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Chanki Kim 2 Articles
Presence of Thrombectomy-capable Stroke Centers Within Hospital Service Areas Explains Regional Variation in the Case Fatality Rate of Acute Ischemic Stroke in Korea
Eun Hye Park, Yong Jin Gil, Chanki Kim, Beom Joon Kim, Seung-sik Hwang
J Prev Med Public Health. 2021;54(6):385-394.   Published online October 22, 2021
DOI: https://doi.org/10.3961/jpmph.21.329
  • 4,309 View
  • 234 Download
  • 3 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study aimed to explore the status of regional variations in acute ischemic stroke (AIS) treatment and investigate the association between the presence of a thrombectomy-capable stroke center (TSC) and the case fatality rate (CFR) of AIS within hospital service areas (HSAs).
Methods
This observational cross-sectional study analyzed acute stroke quality assessment program data from 262 hospitals between 2013 and 2016. TSCs were defined according to the criteria of the Joint Commission. In total, 64 HSAs were identified based on the addresses of hospitals. We analyzed the effects of structure factors, process factors, and the presence of a TSC on the CFR of AIS using multivariate logistic regression.
Results
Among 262 hospitals, 31 hospitals met the definition of a TSC. Of the 64 HSAs, only 20 had a TSC. At hospitals, the presence of a stroke unit, the presence of stroke specialists, and the rate of endovascular thrombectomy (EVT) treatment were associated with reductions in the CFR. In HSAs, the rate of EVT treatment (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99) and the presence of a TSC (OR, 0.93; 95% CI, 0.88 to 0.99) significantly reduced the CFR of AIS.
Conclusions
The presence of a TSC within an HSA, corresponding to structure and process factors related to the quality of care, contributed significantly to lowering the CFR of AIS. The CFR also declined as the rate of treatment increased. This study highlights the importance of TSCs in the development of an acute stroke care system in Korea.
Summary
Korean summary
혈관 내 재개통술(endovascular thrombectomy, EVT)는 많은 전문인력과 장비등 상당한 자원을 필요로 하는 특성으로 인해 상대적으로 자원이 부족한 지역에 치료 공백이 발생할 수 있다. EVT 가능 병원(Thrombectomy capable stroke center, TSC)를 "연간 EVT 15회 이상 시행, 뇌졸중 전문치료실 운영 그리고 뇌졸중 관련 전문의(신경과, 신경외과, 재활의학과)가 모두 근무하는 병원으로 정의하고 진료권 단위로 분석한 결과 진료권 내 TSC의 존재는 허혈성 뇌졸중 환자군의 치명률를 유의하게 감소시켰다. 그러므로 급성 허혈성 뇌졸중 치료의 지역 간 변이를 줄이기 위해서 진료권 내 TSC 를 정의하고 설치하는 것의 중요하며, 이러한 결과는 향후 70개 진료권 단위 지역책임의료기관을 구축하는 과정에 중요한 근거자료로 활용될수 있을 것이다.

