- Prevalence and Related Factors of Knee Osteoarthritis in Rural Woman.
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Sung Ho Yun, Pock Soo Kang, Seok Beom Kim, Kyeong Soo Lee
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Korean J Prev Med. 2001;34(4):331-336.
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To assess the prevalence of knee osteoarthritis through proper diagnosis in a rural community and to elucidate the relevant factors of this health problem in order to develop educational methods for the prevention of female knee osteoarthritis as well to provide basic data for prospective research. METHODS: Over a period of three months starting from August, 2000, 432 women over the age of 40 and living in a rural area were selected by a multistage cluster sampling method in order to investigate the prevalence of knee osteoarthritis and the related factors. The study utilized interviews and radiological examination. The criteria of knee osteoarthritis used was the American College of Rheumatology classification criteria for osteoarthritis of the knee(1995). RESULTS: The adjusted prevalence of knee osteoarthritis among the subjects was 55.0%, and multiple logistic regression analysis showed that the odds ratio(OR) of knee osteoarthritis among subjects 50-59 years of age and subjects older than 60 years of age as compared to subjects 40-49 years of age were 2.43(95% CI: 1.30-4.70) and 4.40(95% CI: 2.47-7.83), respectively. The OR of knee osteoarthritis among factory workers or farmers as compared to others was 1.79(95% CI: 1.03-3.12). The OR of knee osteoarthritis among subjects who had a family history and subjects who had knee injury or surgical history against those subjects had neither were 2.56(95% CI: 1.42-4.63) and 4.70(95% CI:1.45-15.19), respectively. The OR of knee osteoarthritis among smokers against non smokers was 0.47(95% CI: 0.22-0.97). CONCLUSIONS: Related factors of knee osteoarthritis included age, occupation, family history, smoking, knee injury and history of surgery. In order to prevent knee osteoarthritis in high risked rural woman, education concerning self-care methods and safety guideline must be provided at the work place by the public and private health sectors. Additionally, these women should be continually encouraged to exercise, including jogging and swimming regularly.
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- The Patient Recognition, Acceptability and Evaluation of Feasibility for Day Surgery.
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Young Ah Kang, Young Ran Beak, Kyeong Soo Lee, Seok Beom Kim, Pock Soo Kang
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Korean J Prev Med. 2000;33(3):334-342.
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This study was conducted in order to investigate the degree of recognition, acceptability, and attitude towards day surgery of patients who were hospitalized with diseases that were candidates for day surgery; in order to analyze the average length of stay for treatment of the ailments; and to analyze the percentage of patients who could be discharged on the same day after the surgery using the post-anesthesia discharge scoring system. METHODS: Data was collected between February 1 and March 31, 1999 from 353 patients who received surgery for cataract, adenoid hypertrophy, inguinal hernia, strabismus, ptosis, cholelithiasis, hemorrhoid, or anal fistula, at a general hospital in Daegu city. The patients were interviewed and surveyed by a post-anesthesia discharge scoring system(PADS) in order to collect data on patient condition such as vital signs, activity and mental status, pain, nausea and vomiting, surgical bleeding, intake and output after the surgery. RESULTS: Among the 353 patients, 52.7% were awar of the day surgery and 52.1% were interested in day surgery. Of the respondents, 43.1% said 'my ailment was not serious and the surgery was simple' and 30.4% said 'according to my condition rest at home was desirable' as the reasons for wanting day surgery Alternatively, 56.5% of those declining day surgery said the 'uncertainty of staying home' was the reason. The greatest concern in discharging within 24 hours after surgery was a post-op emergency situation. On the other hand, the shortened hospitalization was the largest advantage of day surgery with 39.1% responding this way, followed by the savings in hospitalization costs (25.8%) and emotional stability (13.7%). The majority of those surveyed (47.6%) believed that discharge should be determined within 1-2 days after the surgery. The average hospital stay was 3.1 days for dischargeable ailments. Pain (45.6%), nausea and vomiting (10.5%), and headache (7.9%) were the common symptoms following surgery. The percentage of patients who were able to be discharged within 24 hours after surgery revealed 95.2% were dischargeable after approximately 3 hours, 99.2% dischargeable after 12 hours, and 100% dischargeable atter 24 hours. CONCLUSIONS: According to the PADS score, the cataract extract and strabismus correction patients were eligible for day surgery and the further evaluation concerning the reason for delayed recovery of the other diseases is needed.
