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Special Article
Updating Korean Disability Weights for Causes of Disease: Adopting an Add-on Study Method
Dasom Im, Noor Afif Mahmudah, Seok-Jun Yoon, Young-Eun Kim, Don-Hyung Lee, Yeon-hee Kim, Yoon-Sun Jung, Minsu Ock
J Prev Med Public Health. 2023;56(4):291-302.   Published online June 26, 2023
DOI: https://doi.org/10.3961/jpmph.23.192
  • 2,316 View
  • 195 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Disability weights require regular updates, as they are influenced by both diseases and societal perceptions. Consequently, it is necessary to develop an up-to-date list of the causes of diseases and establish a survey panel for estimating disability weights. Accordingly, this study was conducted to calculate, assess, modify, and validate disability weights suitable for Korea, accounting for its cultural and social characteristics.
Methods
The 380 causes of disease used in the survey were derived from the 2019 Global Burden of Disease Collaborative Network and from 2019 and 2020 Korean studies on disability weights for causes of disease. Disability weights were reanalyzed by integrating the findings of an earlier survey on disability weights in Korea with those of the additional survey conducted in this study. The responses were transformed into paired comparisons and analyzed using probit regression analysis. Coefficients for the causes of disease were converted into predicted probabilities, and disability weights in 2 models (model 1 and 2) were rescaled using a normal distribution and the natural logarithm, respectively.
Results
The mean values for the 380 causes of disease in models 1 and 2 were 0.488 and 0.369, respectively. Both models exhibited the same order of disability weights. The disability weights for the 300 causes of disease present in both the current and 2019 studies demonstrated a Pearson correlation coefficient of 0.994 (p=0.001 for both models). This study presents a detailed add-on approach for calculating disability weights.
Conclusions
This method can be employed in other countries to obtain timely disability weight estimations.
Summary
Korean summary
이 연구에서는 장애보정생존연수의 산출 방법론 중 발생률 기반 접근법을 이용하여 질병부담 산출에 활용할 질병원인에 대한 장애가중치를 산출하고 한국의 문화사회적 특징을 고려하여 이에 대한 타당성을 검증하였다. 특히, 지난 연구에서 활용한 질병원인에 대한 장애가중치 결과값을 add-on study 방법으로 활용하여 장애가중치를 개정하였다. 이번 연구에서 수행한 add-on study 방법을 활용하여 장애가중치 값을 산출할 경우 다수의 전문가의 누적된 의견을 기반으로 장애가중치를 안정적으로 개정하여 특정 질병원인의 장애보정생존연수를 보다 정확하게 산출할 수 있게 될 것이다.

Citations

Citations to this article as recorded by  
  • Trends in Healthy Life Expectancy (HALE) and Disparities by Income and Region in Korea (2008–2020): Analysis of a Nationwide Claims Database
    Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Seok-Jun Yoon
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Measuring the Burden of Disease in Korea Using Disability-Adjusted Life Years (2008–2020)
    Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Seok-Jun Yoon
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
Reviews
DALY Estimation Approaches: Understanding and Using the Incidence-based Approach and the Prevalence-based Approach
Young-Eun Kim, Yoon-Sun Jung, Minsu Ock, Seok-Jun Yoon
J Prev Med Public Health. 2022;55(1):10-18.   Published online January 19, 2022
DOI: https://doi.org/10.3961/jpmph.21.597
  • 6,386 View
  • 293 Download
  • 19 Web of Science
  • 19 Crossref
AbstractAbstract AbstractSummary PDF
Disability-adjusted life-year (DALY) estimates may vary according to factors such as the standard life expectancy, age weighting, time preference and discount rate, calculation of disability weights, and selection of the estimation method. DALY estimation methods are divided into the following 3 approaches: the incidence-based approach, the pure prevalence-based approach, and the hybrid approach. These 3 DALY estimation approaches each reflect different perspectives on the burden of disease using unique characteristics, based on which the selection of a suitable approach may vary by the purpose of the study. The Global Burden of Disease studies, which previously estimated DALYs using the incidence-based approach, switched to using the hybrid approach in 2010, while the National Burden of Disease studies in Korea still mainly apply the incidence-based approach. In order to increase comparability with other international burden of disease studies, more DALY studies using the prevalence-based approach need to be conducted in Korea. However, with the limitations of the hybrid approach in mind, it is necessary to conduct more research using a disease classification system suitable for Korea. Furthermore, more detailed and valid data sources should be established before conducting studies using a broader variety of DALY estimation approaches. This review study will help researchers on burden of disease use an appropriate DALY estimation approach and will contribute to enhancing researchers’ ability to critically interpret burden of disease studies.
Summary
Korean summary
장애보정생존연수 산출 방법은 발생률 접근법, 순수 유병률 접근법 및 하이브리드 접근법으로 나뉜다. 이러한 3가지 장애보정생존연수 산출 접근법은 각각 고유한 특성을 가지고 질병부담에 대한 다양한 관점을 반영하기 때문에, 연구 목적에 따라 산출 접근법의 선택이 달라질 수 있다. 이번 연구의 결과는 연구자들이 장애보정생존연수 산출 방법의 타당성을 향상시키기 위하여 질병부담 연구에 사용할 산출 접근법을 결정하는 데 도움이 될 것이다.

