Journal of Preventive Medicine and Public Health

Original Articles

Mortality Burden Due to Short-term Exposure to Fine Particulate Matter in Korea: Jongmin Oh, Youn-Hee Lim, Changwoo Han, Dong-Wook Lee, Jisun Myung, Yun-Chul Hong, Soontae Kim, Hyun-Joo Bae; J Prev Med Public Health. 2024;57(2):185-196. Published online March 29, 2024; DOI: https://doi.org/10.3961/jpmph.23.514

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Abstract Summary PDF Supplementary Material: Objectives
Excess mortality associated with long-term exposure to fine particulate matter (PM_2.5) has been documented. However, research on the disease burden following short-term exposure is scarce. We investigated the cause-specific mortality burden of short-term exposure to PM_2.5 by considering the potential non-linear concentration–response relationship in Korea.
Methods
Daily cause-specific mortality rates and PM_2.5 exposure levels from 2010 to 2019 were collected for 8 Korean cities and 9 provinces. A generalized additive mixed model was employed to estimate the non-linear relationship between PM_2.5 exposure and cause-specific mortality levels. We assumed no detrimental health effects of PM_2.5 concentrations below 15 μg/m³. Overall deaths attributable to short-term PM_2.5 exposure were estimated by summing the daily numbers of excess deaths associated with ambient PM_2.5 exposure.
Results
Of the 2 749 704 recorded deaths, 2 453 686 (89.2%) were non-accidental, 591 267 (21.5%) were cardiovascular, and 141 066 (5.1%) were respiratory in nature. A non-linear relationship was observed between all-cause mortality and exposure to PM_2.5 at lag0, whereas linear associations were evident for cause-specific mortalities. Overall, 10 814 all-cause, 7855 non-accidental, 1642 cardiovascular, and 708 respiratory deaths were attributed to short-term exposure to PM_2.5. The estimated number of all-cause excess deaths due to short-term PM_2.5 exposure in 2019 was 1039 (95% confidence interval, 604 to 1472).
Conclusions
Our findings indicate an association between short-term PM_2.5 exposure and various mortality rates (all-cause, non-accidental, cardiovascular, and respiratory) in Korea over the period from 2010 to 2019. Consequently, action plans should be developed to reduce deaths attributable to short-term exposure to PM_2.5.; Summary

Korean summary
본 연구는 2010~2019년 한국의 초미세먼지 단기 노출로 인한 사망 부담을 추정하였으며 2010~2019년간, 초미세먼지 단기노출로 인한 전체원인 사망은 10,814명, 비사고 사망은 7,855명, 심혈관 사망은 1,642명, 호흡기 사망은 708명으로 추정하였다. 본 연구 결과는 대기오염 관리, 규제, 정책 수립에 있어 도움을 줄 것으로 예상한다.

Key Message
- We estimated mortality burden attributable to short-term exposure to PM 2.5 in Korea from 2010 to 2019 - Over the 10-years study period, the estimated excess deaths due to short-term exposure to PM 2.5 totaled 10,814 for all-causes, 7,855 for non-accidental, 1,642 for cardiovascular disease, and 708 for respiratory disease. - Our findings can assist in air pollution management, regulation, and policy-making.

Trends in Research on Patients With COVID-19 in Korean Medical Journals: Heejeong Choi, Seunggwan Song, Heesang Ahn, Hyobean Yang, Hyeonseong Lim, Yohan Park, Juhyun Kim, Hongju Yong, Minseok Yoon, Mi Ah Han; J Prev Med Public Health. 2024;57(1):47-54. Published online January 17, 2024; DOI: https://doi.org/10.3961/jpmph.23.254

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Abstract Summary PDF Supplementary Material: Objectives
This study was conducted to systematically summarize trends in research concerning patients with coronavirus disease 2019 (COVID-19) as reported in Korean medical journals.
Methods
We performed a literature search of KoreaMed from January 2020 to September 2022. We included only primary studies of patients with COVID-19. Two reviewers screened titles and abstracts, then performed full-text screening, both independently and in duplicate. We first identified the 5 journals with the greatest numbers of eligible publications, then extracted data pertaining to the general characteristics, study population attributes, and research features of papers published in these journals.
Results
Our analysis encompassed 142 primary studies. Of these, approximately 41.0% reported a funding source, while 3.5% disclosed a conflict of interest. In 2020, 42.9% of studies included fewer than 10 participants; however, by 2022, the proportion of studies with over 200 participants had increased to 40.6%. The most common design was the cohort study (48.6%), followed by case reports/series (35.2%). Only 3 randomized controlled trials were identified. Studies most frequently focused on prognosis (58.5%), followed by therapy/intervention (20.4%). Regarding the type of intervention/exposure, therapeutic clinical interventions comprised 26.1%, while studies of morbidity accounted for 13.4%. As for the outcomes measured, 50.7% of studies assessed symptoms/clinical status/improvement, and 14.1% evaluated mortality.
Conclusions
Employing a systematic approach, we examined the characteristics of research involving patients with COVID-19 that was published in Korean medical journals from 2020 onward. Subsequent research should assess not only publication trends over a longer timeframe but also the quality of evidence provided.; Summary

Korean summary
본 연구는 2020년 이후 국내 의학저널에 보고된 코로나19 환자를 대상으로 진행된 연구의 특성을 체계적 방법론을 통해 살펴보았다. 142개 연구 중 5개는 국제 연구자들과 협력했으며 약 50%가 자금 지원에 관해 보고하였으며, 2022년에는 2020년에 비해 대규모 환자 코호트를 포함하는 연구 수가 증가하였다. 연구의 약 20%는 약물 치료와 같은 개입의 영향을 평가하였으며, 향후 연구에서는 장기간에 걸친 연구 경향 뿐만 아니라 연구의 질도 평가해야 할 것이다.

