- Risks for Readmission Among Older Patients With Chronic Obstructive Pulmonary Disease: An Analysis Using Korean National Health Insurance Service – Senior Cohort Data
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Yu Seong Hwang, Heui Sug Jo
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J Prev Med Public Health. 2023;56(6):563-572. Published online November 10, 2023
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DOI: https://doi.org/10.3961/jpmph.23.346
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 Abstract
Summary
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- Objectives
The high readmission rate of patients with chronic obstructive pulmonary disease (COPD) has led to the worldwide establishment of proactive measures for identifying and mitigating readmissions. This study aimed to identify factors associated with readmission, as well as groups particularly vulnerable to readmission that require transitional care services.
Methods
To apply transitional care services that are compatible with Korea’s circumstances, targeted groups that are particularly vulnerable to readmission should be identified. Therefore, using the National Health Insurance Service’s Senior Cohort database, we analyzed data from 4874 patients who were first hospitalized with COPD from 2009 to 2019 to define and analyze readmissions within 30 days after discharge. Logistic regression analysis was performed to determine factors correlated with readmission within 30 days.
Results
The likelihood of readmission was associated with older age (for individuals in their 80s vs. those in their 50s: odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19 to 2.12), medical insurance type (for workplace subscribers vs. local subscribers: OR, 0.84; 95% CI, 0.72 to 0.99), type of hospital (those with 300 beds or more vs. fewer beds: OR, 0.77; 95% CI, 0.66 to 0.90), and healthcare organization location (provincial areas vs. the capital area: OR, 1.66; 95% CI, 1.14 to 2.41).
Conclusions
Older patients, patients holding a local subscriber insurance qualification, individuals admitted to hospitals with fewer than 300 beds, and those admitted to provincial hospitals are suggested to be higher-priority for transitional care services.
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Summary
Korean summary
국내 만성폐쇄성폐질환(COPD)의 위험도 표준화 재입원율은 12.7%로, 주요 진단군 가운데 재입원율이 가장 높다.
국민건강보험공단 노인코호트를 활용하여 COPD로 입원한 환자의 재입원 위험 요인을 파악한 결과 고령 환자, 국민건강보험 지역가입자, 300병상 미만 규모 병원 또는 도 지역 소재 병원 에 입원한 환자의 경우 재입원 위험이 높았다.
재입원 위험이 높은 환자에 대하여 우선적으로 퇴원환자관리 서비스가 제공될 필요가 있다.
Key Message
The risk-standardized readmission rate for COPD in Korea is 12.7%, the highest among major diagnostic groups.
Using the National Health Insurance Service Senior Cohort to identify risk factors for the readmission of patients hospitalized with COPD, it was found that older patients, local health insurance subscribers, those hospitalized in facilities with fewer than 300 beds, or in hospitals located in provincial areas had a higher risk of readmission.
It is necessary to prioritize transitional care services for patients at a high risk of readmission.
- Associations Between Compliance With Non-pharmaceutical Interventions and Social-distancing Policies in Korea During the COVID-19 Pandemic
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Yu Seong Hwang, Heui Sug Jo
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J Prev Med Public Health. 2021;54(4):230-237. Published online June 16, 2021
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DOI: https://doi.org/10.3961/jpmph.21.139
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Abstract
Summary
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- Objectives
This study explored changes in individuals’ behavior in response to social distancing (SD) levels and the “no gatherings of more than 5 people” (NGM5) rule in Korea during the coronavirus disease 2019 (COVID-19) pandemic.
Methods
Using survey data from the COVID-19 Behavior Tracker, exploratory factor analysis extracted 3 preventive factors: maintenance of personal hygiene, avoiding going out, and avoiding meeting people. Each factor was used as a dependent variable. The chi-square test was used to compare differences in distributions between categorical variables, while binary logistic regression was performed to identify factors associated with high compliance with measures to prevent transmission.