Citations

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    Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Seok-Jun Yoon
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
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    Diseases.2024; 12(3): 56.     CrossRef
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    PLOS ONE.2024; 19(3): e0300794.     CrossRef
  • Global, regional, and national burden and trends analysis of gallbladder and biliary tract cancer from 1990 to 2019 and predictions to 2030: a systematic analysis for the Global Burden of Disease Study 2019
    Jiao Su, Yuanhao Liang, Xiaofeng He
    Frontiers in Medicine.2024;[Epub]     CrossRef
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    Zhenzhu Wu, Jie Li, Peipei Fang, Chenwei Pan, Yi Chen
    Infection and Drug Resistance.2024; Volume 17: 1589.     CrossRef
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    Frontiers in Medicine.2023;[Epub]     CrossRef
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    Addiction.2023; 118(9): 1763.     CrossRef
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    Tropical Medicine and Infectious Disease.2023; 8(7): 351.     CrossRef
  • Updating Korean Disability Weights for Causes of Disease: Adopting an Add-on Study Method
    Dasom Im, Noor Afif Mahmudah, Seok-Jun Yoon, Young-Eun Kim, Don-Hyung Lee, Yeon-hee Kim, Yoon-Sun Jung, Minsu Ock
    Journal of Preventive Medicine and Public Health.2023; 56(4): 291.     CrossRef
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    Cells.2023; 12(20): 2451.     CrossRef
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    Eun Young Choi, Juyoung Kim, Won Lee, Seung Gyeong Jang, Jeehee Pyo, Minsu Ock
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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    Scientific Reports.2022;[Epub]     CrossRef
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A Review of the Types and Characteristics of Healthy Life Expectancy and Methodological Issues
Young-Eun Kim, Yoon-Sun Jung, Minsu Ock, Seok-Jun Yoon
J Prev Med Public Health. 2022;55(1):1-9.   Published online January 16, 2022
DOI: https://doi.org/10.3961/jpmph.21.580
  • 6,279 View
  • 369 Download
  • 15 Web of Science
  • 16 Crossref
AbstractAbstract AbstractSummary PDF
An index that evaluates the health level of a population group considering both death and loss of function due to disease is called a summary measure of population health (SMPH). SMPHs are broadly divided into life year indices and life expectancy indices, the latter of which comprise healthy life expectancy (HLE). HLE is included as a policy target in various national and regional level healthcare plans, and the term “HLE” is commonly used in academia and by the public. However, the overall level of understanding of HLE—such as the precise definition of HLE and methods of calculating HLE—still seems to be low. As discussed in this study, the types of HLE are classified into disability-free life expectancy, disease-free life expectancy, quality-adjusted life expectancy, self-rated HLE, and disability-adjusted life expectancy. Their characteristics are examined to facilitate a correct understanding and appropriate utilization of HLE. In addition, the Sullivan method, as a representative method for calculating HLE, is presented in detail, and major issues in the process of calculating HLE, such as selection of the population group and age group, estimation of death probability, calculation of life years, and incorporation of health weights, are reviewed. This study will help researchers to select an appropriate HLE type and evaluate the validity of HLE research results, and it is expected to contribute to the vitalization of HLE research.
Summary
Korean summary
건강수명의 유형은 무장애기대수명, 질병 없는 기대수명, 질보정기대수명, 자가평가보정 기대수명, 장애보정기대수명으로 분류된다. 건강수명의 올바른 이해와 적절한 활용을 돕기 위해 이들의 특성을 검토하였다. 이번 연구는 연구자들이 적절한 건강수명 유형을 선택하고 건강수명 연구 결과의 타당성을 평가하는 데 도움이 될 것이며, 건강수명 연구의 활성화에 기여할 것으로 기대된다.

