Journal of Preventive Medicine and Public Health

Young Jeon Shin

12 Articles

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; J Prev Med Public Health. 2010;43(5):423-435.; DOI: https://doi.org/10.3961/jpmph.2010.43.5.423

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OBJECTIVES
The low benefit coverage rate of South Korea's health security system has been continually pointed out. A low benefit coverage rate inevitably causes catastrophic health expenditure, which can be the cause of the transition to poverty and the persistence of poverty. This study was conducted to ascertain the effect of catastrophic health expenditure on the transition to poverty and the persistence of poverty in South Korea. METHODS: To determine the degree of social mobility, this study was conducted among the 6311 households that participated in the South Korea Welfare Panel Study in both 2006 and 2008. The effect of catastrophic health expenditure on the transition to poverty and the persistence of poverty in South Korea was assessed via multiple logistic regression analysis. RESULTS: The poverty rate in South Korea was 21.6% in 2006 and 20.0% in 2008. 25.1 - 7.3% of the households are facing catastrophic health expenditure. Catastrophic health expenditure was found to affect the transition to poverty even after adjusting for the characteristics of the household and the head of the household, at the threshold of 28% or above. CONCLUSIONS: 25.1% of the households in this study were found to be currently facing catastrophic health expenditure, and it was determined that catastrophic health expenditure is a cause of transition to poverty. This result shows that South Korea's health security system is not an effective social safety net. As such, to prevent catastrophic health expenditure and transition to poverty, the benefit coverage of South Korea's health security system needs to the strengthened.

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The Impact of Public Transfer Income on Catastrophic Health Expenditures for Households With Disabilities in Korea
Eun Jee Chang, Sanggu Kang, Yeri Jeong, Sungchan Kang, Su Jin Kang
Journal of Preventive Medicine and Public Health.2023; 56(1): 67. CrossRef
Food Insecurity, Healthcare Utilization, and Healthcare Expenditures: A Longitudinal Cohort Study
Hwi Choe, Tae-Young Pak
International Journal of Public Health.2023;[Epub] CrossRef
The effect of catastrophic health expenditure on exit from poverty among the poor in South Korea
Eunkyoung Kim, Soonman Kwon
The International Journal of Health Planning and Management.2021; 36(2): 482. CrossRef
Incidence of household catastrophic and impoverishing health expenditures among patients with Breast Cancer in Iran
Faranak Ahmadi, Hamidreza Farrokh-Eslamlou, Hasan Yusefzadeh, Cyrus Alinia
BMC Health Services Research.2021;[Epub] CrossRef
The Effect of Mid-to-Long-Term Hospitalization on the Catastrophic Health Expenditure: Focusing on the Mediating Effect of Earned Income Loss
Hyunwoo Jung, Jungyeon Yang, Eunyoung Kim, Junhyup Lee
Healthcare.2021; 9(8): 1013. CrossRef
The impact of poverty transitions on frailty among older adults in South Korea: findings from the Korean longitudinal study of ageing
Hin Moi Youn, Hyeon Ji Lee, Doo Woong Lee, Eun-Cheol Park
BMC Geriatrics.2020;[Epub] CrossRef
Modelling unbalanced catastrophic health expenditure data by using machine‐learning methods
Songul Cinaroglu
Intelligent Systems in Accounting, Finance and Management.2020; 27(4): 168. CrossRef
Relationship Between Catastrophic Health Expenditures and Income Quintile Decline
Jeong-Hee Kang, Chul-Woung Kim
Osong Public Health and Research Perspectives.2018; 9(2): 73. CrossRef
Trends of Health Status and Medical Utilization Among Korean Baby Boomers: Analysis From Korean Health Panel Survey 2008-2014
Soong-Nang Jang
Annals of Geriatric Medicine and Research.2017; 21(1): 24. CrossRef
Inequality Status of Household Medical Expenditure Distribution by Household Income Quartile and Associated Factors with Household Catastrophic Medical Expenditure in Korea
Min Jung Kim, Sin Kam, Won Kee Lee
Journal of Health Informatics and Statistics.2017; 42(3): 232. CrossRef
Family Income Inequality and Medical Care Expenditure In Korea
Yong-Jae Lee
The Journal of the Korea Contents Association.2016; 16(8): 366. CrossRef
The Effect of Occurrence and Reoccurrence of Catastrophic Health Expenditure on Transition to Poverty and Persistence of Poverty in South Korea
Eunkyoung Kim, Soonman Kwon
Health Policy and Management.2016; 26(3): 172. CrossRef
Association between chronic disease and catastrophic health expenditure in Korea
Jae-Woo Choi, Jong-Won Choi, Jae-Hyun Kim, Ki-Bong Yoo, Eun-Cheol Park
BMC Health Services Research.2015;[Epub] CrossRef
Catastrophic Health Expenditures and Life Satisfaction: A Case in South Korea
So-Yun Kim, Gong-Soog Hong
Journal of Family and Economic Issues.2015; 36(3): 369. CrossRef
Effect of the Crisis Assistance Program on poverty transition for seriously ill people in South Korea: A quasi-experimental study
Chang-O Kim, Won Oh Joung
Social Science & Medicine.2014; 101: 28. CrossRef
Trends of household income and dental care spending
Hye-sung Kim, Eunsuk Ahn, Min-Young Kim, Sun-Mi Kim, Hosung Shin
Journal of Korean Academy of Oral Health.2014; 38(1): 17. 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
The Effect of Catastrophic Health Expenditure on the Transition to and Persistence of Poverty in South Korea: Analysis of the Korea Welfare Panel Study Data, 2007-2012
Eun-Cheol Song, Young-Jeon Shin
Health Policy and Management.2014; 24(3): 242. CrossRef
Equity in health care: current situation in South Korea
Hong-Jun Cho
Journal of the Korean Medical Association.2013; 56(3): 184. CrossRef

