lee ),홍재석 ( Jae Seok Hong ),강희정 ( Hee Chung Kang ),오희철 ( Hee Choul Ohrr ) 대한보건협회 2005 대한보건연구 Vol.31 No.2

일본뇌염(Japanese Encephalitis)의 역학

오희철(Hee-choul Ohrr),이상욱(Sang-Wook Yi),홍재석(Jae-Seok Hong) 한국역학회 2005 Epidemiology and Health Vol.27 No.1

Japanese encephalitis(JE) is the leading viral cause of encephalitis and disability in Asia. The disease primarily infects children under the age of 15, leaving up to 70% of these who develop illness either dead or with a long-term neurological disability. We reviewed not only JE disease burden, etiology, vector, mode of transmission, reservoir but also geographic distribution and incidence of the disease in Asia, with a focus on the South Korea. A special comment on the methods of control JE and perspective for South Korea also included.

우리나라 노인인구의 주관적 건강상태 관련 요인에 관한 연구

한상희 ( Sang-hee Han ),강정규 ( Jung Kyu Kang ),홍재석 ( Jae-seok Hong ) 한국보건행정학회 2021 보건행정학회지 Vol.31 No.1

Background: Despite the high life expectancy, the subjective health status of the elderly people in Korea is reported to be the lowest as compared to other age groups. The purpose of the conducted study was to identify the factors related to the subjective health status of elderly people aged over 65 in Korea. Methods: This study used data from the 7th Korea National Health and Nutrition Examination Survey (2016-2017) of the Korea Disease Control and Prevention Agency. The subjects of the study were selected to be 2,904 elderly people aged over 65. The factors that were selected related to subjective health status were socio-demographics, perceived diseases, health behaviors, and mental health. Results: As a result of the examination of the subjective health status according to the characteristics of the subjects of study, the subjective health status was high in males (β=0.144, p=0.011), urban dwellers (β=0.107, p=0.015), employed persons (β=0.139, p=0.001), college graduates (β=0.322, p<0.001), persons with high household income (β=0.226, p<0.001), persons without chronic disease, nonsmokers (β=0.146, p=0.009), drinkers (β=0.111, p=0.003), persons who practiced aerobic physical activity (β=0.150, p<0.001), persons without depression (β=0.286, p<0.001), and persons who rarely had stress (β=0.837, p<0.001). Conclusion: More attention should be paid to those with low subjective health to improve health for elderly people. Expanding policy supports are required for elderly people with low socioeconomic status, chronic disease or depression, or unhealthy behaviors (smoking or lack of physical activity).