Journal of Preventive Medicine and Public Health

Eun cheol Park

24 Articles

Costs of Initial Cancer Care and its Affecting Factors.: So Young Kim, Sung Gyeong Kim, Jong Hyock Park, Eun Cheol Park; J Prev Med Public Health. 2009;42(4):243-250.; DOI: https://doi.org/10.3961/jpmph.2009.42.4.243

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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 late-stage 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.

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Projecting Lifetime Health Outcomes and Costs Associated with the Ambient Fine Particulate Matter Exposure among Adult Women in Korea
Gyeyoung Choi, Yujeong Kim, Gyeongseon Shin, SeungJin Bae
International Journal of Environmental Research and Public Health.2022; 19(5): 2494. CrossRef
Expenditure and Financial Burden for Stomach Cancer Diagnosis and Treatment in China: A Multicenter Study
Kai Zhang, Jian Yin, Huiyao Huang, Le Wang, Lanwei Guo, Jufang Shi, Min Dai
Frontiers in Public Health.2020;[Epub] CrossRef
Early Detection is Important to Reduce the Economic Burden of Gastric Cancer
Jie-Hyun Kim, Sung Soo Kim, Jeong Hoon Lee, Da Hyun Jung, Dae Young Cheung, Woo-Chul Chung, Soo-Heon Park
Journal of Gastric Cancer.2018; 18(1): 82. CrossRef
Supporting Low-income Cancer Patients: Recommendations for the Public Financial Aid Program in the Republic of Korea
Hye Sook Min, Hyung Kook Yang, Keeho Park
Cancer Research and Treatment.2018; 50(4): 1074. CrossRef
The Relief Effect of Copayment Decreasing Policy on Unmet Needs in Targeted Diseases
Jae-Woo Choi, Jae-Hyun Kim, Eun-Cheol Park
Health Policy and Management.2014; 24(1): 24. CrossRef
Changes in Economic Status of Households Associated with Catastrophic Health Expenditures for Cancer in South Korea
Jae-Woo Choi, Kyoung-Hee Cho, Young Choi, Kyu-Tae Han, Jeoung-A Kwon, Eun-Cheol Park
Asian Pacific Journal of Cancer Prevention.2014; 15(6): 2713. CrossRef
Medicaid inpatient costs and nested structural analysis using a hierarchical linear modeling (HLM) approach
Keon-Hyung Lee, Sang-Chul Park, Jungwon Park, Seunghoo Lim
Health Services and Outcomes Research Methodology.2013; 13(2-4): 157. CrossRef
Costs During the First Five Years Following Cancer Diagnosis in Korea
Ji-Yeon Shin, So Young Kim, Kun-Sei Lee, Sang-Il Lee, Young Ko, Young-Soon Choi, Hong Gwan Seo, Joo-Hyuk Lee, Jong-Hyock Park
Asian Pacific Journal of Cancer Prevention.2012; 13(8): 3767. CrossRef
Cost‐effectiveness of bevacizumab‐based therapy versus cisplatin plus pemetrexed for the first‐line treatment of advanced non‐squamous NSCLC in Korea and Taiwan
Myung‐Ju AHN, Chun‐Ming TSAI, Te‐Chun HSIA, Elaine WRIGHT, John Wen‐Cheng CHANG, Heung Tae KIM, Joo‐Hang KIM, Jin Hyoung KANG, Sang‐We KIM, Eun‐Jin BAE, Mijeong KANG, Johanna LISTER, Stefan WALZER
Asia-Pacific Journal of Clinical Oncology.2011; 7(s2): 22. CrossRef

Economic Burden of Cancer in South Korea for the Year 2005.: Jinhee Kim, Myung Il Hahm, Eun Cheol Park, Jae Hyun Park, Jong Hyock Park, Sung Eun Kim, Sung Gyeong Kim; J Prev Med Public Health. 2009;42(3):190-198.; DOI: https://doi.org/10.3961/jpmph.2009.42.3.190

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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.