Analysis for the Impact of Adulthood and Childhood Socioeconomic Positions and Intergenerational Social Mobility on Adulthood Health.: Jae Hee Seo, Ho Kim, Young Jeon Shin; J Prev Med Public Health. 2010;43(2):138-150.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.138

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OBJECTIVES
There are at least three conceptual models for the effects of the childhood social environment on adult health: the critical period model, the social mobility model, and the cumulative risk model. However, few studies have investigated all three different models within the same setting. This study aims to examine the impact of childhood and adulthood socioeconomic positions and intergenerational social mobility over the life course on the health in adulthood based both on the critical period model and the social mobility model. METHODS: This study was conducted on 9583 adults aged between 25 and 64 years old and they were the respondents to the Korea Welfare Panel Study (2006). A multivariate logistic regression analysis was carried out, using the critical period model and the social mobility model out of the life course approaches, to look into the impact of childhood and adulthood socioeconomic positions and intergenerational social mobility on the health status in adulthood. RESULTS: Household income and occupation out of the adulthood socioeconomic position indicators had an independent influence on the adulthood health status. The childhood socioeconomic position indicators, except for the place of childhood residence, affected the adulthood health status even after adjustment for the adulthood socioeconomic position. The effect of intergenerational social mobility was also statistically significant even after adjusting for the adulthood socioeconomic position, but it became insignificant when the childhood socioeconomic position was additionally adjusted for. CONCLUSIONS: Adulthood health is indeed affected by both the childhood and adulthood socioeconomic positions as well as intergenerational social mobility. This result shows that a life course approach needs to be adopted when dealing with health issues.

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Impact of Childhood Socioeconomic Position on Self‐Rated Health Trajectories of South Korean Adults
Joan P. Yoo, Min Sang Yoo
Asian Social Work and Policy Review.2016; 10(1): 142. CrossRef
Interaction Effects of Social Determinants Affecting School-Aged Children’s Health
Mi Young Kim, Mee Sok Park
Family and Environment Research.2016; 54(5): 515. CrossRef
Grandparental education, parental education and child height: evidence from Hong Kong’s “Children of 1997” birth cohort
Man Ki Kwok, Gabriel M. Leung, Tai Hing Lam, Shirley S.L. Leung, C. Mary Schooling
Annals of Epidemiology.2013; 23(8): 475. CrossRef
Health Inequalities Policy in Korea: Current Status and Future Challenges
Young-Ho Khang, Sang-il Lee
Journal of Korean Medical Science.2012; 27(Suppl): S33. CrossRef
Social Determinants of Smoking Behavior: The Healthy Twin Study, Korea
Youn Sik Kim, Hansoo Ko, Changgyo Yoon, Dong-Hun Lee, Joohon Sung
Journal of Preventive Medicine and Public Health.2012; 45(1): 29. CrossRef