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  • Trends in Healthy Life Expectancy (HALE) and Disparities by Income and Region in Korea (2008–2020): Analysis of a Nationwide Claims Database
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    Journal of Korean Medical Science.2024;[Epub]     CrossRef
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    Geun Hyuk Choi, Na Young Jeong, Jun Bum Park, Soon Chan Kwon, Jong Min Lee
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  • Updating Korean Disability Weights for Causes of Disease: Adopting an Add-on Study Method
    Dasom Im, Noor Afif Mahmudah, Seok-Jun Yoon, Young-Eun Kim, Don-Hyung Lee, Yeon-hee Kim, Yoon-Sun Jung, Minsu Ock
    Journal of Preventive Medicine and Public Health.2023; 56(4): 291.     CrossRef
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Perspective
What Else Is Needed in the Korean Government’s Master Plan for People With Developmental Disabilities?
Jin Yong Lee, Jieun Yun
J Prev Med Public Health. 2019;52(3):200-204.   Published online May 7, 2019
DOI: https://doi.org/10.3961/jpmph.18.249
  • 4,980 View
  • 113 Download
  • 5 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
On September 12, 2018, President Jae-In Moon announced the Comprehensive Plan for Lifelong Care for People with Developmental Disabilities, with representatives from the associated government branches (Ministry of Health and Welfare, Ministry of Education, and Ministry of Employment and Labor) in attendance. The goals of this plan are to provide health, medical, rehabilitative, special education, and social welfare services according to the life-stages of the affected individuals; to reduce parental pressure; to promote social interventions; and to enhance community-level participation in order to create a ‘welfare society in harmony.’ However, in order for the plan to succeed, additional efforts must be made in the following areas. First, an epidemiological survey is needed to understand the scale, prevalence, and incidence of developmental disabilities and to establish an evidence base to support policy development. Second, accurate definitions of developmental disabilities must be established in order to avoid policy discrimination based on impairment type and age. Third, personal evaluations to assess disabled individuals’ unmet needs and customized service designs to deliver those needs are required. Fourth, the plan must fulfill the goals of accessibility and fairness that the government intends to provide. Fifth, the government should consider an integrated financial support system and to propose a detailed plan for monetary distributions. Finally, an integrated system that links health, medical, employment, educational, and welfare services must be constructed.
Summary
Korean summary
2018년 9월 대통령이 직접 발표한 “발달장애인 평생케어 종합대책”의 성공적인 수행을 위해 필수적인 정책을 제안하였다. 특히, 발달장애인의 정확한 규모, 유병률, 발생률 등 기초적인 현황 파악과 정책 개발을 뒷받침하기 위한 역학연구, 발달장애인 개인평가에 기반한 미충족 필요의 측정과 이를 바탕으로 한 개인별 맟춤형 서비스 디자인, 서비스의 접근성과 형평성 달성, 그리고 보건-의료-고용-교육-복지서비스를 통합적으로 제공할 수 있는 시스템 구축이 필요함을 지적하였다.

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Original Article
Health Conditions Sensitive to Retirement and Job Loss Among Korean Middle-aged and Older Adults
Susan Park, Sung-Il Cho, Soong-Nang Jang
J Prev Med Public Health. 2012;45(3):188-195.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.188
  • 8,772 View
  • 79 Download
  • 14 Crossref
AbstractAbstract PDF
Objectives

This study was conducted to examine the association between health condition and leaving the labor market among middle-aged and older adults in South Korea.

Methods

Data was obtained from individuals aged 45 years and older participating in the 2006 and 2008 Korean Longitudinal Study of Ageing. We used various health measures including chronic diseases, comorbidities, traffic accident injuries, disabilit of instrumental activities of daily living, depressive symptoms, and self-rated health. The odds ratios of job loss, and retirement, versus employment were calculated using multinomial logistic regression by each health measure.

Results

In our cross-sectional and longitudinal analysis, health problems related to physical disabilities had the greatest effect on leaving the worksite. A shift in health condition from good to poor in a short period was a predictor of increased risk of unemployment but a persistent pattern of health problems was not associated with unemployment. Women with health problems showed a high probability of retirement, whereas among men, health problems instantly the possibility of both job loss and retirement.

Conclusions

Health problems of middle aged and older workers were crucial risk factors for retirement and involuntarily job loss. Especially functional defect and recent health problems strongly and instanty affected employment status.