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Regional Health Disparities between Mortality Rates in Three Leading Causes of Death : A Comparative Study of Spatial Dependence in Local Death Rate between Cancer, Heart Disease, and Pneumonia
Hee-Jung Jun, SeungYeoup Kang
Journal of Korea Planning Association.2023; 58(2): 38. CrossRef
Prevalence and socioeconomic burden of diabetes mellitus in South Korean adults: a population-based study using administrative data
Sung-Hee Oh, Hyemin Ku, Kang Seo Park
BMC Public Health.2021;[Epub] CrossRef
Analysis of Medical Use and Treatment Costs of Hepatocellular Carcinoma Patients Using National Patient Sample Data
Byeong-Chan Oh, Jeong-Yeon Cho, Sun-Hong Kwon, Eui-Kyung Lee, Hye-Lin Kim
Korean Journal of Clinical Pharmacy.2021; 31(2): 153. CrossRef
Sex Difference in the Socioeconomic Burden of Osteoporosis among South Koreans
Eun-Whan Lee, Jin Young Nam
Healthcare.2021; 9(10): 1304. CrossRef
Socioeconomic Burden of Disease Due to Asthma in South Korea
Eun-Whan Lee, Hee-Sun Kim, Wook Kim, Jin-Young Nam, Jae-Hyun Park
Asia Pacific Journal of Public Health.2020; 32(4): 188. CrossRef
The Economic Burden of Brain Disability in Korea, 2008-2011
Hyun-Jin Kim, Seung Hee Ho, Sol Lee, In-Hwan Oh, Ju Hee Kim, Eun Joo Kim, Seong Jae Lee
INQUIRY: The Journal of Health Care Organization, Provision, and Financing.2020; 57: 004695802093639. CrossRef
Socioeconomic Burden of Cancer in Korea from 2011 to 2015
Young Ae Kim, Ye-Rin Lee, Jeongjoo Park, In-Hwan Oh, Hoseob Kim, Seok-Jun Yoon, Keeho Park
Cancer Research and Treatment.2020; 52(3): 896. CrossRef
Measuring the Economic Burden of Disease and Injury in Korea, 2015
Ye-Rin Lee, Bogeum Cho, Min-Woo Jo, Minsu Ock, Donghoon Lee, Doungkyu Lee, Moon Jung Kim, In-Hwan Oh
Journal of Korean Medical Science.2019;[Epub] CrossRef
The economic burden of cancer attributable to obesity in Korea: A population‐based cohort study
Joo Eun Lee, Chung Mo Nam, Sang Gyu Lee, Sohee Park, Tae Hyun Kim, Eun‐Cheol Park
European Journal of Cancer Care.2019;[Epub] CrossRef
Association of Bedtime with both Suicidal Ideation and Suicide Planning among Korean Adolescents
Wonjeong Jeong, Yun Kyung Kim, Hyeon Ji Lee, Jieun Jang, Selin Kim, Eun-Cheol Park, Sung-In Jang
International Journal of Environmental Research and Public Health.2019; 16(20): 3817. CrossRef
Cancer Survivorship in Primary Care
Jihun Kang, Eun Ju Park, Jungkwon Lee
Korean Journal of Family Medicine.2019; 40(6): 353. CrossRef
The economic burden of kidney disorders in Korea
Ju Hee Kim, Seung Hee Ho, Hyun-Jin Kim, Sol Lee
Journal of Medical Economics.2018; 21(3): 262. CrossRef
How great is current curative expenditure and catastrophic health expenditure among patients with cancer in China? A research based on “System of Health Account 2011”
Ang Zheng, Wenjuan Duan, Lin Zhang, Xintong Bao, Xiaoyun Mao, Zhuojun Luo, Feng Jin
Cancer Medicine.2018; 7(8): 4036. CrossRef
The Burden of Cancer in Korea during 2012: Findings from a Prevalence-Based Approach
Young-hoon Gong, Seok-Jun Yoon, Min-Woo Jo, Arim Kim, Young Ae Kim, Jihyun Yoon, Hyeyoung Seo, Dongwoo Kim
Journal of Korean Medical Science.2016; 31(Suppl 2): S168. CrossRef
Factors Influencing the of Middle-Aged Men the NCSP(National Cancer Screening Program)
Geum-Ja Park, Kyoung-Min Lim, Sook-Nam Kim
The Korean Journal of Health Service Management.2016; 10(3): 51. CrossRef
Total costs and clinical outcome of hematopoietic stem cell transplantation in adults with leukemia: comparison between reduced‐intensity and myeloablative conditioning
Koung Jin Suh, Inho Kim, Jin Lim, Hyerim Ha, Seongyeol Park, Youngil Koh, Sung‐Soo Yoon, Seonyang Park
Clinical Transplantation.2015; 29(2): 124. CrossRef
The Epidemiology and Economic Burden ofClostridium difficileInfection in Korea
Hyung-Yun Choi, So-Youn Park, Young-Ae Kim, Tai-Young Yoon, Joong-Myung Choi, Bong-Keun Choe, So-Hee Ahn, Seok-Jun Yoon, Ye-Rin Lee, In-Hwan Oh
BioMed Research International.2015; 2015: 1. CrossRef
The Economic Burden of Cancer in Korea in 2009
So Young Kim, Jong-Hyock Park, Kyoung Hee Kang, Inuk Hwang, Hyung Kook Yang, Young-Joo Won, Hong-Gwan Seo, Dukhyoung Lee, Seok-Jun Yoon
Asian Pacific Journal of Cancer Prevention.2015; 16(3): 1295. CrossRef
The Economic Burden of Cancers Attributable to Metabolic Syndrome in Korea
Dongwoo Kim, Seok-Jun Yoon, Young-Hoon Gong, Young Ae Kim, Hye-Young Seo, Jihyun Yoon, A-Rim Kim
Journal of Preventive Medicine and Public Health.2015; 48(4): 180. CrossRef
The Economic Burden of Breast Cancer in Korea from 2007-2010
Young Ae Kim, In-Hwan Oh, Seok-Jun Yoon, Hyun-Jin Kim, Hye-Young Seo, Eun-Jung Kim, Yo Han Lee, Jae Hun Jung
Cancer Research and Treatment.2015; 47(4): 583. CrossRef
Quality of Life among End-stage Renal Disease Treatments and Economic Evaluation of Renal Transplantation and Hemodialysis Treatments
Kyung-Ock Jeon, Sun-Young Son, Myung-Il Hahm, Soon-Il Kim
Korean Journal of Transplantation.2015; 29(4): 200. CrossRef
Economic Burden of Colorectal Cancer in Korea
Ju-Young Byun, Seok-Jun Yoon, In-Hwan Oh, Young Ae Kim, Hye-Young Seo, Yo-Han Lee
Journal of Preventive Medicine and Public Health.2014; 47(2): 84. CrossRef
Attributable fraction of alcohol consumption on cancer using population-based nationwide cancer incidence and mortality data in the Republic of Korea
Sohee Park, Hai-Rim Shin, Boram Lee, Aesun Shin, Kyu-Won Jung, Duk-Hee Lee, Sun Ha Jee, Sung-Il Cho, Sue Kyung Park, Mathieu Boniol, Paolo Boffetta, Elisabete Weiderpass
BMC Cancer.2014;[Epub] CrossRef
Setting a Health Policy Research Agenda for Controlling Cancer Burden in Korea
Sung-In Jang, Kyoung-Hee Cho, Sun Jung Kim, Kwang-Sig Lee, Eun-Cheol Park
Cancer Research and Treatment.2014; 47(2): 149. CrossRef
The costs of hepatitis A infections in South Korea
Kyohyun Kim, Baek-Geun Jeong, Moran Ki, Mira Park, Jin Kyung Park, Bo Youl Choi, Weon-Seob Yoo
Epidemiology and Health.2014; 36: e2014011. CrossRef
Economic Burden of Cancer in Korea during 2000-2010
Kwang-Sig Lee, Hoo-Sun Chang, Sun-Mi Lee, Eun-Cheol Park
Cancer Research and Treatment.2014; 47(3): 387. CrossRef
Review of Tumor Dormancy Therapy Using Traditional Oriental Herbal Medicine
Jong-Ho Lee, Fan-Pei Koung, Chong-Kwan Cho, Yeon-Weol Lee, Hwa-Seung Yoo
Journal of Pharmacopuncture.2013; 16(1): 12. CrossRef
Management of Cancer Survivors in Clinical and Public Health Perspectives: Current Status and Future Challenges in Korea
Dong Wook Shin, BeLong Cho, So Young Kim, Je Hyuck Jung, Jong Hyock Park
Journal of Korean Medical Science.2013; 28(5): 651. CrossRef
Disability Weights for Cancers in Korea
Kyu Sik Choi, Jae Hyun Park, Kwang Sig Lee
Journal of Korean Medical Science.2013; 28(6): 808. CrossRef
Relationship Between Current Sleep Duration and Past Suicidal Ideation or Attempt Among Korean Adolescents
Sung-In Jang, Kwang-Sig Lee, Eun-Cheol Park
Journal of Preventive Medicine and Public Health.2013; 46(6): 329. CrossRef
Union for International Cancer Control International Session: Healthcare Economics: The significance of the UN summit non‐communicable diseases political declaration in Asia
Hideyuki Akaza, Norie Kawahara, Tohru Masui, Kunihiko Takeyama, Masafumi Nogimori, Jae Kyung Roh
Cancer Science.2013; 104(6): 773. CrossRef
A Single Measure of Cancer Burden in Korea from 1999 to 2010
Kyoung-Hee Cho, Sohee Park, Kwang-Sig Lee, Sung-In Jang, Ki-Bong Yoo, Jae-Hyun Kim, Eun-Cheol Park
Asian Pacific Journal of Cancer Prevention.2013; 14(9): 5249. CrossRef
The Socioeconomic Burden of Coronary Heart Disease in Korea
Hoo-Sun Chang, Han-Joong Kim, Chung-Mo Nam, Seung-Ji Lim, Young-Hwa Jang, Sera Kim, Hye-Young Kang
Journal of Preventive Medicine and Public Health.2012; 45(5): 291. CrossRef
Evaluation of the willingness‐to‐pay for cancer treatment in Korean metastatic breast cancer patients: A multicenter, cross‐sectional study
Do‐Youn OH, Bruce CRAWFORD, Sung‐Bae KIM, Hyun‐Cheol CHUNG, Jeffrey MCDONALD, Sang Yoon LEE, Su‐Kyoung KO, Jungsil RO
Asia-Pacific Journal of Clinical Oncology.2012; 8(3): 282. CrossRef
The economic burden of stroke in 2010 in Korea
Hyun-Jin Kim, Young-Ae Kim, Hye-Young Seo, Eun-Jung Kim, Seok-Jun Yoon, In-Hwan Oh
Journal of the Korean Medical Association.2012; 55(12): 1226. CrossRef
The Economic Burden of Inflammatory Heart Disease in Korea
Seul-Ki Ko, Seok-Jun Yoon, In-Hwan Oh, Hye-Young Seo, Eun-Jung Kim
Korean Circulation Journal.2011; 41(12): 712. CrossRef
Needs Assessment for the Beneficiaries of Home-Based Cancer Patients Management Project
Ju-Hyung Lee, Jung-Im Park, Ji-Hoon Kang, Jung-Ho Youm, Dai-Ha Koh, Keun-Sang Kwon
Journal of agricultural medicine and community health.2011; 36(4): 238. CrossRef
Socioeconomic costs of liver disease in Korea
Sunmi Lee, Woojin Chung, Kyung-Rae Hyun
The Korean Journal of Hepatology.2011; 17(4): 274. CrossRef
How Much Amount of Socioeconomic Loss Is Caused by Digestive Diseases?
Kyung Sik Park
The Korean Journal of Gastroenterology.2011; 58(6): 297. CrossRef
Comprehensive needs assessment tool in cancer (CNAT): the development and validation
Eun-Jung Shim, kyung-Sook Lee, Jong-Hyock Park, Jae-Hyun Park
Supportive Care in Cancer.2011; 19(12): 1957. CrossRef
Factors Affecting Beneficiary Satisfaction on Financial Aid Program for Cancer Patients in Korea
Ju-Ho Sim, Jong-Hyock Park, Jung-A Lee, So-Young Kim, Bo-Ram Park, Eun-Cheol Park
Korean Journal of Health Policy and Administration.2011; 21(1): 61. CrossRef
A Renal Transplantation and Hemodialysis Cost-Utility Analysis in Patients with End-Stage Renal Disease
Soon-Il Kim, Yu-Seun Kim, Myoung-Soo Kim, Eun-Cheol Park, Kyung-Ock Jeon, Sun-young Son, Myung-Il Hahm, Hoo-Yeon Lee
Korean Journal of Transplantation.2010; 24(3): 173. CrossRef
Cancer patients' need for financial assistance and its related factors
Youn-Gu Kim, Jae-Hyun Park, Jong-Hyock Park
Korean Journal of Health Policy and Administration.2010; 20(4): 58. CrossRef
Estimating Medical Expenditure Associated with Osteoporotic Hip Fracture in Elderly Korean Women Based on the National Health Insurance Claims Database 2002–2004
Hye-Young Kang, Sung-Eun Park, Dae Ryong Kang, Ji Yoon Kim, Young Hwa Jang, Won-Jung Choi, Seong-Hwan Moon, Kyu-Hyun Yang, Jin-Young Park, Soon-Yong Kwon
Value in Health.2009; 12: S93. CrossRef