The Association Between Public Social Expenditure and Suicides: Evidence from OECD Countries.: Yoojin Park, Myoung hee Kim, Soonman Kown, Young jeon Shin; J Prev Med Public Health. 2009;42(2):123-129.; DOI: https://doi.org/10.3961/jpmph.2009.42.2.123

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OBJECTIVES
This study aimed to examine the association between public social expenditure (PSE) and suicides in the 27 countries of the Organization for Economic Cooperation and Development (OECD) from 1980 to 2003. METHODS: The age-standardized suicide rates and their annual change (%) were obtained from the OECD Health Data 2007. As a measure of social protection, the PSE (% GDP) was used. The covariates included the annual divorce rate (/100,000 population), fertility rate (number of children/woman aged 15 to 49 years), GDP per capita (US$PPP), male unemployment rate (%), life expectancy (years) and alcohol consumption (liter/capita) for each country, which were all obtained from the OECD Health Data 2007 and the OECD Social Indicators 2006. Using hierarchical linear models that included these covariates, the effects of PSE on suicides (Model 1) and the annual percent change (Model 2) were examined (Model 3). Also, sub-sample analyses were done for six countries that experienced political/economic transition. RESULTS: We could not find significant effects of PSE on suicides (Model 1), but we observed significantly negative effects on the annual percent change for men and women (Model 2). Such findings were replicated in the sub-sample analysis, and moreover, the effect size was much larger (Model 3). CONCLUSIONS: Our finding suggests that social welfare protection can be a pivotal factor for suicide epidemiology, and especially in countries experiencing a social crisis or transition.

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Spatiotemporal clustering of suicide attempt in Kermanshah, West-Iran
Alireza Zangeneh, Nahid Khademi, Naser Farahmandmoghadam, Arash Ziapour, Reyhane Naderlou, Somayyeh Shalchi Oghli, Raziyeh Teimouri, Komali Yenneti, Shahrzad Moghadam
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Impacts of Economic Freedom, Health, and Social Expenditures on Well-Being Measured by the Better Life Index in OECD Countries
Seda Aydan, Gamze Bayin Donar, Cengiz Arikan
Social Work in Public Health.2022; 37(5): 435. CrossRef
Cross-national comparisons of increasing suicidal mortality rates for Koreans in the Republic of Korea and Korean Americans in the USA, 2003–2012
A. Kung, K. G. Hastings, K. I. Kapphahn, E. J. Wang, M. R. Cullen, S. L. Ivey, L. P. Palaniappan, S. Chung
Epidemiology and Psychiatric Sciences.2018; 27(1): 62. CrossRef
The Impacts of Social Protection Policies and Programs on Suicide: A Literature Review
Chungah Kim
International Journal of Health Services.2018; 48(3): 512. CrossRef
A fuzzy set approach to economic crisis, austerity and public health. Part II: How are configurations of crisis and austerity related to changes in population health across Europe?
Therese Saltkjel, Mari Holm Ingelsrud, Espen Dahl, Knut Halvorsen
Scandinavian Journal of Public Health.2017; 45(18_suppl): 48. CrossRef
The 2008/09 Economic Crisis: The Impact on Psychological Well-Being in the USA
Chiara Piovani, Nursel Aydiner-Avsar
Forum for Social Economics.2015; 44(1): 18. CrossRef
Regional Disparities of Suicide Mortality by Gender
Eun-Won Seo, Jin-Mi Kwak, Da-Yang Kim, Kwang-Soo Lee
Health Policy and Management.2015; 25(4): 285. CrossRef
Elderly's Suicide Differentials and Their Factors: Focusing on 16 Metropolises and Provinces in Korea
Hyoung-Soo Kim, Sin-Hayng Kim
The Journal of the Korea Contents Association.2014; 14(11): 215. CrossRef
Association Between Local Government Social Expenditures and Mortality Levels in Korea
Hansoo Ko, Jinseob Kim, Donggil Kim, Saerom Kim, Yukyung Park, Chang-yup Kim
Journal of Preventive Medicine and Public Health.2013; 46(1): 1. CrossRef
Suicide Rate Differences by Sex, Age, and Urbanicity, and Related Regional Factors in Korea
Kyu-Seok Cheong, Min-Hyeok Choi, Byung-Mann Cho, Tae-Ho Yoon, Chang-Hun Kim, Yu-Mi Kim, In-Kyung Hwang
Journal of Preventive Medicine and Public Health.2012; 45(2): 70. CrossRef
Economic crisis and mental health
Antti Uutela
Current Opinion in Psychiatry.2010; 23(2): 127. CrossRef

