Journal of Preventive Medicine and Public Health

Volume 42(3); May 2009

Original Article

Perceived Service Quality among Outpatients Visiting Hospitals and Clinics and Their Willingness to Re-utilize the Same Medical Institutions.: Minsoo Jung, Keon Hyung Lee, Mankyu Choi; J Prev Med Public Health. 2009;42(3):151-159.; DOI: https://doi.org/10.3961/jpmph.2009.42.3.151

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OBJECTIVES
This study was to determine how the perception and the satisfaction of outpatients who utilized clinics and hospitals are structurally related with their willingness to utilize the same institution in the future. METHODS: Three hundred and ten responses (via convenient sampling) were collected from 5 hospitals and 20 clinics located in Seoul listed in the "Korea National Hospital Directory 2005". Service quality was utilized as the satisfaction measurement tool. For analysis, we used a structural equation modeling method. RESULTS: The determining factors for general satisfaction with medical services are as follows: medical staff, reasonability of payment, comfort and accessibility. Such results may involve increased competition in the medical market and increased demands for quality medical services, which drive the patients to visit hospitals on their own on the basis of changed determining factors for satisfaction. CONCLUSIONS: The structural equation model showed that the satisfaction of outpatients with the quality of medical services is influenced by a few sub-dimensional satisfaction factors. Among these sub-dimensional satisfaction factors, the satisfaction with medical staff and payment were determined to exert a significant effect on overall satisfaction with the quality of medical services. The structural relationship in which overall satisfaction perceived by patients significantly influences their willingness to use the same institution in the future was also verified.

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English Abstracts

Association of Current and Past Smoking with Metabolic Syndrome in Men.: A Rum Hong, Kang Sook Lee, Seon Young Lee, Jae Hee Yu; J Prev Med Public Health. 2009;42(3):160-164.; DOI: https://doi.org/10.3961/jpmph.2009.42.3.160

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OBJECTIVES
The objective of this study was to determine the relationship between past smoking and the risk factors for metabolic syndrome. METHODS: From January 2007 to December 2007, a total of 3,916 over thirty years old male health screen examinees were divided into the nonsmoking, smoking, ex-smoking groups. The diagnosis of metabolic syndrome was based on the criteria of the NCEP ATP (Executive Summary of The Third Report of The National Cholesterol Education Program). Metabolic syndrome was defined as the presence of three or more of the following: a blood pressure > or = 130/85 mmHg, a fasting glucose level > or = 110 mg/dL, a HDL-C (High Density Lipoprotein Cholesterol) level < 40 mg/dL, a triglyceride level > or = 150 mg/dL and, a waist circumference men > or = 102 cm, but a waist to hip ratio > 0.90 was used as a surrogate for the waist circumference. RESULTS: After adjustment for age, alcohol consumption and, exercise in the smokers, for the ex-smokers compared with the nonsmokers, the odds ratio (OR) of a lower HDL cholesterol level (< 40 mg/dL) was 1.29 (95% CI=1.03-1.61) in the smokers, the ORs of a higher triglyceride level were 1.35 (95% CI=1.09-1.66) in the ex-smokers and, 2.12 (95% CI=1.75-2.57) in the smokers, and the OR of a waist to hip ratio was 1.25 (95% CI=1.03-1.52) in the ex-smokers. When there were over three components of metabolic syndrome in the ex-smokers and smokers as compared with the nonsmokers, the odds ratio against the risk of metabolic syndrome were 2.39 (95% CI=1.00-6.63) and 2.37 (95% CI=1.02-6.46), respectively. CONCLUSIONS: The present study suggested that there is an association of smoking with metabolic syndrome in men.