Measuring Workload of Home Visit Care Activities Using Relative Values.: Seong Ok Han, Eun Cheol Park, Dae Ryong Kang, Im Ok Kang; J Prev Med Public Health. 2008;41(5):331-338.; DOI: https://doi.org/10.3961/jpmph.2008.41.5.331

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Abstract PDF: OBJECTIVES
The purpose of this study was to measure the workload of home visit care activities and their relative values. This study examined also factors that affect the workload of home visit care activities. METHODS: The participants of this study were 126 homehelpers of 50 home visit care agencies at the 2nd Longterm Care Insurance Demonstration Project. The workload of home visit care activities was divided into total work and four dimensions ; physical efforts, mental efforts, stress and time. Home visit care activities consisted of four categories with 24 items. We used magnitude estimation method to measure their relative values of the four dimensions. The participants answered the relative values of each activities based on the reference service. We used the activity for supporting their elderly's evacuation as the reference service. RESULTS: Most of the respondents were over 40 years old female. They consumed most their time supporting elderly's going out. They consumed their highest physical, mental efforts, and stress for activities of coping with emergency situation. The Pearson correlation coefficients showed significant relationships between workload and each dimensions. This study showed that all four dimensions are statistically significant predictors of workload of home visit care activities. Also, we found that the home-helper's career affects the workload of home visit care activities. CONCLUSIONS: The workload of home visit care activities could be explained by physical efforts, mental efforts, stress and time.; Summary

Effects of Private Health Insurance on Health Care Utilization and Expenditures in Korean Cancer Patients: Focused on 5 Major Cancers in One Cancer Center.: Jin Hwa Lim, Kui Son Choi, Sung Gyeong Kim, Eun Cheol Park, Jae Hyun Park; J Prev Med Public Health. 2007;40(4):329-335.; DOI: https://doi.org/10.3961/jpmph.2007.40.4.329

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OBJECTIVES
To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea. METHODS: The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer were included as study subjects. Data were gathered using a structured questionnaire from face-to-face interviews, the hospital Order Communication System (OCS) and medical records. Clinical, socio-demographic and private health insurance related factors were also gathered. The differences of health care utilization and expenditure were compared between those who have private health insurance and those who do not using t-test and multivariable regression analysis. RESULTS: Individuals with private health insurance spent larger inpatient costs than those without, but no differences were found in utilization in other service such as hospital admissions, hospital days and physician visits. CONCLUSIONS: We found that private health insurance exerts a significant effect on the health care expenditure in inpatient service. These study results can provide a rational basis to plan a national health policy regarding private health insurance. Further studies are needed to investigate the impacts of private health insurance on cancer patients' outcomes and survival rates.

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Treatment interruption during radiation therapy: Experience at a single institution in the Republic of Korea
Jung Ae Lee, Nam Kwon Lee, Won Sup Yoon, Dae Sik Yang, Chul Yong Kim, Se Ryun Lee, Hwa Jeong Seong
Asia-Pacific Journal of Clinical Oncology.2017;[Epub] CrossRef
Cancer Treatment near the End-of-Life Becomes More Aggressive: Changes in Trend during 10 Years at a Single Institute
Younak Choi, Bhumsuk Keam, Tae Min Kim, Se-Hoon Lee, Dong-Wan Kim, Dae Seog Heo
Cancer Research and Treatment.2015; 47(4): 555. CrossRef
Ubiquitous Environment with Private Health Insurance and the Relevance of Length of Stay
Dong-Ruyl Jang, Seong-Woo Choi, Bu-Yeon Park, Sung-Gil Kim
The Journal of the Korea institute of electronic communication sciences.2014; 9(2): 203. CrossRef
Analysis of factors affecting the life quality of the patients with late stomach cancer
Yan‐Mei Ma, Cai‐Feng Ba, Yu‐Bin Wang
Journal of Clinical Nursing.2014; 23(9-10): 1257. CrossRef
The Effect of Private Health Insurance on Health Care Utilization: Evidence from Korea Health Panel (2008~2010)
Chang-Hoon You, Sung-Wook Kang, Ji-Heon Choi, Eun-Hwan Oh, Young-Dae Kwon
The Korean Journal of Health Service Management.2014; 8(2): 101. CrossRef
An Association between Private Health Insurance and Use of Endoscopy, An Association between Private Health Insurance and Use of Endoscopy,
Chang-Hoon You, Young-Dae Kwon, Ji-Heon Choi, Sung-Wook Kang
The Korean Journal of Health Service Management.2014; 8(4): 25. CrossRef
The Influence of Private Health Insurance on Admission among Some Patients with Cervical or Lumbar Sprain
Dong-Ryul Jang, Myung-Geun Kang
Journal of agricultural medicine and community health.2012; 37(2): 84. CrossRef
Private health insurance in South Korea: An international comparison
Jaeun Shin
Health Policy.2012; 108(1): 76. CrossRef
Sociodemographic gradients in breast and cervical cancer screening in Korea: the Korean National Cancer Screening Survey (KNCSS) 2005-2009
Mi Jin Park, Eun-Cheol Park, Kui Son Choi, Jae Kwan Jun, Hoo-Yeon Lee
BMC Cancer.2011;[Epub] CrossRef
Comparison of hospital charge prediction models for gastric cancer patients: neural network vs. decision tree models
Jing Wang, Man Li, Yun-tao Hu, Yu Zhu
BMC Health Services Research.2009;[Epub] CrossRef

Factors Influencing the Intention to have Stomach Cancer Screening.: Myung Il Hahm, Kui Son Choi, Su Yeon Kye, Min Son Kwak, Eun Cheol Park; J Prev Med Public Health. 2007;40(3):205-212.; DOI: https://doi.org/10.3961/jpmph.2007.40.3.205

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Abstract PDF

OBJECTIVES
The purpose of this study was to identify the factors influencing the intention to have stomach cancer screening using the theory of planned behavior (TPB) in Korea. METHODS: For this population-based study, 1,535 adult respondents (aged 40 to 70 years) were recruited using multi-stratified random sampling and a face-to-face administered questionnaire. This study was based on Ajzen's theory of planned behavior. Intentions were divided into three scenarios for fee payment in the next two years: (1) free of charge, (2) co-payment, and (3) full charge. Multiple linear regression was used to identify the factors influencing the intention to have stomach cancer screening. RESULTS: Perceived behavioral control and attitude toward stomach cancer screening were significant predictors of the intention to have stomach cancer screening. However, subjective norm only influenced the intention to have stomach cancer screening with full charge in the next two years. CONCLUSIONS: The results suggest that attitude and perceived behavioral control are likely to contribute toward increasing the intention to have stomach cancer screening. Especially, perceived behavioral control is a good predictor. Because the study subjects were nation wide residents, the study results can be generalized.