The Concept and Measurement of Food Security.: Kirang Kim, Mi Kyung Kim, Young Jeon Shin; J Prev Med Public Health. 2008;41(6):387-396.; DOI: https://doi.org/10.3961/jpmph.2008.41.6.387

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OBJECTIVES
During the past two decades, food deprivation and hunger have been recognized to be not just the concerns of only underdeveloped or developing countries, but as problems for many affluent Western nations as well. Many countries have made numerous efforts to define and measure the extent of these problems. Based on these efforts, the theory and practice of food security studies has significantly evolved during the last decades. Thus, this study aims to provide a comprehensive review of the concept and measurement of food security. METHODS AND RESULTS: In this review, we introduce the definition and background of food security, we describe the impact of food insecurity on nutrition and health, we provide its measurements and operational instruments and we discuss its applications and implications. Some practical information for the use of the food security index in South Korea is also presented. CONCLUSIONS: Food security is an essential element in achieving a good nutritional and health status and it has an influence to reduce poverty. The information about the current understanding of food security can help scientists, policy makers and program practitioners conduct research and maintain outreach programs that address the issues of poverty and the promotion of food security.

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Basic Concepts and Detailed Dimensions of Food Security and Related Indicators for Policy Development and Evaluation
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The effects of a personalized nutrition intervention program on food security, health and nutritional status of low-income older adults in Seoul city
Yeyeon Lee, Narae Yang, Minjeong Shin, Kyung-Eun Lee, Chang Hee Yoo, Kirang Kim
Journal of Nutrition and Health.2020; 53(4): 416. CrossRef
Health and nutritional status of Korean adults according to age and household food security: Using the data from 2010~2012 Korea National Health and Nutrition Examination Survey
Geun Ah Park, Sung Hee Kim, Seok Joong Kim, Yoon Jung Yang
Journal of Nutrition and Health.2017; 50(6): 603. CrossRef
Association of food insecurity and depression in Korean adults
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Journal of the Korea Academia-Industrial cooperation Society.2016; 17(1): 62. CrossRef
Food deserts in Korea? A GIS analysis of food consumption patterns at sub-district level in Seoul using the KNHANES 2008-2012 data
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Korean Journal of Community Nutrition.2015; 20(1): 30. CrossRef
Nutritional status of toddlers and preschoolers according to household income level: overweight tendency and micronutrient deficiencies
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Nutrition Research and Practice.2015; 9(5): 547. CrossRef
Food Insecurity and Related Risk Factors in the Elderly: Korea National Health and Nutrition Examination Survey 2013 Data
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Journal of the Korean Dietetic Association.2015; 21(4): 308. CrossRef
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Nutrition Research and Practice.2014; 8(4): 425. CrossRef
A Qualitative Study on Attitude, Acceptability, and Adaptation for Home-delivered Meal Services in the Korean Elderly from the Perspective of Life Context
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Why Do Health Inequalities Matter?.: Young Jeon Shin, Myoung Hee Kim; J Prev Med Public Health. 2007;40(6):419-421.; DOI: https://doi.org/10.3961/jpmph.2007.40.6.419