Summary

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Research Support, Non-U.S. Gov't
Age and Gender Differences in the Relation of Chronic Diseases to Activity of Daily Living (ADL) Disability for Elderly South Koreans: Based on Representative Data.
Il Ho Kim
J Prev Med Public Health. 2011;44(1):32-40.
DOI: https://doi.org/10.3961/jpmph.2011.44.1.32
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  • 161 Download
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AbstractAbstract PDF
OBJECTIVES
This study investigated the gender and age differential effect of major chronic diseases on activity of daily living (ADL) disability. METHODS: Surveyfreq and Surveylogistic regression analyses were employed on the 2005 Korean National Health and Nutrition Examination Survey (KNHANES) with a sample of 3,609 persons aged 65 - 89. RESULTS: After adjusting for potential covariates, stroke, among elderly men more so than women, had a 2-3 times greater odds of engendering ADL disability in the 65-69 (p < 0.05) and 70-79 age groups (p < 0.01). In comparison to elderly women, cancer, diabetes, and incontinence in elderly men was associated with a higher risk of ADL disability in the 70 - 79 age group (p < 0.05), and this association was also observed for pulmonary disease in the 80-89 age group. Among elderly women, however, a significant association between incontinence and ADL disability was identified in all three age groups. In addition, this association was found in pulmonary disease and diabetes in elderly women aged 70 - 79 years. Significant gender differences were observed in the association between stroke in the 60 - 79 age group and cancer in the 70 - 79 age group. CONCLUSIONS: Age and gender differences were observed in the effect of chronic diseases on ADL disability.
Summary

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English Abstracts
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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  • 55 Download
  • 9 Crossref
AbstractAbstract PDF
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.
Summary

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    Seieun Oh, Young Ko
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Association of Social Support and Social Activity with Physical Functioning in Older Persons.
Kyunghye Park, Yunhwan Lee
J Prev Med Public Health. 2007;40(2):137-144.
DOI: https://doi.org/10.3961/jpmph.2007.40.2.137
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AbstractAbstract PDF
OBJECTIVES
According to Rowe and Kahn (1998), successful aging is the combination of a low probability of disease, high functioning, and active engagement with life. The purpose of this study was to assess the relationship between active engagement with life and functioning among the community-dwelling elderly. METHODS: Data were collected from Wave 2 of the Suwon Longitudinal Aging Study (SLAS), consisting of a sample of 645 persons aged 65 and older living in the community. A social activity checklist and social support inventory were used as measures of engagement with life, along with the Physical Functioning (PF) scale as a measure of functioning. The effects of social support and social activity on physical functioning, taking into account the covariates, were analyzed by hierarchical linear regression analysis. RESULTS: Maintenance of social activity and social support were significantly associated with higher physical function, after adjusting for sociodemographic and healthrelated covariates. Social support appeared to be more prominent than social activity in predicting physical functioning. CONCLUSIONS: Social support and social activity are potentially modifiable factors associated with physical function in older persons. Studies examining the role social engagement may play in preventing disability are warranted.
Summary