Results
In men, all 3 factors were significantly associated with lower compliance. Younger age groups were associated with lower compliance with maintenance of personal hygiene and avoiding meeting people. Employment status was significantly associated with avoiding going out and avoiding meeting people. Residence in the capital area was significantly associated with higher compliance with personal hygiene and avoiding venturing out. Increasing SD levels were associated with personal hygiene, avoiding going out, and avoiding meeting people. The NGM5 policy was not significantly associated with compliance.
Conclusions
SD levels, gender, age, employment status, and region had explanatory power for compliance with non-pharmaceutical interventions (NPIs). Strengthening social campaigns to inspire voluntary compliance with NPIs, especially focused on men, younger people, full-time workers, and residents of the capital area is recommended. Simultaneously, efforts need to be made to segment SD measures into substrategies with detailed guidance at each level.
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Summary
Korean summary
이 연구에서는 대한민국 정부가 COVID-19 방역 정책으로 시행한 ‘사회적 거리두기 단계 조절’과 ‘5인 이상 집합 금지 조치’에 대한 개인의 순응도를 파악하였다. 이를 위해 영국 임페리얼 대학이 2020년 4월부터 2021년 4월까지 24회에 걸쳐 한국인 총 13,300명에게 개인 행동을 조사한 공개 데이터를 분석하였다. 그 결과, 더 높은 수준의 사회적 거리두기 단계 – 특히 다중이용시설들이 폐쇄되는 2.5 단계 -에서 비약물적 중재 조치의 순응도와 더 강한 상관관계를 보였다. 그러나 5인 이상 집합금지는 순응도와 유의한 상관관계를 보이지 않아 사람들이 모임 인원을 제한할 뿐 지속적으로 모임을 하는 것으로 해석된다. 연령, 성별, 직업 구분, 거주지와 같은 인구-사회학적 특성들이 순응도에 영향을 주는 것으로 나타났으므로, 낮은 순응도를 보이는 인구집단의 순응도를 고취시킬 수 있도록 세부적인 전략 (예: 재택근무, 온라인회의, 온라인 수업 권장 등)이 필요하다.
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Citations
Citations to this article as recorded by  - Behavioural Sciences Contribution to Suppressing Transmission of Covid-19 in the UK: A Systematic Literature Review
Gill Hubbard, Chantal den Daas, Marie Johnston, Jennifer Dunsmore, Mona Maier, Rob Polson, Diane Dixon
International Journal of Behavioral Medicine.2024; 31(1): 1. CrossRef - Real-time forecasting of COVID-19 spread according to protective behavior and vaccination: autoregressive integrated moving average models
Chieh Cheng, Wei-Ming Jiang, Byron Fan, Yu-Chieh Cheng, Ya-Ting Hsu, Hsiao-Yu Wu, Hsiao-Han Chang, Hsiao-Hui Tsou
BMC Public Health.2023;[Epub] CrossRef - The Unequal Effects of Social Distancing Policy on Subway Ridership during the COVID-19 Pandemic in Seoul, South Korea
Jaeyoung Ha, Suyoung Jo, Hee-kyoung Nam, Sung-il Cho
Journal of Urban Health.2022; 99(1): 77. CrossRef - Do the Self-Reported Changes in Physical Activity After the Emergence of the COVID-19 Pandemic Associate With Major Depression According to Moderate to Vigorous Physical Activity Status?
Jeong Hyun Ahn, Jin Young Nam
Journal of Physical Activity and Health.2022; 19(7): 518. CrossRef - Different patterns of excess all-cause mortality by age and sex in Hungary during the 2nd and 3rd waves of the COVID-19 pandemic
Vince Fazekas-Pongor, Zsófia Szarvas, Norbert D. Nagy, Anna Péterfi, Zoltán Ungvári, Viktor J. Horváth, Szilvia Mészáros, Adam G. Tabák
GeroScience.2022; 44(5): 2361. CrossRef - Generic Logic Model for Coronavirus Disease-2019 Responses Based on the South Korean Experience
Hae-ryoung Chun, Kyuhyun Yoon, Hana Kim, Eunsil Cheon, Jaeyoung Ha, Sangwoo Tak, Sung-il Cho
Risk Management and Healthcare Policy.2021; Volume 14: 4765. CrossRef
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