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OBJECTIVES
The aim of this study was to introduce the concept of health inequalities, and to discuss the underlying assumptions and ethical backgrounds associated with the issue, as well as the theoretical and practical implications of health inequalities. METHODS: Based on a review of the literature, we summarize the concepts of health inequalities and inequities and discuss the underlying assumptions and ethical backgrounds associated with these issues from the view of social justice theory. We then discuss the theoretical and practical implications of health inequalities. RESULTS: Health inequality involves ethical considerations, such as judgments on fairness, and it could provide a sensitive barometer to reflect the fairness of social arrangements. Discussion on health inequalities could deepen our understanding of the social etiology of health and provide a basis for the development of comprehensive and integrative social policies. CONCLUSIONS: Health equity is not a social goal in and of itself, but should be considered as a part of a broader effort to seek social justice.

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A Study on Factors Affecting Cancer Mortality in Busan
Su-Kyung Song, Hye-Sook Kim, Kyoung-Min Lim
The Korean Journal of Health Service Management.2014; 8(4): 81. CrossRef

Health Policy and Social Epidemiology.: Young Jeon Shin; J Prev Med Public Health. 2005;38(3):252-258.

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Abstract PDF: Major approaches of Social epidemiology; 1) holistic, ecological approach, 2) population based approach, 3) development and life-course approach, 4) contextual multi-level approach, have stressed the importance of not only social context of health and illness, but also the population based strategy in the health interventions. Ultimately, it provides the conceptual guidelines and methodological tools to lead toward the healthy public policies; integrated efforts to improve condition which people live: secure, safe, adequate, and sustainable livelihoods, lifestyles, and environments, including housing, education, nutrition, information exchange, child care, transportation, and necessary community and personal social and health services.; Summary

Social Support and Self-rated Health Status in a Low Income Neighborhood of Seoul, Korea.: Min Kyoung Lim, Myoung Hee Kim, Young Jeon Shin, Weon Seob Yoo, Bong Min Yang; Korean J Prev Med. 2003;36(1):54-62.

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Abstract PDF: OBJECTIVES
To assess the distribution of social support, and explore its effects on self-rated health status in a low income neighborhood of Seoul, Korea. METHODS: In September 2001 we conducted a survey in a low income neighborhood of Seoul, Korea, in which 862 residents, aged 18 years or over, participated. We measured the general sociodemographic characteristics, self-rated health status and social support with the instrument developed from Korean translation of the Medical Outcomes Study Social Support Survey (MOS-SSS) scale of the US. Logistic regression was used to identify the determinants of social support, and explore its effects on self-rated health status. RESULTS: Lower social class, women or divorced people had much less social support compared to higher social class, men or those never married, respectively. Those families on much lower income also received less social support. Social support has a positive impact on the self-rated health status, which remains statistically significant even when other relevant variables are adjusted. CONCLUSIONS: This study suggests that social support has an important role in health, and the socially disadvantaged have lower social support. Therefore, to improve the health status of the poor, it is necessary to encourage community participation, and develop strategies that could strengthen their provision of social support.; Summary

Development and Evaluation of the Reliability and Validity of the VSSS-82 Korean Version for Measuring Satisfaction with Community-based Mental Health Services in Psychiatric Patients.: Weon Seob Yoo, Young Jeon Shin, Ok Ryun Moon, Jung Hyun Nam; Korean J Prev Med. 2001;34(3):211-218.

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Abstract PDF: OBJECTIVES
To develop a Korean version of VSSS-82 for measuring the multi-dimensional satisfaction with community-based mental health services in psychiatric patients and to investigate both the reliability and validity of the Korean version. METHODS: The VSSS-82 English version was translated and back-translated with some modification. Data from 68 psychosis patients using community-based mental health services in three Community Mental Health Centers (CMHCs) was collected through a personal interview survey regarding the satisfaction and suitability of service. Variability of satisfaction and internal consistency, discriminant validity, and concurrent validity of the VSSS-82 Korean version were evaluated. RESULTS: A higher number of dissatisfied subjects and significant pairwise differences for the dimensions were found. The Crohnbach's alpha coefficient, a measure of internal consistency, ranged from 0.56 (overall satisfaction) to 0.90 (skills and behavior) and significant differences in satisfaction was found in patients by the self-rated suitability of service. CONCLUSIONS: The VSSS-82 Korean version is a reliable and valid instrument for measuring multi-dimensional satisfaction with community-based mental health service.; Summary