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Original Articles
Study of Disability-Adjusted Life Expectancy(DALE) Using National Health Interview Survey in Korea.
Young Hoon Kwon, Jung Kyu Lee, Young Kyung Do, Seok Jun Yoon, Chang Yup Kim, Yong Ik Kim, Young Soo Shin
Korean J Prev Med. 2002;35(4):331-339.
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AbstractAbstract PDF
OBJECTIVES
To measure DALE (Disability-Adjusted Life Expectancy) in Korea to find out how long Koreans live in a state of full heath. METHODS: DALE was calculated using the life table of 1999 and the disability prevalence from the National Health Interview Survey (NHIS), which was conducted with a sample of 13,523 households in 1998. The disability prevalence was measured using the annual prevalence of the long-term limitation of activities, which were divided into classes 1, 2, 3, 4, 5 and 6 according to the severity of the limitation. The disability weights were measured for each 6 class by conducting a survey of 16 healthcare professionals. The severity-adjusted disability prevalence was calculated by multiplying the disability prevalence of each class by the disability weights respectively. Healthy life years lost due to disability was calculated by multiplying the life expectancy by the severity-adjusted disability prevalence. Finally DALE was measured as the life expectancy minus healthy life years lost due to disability. RESUJLTS: DALE for 1999, which refers to the expectation of equivalent years of good health, were 72.5, 69.5 and 75.3 years, for total, for males and for females, respectively. The percentages for DALE out of the life expectancy were 95.8, 96.6 and 94.4% for total, for males and for females, respectively. CONCLUSIONS: DALE is a newly developed indicator, which could effectively show the healthy life expectancy of populations. A greater notice and use of DALE would be expected as life expectancies increase and the quality of life changes in Korea.
Summary
Estimating the Disability Weight of Major Cancers in Korea Using Delphi Method.
Seok Jun Yoon, Young Dae Kwon, Byoung Yik Kim
Korean J Prev Med. 2000;33(4):409-414.
  • 2,299 View
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AbstractAbstract PDF
OBJECTIVES
To estimate the weighting for the disability caused by major cancers in Korea using the Delphi method. METHODS: We selected 19 panelists to estimate the disability weighting of major cancers in Korea by using the Delphi method. To select the relevant kinds of cancers, we used National Death Certificate Data produced by the National Statistical Office in 1996. Then the stability of each delphi round was calculated by using the coefficient of variance. RESULTS: The disability weight of major cancers for males was pancreas cancer(0.36), liver cancer(0.35), esophageal cancer(0.30), stomach cancer(0.27), lung cancer(0.26), and colorectal cancer(0.30). The disability weight of major cancers for females was pancreas cancer(0.36), liver cancer(0.34), esophageal cancer(0.29), stomach cancer(0.28), lung cancer(0.26), and colorectal cancer(0.28). CONCLUSION: The results of this study will provide baseline data useful for the measurement of the burden of disease caused by cancers in Korea.
Summary
Factors Associated with Physical Functioning among Community-Dwelling Older Adults.
Yunhwan Lee, Kwisook Choi
Korean J Prev Med. 1999;32(3):325-332.
  • 2,047 View
  • 19 Download
AbstractAbstract PDF
OBJECTIVES
The aim of this study is to identify major factors associated with physical functioning among the Korean elderly. METHODS: Data come from a survey of a nationally representative sample of 2,058 older people aged 60 years or older living in the community. A hierarchical functioning scale was constructed, using upper and lower body mobility, IADLs, and ADLs. Socioeconomic characteristics, chronic conditions, measures of health status, health service use, and social support were analyzed to explore their influence on functioning. Polytomous logistic regression analysis was conducted to identify major contributing factors to different levels of functioning. RESULTS: Persons of older age, female, with chronic diseases (heart disease, stroke, fracture/dislocation) were consistently more likely to show a higher degree of functional limitation. There were variations, however, among other factors; e.g., those with arthritis were more likely to be only mildly impaired, but not moderately or severely impaired. CONCLUSIONS: Older Korean adults living in the community with impaired functioning constitute persons with diverse characteristics. Policy and program activities need to address specific needs of older people in different functioning states.
Summary
Burden of disease of major cancers assessment using years of lives with disability in Korea.
Seok Jun Yoon, Hye Jung Chang, Young Soo Shin
Korean J Prev Med. 1998;31(4):801-813.
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AbstractAbstract PDF
This study was carried out for the burden of disease of major cancers assessment using years of lives with disability in Korea. With the years of lives with disability, this indicator was applied in order to estimate burden of major cancer disease. For this work, We also estimated incidence rate, remission rate, case fatality rate, average age of onset, expected duration with disability in each cancer disease. As sources of information, national health insurance data and national mortality registration data were analyzed. The results of the study are as follows; The top five causes of the burden of major cancer disease are evaluated as stomach cancer, liver cancer, colon and rectum cancer , esophageal cancer, lung cancer in male. The top five causes of the burden of major cancer disease are evaluated as stomach cancer, esophageal cancer, liver cancer, uterine cervix cancer ovarian cancer in female. The process of evaluating the burden disease of major cancers in Korea has not finished with this paper. This study should be seen as the first in a series in Korea. It is necessary to analyse with more accuracy the assumptions behind the methodology.
Summary
Effect of Therapeutic Exercises on Shoulder Dysfunction in VDT-related female Office Workers.
Soon Seok Choi, Kui Won Jeong, Sang Hwa Urm, Soo Jin Jeong, Jong Tae Lee, Jin Ho Chun, Chae Un Lee, Ki Taek Pae
Korean J Prev Med. 1998;31(2):228-239.