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Ji Hye Jeong, Nam Hee Park
Journal of Korean Academy of Community Health Nursing.2019; 30(4): 471. CrossRef
Factors Influencing the of Middle-Aged Men the NCSP(National Cancer Screening Program)
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The Korean Journal of Health Service Management.2016; 10(3): 51. CrossRef
Quels sont les facteurs psychosociaux déterminant la participation au dépistage du cancer colorectal ? Intérêt de la théorie du comportement planifié et du concept de coping
A. Le Bonniec, K. Djoufelkit, F. Cousson-Gélie
Psycho-Oncologie.2015; 9(2): 108. CrossRef
Barriers to Cancer Screening among Medical Aid Program Recipients in the Republic of Korea: A Qualitative Study
Yoon Young Lee, Jae Kwan Jun, Mina Suh, BoYoung Park, Yeol Kim, Kui Son Choi
Asian Pacific Journal of Cancer Prevention.2014; 15(2): 589. CrossRef
Factors Affecting Cancer Screening Intention and Behavior of the Korean Elderly
Hee-Jung Kim, Hyun-Woo Yim, Nam-Cho Kim
Asian Pacific Journal of Cancer Prevention.2014; 15(19): 8461. CrossRef
Regional Factors Associated with Participation in the National Health Screening Program: A Multilevel Analysis Using National Data
Hyung-Kook Yang, Dong-Wook Shin, Seung-Sik Hwang, Juwhan Oh, Be-Long Cho
Journal of Korean Medical Science.2013; 28(3): 348. CrossRef
Factors Associated with Cancer Screening Intention in Eligible Persons for National Cancer Screening Program
Rock-Bum Kim, Ki-Soo Park, Dae-Yong Hong, Cheol-Heon Lee, Jang-Rak Kim
Journal of Preventive Medicine and Public Health.2010; 43(1): 62. CrossRef
Factors Associated with Gastric Cancer Screening of Koreans Based on a Socio-ecological Model
Sang Soo Bae, Heui Sug Jo, Dong-Hyun Kim, Yong-Jun Choi, Hun Jae Lee, Tae Jin Lee, Hye Jean Lee
Journal of Preventive Medicine and Public Health.2008; 41(2): 100. CrossRef

The Determinants of Purchasing Private Health Insurance in Korean Cancer Patients.: Jin Hwa Lim, Sung Gyeong Kim, Eun Mi Lee, Sin Young Bae, Jae Hyun Park, Kui Son Choi, Myung Il Hahm, Eun Cheol Park; J Prev Med Public Health. 2007;40(2):150-154.; DOI: https://doi.org/10.3961/jpmph.2007.40.2.150

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Abstract PDF

OBJECTIVES
The aim of this study is to identify factors determining the purchase of private health insurance under the mandatory National Health Insurance(NHI) system in Korea. METHODS: The data were collected by the National Cancer Center in Korea. It includes cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer. Data were gathered from the hospital Order Communication System (OCS), medical records, and face-to-face interviews, using a structured questionnaire. Clinical, socio-demographic and private health insurance related factors were also gathered. RESULTS: Overall, 43.9% of patients had purchased one or more private health insurance schemes related to cancer, with an average monthly premium of won 65,311 and an average benefit amount of won 19 million. Females, younger aged, high income earners, national health insurers and metropolitan citizens were more likely to purchase private health insurance than their counterparts. CONCLUSIONS: About half of Korean people have supplementary private health insurance and their benefits are sufficient to cover the out-of-pocket fees required for cancer treatment, but inequality remains in the purchase of private health insurance. Further studies are needed to investigate the impacts of private health insurance on NHI, and the relationship between cancer patients' burden and benefits.

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Myung Suk Lee
Journal of Korean Academy of Community Health Nursing.2010; 21(1): 43. CrossRef
The Effect of Catastrophic Health Expenditure on the Transition to Poverty and the Persistence of Poverty in South Korea
Eun-Cheol Song, Young-Jeon Shin
Journal of Preventive Medicine and Public Health.2010; 43(5): 423. CrossRef
The Effect of Health Care Expenditure on Income Inequality
Eun-Cheol Song, Chang-Yup Kim, Young-Jeon Shin
Korean Journal of Health Policy and Administration.2010; 20(3): 36. CrossRef
Impact of supplementary private health insurance on stomach cancer care in Korea: a cross-sectional study
Dong Wook Shin, Kee-Taig Jung, Sung Kim, Jae-Moon Bae, Young-Woo Kim, Keun Won Ryu, Jun Ho Lee, Jae-Hyung Noh, Tae-Sung Sohn, Young Ho Yun
BMC Health Services Research.2009;[Epub] CrossRef
Comparison of Cancer Survival by Age Group for 1997 and for 2002: Application of Period Analysis using the National Cancer Incidence Database
Seon-Hee Yim, Kyu-Won Jung, Young-Joo Won, Hyun-Joo Kong, Hai-Rim Shin
Journal of Preventive Medicine and Public Health.2008; 41(1): 17. CrossRef
Strengthening Causal Inference in Studies using Non-experimental Data: An Application of Propensity Score and Instrumental Variable Methods
Myoung-Hee Kim, Young Kyung Do
Journal of Preventive Medicine and Public Health.2007; 40(6): 495. CrossRef
Effects of Private Health Insurance on Health Care Utilization and Expenditures in Korean Cancer Patients: Focused on 5 Major Cancers in One Cancer Center
Jin Hwa Lim, Kui Son Choi, Sung Gyeong Kim, Eun-Cheol Park, Jae Hyun Park
Journal of Preventive Medicine and Public Health.2007; 40(4): 329. CrossRef

Women's Willingness to Pay for Cancer Screenin.: Min Son Kwak, Na Young Sung, Jeong Hee Yang, Eun Cheol Park, Kui Son Choi; J Prev Med Public Health. 2006;39(4):331-338.