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- Community-based Helicobacter pylori Screening and its Effects on Eradication in Patients with Dyspepsia.
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Seong Ho Kim, Dae Yong Hong, Pock Soo Kang, Seok Beom Kim, Kyeong Soo Lee, Sang Kyu Kim, Jeong Ill Suh, Mee Kyung Kim
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Korean J Prev Med. 2000;33(3):285-298.
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- CONCLUSIONS: To investigate the positive rate of Helicobacter pylori in patients with dyspepsia; medical compliance and related factors; the eradication rate a year after screening and related factors; the relationship between the eradication of Helicobacter pylori and the improvement of symptoms; and the estimated cost of three alternative approaches to treat Helicobacter pylori in the community. METHODS: A total of 510 subjects with dyspeptic symptoms were selected and given the serological test in March 1998. The subjects were all adults over 30 years of age residing in Kyongju city. RESULTS: Of the 510 selected subjects, 375 (73.5%) subjects proved positive for Helicobacter pylori on serological testing. Of these 304 (81.1%) who consented to an endoscopic examination, underwent a Campylobacter-like organism (CLO) test. Of these 304 subjects, 204 (67.1%), who had positive CLO test results, were given the triple therapy - tripotassium dicitrato bismuthate, amoxicillin, and metronidazole. To determine the eradication rate of Helicobacter pylori, 181 (88.7%) out of the 204 subjects who were given the triple therapy completed a follow-up urea breath test one year later. Of these, the Helicobacter pylori of 87(48.1%) subjects was eradicated. Among the 122 subjects who were medication compliant, the Helicobacter pylori eradication rate was 57.4% (70 subjects), while the eradication rates was only 28.8% (17subjects) in the non-compliant group. The Helicobacter pylori eradication was significantly related to compliance (p<0.01), but not to other characteristics and habits. The symptom improvement rate tended to be higher 62.1%), in the Helicobacter pylori eradicated group than in the non-eradicated group (59.6%). CONCLUSIONS: When the advantages and disadvantages of each alternative treatment were considered in the light of cost, antibiotic tolerance and the number of patients to be treated, alternative II was favorable in terms of cost. Alternative III was favorable in terms of the number of patients to be treated, antibiotic tolerance and early detection of gastric cancer. Further long-term research analyzing the cost-benefit and cost-effectiveness of each treatment will be needed as supporting material in creating new policies.
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- Association between Cognitive Impairment and ADL of the Elderly in Rural Area.
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Sang Kyu Kim, Seok Beom Kim, Pock Soo Kang
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Korean J Prev Med. 1999;32(1):65-71.
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The purpose of this investigation was to study the correlation between cognitive impairment and activities of daily living(ADL) in the elderly of rural area. METHODS: The study population consisted of 210 elderly people aged 65 years and older, living in a district of Kyongju City. The cognitive impairment was measured with the Korean version of mini-mental state examination(MMSE-K) and newly constructed the Korean version of mini-mental state examination (K-MMSE). Bristol activities of daily living scale developed specifically to be used with people with dementia was used to measure ADL. RESULTS: The mean scores of both MMSE-K and K-MMSE were significantly different by sex groups and by age groups, respectively(p<0.05). The mean scores of ADL were significantly different by age groups(p<0.01) not by sex groups. Among the 4 components of ADL(instrumental activities of daily living(IADL), self care, orientation, and mobility), the mean score of the orientation was significantly higher in men(p<0.01); and IADL, orientation and mobility components were significantly different by age groups(p<0.01). ADL correlated well with MMSE-K (r=0.54) and K-MMSE(r=0.52) and showed higher correlation in female (r=0.73, 0.71) than male(r=0.27, 0.29). IADL and orientation showed significant correlation with MMSE-K(r=0.52, 0.62) and K-MMSE(r=0.50, 0.63), respectively(p<0.01). CONCLUSIONS: In developing and establishing a care model for people with dementia in the community, both cognitive impairment and the activities of daily living(ADL) need to be considered.
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Summary
- Effects of Regional Medical Insurance on Utilization of Medical Care in Urban Population.
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Seok Beom Kim, Pock Soo Kang
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Korean J Prev Med. 1994;27(1):117-134.