Citations

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  • Prioritization of Injury Prevention and Management Programs and Research and Development (R&D) Projects: Survey Using the Delphi Technique and Analytic Hierarchy Process
    Won Kyung Lee, Minsu Ock, Ju Ok Park, Changsoo Kim, Beom Sok Seo, Jeehee Pyo, Hyun Jin Park, Ui Jeong Kim, Eun Jeong Choi, Shinyoung Woo, Hyesook Park
    Asia Pacific Journal of Public Health.2024; 36(1): 78.     CrossRef
  • Regional variation in access to and quality of acute stroke care: results of Germany’s Health System Performance Assessment pilot, 2014–2020
    P. Hengel, U. Nimptsch, M. Blümel, K. Achstetter, R. Busse
    Research in Health Services & Regions.2024;[Epub]     CrossRef
  • Patterns in the number of interventionalists for endovascular treatment of acute ischemic stroke in the US
    Ankita Tripathi, Laura K. Stein, Mandip S. Dhamoon
    Journal of Stroke and Cerebrovascular Diseases.2023; 32(2): 106943.     CrossRef
  • Thrombectomy-Capable Stroke Centre—A Key to Acute Stroke Care System Improvement? Retrospective Analysis of Safety and Efficacy of Endovascular Treatment in Cardiac Cathlab
    Krzysztof Pawłowski, Artur Dziadkiewicz, Anna Podlasek, Jacek Klaudel, Alicja Mączkowiak, Marek Szołkiewicz
    International Journal of Environmental Research and Public Health.2023; 20(3): 2232.     CrossRef
  • COVID-19 case-fatality variations with application to the Middle East countries
    Sami Khedhiri
    GeoJournal.2022; 88(1): 1127.     CrossRef
Regional Differences in the Effects of Social Relations on Depression Among Korean Elderly and the Moderating Effect of Living Alone
Chanki Kim, Eun Jee Chang, Chang-yup Kim
J Prev Med Public Health. 2021;54(6):441-450.   Published online October 22, 2021
DOI: https://doi.org/10.3961/jpmph.21.337
  • 4,267 View
  • 145 Download
  • 7 Web of Science
  • 8 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Socioeconomic disadvantages interact with numerous factors which affect geriatric mental health. One of the main factors is the social relations of the elderly. The elderly have different experiences and meanings in their social lives depending on their socio-cultural environment. In this study, we compared the effects of social relations on depression among the elderly according to their living arrangement (living alone or living with others) and residential area.
Methods
We defined social relations as “meetings with neighbors” (MN). We then analyzed the impact of MN on depression using data from the Korean Longitudinal Study of Aging Panel with the generalized estimating equation model. We also examined the moderating effect of living alone and performed subgroup analysis by dividing the sample according to which area they lived in.
Results
MN was associated with a reduced risk of depressive symptoms among elderlies. The size of the effect was larger in rural areas than in large cities. However, elderly those who lived alone in rural areas had a smaller protective impact of MN on depression, comparing to those who lived with others. The moderating effect of living alone was significant only in rural areas.
Conclusions
The social relations among elderlies had a positive effect on their mental health: The more frequent MN were held, the less risk of depressive symptoms occurred. However, the effect may vary depending on their living arrangement and environment. Thus, policies or programs targeting to enhance geriatric mental health should consider different socio-cultural backgrounds among elderlies.
Summary
Korean summary
본 연구는 사회적 관계가 노인의 우울에 미치는 영향이 독거 상태 및 거주 지역에 따라 달라지는지 확인하였다. 사회적 관계를 이웃과의 만남 빈도로 정의하고 고령화연구패널자료를 분석한 결과 사회적 관계의 효과 크기는 대도시에서 가장 작었고 독거의 조절효과는 농어촌에서만 유의하였다.

Citations

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  • Association between area deprivation index and concerns to COVID-19: A multi-level analysis of individual and area factors
    Doo Woong Lee, Jieun Jang, Jaeyong Shin
    SSM - Population Health.2024; 25: 101580.     CrossRef
  • Nutritional Risk, Depression, and Physical Function in Older People Living Alone
    Jeong-Hye Park, Se-Won Kang
    Healthcare.2024; 12(2): 164.     CrossRef
  • Urban-Rural Differences in Prevalence of Depressive Symptoms and Its Related Factors Among Older Adults: Findings from the Korean Longitudinal Study of Aging
    Bongjeong Kim, Jinseub Hwang, Dohyang Kim, Soo Jin Kang
    Research in Community and Public Health Nursing.2024; 35: 51.     CrossRef
  • The Effectiveness of Digital Interactive Intervention on Reducing Older Adults’ Depressive and Anxiety Symptoms: A Systematic Review and Meta-Analysis
    Xinyu Shi, Jiaxin Zhang, Hailiang Wang, Yan Luximon
    Gerontology.2024; 70(9): 991.     CrossRef
  • Global rural health disparities in Alzheimer's disease and related dementias: State of the science
    Lisa Ann Kirk Wiese, Allison Gibson, Marc Aaron Guest, Amy R. Nelson, Raven Weaver, Aditi Gupta, Owen Carmichael, Jordan P. Lewis, Allison Lindauer, Samantha Loi, Rachel Peterson, Kylie Radford, Elizabeth K. Rhodus, Christina G. Wong, Megan Zuelsdorff, La
    Alzheimer's & Dementia.2023; 19(9): 4204.     CrossRef
  • Living alone and the risk of depressive symptoms: a cross-sectional and cohort analysis based on the China Health and Retirement Longitudinal Study
    Guangjun Zheng, Biying Zhou, Zhenger Fang, Chunxia Jing, Sui Zhu, Mingliang Liu, Xia Chen, Lei Zuo, Haiyan Chen, Guang Hao
    BMC Psychiatry.2023;[Epub]     CrossRef
  • Assessment of the relationship between living alone and the risk of depression based on longitudinal studies: A systematic review and meta-analysis
    Daolin Wu, Fuwei Liu, Shan Huang
    Frontiers in Psychiatry.2022;[Epub]     CrossRef
  • Effects of Serious Games on Depression in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials
    Yesol Kim, Soomin Hong, Mona Choi
    Journal of Medical Internet Research.2022; 24(9): e37753.     CrossRef

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