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Abstract PDF: OBJECTIVES
The goal of this study is to measure women's willingness to pay for cancer screening and to identify those factors associated with this willingness to pay METHODS: A population-based telephone survey was performed on 1,562 women (aged 30 years or over) for 2 weeks (9-23th, July, 2004). Data about sociodemographic characteristics, health behaviors, the intention of the cancer screenings and willingness to pay for cancer screening were collected. 1,400 respondents were included in the analysis. The women's willingness to pay for cancer screening and the factors associated with this willingness to pay were evaluated. RESULTS: The results show that 76% of all respondents have a willingness to pay for cancer screening. Among those who are willing to pay, the average and median amount of money for which the respondents are willing to pay are 126,636 (s.d.: 58,414) and 120,000 won, respectively. As the status of education & the income are higher, the average amount that women are willing to pay becomes much more. The amount of money women are willing to pay is the highest during the 'contemplation' stage. Being willing to pay or not is associated with a change of behavior (transtheoretical model), the income, the concern about the cancer risk, the family cancer history, the marital status, the general health exam, age and the place of residence. Income is associated with a greater willingness to pay. Old age was associated with a lower willingness to pay. CONCLUSIONS: According to the two-part model, income and TTM are the most important variables associated with the willingness to pay for cancer screening. The cancer screening participation rate is low compared with the willingness to pay for cancer screening. It is thought that we have to consider the participants' behavior that&s associated with cancer screening and their willingness to pay in order to organize and manage cancer screening program.; Summary

Changes in Distributive Equity of Health Insurance Contribution Burden.: Hee Chung Kang, Eun Cheol Park, Kyu Sik Lee, Tae Kyu Park, Woo Jin Chung, Han Joong Kim; J Prev Med Public Health. 2005;38(1):107-116.

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Abstract PDF: OBJECTIVES
We analyzed the changes from 1996 to 2002 in distributive equity of the contribution burden in the Korean National Health Insurance. METHODS: The study subjects were a total of 8, 923 employee households and a total of 7, 296 self-employed households over the period from 1996 to 2002. Those were the households meeting the two criteria as completing each annual survey and having no change in the job of head of the household during that period from the raw data of the Household Income and Expenditure Survey annually conducted by the Korean National Statistical Office. The unit of analysis was a household, and this was the standard for assessing the contribution that is now applied on a monthly basis. Deciles Distribution Ratio, Contribution Concentration Curve and Contribution Concentration Index were estimated as the index of inequality. Multiple regression analysis was conducted to compare the annual ability-to-pay elasticity of the contribution to the reference year of 1996 for three groups (all households, the employee households, and the self-employed households). RESULTS: For the index of inequality, the distributive equity of contribution was improved in all three groups. In particular, the employee group experienced a substantial improvement. Using multiple regression analysis, the ability-to-pay elasticity of the contribution in the employee group significantly increased ( beta=0.232, p< 0.0001) in the year 2002 as compared to the reference year of 1996. The elasticity in the self-employed group also significantly increased ( beta=0.186, p< 0.05), although its change was smaller than that in the employee group. CONCLUSIONS: The employee group had a greater improvement for the distributive equity of the contribution burden than the self-employed group. Within the observation period, there were two important integration reforms: one was the integration of 227 self-employed societies in 1998 and the other was the integration of 139 employee societies in 2000. We expected that the equity of the contribution burden would be improved for the self-employed group since the integration reform of 1998. However, it was not improved for the self-employed group until the year 2000. This result suggests that capturing exactly the beneficiaries' ability-to-pay such as income is the precedent for distributive equity of the contribution burden, although a more sophisticated imposition standard of contribution is needed.; Summary

Participation Rate and Related Socio-demographic Factors in the National Cancer Screening Program.: Na Young Sung, Eun Cheol Park, Hai Rim Shin, Kui Son Choi; J Prev Med Public Health. 2005;38(1):93-100.

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Abstract PDF: BACKGROUND
Cancer is the leading cause of death and one of the largest burdens of disease in Korea. In 1996, the 'Ten year Plan for Cancer Control' was formulated and the government then adopted the plan as a national policy. As part of this plan, the National Cancer Screening Program (NCSP) for Medicaid recipients was formulated, and the government adapted this in 1999. For low-income beneficiaries of the National Health Insurance Corporation (NHIC), the screening program has been in place since 2002. In 2002, the target cancers of NCSP were stomach, breast and cervical cancer. This study was conducted to examine the relationships between the participation rate, the abnormal screening rate and the socio-demographic factors associated with participation in the screening program. METHODS: To analyze the participation rate and abnormal rate for the NCSP, we used the 2002 NCSP records. The information on the socio-demographic factors was available from the database of the beneficiaries in the NHIC and Medicaid. RESULTS: The participation rate of the Medicaid beneficiaries for the stomach, breast and cervical cancer screening were 9.2%, 15.5% and 15.0%, respectively, and 11.3% and 12.5%, except cervical cancer which wasn't be included in the NCSP, for the beneficiaries of the NHIC. The abnormal rate of stomach, breast and cervical cancer screening were 25.7%, 11.2% and 21.0%, respectively, for the beneficiaries of Medicaid and 42.6% and 19.4% for the beneficiaries of the NHIC. On the multiple logistic regression analysis, gender, age and place of residence were significantly associated with participation rates of the NCSP. For stomach cancer, women participated in the NCSP more than men. The participation rate was higher among people in their fifties and sixties than for those people in their forties and those people over seventy years in age. For the breast and cervical cancer, people in their fifties were more likely to participate in the NCSP than people in their forties and people over sixty. For the place of residence, people in the rural areas participated more than those people in any other places. CONCLUSIONS: The above results show that the participation rate and abnormal rate were significantly associated with the socio-demographic factors. To improve the participation rate for the NCSP, more attention should be given to the underserved groups.; Summary

Cost-Utility Analysis of the Cochlear Implant.: Hoo Yeon Lee, Hee Nam Kim, Han Joong Kim, Jae Young Choi, Eun Cheol Park; J Prev Med Public Health. 2004;37(4):353-358. Published online November 30, 2004

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Abstract PDF: OBJECTIVE
To determine the quality of life and cost consequences for deaf adults who received a cochlear implant. METHODS: The data from 11 patients, post-lingual deaf adults who received cochlear implants from 1990 to 2002, underwent cost-utility analysis. The average age of the participants was 49.6 years. The main outcomes were direct cost per quality-adjusted life-year (QALY) using the visual analog scale (VAS), health utility index (HUI), EuroQol (EQ-5D), and quality well-being (QWB), with costs and utilities being discounted 3% annually. RESULTS: Recipients had an average of 5.6 years of implant use. Mean VAS scores increased by 0.33, from 0.27 before implantation to 0.60 at survey. HUI scores increased by 0.36, from 0.29 to 0.65, EQ-5D scores increased by 0.26, from 0.52 to 0.78, and QWB scores increased by 0.16, from 0.45 to 0.61. Discounted direct costs were $22, 320, yielding $19, 223/QALY using VAS, $17, 387/QALY using HUI, $24, 604/QALY using EQ-5D, and $40, 474/QALY using QWB. Cost-utility ratios using VAS, HUI, and EQ-5D were all below $25, 000 per QALY, except using QWB. CONCLUSION: Cochlear implants in post-lingual deaf adult have a positive effect on quality of life at reasonable direct costs and appear to produce a net saving to society.; Summary

Factors Associated with Performance of National Cancer Screening Program in Korea.: Kui Son Choi, Jeong Hee Yang, Su Yeon Kye, Sun Hee Lee, Eun Cheol Park, Hai Rim Shin, Chang Min Kim; J Prev Med Public Health. 2004;37(3):246-252.

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Abstract PDF: OBJECTIVES
Cancer is the leading cause of death in Korea. Therefore, a National Cancer Screening Program (NCSP) was launched in 1999. This study planned to evaluate the performance of the NCSP to identifying the influencing factors in relation to characteristic public health centers. METHODS: To analyze the performance, the database of the NCSP records for 2002 was used. The performance index was measured by the goal achievement rate, which was defined by the real number of screenees against the expected number of screenees. Also, a survey was conducted by a self-administered questionnaire to identify the factors associated with the goal achievement rate. The questionnaire was divided into two sections. In the first section, the individual characteristics of the program coordinator in each public health center were measured, and second section was comprised of questions about the organizational characteristics associated with the NCSP. A total of 121 subjects from 241 public health centers completed the questionnaire. RESULTS: Of the 121 public health centers (50.2% response rate), the average goal achievement rate was 72.8%. The results of the regression model showed that public health centers located in rural area (parameter estimates=38.2) and had great support from a head of center or province (parameter estimates=0.20) and tended to have higher goal achievement rates. However, the characteristics of the program coordinator, especially their knowledge of and attitude toward cancer screening, were not significantly related to the goal achievement rates. CONCLUSIONS: It appears that the most important associated factors to the goal achievement rate in the NSCP were the location of the public health center and the support for the NCSP from the head of the center or province.; Summary

Economic Value of the Sirolimus Eluting Stent (CYPHER(TM)) in Treating Acute Coronary Heart Disease.: Hoo Yeon Lee, Eun cheol Park; Korean J Prev Med. 2003;36(4):339-348.