A Study on the Family Burden of the Mentally Ill in a Rural Area.: Weon Young Lee, Young Jeon Shin, Jung Hoe Kim, Chung Hyun Nam, Ok Ryun Moon; Korean J Prev Med. 1999;32(3):400-414.

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Abstract PDF: OBJECTIVES
This is a descriptive study which was carried out to identify characteristics of the chronic mentally ill and their families in a rural area and the influencing factors on family burden. METHODS: Data was collected for seven months beginning April 1, 1998 by questionnaire from chronic mentally ill patients and their families in two towns and seven townships of the rural areas of Kyonggi Province. In additional to the mental diagnosis of the mentally ill patients, family burden was measured by interviewing the other family members using the questionnaire developed by Pai & Kapur (1981). Of those interviewed, 103 patients were selected for final analysis. RESULTS: Of 103 mentally ill patients, 36.1% of the subjects were not under treatment. In particular, of 29 patients with schizophrenia, 48.3% of the subjects had stopped taking medication and 6.9% of the subjects had never been treated. According to the results of a specialized examination by a psychologist, 81% of patients were in need of hospitalization. Most primary caregivers were parents. Of the 101 primary caregivers in the study, 39.6% were over 65 years old. In case of death of the primary caregiver, 50.5% of these 101 mentally ill patients would not have anyone to care for them. Of the various kinds of family burden, primary caregivers most often reported psychological stress. Overall, the families of dementia and schizophrenia patients complained of the most family burden. Through univariative analysis, the variables of sex, education and current treatment type of the patients, the relationship with the patient and marital status of the primary caregiver and the number of people living together in the household showed significant correlation with the family burden of schizophrenia patients. Univariative analysis also showed that there were a number of variables which were correlated to the family burden in mentally retarded patients. Concerning the need for mental health services, the most common requests were for entitlement to disability benefits and housing programs. CONCLUSIONS: Community mental health services in rural areas must be developed, planned and executed in consideration of the local situation. In particular, the development of various family support programs is needed in order to mitigate emotional, mental and economic burdens and carry out a positive role to care for and rehabilitate patients.; Summary

A Comparative Study on Enhancing the Function of the Heath Center in a urban area.: Weon Young Lee, Young Jeon Shin, Young Jun Kwon, Bo Youl Choi, Ok Ryun Moon, Hye Jeong Jeon; Korean J Prev Med. 1998;31(4):857-874.

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A Seroepidemiologic Study on Rubella Antibody in Pregnant Women in Kyonggi Do.: Moran Ki, Boyoul Choi, Young Jeon Shin, Hung Bae Park, Bae Joong Youn, Joong Surk Hahn; Korean J Prev Med. 1997;30(2):279-292.

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Abstract PDF: The vaccinations of susceptible children and postpubertal females are the major means to prevent congenital rubella syndrome(CRS). Another means for reducing the CRS is therapeutic abortion or fetal monitoring for women who are infected in the first four months of pregnancy. We couldnt estimate the incidence of CRS in Korea, because there was no surveillance system for rubella and CRS. Nationwide vaccination program for 15months infant had been started early 1980s. So, most women at childbearing age during study period were not received rubella vaccination. We set forth CRS management system for pregnant women in two rural county of Kyonggi province, Korea. In this system, the presence of rubella IgG and IgM antibodies for early pregnant women were examined with MEIA(Microparticle Enzyme Immunoassay) method by IMx automated analyzer Abbott. The infected pregnant women followed up in order to confirm their children CRS. This study was carried out from Mar.1993 to Jun.1994, and pregnant women examined were 874 persons. The results were summarized as follows. The overall positive rate of rubella IgG antibody was 94.5%(826/874). The positive rate was significantly increase as the age increased, and reached 100% in pregnant women who were over 35 years old. This results suggest that a meaningful number of women are infected during childbearing years. The geometric mean titer of IgG of sero-positive subjects was significantly declined as the age increased. On the question about history of URI symptoms and rash in pregnancy, 20.7% of respondents checked on URI symptoms with rash, 13.5% only URI symptoms without rash, and 65.8% no symptoms. However there was no demonstrable association between the rubella like infection history in pregnancy and the rubella IgG and IgM antibody status. Rubella infection rate in pregnant women was 0.9%(95% CI 0.4-1.8%). Two of these 8 infected pregnancies were terminated by therapeutic abortion. One of them was not followed. Five babies had no gross anomalies at birth. In Dec.1996, three of five babies were normal appeared infants. Two of them were not followed. Throughout this study results, we confirmed the need of CRS management system for pregnant women, in Korea.; Summary

