OBJECTIVES The purpose of this study was to define the association between the medical utilization of osteoarthritis patient and its related factors. METHODS: We used the 2005 Korean National Health and Nutrition Survey data and we enrolled 2833 participants who were forty or older and who were diagnosed as having osteoarthritis by a doctor within 1 year and who had suffered from osteoarthritis for more than 3 months. The Andersen behavioral model was used as the analytic framework, and the variables were categorized into predisposing, enabling, and need factors. To determine the influence of each variable on the medical utilization of osteoarthritis patient, we applied hierarchical logistic regression analysis with two stages: the first stage included the predisposing and enabling factors and the second stage included the need factors. RESULTS: On the hierarchical logistic analysis, the variables of personal income, the type of medical security, the duration of arthritis related symptoms within 1 month, the subjective health status and the duration of osteoarthritis showed a statistically significant difference between whether the medical utilization in men patients. And the variables of age, limitation activity due to osteoarthritis, arthritis related symptoms within 1 month, and the subjective health status had a statistically significant difference between whether the medical utilization in women patients. CONCLUSIONS: The patients who tend to receive less care are those suffer less from symptoms of osteoarthritis, those who are within the initial phase, or those with a low-level severity of osteoarthritis. It is necessary to encourage patients to receive the treatment in the initial phase.
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Associations Between Fat Mass, Lean Mass, and Knee Osteoarthritis: The Fifth Korean National Health and Nutrition Examination Survey (KNHANES V) Seong Rae Kim, Kyung-Hyun Choi, Go-Un Jung, Doosup Shin, Kyuwoong Kim, Sang Min Park Calcified Tissue International.2016; 99(6): 598. CrossRef
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OBJECTIVES To examine the prophylactic antibiotic use in reducing surgical site infection. METHODS: This was a retrospective study for patients aged 18 years and older who underwent gastrectomy, cholecystectomy, colectomy, cesarean section and hysterectomy. The data source was quality assessment data of the Health Insurance Review & Assessment Service gathered from medical records of 302 national hospitals. Prophylactic antibiotic use was defined as: timely antibiotic administration or inappropriate antibiotic selection. We performed hierarchical logistic regression to examine the association between prophylactic antibiotic use and surgical site infection with adjustment for covariates. RESULTS: The study population consisted of 16 348 patients (1588 gastrectomies, 2327 cholecystectomies, 1,384 colectomies, 3977 hysterectomies and 7072 cesarean sections) and surgical site infection was identified in 351 (2.1%) patients. The rates of timely antibiotic administration and inappropriate antibiotic selection varied according to procedures. Cholecystectomy patients who received timely prophylactic antibiotic had a significantly reduced risk of surgical site infection compared with those who did not receive a timely prophylactic antibiotics (OR 0.64, 95% CI=0.50-0.83), but no significant reduction was observed for other procedures. When inappropriate prophylactic antibiotics were given, the risk of surgical site infection significantly increased: 8.26-fold (95% CI=4.34-15.7) for gastrectomy, 4.73-fold (95% CI=2.09-10.7) for colectomy, 2.34-fold (95% CI=1.14-4.80) for cesarean section, 4.03-fold (95% CI=1.93-8.42) for hysterectomy. CONCLUSIONS: This study examines the association among timely antibiotic administration, inappropriate antibiotic selection and surgical site infection. Patients who received timely and appropriate antibiotics had a decreased risk of surgical site infection. Efforts to improve the timing of antibiotic administration and use of appropriate antibiotic are needed to lower the risk of surgical site infection.
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