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Abstract PDF: OBJECTIVE
To quantify the economic value of the Sirolimus Eluting Stent (CYPHER(TM)) in treating acute coronary heart disease (CHD), and to assist in determining an adequate level of reimbursement for CYPHER(TM) in Korea. METHODS: A decision-analytical model, developed by the Belgium Health Economics Disease Management group, was used to investigate the incremental cost-effectiveness of CYPHER(TM) versus conventional stenting. The time horizon was five years. The probabilities for clinical events at each node of the decision model were obtained from the results of large, randomized, controlled clinical trials. The initial care and follow-up direct medical costs were analyzed. The initial costs consisted of those for the initial procedure and hospitalization. The follow-up costs included those for routine follow-up treatments, adverse reactions, revascularization and death. Depending on the perspective of the analysis, the costs were defined as insurance covered or total medical costs (=sum of insurance covered and uncovered medical costs). The cost data were obtained from the administrative data of 449 patients that received conventional stenting from five participating Korean hospitals during June 2002. Sensitivity analyses were performed for discount rates of 3, 5 and 7%. Since the major clinical advantage of CYPHER(TM) over conventional stenting was the reduction in the revascularization rates, the economic value of CYPHER(TM), in relation to the direct medical costs of revascularization, were evaluated. If the incremental cost of CYPHER(TM) per revascularization avoided, compared to conventional stenting, was no higher than that of a revascularization itself, CYPHER(TM) would be considered as being cost-effective. Therefore, the maximum acceptable level for the reimbursement price of CYPHER(TM) making the incremental cost-effectiveness ratio equal to the cost of a revascularization was identified. RESULTS: The average weighted initial insurance covered and total medical costs of conventional stenting were about 6, 275, 000 and 8, 058, 000 Won, respectively. The average weighted sum of the initial and 5-year follow-up insurance covered and total medical costs of conventional stenting were about 13, 659, 000 and 17, 353, 000 Won, respectively. The estimated maximum level of reimbursement price of CYPHER(TM) from the perspectives of the insurer and society were 4, 126, 897 ~ 4, 325, 161 and 4, 939, 939 ~ 5, 078, 781 Won, respectively. CONCLUSION: By evaluating the economic value of CYPHER(TM), as an alternative to conventional stenting, the results of this study are expected to provide a scientific basis for determining the acceptable level of reimbursement for CYPHER(TM).; Summary

Comparing Difference of Volume of Psychiatric Treatments between the Patient with Health Insurance and Those with Medical Assistance: For Inpatients of Korean Psychiatric Hospitals.: Dae Hee Lee, Eun Cheol Park, Chung Mo Nam, Sang Gyu Lee, Dong Han Lee, Seung Hum Yu; Korean J Prev Med. 2003;36(1):33-38.

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Abstract PDF: OBJECTIVES
To assess the difference in the volume of psychiatric treatments provided to health insurance inpatients, compared with those on medical assistance (the medical aid program) Korean psychiatric hospitals, and to determine factors which affect the volume of the services. METHODS: 21 psychiatrists, from 3 Korean psychiatric hospitals recorded the frequencies psychiatric treatments provided to inpatients in one week (February18-24, 2002). The records of 329 patients were analyzed through t-tests, and random effectmixed model analyses to define the difference between the two groups, and to find other factors affecting the volume of service. RESULTS: A significant difference in the volume of psychiatric treatments provided was observed between the health insurance and medical assistance groups. The variation in the volume of service between hospitals was prominent, and other factors (gender, agegroup, length of stay and mental disorder) were also found to be significant. The patients on medical assistance received only 70% of the psychiatric treatments of those on health insurance. CONCLUSIONS: More effort is required to improve the methods of payment to increase the level of fee scheduling for medical assistance. Further studies on the mechanisms causing these differences in the volume of service are required.; Summary

Time Series Observations of Outcome Variables and the Factors Associated with the Improvement in the Patient Outcomes of Cataract Surgery.: Han Joong Kim, Eun Cheol Park, Yoon Jung Choi, Hyung Gon Kang; Korean J Prev Med. 2001;34(2):175-181.

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Abstract PDF: OBJECTIVES
To compare the multiple outcomes of patients with cataract surgery at perioperative time, 3-4 months and 12 months after surgery and to assess patient outcomes associated with visual improvement(visual acuity of operated eye, visual function-14(VF-14), symptom score). METHODS: For this assessment, a prospective study was conducted with 389 patients who had undergone cataract surgery for either one eye or both eyes. The surgery was performed by 20 ophthalmologists who were practicing at university hospitals and general hospitals. Patients were interviewed and clinical data were obtained. Doctors were questioned with self-reported questionnaire forms. Medical records were examined in order to measure variables related to the surgical process such as surgical methods and ocular comorbidity. The survey was conducted at 4 stages : preoperative time(389 cases), perioperative time(344 cases, 88.4%), postoperative 3-4 months (343 cases, 88.2%), and postoperative 12 months (281 cases, 72.2%). After excluding cases with incomplete data, 198 cases were enrolled in the study. Patient outcomes was measured for any improvement in the functional outcomes(visual acuity of operated eye, visual function, symptom score) at postoperative 3-4 months. RESULTS: The visual acuity(operated, weighted average), symptom score, VF-14 score, satisfaction with vision, and subjective health status were shown to be improved at the perioperative time, postoperative 3-4 months and 12 months. An improvement in the Snellen visual acuity score was observed in 190 patients(96.0%), whereas improvements of the VF-14 score and cataract symptom score were observed in 151 patients(76.3%) and 179 patients(90.4%), respectively. All three outcome measures demonstrated improvement in 137 patients(69.2%). The improvement of the three functional outcomes at 3-4 months after receiving surgery was associated with a lower level of visual function and a higher level of cataract symptom score at perioperative time, as well as a greater experience level of the surgeon. CONCLUSIONS: In this study, the estimates of the proportion of patients benefiting from cataract surgery varied with the outcome measure of benefit. Preoperative VF-14 score, a measure of functional impairment related to vision, and symptom score may be better measures of the benefit derived from cataract surgery than the change in visual acuity.; Summary

Cost-benefit Analysis of Mandatory Prescription in Korea.: Young Keon Jee, Han Joong Kim, Eun Cheol Park, Hye Young Kang; Korean J Prev Med. 2000;33(4):484-494.