Cost-Benefit Analysis on Rubella Vaccination Policy.: Young Jeon Shin, Bo Youl Choi, Hung Bae Park, Ok Ryun Moon, Bae Joong Yoon; Korean J Prev Med. 1994;27(2):337-365.

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Abstract PDF: Rubella is a viral disease with mild constitutional symptoms and generalized rashes ln childhood, it is an inconsequential illness, but when it occurs during early pregnant period, there are significant risks of heart defects, cataract, mental retardation to the fetus. The series of congenital defects induced by rubella is called 'congenital rubella syndrome'. Many research have been performed to find out more effective prevention program on rubella. The objectives of this study are, first, to calculate the incidence rate of acute rubella infection and congenital rubella syndrome in korea, second, to evaluate economic efficiency of several rubella vaccination policies and to offer data for the most reasonable decision on vaccination policy. Study populations are 663,312 children of one year-old in 1992. The author has performed cost-benefit analyses according to the three vaccination policies-U.S.A.'s. U.K's and Sweden's. In this study, the author got the incidence rate of acute rubella infection using the catalytic model. In the meantime, the author used 50 per 100,000 live births as the incidence rate of congenital rubella syndrome. The discount rate used in this study was 5 percent per annum. The sensitivity analyses were done with different discount rates (4%, 7%) and different incidence rate of congenital rubella syndrome (10,100 per 100,000 live births): The study results are as follows: 1. Without vaccination, lifetime expenditures per patient for acute rubella infection amount to 14,822 won and the total expenditures to about 3.1 billion won. Meanwhile, lifetime expenditures per patient for congenital rubella syndrome amount to about 91 million won and the total expenditures to about 16.3 billion won without vaccination. 2. The cost of vaccination for a child of one year old was 2,322 won and the total cost for the one year old children was about 1.5 billion won(American style). The cost for vaccination of female children at fifteen was about 339 million won (British style). And the cost of vaccination at one for both sex and female children at fifteen was about 1.9billion won (Swedish style). 3. The benefit to cost ratios of vaccination or female children at fifteen that is the british mode of rubella vaccination, was 60.0 at the level of 80 % population coverage and 48.6 at 100% coverage. It shows much higher benefit to cost ratio than those of the other two vaccination policies. 4. Both net benefits of vaccination at one (American style) and that of vaccinations at one and fifteen (Swedish style) range from about 17.0 billion to 17.8 billion won, those were larger than that of vaccinations of female children at fifteen(British style, about 16.0 billion). 5. In marginal cost-benefit analysis of only additional program or revaccination, the benefit to cost ratios were 3.6(80% coverage rate) or 0.6 (100% coverage rate). It implies that additional program was less efficient or inefficient 6. In sensitively analysis with different discount rates (4% or 7%) and different incidence rates of congenital rubella syndrome (l0 or 100 per 100,000 live births), the benefit to cost ratios has fluctuated in wide range. However, all the ratios of vaccination of female children at fifteen were higher than those of the others. Even under the most conservative assumption, the benefit to cost ratios of all the rubella vaccination policies were higher than 3.3. In conclusion all the rubella vaccination policies found to be cost-effective and particularly the vaccination of female children at fifteen was strongly recommended.; Summary

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