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The relationship between smoking cigarettes and metabolic syndrome: A cross-sectional study with non-single residents of Seoul under 40 years old
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PLOS ONE.2021; 16(8): e0256257. CrossRef
Association between Metabolic Syndrome and Triglyceride to HDL-Cholesterol Ratio according to Smoking Status in Korean Men Aged 60 Years and Over
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The Korean Journal of Clinical Laboratory Science.2018; 50(2): 190. CrossRef
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Korean Journal of Family Medicine.2014; 35(5): 219. CrossRef
Gender Differences in the Relationship between Alcohol Use Behaviors and Metabolic Syndrome - Korean National Health and Nutrition Examination Survey (KNHANES) V 2010 -
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Korean Journal of Health Education and Promotion.2013; 30(1): 83. CrossRef
The Effects of Lifestyle Factors on Metabolic Syndrome among Korean Adults
Mee Young Im, Young-Ran Lee, Suk Jung Han, Chung-Min Cho
Journal of Korean Academy of Community Health Nursing.2012; 23(1): 13. CrossRef
Alcohol use behaviors and risk of metabolic syndrome in South Korean middle-aged men
Jinhee Kim, Su-Kyung Chu, Kyungjoo Kim, Ju-Ryoung Moon
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Smoking, C-reactive Protein, and the Metabolic Syndrome
Hyo-Jin Chon, Dong-Eun Lee, Hye-Rim Kwak, Yun-Jun Yang, Eon-Sook Lee, Jun-Hyung Lee, Yeong-Sook Yoon
Journal of the Korean Society for Research on Nicotine and Tobacco.2011; 2(2): 89. CrossRef
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Seung-Ji Lim, Woo-Jin Chung, Woo-Hyun Cho
Injury Prevention.2011; 17(5): 291. CrossRef
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Metabolic Syndrome and Related Disorders.2010; 8(3): 235. CrossRef

The Risk of Fracture with Taking Alpha Blockers for Treating Benign Prostatic Hyperplasia.: Joongyub Lee, Nam Kyoung Choi, Sun Young Jung, Ye Jee Kim, Jong Mi Seong, Seung June Oh, Byung Joo Park; J Prev Med Public Health. 2009;42(3):165-170.; DOI: https://doi.org/10.3961/jpmph.2009.42.3.165

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OBJECTIVES
We evaluated the risk of fracture associated with hypotension-related adverse drug reaction caused by taking alpha blockers to treat benign prostatic hyperplasia (BPH). METHODS: We used the Health Insurance Review and Assessment Service database from January 1st 2005 to June 30th 2006 for this study. The male patients with BPH and who had a prescription for alpha blockers following any fractures were defined as the cases. We set the 20 day long hazard period prior to the index date and the four control periods whose lengths were same with hazard period. After 1:4 matching of the hazard and control periods, conditional logistic regression was used to calculate the odds ratios for the risk of fractures as related to the alpha blocker exposure. RESULTS: Doxazosin and tamsulosin showed the increased risk of fractures, whereas terazosin did not. After stratification using the defined daily doses, a protective effect was shown for the patients who took terazosin at the doses lower than 0.4 DDD and the hazardous effect at the doses higher than or equal to 0.4 DDD. There was no significant difference for the risk of patients taking tamsulosin at the doses higher than 1.0 DDD but there was a statistically significant increase in the risk at the doses higher than or equal to 1.0 DDD. CONCLUSIONS: Alpha blockers for BPH may increase the risk of fracture in elderly patients who have comorbidities and take the concomitant medications. Alpha blockers need to be prescribed with caution, although some have high prostate specificity.

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Risk for Hip Fracture due to Alpha Blocker Treatment in Korean Women: National Health Insurance Database Study
Gi H. SEO, Sung R. SHIM, Hwan W. LEE, Jin H. KIM, Dong‐Il CHUN, Hyun J. KIM, Hyun Y. LEE, Jae H. KIM
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Risk of hip/femur fractures during the initiation period of α‐adrenoceptor blocker therapy among elderly males: a self‐controlled case series study
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The Association of Alpha-Blockers and 5-Alpha Reductase Inhibitors in Benign Prostatic Hyperplasia With Fractures
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Estimating the Prevalence of Atopic Dermatitis in School Students of Jejudo, Korea.: Jong Myon Bae, Kyung Sue Shin; J Prev Med Public Health. 2009;42(3):171-176.; DOI: https://doi.org/10.3961/jpmph.2009.42.3.171