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Abstract PDF: OBJECTIVE
To evaluate the relative benefits and the costs associated with the introduction of the new pharmaceutical provision called 'Mandatory Prescription Syste m' which separates the role of physicians from that of pharmacists with respect to the prescription and dispensation of from the perspective of consumers (i.e., patients). METHODS: The costs of the system were measured by considering both direct and indirect costs. Direct costs included additional payments for ambulatory care and dispensing fees that occurred under the new system. Indirect costs consisted of transportation expenses and costs related to time spent for physician consultation, waiting for the prescriptions to be filled, and extra traveling. Benefits identified in this study were the reduction of drug misuse and overuse, and the overall decrease in drug consumption among the Korean population. Sensitivity analysis was performed for the inclusion of benefits for outpatients of hospitals, price elasticity, and increased fees for established patients. RESULTS: The net benefit was estimated to be about minus 1,862 billion won and the benefit-cost ratio was 0.478. This indicates that the costs of 'Mandatory Prescription' outweigh its benefits, relative to the previous system. The sensitivity analysis results for all the variables considered in this study consistently showed the benefit-cost ratio to be less than 1. CONCLUSION: The results of this study suggest that implementing Mandatory Prescription System in Korea might be inefficient from the consumer's perspective. The results of this study do not coincide with the results of previous studies, presumably because of the differences in study design and in which items of costs and benefits were considered.; Summary

Statistical Methods for Multivariate Missing Data in Health Survey Research.: Dong Kee Kim, Eun Cheol Park, Myong Sei Sohn, Han Joong Kim, Hyung Uk Park, Chae Hyung Ahn, Jong Gun Lim, Ki Jun Song; Korean J Prev Med. 1998;31(4):875-884.

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Abstract PDF: Missing observations are common in medical research and health survey research. Several statistical methods to handle the missing data problem have been proposed. The EM algorithm (Expectation-Maximization algorithm) is one of the ways of efficiently handling the missing data problem based on sufficient statistics. In this paper, we developed statistical models and methods for survey data with multivariate missing observations. Especially, we adopted the Em algorithm to handle the multivariate missing observations. We assume that the multivariate observations follow a multivariate normal distribution, where the mean vector and the covariance matrix are primarily of interest. We applied the proposed statistical method to analyze data from a health survey. The data set we used came from a physician survey on Resource-Based Relative Value Scale(RBRVS). In addition to the EM algorithm, we applied the complete case analysis, which used only completely observed cases, and the available case analysis, which utilizes all available information. The residual and normal probability plots were evaluated to access the assumption of normality. We found that the residual sum of squares from the EM algorithm was smaller than those of the complete-case and the available-case analyses.; Summary

Analysis of influencing factors on self-employed physician's income.: Woong Sub Park, Han Joong Kim, Myong Sei Sohn, Eun Cheol Park; Korean J Prev Med. 1998;31(4):770-785.

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Abstract PDF: This study describes the relation of physician's income and price of medical service and social welfare through microeconomic view, reviews the literature of influencing factor on physician's income, and it describes general distribution of physician's income, and analyzes influencing factor of physician's income. A total of 844 persons responded to the mail survey, through stratified sampling by 23 branches of medical society in Korean RBRVS study. The design of the study is cross sectional study, and the unit of analysis is a physician. To examine the change of average income per month, multiple regression was used to test the change according to physician's characteristics, demographic characteristics, scale of clinic(or hospital), average intensity of ordinary work, and specialty. The major findings of this study are as follows; 1. As for self-employed physicians, the difference of average income per month among specialties was 4,850,000won, but the difference was 6,020,000won under the control of control variables, and average income per month was significantly higher for physicians who had sick-beds than physicians who had no sick-beds. 2. The number of average out-patients per month and number of nurses and nursing aides significantly positively associated, but the number of physician significantly negatively associated with average income per month. In conclusion, the number of out-patient and number of nurses and nursing aides is the major influencing factor, and the difference of average income per month among specialties existed in self-employed physicians. So this study suggests basic hypothesis that the price of medical service and supply of physician by specialties are not pertinent. Being a cross-sectional study, this study can not suggest causal explanations. In the future, further study is needed for causal explanations.; Summary

The Development of Classification System of Medical Procedures in Korea.: Hyoung Wook Park, Myongsei Sohn, Han Joong Kim, Eun Cheol Park, Seung Hum Yu; Korean J Prev Med. 1996;29(4):877-897.

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Abstract PDF: In recent years, the Korean Medical Association has undertaken the feat of establishing the Korean Standard Terminology of Medical Procedures with the dedicated help of 32 medical academic societies. However, because the project is being conducted by several different circles, it has yet to see a clear system of classification. This thesis, therefore, proposes the three principles of scientific properties, usefulness and ideology as the basis for classification system and has developed the Classification System of Medical Procedures in Korea upon their foundation. The methodology and organization of this thesis as follows. First, by adopting scientific classification system of Feinstein(1988), an analysis of the classification systems of the medical procedures in the United States, Japan, Taiwan, Who Was carried out to reveal the framework and the basic principles in each system. Second, the direction of classification system has been constructed by applying the normative principle of medical field in order to show the future direction of the medical field and realize its ideology. Third, a finalized framework for the classification system will be presented as based on the direction of classification system. Of the three basis principles mentioned above, the analysis on the principles of usefulness was left out of this thesis due to the difficulty of establishing specific standards of analysis. The results of the study are as follows. The overall structure of the thesis is aimed at showing the 'Prevention-Therapy-Rehabilitation' quality of comprehensive health care and consists of six chapters; I. Prevention and Health Promotion. II. Evaluation and Management . III. Diagnostic Procedures. IV. Endoscopy. V. Therapeutic Procedures. VI. Rehabilitation. Chapter three Diagnostic Procedures is divided into four parts; Functional Diagnosis, Visual Diagnosis, Pathological Diagnosis, Biopsy and Sampling. Chapter five Therapeutic Procedures is divided into Psychiatry, Non-Invasive Therapy, Invasive Therapy, Anaesthesia and Radiation Oncology. Of these sub-divisions, Functional Diagnosis, Biopsy and Sampling, Endoscopy and Invasive Therapy employs the anatomical system of classification. On the other hand, Visual Diagnosis, Pathological Diagnosis, Anesthesia and Diagnostic Radiology, namely those divisions in which there is little or no overlapping in services with other divisions, used the classification system of its own division. The classification system introduced in this thesis can be further supplemented through the use of the cluster analysis by incorporating the advice and assistance of other specialists.; Summary

An Analysis of Small Area Variations of Hospital Services Utilization in Korea.: Woo Hyun Cho, Sun Hee Lee, Eun Cheol Park, Myong Sei Sohn, Se Ra Kim; Korean J Prev Med. 1994;27(3):609-626.

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Abstract PDF: This study was conducted to investigate whether variations in hospital services utilization across small geographic areas in Korea existed, and if so, what factors are responsible for the variation. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main finding of the research can be summarized as follows: 1. External Quotients (EQ) of hospital expenditure per capita and hospital days per capita were 2.69 and 2.73, and coefficient of variation (CV) were 0.14,both, respectively. The EQ and the CV of admission rate were also 2.71, 0.15. The EQ and the CV of expenditure per admission were 1.73, 0.10 and those of hospital days per admission were 1.29, 0.06. All these statistics were statistically significant and this result provides strong evidence for the existence of small area variations. 2. Comparing patterns of variation among areas, the area which showed higher utilization amounts is cbansungp'o. Koje area, whereas the areas which showed lower utilization amounts are Yongju, Changhung, Miryang, Mokp'o, Koch'ang area. 3. Multivariate analytic methods were used to examine factors related to the variation across areas. In terms of the health resource availability variables, beds per capita or physicians per capita were positively associated with all utilization indices. As for the health service market structure variables, the proportion of health care institutions operating for less than 5 years was positively related to the expenditure per capita, hospital days per capita and expenditure per admission. In addition the proportion of lhe private health care institutions also had a negative relationship with total utilization amount and admission rate and the proportion of physicians under age 40 was negatively associated with expenditure per capita and expenditure per admission. With regard to the socio-demographic characteristics, proportion of medicaid population was positively related to hospital days per capita, and percentage of paved road was positively related to hospital days per admission. As a conclusion, wide variations existed across small areas in Korea and supply factors were found to be important in explaining the variation.; Summary

An Analysis of Determinants of Elderly Medical Costs Inflation Using Deterministic Model.: Seung Hum Yu, Myong Sei Sohn, Eun Cheol Park; Korean J Prev Med. 1994;27(1):135-144.