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- The effects of regional medical insurance on utilization of medical care in urban population was examined in this study. The data was collected in a 2-year follow-up household survey conducted at Taegu city before and after implementation of the regional medical insurance. The study population was divided into 2 groups. Cohort I was the uninsured in 1989 and cohort II was the insured in 1989. After the coverage of medical insurance, physician visit rate per 1,000 population, use-disability ratio and use-restricted activity ratio in cohort I were increased compared to cohort II in both of acute and chronically ill people. The use-disability ratio and use-restricted activity ratio of the insured poor were lower than those of the insured nonpoor in both of cohort I and cohort II. The major reasons for pharmacy use were accessibility and affordability before the coverage of medical insurance in cohort I, however, after the coverage of medical insurance, the important reason was accessibility rather than affordabifity. In logistic regression analysis of physician visit, the significant independent variables were acute illness episode(+), chronic illness episode(+) and income(+) in both of cohort I and cohort II. In cohort I, after the coverage of medical insurance, more people replied that the medical cost of hospital and clinic was reasonable. The people who covered by the regional medical insurance were more dissatisfied with the imposed premium than those who covered by other types of medical insurance in both of cohort I and cohort II. More people in cohort II than cohort I were dissatisfied with the services from hospitals and clinics after implementation of the regional medical insurance. In conclusion. after the coverage of medical insurance, the gap between the poor and the nonpoor still exists in terms of medical care utilization.
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Summary
- Utilization Rate of Medical Facility and Its Related Factors in Taegu.
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Seok Beom Kim, Pock Soo Kang
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Korean J Prev Med. 1989;22(1):29-44.
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- A household survey was conducted to determine the utilization rate of medical facilities and to identify the factors related with the utilization in the South District of Taegu from July 3 to July 15, 1988. Study population included 1,723 family members of 431 households which were selected by one-stage simple cluster random sampling. Well trained medical college students interviewed mainly housewives with a structurized questionnaire. Morbidity rate of acute illness during the 2-week period was 101 per 1,000 persons and it was highest in the age group of 9 years below. The rate for chronic illness was 77 per 1,000 persons, increasing with age, low income and medicaid benefit. During the 2-week period, 689 of 1,000 persons utilized the medical facilities, Of the facilities, most number, 294, used hospital and clinic, and the order ran as pharmacy, health center, and herb medical clinic. The utilization rate was higher in the female, 70-year and older group, medicaid group, the lowest income class and self-employed group than other groups. The average number of visits among users of medical facilities during the 2-week period was 3.25. those who visited medical facilities most frequently were females, the 70-year and older group, the lowest income class and blue collar worker group. During one-year period, admission rate of 1,000 persons was 27.6 and that of female was 38.9, higher than that of male. the eldest group had the highest admission rate. Admission rate of medical insurance beneficiaries was twice or higher than non-beneficiaries. The higher the family monthly income, the more frequently they admitted. During one-year period, average admission days of the persons hospitalized were 22.5 days and males were hospitalized longer than females. The groups which were hospitalized longest were those between the ages of 40 and 49, medical insurance beneficiaries, the lowest income group and unemployed group. During one-year period, average admission days of 1,000 persons were 560 days and those of female were 661 days, more than those of male. The guoups which had the longest admission days were those above 70 years of age, the lowest income and unemployed groups. The medical insurance beneficiaries were three times or longer than non-beneficiaries. In logistic regression analysis of utilization of physician, significant independent variables were the 9-year and younger group(+), the 70-year and older group(+), acute illness episode(+), chronic illness episode(+), medical insurance beneficiary(+) and white collar workers(-). Acute and chronic illness episode(+), and medical insurance for government employees and private school teacher(-) were significant variables in analysis of utilization of pharmacy. In multiple regression analysis of the number of physician visits, siginificant variables were acute illnes episode(+), chronic illness episode(+), industrial, occupational and regional medical insurance beneficiary(+), white collar workers(-). Acute and chronic illness episode(+), and medical insurance beneficiary() were significant variables in analysis of the number of pharmacy visits. In logistic regression analysis of admission event, significant independent variables were the 9-year and younger group(+), the 70-year and older group(+), chronic illness episode(+), and medical insurance beneficiary(+).
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KSPM