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OBJECTIVES
The frequency of visiting clinics in Jejudo for treating atopic dermatitis (AD) has been reported to be higher than that for other counties of Korea. The aim of this work was to estimate the prevalence of AD for the students of the primary, middle and high schools in Jejudo, Korea. METHODS: We planned to evaluate about 5,000 students, so classes were randomly selected by random systematic sampling methods. The parents of all the students in the selected classes were asked to respond to a structured questionnaire concerned with the prevalence of AD. RESULTS: The prevalence of AD based on ever being diagnosed by a doctor, on currently being diagnosed by a doctor, on ever being treated for AD by a doctor, on currently being treated for AD by a doctor was 25.57% (95% CI=25.3-25.8), 14.67% (95% CI=14.5-14.9), 21.90% (95% CI=21.6-22.2) and 14.41% (95% CI=14.2-14.6), respectively. CONCLUSIONS: On comparing the prevalence of AD, the students in Jejudo had a higher number of recurrence events in spite of their lower number of cases. Further studies are needed to evaluate these aspects of AD.

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Time trends of the prevalence of allergic diseases in Korea: A systematic literature review
Sung-Yoon Kang, Woo-Jung Song, Sang-Heon Cho, Yoon-Seok Chang
Asia Pacific Allergy.2018;[Epub] CrossRef
Prevalence of Atopic Dermatitis in Korean Children Based on Data From the 2008-2011 Korean National Health and Nutrition Examination Survey
Ji Hyun Lee, Kyung Do Han, Kyung min Kim, Yong Gyu Park, Jun Young Lee, Young Min Park
Allergy, Asthma & Immunology Research.2016; 8(1): 79. CrossRef
Prevalence of Atopic Dermatitis in Korean Children Based on Data From the 2008-2011 Korean National Health and Nutrition Examination Survey
Ji Hyun Lee, Kyung Do Han, Kyung min Kim, Yong Gyu Park, Jun Young Lee, Young Min Park
Allergy, Asthma & Immunology Research.2016; 8(1): 79. CrossRef
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The Determinants of the Use of Opportunistic Screening Programs in Korea.: Sungwook Kang, Chang Hoon You, Young Dae Kwon; J Prev Med Public Health. 2009;42(3):177-182.; DOI: https://doi.org/10.3961/jpmph.2009.42.3.177

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OBJECTIVES
Both organized and opportunistic screening programs have been widely used in Korea. This paper examined the determinants of the use of opportunistic screening programs in Korea. METHODS: The subjects were a national stratified random sample of 10,254 people aged 45 or older from the first wave of the Korean Longitudinal Study of Ageing in 2006. A logit model was used to examine the determinants of the use of opportunistic screening programs in terms of the demographic and socioeconomic characteristics, the type of health insurance and the health status. RESULTS: Thirteen point seven percent of the individuals received opportunistic screening programs within 2 years from the time the survey was conducted in 2006. The individuals who graduated from college or who had even more education were 3.0 times more likely to use opportunistic screening programs compared with the individuals who were illiterate. The individuals who resided in urban areas and who had religious beliefs were more likely to receive opportunistic screening programs compared with their counterparts. Those who were in the first quartile for the total household assets were 2.6 times more likely to use opportunistic screening programs than those who were in the fourth quartile for the total household assets. Privately insured people were 1.6 times more likely to use opportunistic screening programs than those who were not insured. Finally, the individuals who self-assessed their health status as worst were 2.1 times more likely to use opportunistic screening programs compared individuals who self-assessed their health status as best. CONCLUSIONS: This study suggests that opportunistic screening programs can be an indicator for whether or not an individual is among the advantaged group in terms of their socioeconomic characteristics and type of health insurance.

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A Multi-level Analysis of Factors Affecting Participation in Health Screenings in Korea: A Focus on Household and Regional Factors
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Awareness and Attitude Toward Suicide in Community Mental Health Professionals and Hospital Workers.: Soung Nam Kim, Kang Sook Lee, Seon Young Lee, Jae Hee Yu, A Rum Hong; J Prev Med Public Health. 2009;42(3):183-189.; DOI: https://doi.org/10.3961/jpmph.2009.42.3.183