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Abstract PDF: The purpose of this study compares determinants of eldery medical cost inflation with those of other age groups by analysing aggregated data with a deterministic model. The deterministic model of per capita medical cost inflation consists of increases in price, intensity of services, and medical utilization. We used a time series data (1985-1991) from National Medical Insurance and analyzed by age groups. In total population, the average increase rates of inpatient and outpatient medical costs were respectively 9.5% and 8.8% during 6 years and the major cause of inflation was the increase in service intensity in both of inpatient and outpatient cases. But in the population of 65 years old and over, the average increase rates of inpatient and outpatient medical costs were respectively 13.8% and 14.8% and the major cause of inflation was the increase in per-capita medical utilization in both of inpatient and outpatient cases. Also, the increase in service intensity of 65 years old and over was the highest of other age groups. This pattern was similar during study periods. we concluded that the level of medical cost inflation and the determinants in elderly was the highest-especially in per capita medical utilization, therefore, the inflation of medical costs in elderly will be higher than other age groups for the further in Korea.; Summary

Cost analysis of hypertension screening program.: Eun Cheol Park, Seung Hum Yu; Korean J Prev Med. 1989;22(3):380-388.

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Abstract PDF: To evaluate the costs the hypertension screening program of the Korea Medical Insurance Corporation, the records of the screening examinations were used. The sample size was 49,983 of the 906,554 people insured by the Corporation and was obtained by two-stage stratification random sampling. The alternatives for efficiency of the screening program, which were divided into three categories: modification of the screening test package, application of other hypertension diagnostic criteria, and selective approach of tested groups by age, were evaluated according to the cost per patient detected. The results of this study were as follows: In the hypertension screening system, the cost per patient detected was Won 30,833. The most nonsensitive test for hypertension detection was ophthalmoscopy, which was examine during the second stage of screening. If the ophthalmoscope examination was excluded, only one person was not detected, which was 0.2% of detected persons, and the cost per patient detected decreased to Won 28,098. The most efficient modification of the screening test package was measurement of blood pressure through the first and second stages of screening. The cost per patient detected by this modification was Won 24,408. The application of other diagnostic criteria, which were more restricted criteria, increased the cost per patient detected by 3.7%-6.7%. The cost per patient detected were Won 170,582 for persons less than 39 years old, Won 20,032 for persons 40 to 59 years old, and Won 8,675 for persons 60 years old and over. In conclusion, the best alternative suggested with respect to efficiency and practical application excluded the ophthalmoscope examination of second stage screening and restricted the target population to persons greater than 40 years old. The application of this alternative decreased 54.9% of the screening costs and the cost per patient detected was Won 15,222. This study was limited in that measurement of effectiveness was not of the ultimate goal of screening, which is decreasing morbidity and mortality, but was of disease detection as the short-term objective.; Summary

The Change of Children's Blood Pressure and Factors Affecting the Level of Blood Pressure In Children.: Il Suh, Il Soon Kim, Chung Mo Nam, Soon Young Lee, Hee Chul Oh, Chun Bae Kim, Eun Cheol Park; Korean J Prev Med. 1989;22(3):303-312.

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Abstract PDF: To show the distribution and change of blood pressure according to age and find factors affecting the level of blood pressure in primary school children, a follow-up study was conducted from 1986 to 1989 on 401 first grade children attending primary school in Kangwha county in 1986 and their parents. The blood pressure of the children was significantly increased according to age. The average annual increase was 1.8mmHg in systolic blood pressure and 2.5mmHg in diastolic blood pressure. The level of blood pressure did not show any significant difference in both sexes. Among children who were at or above the 80th percentile of blood pressure in the first grade, 35 and 30% of them have remained at the same level of systolic and diastolic blood pressure respectively in the fourth grade. But we could not find any significance in the tracking of blood pressure of children who were at or above the 90th percentile of blood pressure in the first grade. Weight and pulse rate were shown to significant factors affecting systolic blood pressure in children of both sexes and mother's blood pressure and skinfolds thickness were also affected systolic blood pressure in girls. The variables significantly affecting diastolic blood pressure were arm circumference and pulse rate for boys and height and pulse rate for girls.; Summary

Cost-benefit Analysis of Health Screening Test for the Insured.: Seung Hum Yu, Myongsei Sohn, Woo Hyung Cho, Eun Cheol Park, Young Doo Lee, Kyu Sik Lee, Ki Hong Chun; Korean J Prev Med. 1989;22(2):248-258.

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Abstract PDF: As a result of cost-benefit analysis by making a macroscopic approach to the health screening projects conducted 4 times since 1980 for the insured people of the Korea Medical Insurance Corporation, the following conclusions were reached. 1. The direct costs put into the health screening project, and the time costs which were paid by examines or calculated in terms of social costs have been estimated. The results is that the lowest estimation was 10,337 million won and the highest 15,141 million won when a minimum of 1.5 hours of time spent and a maximum 4 hours were applied. 2. In terms of the psychiatric benefits, the lowest estimation was 5,341 million won while the highest was 5,585 million won. 3. In terms of the benefits for each kind of diseases, the lowest estimation of 37,188 million won and highest estimation of 74,383 million won have been calculated for the liver diseases. And for the cardiovascular diseases, the minimum estimation was 14,475 million won while the maximum was 20,532 million won. In case of pulmonary tuberculosis, with external effect benefits being included, the estimation ranged from the minimum of 1,649 million won to the maximum of 1,832 million won. And the estimation of benefits for diabetes mellitus and renal diseases ranged from 89 million won to 92 million won and from 4,567 million won respectively. 4. In comparing costs and benefits, as a results of comparing each highest and lowest estimation, a range of minimum 46,708 million won and maximum 98,071 million won of benefits has been gained.; Summary

Analysis of Sports Medical Care Utilization during the 24th Seoul Olympic Games.: Seung Hum Yu, Myongsei Sohn, Young Doo Lee, Eun Cheol Park, Chun Bae Kim; Korean J Prev Med. 1989;22(1):136-145.

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Abstract PDF: This study made a descriptive analysis of the cumulative amount and rate of sports medical care utilization during the 24th Seoul Olympic Games by the participating athletes, officials, etc. The sports medical care utilization was a component of the total medical care use and was basically caused by the prevention and treatment of sports injuries. The analytic data were derived from the Olympic Health Management Information System (OHMIS) of the SLOOC and the Korea Athlete Trainer Association(KATA). These were analyzed according to the., quantity of physician visits and the utilization rate, which was the amount of utilization divided by the total number of participating persons. The results were as follows: Firstly, the sports medical care utilization by the persons participating in the Seoul Olympics amounted to 17.9 % of the total medical care utilization. The venue medical services utilization accounted for 54.7 % of the total physician visits, which was larger than the village medical center's utilization. The number of physician visits per hundred persons during the 2 week period in the venue clinic was 3.03 and that of the village medical center was 2.51, therefore, the total was 5.54. Secondly, athletes accounted for 82.3% and officials 12.2% in the sports medical care utilization by participants. These results were because athletes, who were directly related to the games, called extremely often on the physicians. The utilization rate of sports medical care by athletes was 34.29. Thirdly, the sports medical demand according to type of therapy could be ranked from high to low in the following order: sports massage, thermal therapy, and electrical stimulation treatment, etc. The department of physical therapy in the village medical center was used a great deal. Fourthly, the trend of daily sports medical care utilization by the athletes showed a bell shape centering around the opening day of the Seoul Olympic Games. The utilization rate of athletes was 2.3; however, that of officials was 0.6. Lastly, the sports medical demand was calculated according to the continents, and Central America, Africa and Middle-East Asia proved to have a higher rate of sports medical care utilization than the more powerful and industrialized continent or regions.; Summary

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