  • 2,204 View
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AbstractAbstract PDF
Visual display terminal(VDT) is popular in majority of office in modern countries. Musculoskeletal pain due to repetitive work with VDT is a serious industrial accident at present. In recent studies, shoulder pain in VDT users is the most common problem in Korea. The purpose of this study was to evaluate and compare the effect of exercises on shoulder dysfunction in VDT-related female office workers. Of the l19 patients with shoulder dysfunction, 32 patients entered into the study. 16 patients(Group I) were not prescribed exercises, other 16 patients (Group II) performed throughout the specific shoulder exercises such as pendular exercises(forward, backward and circumduction) and sidelying external rotation exercises with weights. After 3 months of exercises, the two groups were compared in term of the pain rating scale, disability questionnaire score and range of motion score. The results were summarized as follows ; l. The pain rating scale in Group I before and after 3 months were not differenced significantly(p value=0.784) and in Group II, the scale before and after exercises were differenced significantly(p value=0.0005). 2. The disability, questionnaire scores in Group I before and after 3 months were not differenced significantly(p value=0.437) and in Group II, the scores before and after exercises were differenced significantly(p value=0.0002). 3. The ROM scores of the affected shoulder in Group I before and after 3 months were not differenced significantly(p value=0.876) and in Group II, the scores before and after exercises were differenced significantly(p value=0.0017). In conclusion, that the specific shoulder exercises on shoulder dysfunction in VDT-related female office workers are encouraged.
Summary
A Comparative Study on Evaluation Methods of Permanent Impairment in Korea.
Chang Ok Rhee, Jung Keun Choi, Mi A Son, Ok Ryun Moon
Korean J Prev Med. 1994;27(3):627-651.
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In this study, literature review was done to examine and compare the current status and problems of different evaluation approaches toward permanent impairment in Korea. Alternatives and improvements in the current approaches in Korea were suggested. Series of cases were also examined to compare different approaches applied to the real cases, using 105 cases from a hospital data and another 207 cases from insurance company data. The main findings of the literature review are as follows; 1. The current evaluation methods of permanent impairment in Korea are grouped into two categories, grading and rating. Grading of impairments are expressly specified in 17 various statutes. 2. In Grading methods, the rigid system of 14 different grades has been adopted uniformally for the convenience of administration, which may not be, appropriate or valid from medical and scientifical aspect. 3. The advantage of McBride method is assessment of occupational disability rate. However the classified compensable occupations are only 280 and limited to manufacturing industries in 1960s' of U.S.A., which is not appropriate to current Korean circumstances. Especially, the job list does not include managerial officers or mental workers. 4. AMA Guides is the scientific and reasonable method for the assessment of physical impairment rate. However compensation and reparation of impairment case is difficult because this method cannot assess the disability rate according to occupation, age, etc. The results of cases comparative study are as follows: 5. The physical impairment could be compared in 167 out of total 312 cases and for the cases of complex impairment, McBride method underestimate physical impairment rate compared with AMA method. 6. When disability rate was assessed, occupation was considered the compensation of only 85 cases, and age was used in only 21 cases. This was because occupation and age compensation in McBride method are unreasonable. 7. The most ideal alternative is to assess physical impairment according to AMA method and then to develop a compensation method appropriate for the circumstances of Korea society.
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English Abstract
The Continuum of Rehabilitation Care and the Rehabilitation Services that are Needed by People with Severe Disabilities.
Soong Nang Jang, Seonja Rhee, Wan Ho Kim, Kyu Beom Lee, Sukyung Kim, Jae Young Lim
J Prev Med Public Health. 2006;39(3):263-269.
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OBJECTIVES
As the number of people with disabilities is increasing and their needs for care are varied, the continuum and comprehensiveness of their rehabilitative care are getting more important. This study was performed to understand the utilization of rehabilitation services and requirements of care among the people with severe disabilities in Korea. METHODS: We interviewed 578 disabled persons who had severe extremity and cerebral impairment in the urban and rural areas of Korea. The questionnaire included questions on their general characteristics, the type of disability, their physical function (ADL, IADL), their use of rehabilitation services after discharge and their requirements for rehabilitation care. RESULTS: Only 12.6% of people with disability in the community continuously used the available medical rehabilitation care. The associated factors for utilization of rehabilitation services were pain and admission for rehabilitative treatment in the acute phase. There was a great need for rehabilitation services in community and this varied according to gender, the socio-economic status, the functional status and the geographic region. The gap between utilization and need for rehabilitation services was largest in the economic support. The gap of primary health care was larger in the rural area than in the urban area. CONCLUSIONS: The needs for rehabilitation service were diverse according to the individual functional status, the regional characteristics and other general characteristics of people with disability. Strategies should be considered to eliminate the barriers to obtain rehabilitation services for the people with disability in the community.
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JPMPH : Journal of Preventive Medicine and Public Health