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JPMPH : Journal of Preventive Medicine and Public Health

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You Cheol Shin 2 Articles
Mortality among Medical Doctors Based on the Registered Cause of Death in Korea 1992-2002.
You Cheol Shin, Jae Heon Kang, Cheol Hwan Kim
J Prev Med Public Health. 2005;38(1):38-44.
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AbstractAbstract PDF
OBJECTIVE
To compare the mortality rate of Korean medical doctors to that of the general Korean population for the period 1992-2002. METHODS: The membership records of the Korean Medical Association were linked to the 1992-2002 death certificate data of Korea's National Statistical Office using 13-digit unique personal identification numbers. The study population consisted of 61, 164 medical doctors with a follow-up period of 473, 932 person-years. Standardized mortality ratios (SMRs) were calculated to compare cause-specific mortality rates of medical doctors to those of the general population. RESULTS: We confirmed 1, 150 deaths at ages from 30 to 75 years from 1 January 1992 to 31 December 2002. The SMR for all-cause of death was 0.47 (95% CI : 0.44~0.50). The SMRs for smoking-related diseases such as cerebrovascular accidents and chronic obstructive pulmonary disease were smaller than the SMR of all-cause of death. However, the SMRs for colorectal and pancreatic cancers were not significantly lower than those of the general population. Transport accidents and suicides accounted for 72% (94 of 131) of external causes of death. The SMR for suicide was 0.51 (95% CI : 0.38~0.68). CONCLUSIONS: The mortality rate of South Korean medical doctors was less than 50% that of the general population of South Korea. Cause-specific analysis showed that mortality rates in leading causes of death were lower among medical doctors although differences in mortality rates between medical doctors and the general population varied with the causes of death. These health benefits found among medical doctors may be attributable to the lower level of health damaging behaviors (e.g., lower smoking rates) and better working conditions.
Summary
Severity-Adjusted Mortality Rates: The Case of CABG Surgery.
Hyeung Keun Park, Hyeongsik Ahn, Young Dae Kwon, You Cheol Shin, Jin Seok Lee, Hae Joon Kim, Moon Jun Sohn
Korean J Prev Med. 2001;34(1):21-27.
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AbstractAbstract PDF
OBJECTIVES
To develop a model that will predict the mortality of patients undergoing Coronary Artery Bypass Graft (CABG) and evaluate the performance of hospitals. METHODS: Data from 564 CABGs performed in six general hospitals were collected through medical record abstraction by registered nurses. Variables studied involved risk factors determined by severity measures. Risk modeling was performed through logistic regression and validated with cross-validation. The statistical performance of the developed model was evaluated using c-statistic, R2, and Hosmer-Lemeshow statistic. Hospital performance was assessed by severity-adjusted mortalities. RESULTS: The developed model included age, sex, BUN, EKG rhythm, Congestive Heart Failure at admission, acute mental change within 24 hours, and previous angina pectoris history. The c-statistic and R2 were 0.791 and 0.101, respectively. Hosmer-Lemeshow statistic was 10.3(p value=0.2415). One hospital had a significantly higher mortality rate than the average mortality rate, while others were not significantly different. CONCLUSION: Comparing the quality of service by severity adjusted mortality rates, there were significant differences in hospital performance. The severity adjusted mortality rate of CABG surgery may be an indicator for evaluating hospital performance in Korea.
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JPMPH : Journal of Preventive Medicine and Public Health