- Differences in Medical Care Utilization Rates of the Disabled and the Non-disabled with Ambulatory Care Sensitive Conditions.
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Sang Jun Eun, Jee Young Hong, Jin Yong Lee, Jin Seok Lee, Yoon Kim, Yong Ik Kim, Youngsoo Shin
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J Prev Med Public Health. 2006;39(5):411-418.
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The purpose of this study was to determine whether the disabled have worse access to primary care than the non-disabled. METHODS: We used the National Disability Registry data and the National Health Insurance data for the calendar year 2003, and we analyzed 807,380 disabled persons who had been registered until December 2001 and we also analyzed 1,614,760 non-disabled persons for nine ambulatory care sensitive conditions (ACSCs). The rates of physician visits and hospitalizations for the patients with ACSCs were compared between the disabled and the nondisabled. Multiple logistic regression analysis was used to evaluate the association between medical care utilization and disability and to assess the association between hospitalization and the number of physician visits while controlling for potential confounders. RESULTS: The numbers of physician visits per 100 patients were 0.78~0.97 times lower for the disabled than that for the non-disabled with five of nine ACSCs. The numbers of hospitalizations per 100 patients were 1.16~1.77 times higher for the disabled than that for the non-disabled with all the ACSCs. While the ORs of a physician visit for the disabled were significantly lower than that for the non-disabled with all the ACSCs (OR: 0.44~0.70), and the ORs of hospitalization for the disabled were significantly higher (OR: 1.16~1.89). The lower physician visit group (number of physician visits < or =1) was more likely to be hospitalized than the higher physician visit group (number of physician visits > or =2) (OR: 1.69~19.77). The effect of the physician visit rate on hospitalization was larger than the effect of disability on hospitalization. CONCLUSIONS: The results suggest that the disabled were more likely to be hospitalized for ACSCs due to their lower access to primary care.
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- Related Factors for the Initiation of Smoking in High School Students Based on the Transtheoretical Model.
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Jee Young Hong, Moo Sik Lee, Baeg Ju Na, Keon Yeop Kim
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J Prev Med Public Health. 2006;39(1):67-73.
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This study was conducted to investigate the relationship between the intention of smoking and its related factors in high school students. METHODS: Our study subjects were 1,203 high school students who resided in one city and in one county region. We conducted a self-administered questionnaire survey from June 7 to June 19, 2004. Both the decisional balance and temptation inventory showed high reliability estimates. We provided good fit for the 12-item decisional balance inventory and the 10-item temptation inventory by using a confirmatory factor analysis. We also used multiple logistic regression analysis to identify the major contributing factors for the intention to start smoking. RESULTS: On the univariate analysis, the subjects who were female, the 2nd and 3rd grade students,the students in vocational high school, the ex-drinkers or current drinkers, and ex-smokers were found to be significantly more distributed in the groups with intention to start smoking. Except for the concept of the cons, the group with intention to start smoking showed significantly higher standardized T scores for the 7 concepts of decisional balance and temptations. On the multiple logistic regression analysis, the females, the 2nd and 3rd grade students, the students in vocational high school, the experience of cigarette smoking and low T score of the cons were significantly related to the intention to start smoking. CONCLUSIONS: The intention to start smoking in high school students was affected by various factors such as gender, the school grade and the experience of smoking. Therefore, further research should be conducted for providing the essential data for developing a brief instrument for selecting the groups with intention of starting smoking among adolescents.
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- The Relation between Type of Insurance and Acute Appendicitis Rupture Rate.
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Baeg Ju Na, Jee Young Hong, Keon Yeop Kim, Moo Sik Lee, Hae Sung Nam, Jeong Soo Im, Jung Ae Rhee
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J Prev Med Public Health. 2004;37(3):267-273.
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This study was aimed at investigating the medical service utilization pattern of patients who use public medical aid compared to those who have health insurance. METHODS: We selected every patient between the age of 18 and 69 who used public medical aid from January 1, 1999, to December 31, 2001, in Gwangju metropolitan city, South Korea. For comparison, a list of patients with health insurance was gathered for same period. Then the medical records of those who had been hospitalized for acute appendicitis were selected among both groups. Of those records, we compared the number of cases of ruptured appendicitis to cases of whole acute appendicitis in both groups. Regarding coding for ruptured appendicitis, International Classification of Diseases - 10 (ICD-10) was used. Multiple logistic regression was used as a statistical tool to determine the effectiveness of risk factors. RESULTS: Even after adjusting for risk factors, such as age and sex, the proportion of perforation of acute appendicitis among public medical aid patients was found to be significantly higher than among insured patients. CONCLUSIONS: This comparative study on ruptured appendicitis among public medical aid patients and insured patients, indicates that the proportion of perforation of acute appendicitis could be an index showing that these types of patients utilize medical services differently than insured patients. We know that when abdominal pain is not properly treated at the outset, it easily develops into ruptured appendicitis complicated with peritonitis. Considering this data analysis, we guess the public medical aid system to have significant problem with medical accessibility. So additional and systematic research on the pattern of utilization of medical services of public medical aid patients is needed.
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- A Study on the Related Factors with Internet Addiction of the 11th Grade Students in an Urban Area.
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Moo Sik Lee, Keon Yeop Kim, Kyung Jae Ko, Hyo Jin Lee, Wook Nam, Eun Young Kim, Jee Young Hong, Bak Ju Na
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Korean J Prev Med. 2003;36(4):390-398.
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To evaluate the degree of adolescent internet addiction, and investigate its relationship to the general characteristics, internet environments, and contents, especially the stress measured by the psychosocial wellbeing index-short form (PWI-SF). METHODS: The data was obtained from self-administered questionnaires from 886 11th grade urban area students. The questionnaires consisted of general characteristics, internet user's environments, frequencies by internet contents, internet addiction test and PWI-SF. RESULTS: The possible rate of internet use at home was 95.1%, and the area of most internet use was the home. The frequencies of internet game and porno site use were higher in males, with web searching and community uses higher in females. The total mean of internet addiction score was 56.8, and was higher for male than for female students. From multiple regression, as analyzed by the internet addiction score as a dependent variable, on-line friends, internet use times, years of internet use, frequencies of internet game & porno site use, and PWI-SF scores were significant in male. Internet use times, the frequencies of internet game, chatting, community use, and PWI-SF score were significant in female. Four PWI-SF subscales (social role & self reliability, depression, general health & vitality, and sleep disturbance & anxiety) and internet addiction were significantly correlated in both male and female students, with depression having the most correlation. CONCLUSION: The results of this study suggest that intervention should be provided to prevent internet addiction, especially for coping with stress in Korean teenage students.
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KSPM