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OBJECTIVES
The purpose of this study was to evaluate community mental health professionals and hospital workers attitude and awareness towards suicide. METHODS: This study investigated 264 community mental health professionals and 228 hospital workers. SOQs (Suicidal Opinion Questionnaires) were used from July 2007 to September 2007. After a factor analysis for the attitude towards suicide, the items on ethics, mental illness, religion, risk, and motivation were included in the subsequent analysis. RESULTS: There were significant differences in the attitude towards suicide according to religion, age, educational background, the marriage status, the economic position, and different professional licenses. Hospital workers' view was different from the community workers'. The hospital workers judged that suicide was due to mental illness, and suicide was high for the people in a special environment and who lacked motivation, which caused them to fall in a dangerous situation. For the lower educational group, they thought that suicide was attributable to mental illness. The awareness for suicide was significantly higher in the group with a postgraduate education, unmarried people, mental health professionals and the persons who had concern and experience with suicide. The factors that had an influence on the awareness of suicide were the items of mental illness, religion, risk and motivational factors. CONCLUSIONS: This study suggested that the factors to increase the awareness and attitude for suicide were the experience of increased education and case management of suicide. Therefore, education dealing with suicide and reinforcement of crisis management programs should be developed.

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Economic Burden of Cancer in South Korea for the Year 2005.: Jinhee Kim, Myung Il Hahm, Eun Cheol Park, Jae Hyun Park, Jong Hyock Park, Sung Eun Kim, Sung Gyeong Kim; J Prev Med Public Health. 2009;42(3):190-198.; DOI: https://doi.org/10.3961/jpmph.2009.42.3.190

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OBJECTIVES
The objective of this study is to estimate the economic costs of cancer on society. METHODS: We estimated the economic burden of people with cancer in South Korea. To perform the analysis, we reviewed the records of people who were cancer patients and those who were newly diagnosed with cancer. The data was compiled from the National Health Insurance Corporation, which included the insurance claims database, a list of cancer patients, a database that records the cancer rates, the Korea Central Cancer Registry Center's cancer patient registry database and the Korea National Statistical Office's causes of death database. We classified the costs as related to cancer into direct costs and indirect costs, and we estimated each cost. Direct costs included both medical and non-medical care expenses and the indirect costs consisted of morbidity, mortality and the caregiver's time costs. RESULTS: The total economic costs of cancer in South Korea stood at 14.1 trillion won in 2005. The largest amount of the cost 7.4 trillion won, was the mortality costs. Following this were the morbidity costs (3.2 trillion won), the medical care costs (2.2 trillion won), the non-medical care costs (1.1 trillion won) and the costs related to the caregiver's time (100 billion won). As a result, the economic cost of cancer to South Korea is estimated to be between 11.6 trillion won to 14.1 trillion won for the year 2005. CONCLUSIONS: We need to reduce the cancer burden through encouraging people to undergo early screening for cancer and curing it in the early stage of cancer, as well as implementing policies to actively prevent cancer.

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The Impact of Socioeconomic Factors on the Gender Differences of Disability and Subjective Health Among Elderly Koreans.: Gyeong Suk Jeon, Soong Nang Jang, Seon Ja Rhee; J Prev Med Public Health. 2009;42(3):199-207.; DOI: https://doi.org/10.3961/jpmph.2009.42.3.199

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OBJECTIVES
Research on the gender differences of health among older Korean people has been limited compared with the research for other stages of life. This study first examined the patterns and magnitude of the gender differences of health in later life. Second, we examined the gender differences in the health of older men and women that were attributable to differing socioeconomic conditions. METHODS: Using the nationally representative 2005 Korean National Health and Nutrition Examination Survey, the gender differences in disability and subjective poor health were assessed by calculating the age adjusted and gender-specific prevalence. Logistic regression analyses were used to assess if the differences between the men and women for health could be explained by differential exposure to socioeconomic factors and/or the differential vulnerability of men and women to these socioeconomic factors. RESULTS: Our results indicated that older women were more likely than the men to report disability and poor subjective health. The health disadvantage of older women was diminished by differential experiences with socioeconomic factors, and especially education. The differences shrink as much as 43.7% in the case of disability and 35.4% in the case of poor subjective health by the differential exposure to educational attainment. Any differential vulnerability to socioeconomic factors was not found between the men and women, which means that socioeconomic factors may have similar effect on health in both genders. CONCLUSIONS: Differential socioeconomic experience and exposure between the men and women might cause gender difference in health in old age Koreans.

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