Key Message
This study employed a systematic approach to examine the characteristics of research conducted among patients with COVID-19, as reported in Korean medical journals from 2020 onward. Of 142 studies, 5 involved collaborations with international researchers, and approximately 50% made any declaration regarding funding, and By 2022, an increase was evident in the number of studies that included a large patient cohort relative to the year 2020. Roughly 20% of the studies assessed the impact of interventions, such as pharmaceutical treatments, and further research should assess not only publication trends over a longer timeframe but also the quality of evidence provided.

Behavioral Predictors Associated With COVID-19 Vaccination and Infection Among Men Who Have Sex With Men in Korea: Minsoo Jung; J Prev Med Public Health. 2024;57(1):28-36. Published online November 27, 2023; DOI: https://doi.org/10.3961/jpmph.23.381

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Abstract Summary PDF: Objectives
This study investigated the impact of socioeconomic factors and sexual orientation-related attributes on the rates of coronavirus disease 2019 (COVID-19) vaccination and infection among men who have sex with men (MSM).
Methods
A web-based survey, supported by the National Research Foundation of Korea, was conducted among paying members of the leading online portal for the lesbian, gay, bisexual, transgender, or queer and questioning (LGBTQ+) community in Korea. The study participants were MSM living in Korea (n=942). COVID-19 vaccination and infection were considered dependent variables, while sexual orientation-related characteristics and adherence to non-pharmacological intervention (NPI) practices served as primary independent variables. To ensure analytical precision, nested logistic regression analyses were employed. These were further refined by dividing respondents into 4 categories based on sexual orientation and disclosure (or “coming-out”) status.
Results
Among MSM, no definitive association was found between COVID-19 vaccination status and factors such as socioeconomic or sexual orientation-related attributes (with the latter including human immunodeficiency virus [HIV] status, sexual orientation, and disclosure experience). However, key determinants influencing COVID-19 infection were identified. Notably, people living with HIV (PLWH) exhibited a statistically significant predisposition towards COVID-19 infection. Furthermore, greater adherence to NPI practices among MSM corresponded to a lower likelihood of COVID-19 infection.
Conclusions
This study underscores the high susceptibility to COVID-19 among PLWH within the LGBTQ+ community relative to their healthy MSM counterparts. Consequently, it is crucial to advocate for tailored preventive strategies, including robust NPIs, to protect these at-risk groups. Such measures are essential in reducing the disparities that may emerge in a post–COVID-19 environment.; Summary

Korean summary
한국에서 남성 동성애자의 코로나-19 예방접종과 그들의 사회경제적 지위 또는 성적 지향과 관련된 요인 사이에는 명확한 연관성이 없었지만, HIV에 감염된 남성 동성애자는 코로나-19의 감염 위험이 유의미하게 높았다. 또한, 남성 동성애자의 비약물적 중재 실천율이 높을수록 그들의 코로나-19 감염 가능성은 감소하는 경향이 있었다. 이 연구는 LGBTQ+ 커뮤니티 내의 HIV 양성 동성애자와 같은 취약한 집단을 보호하고 포스트 코로나-19 환경에서 성 소수자 간의 건강 격차를 줄이기 위한 강력한 맞춤형 예방 전략의 필요성을 강조한다.

Key Message
While there were no clear associations between COVID-19 vaccination and socioeconomic or sexual orientation-related factors among men who have sex with men (MSM) in Korea, individuals living with HIV (PLWH) had a significantly higher risk of COVID-19 infection. Additionally, greater adherence to non-pharmacological intervention (NPI) practices was linked to a reduced likelihood of COVID-19 infection among MSM. This study emphasizes the need for tailored preventive strategies, including robust NPIs, to protect at-risk groups like PLWH within the LGBTQ+ community and reduce health disparities in a post-COVID-19 environment.

Brief Report

Characteristics and Health Care Spending of Persistently and Transiently High-cost Older Adults in Korea: Sungchul Park, Giryeon Bae; J Prev Med Public Health. 2023;56(5):475-480. Published online September 4, 2023; DOI: https://doi.org/10.3961/jpmph.23.270

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Abstract Summary PDF: Objectives
This study examined differences in health care spending and characteristics among older adults in Korea by high-cost status (persistently, transiently, and never high-cost).
Methods
We identified 1 364 119 older adults using data from the Korean National Insurance Claims Database for 2017-2019. Outcomes included average annual total health care spending and high-cost status for 2017-2019. Linear regression was used to estimate differences in the outcomes while adjusting for individual-level characteristics.
Results
Persistently and transiently high-cost older adults had higher health care spending than never high-cost older adults, but the difference in health care spending was greater among persistently high-cost older adults than among transiently high-cost older adults (US$20 437 vs. 5486). Despite demographic and socioeconomic differences between transiently high-cost and never high-cost older adults, the presence of comorbid conditions remained the most significant factor. However, there were no or small differences in the prevalence of comorbid conditions between persistently high-cost and transiently high-cost older adults. Rather, notable differences were observed in socioeconomic status, including disability and receipt of Medical Aid.
Conclusions
Medical risk factors contribute to high health care spending to some extent, but social risk factors may be a source of persistent high-cost status among older adults in Korea.; Summary

Korean summary
- 한국에서 65세 이상의 고령층 고비용 환자 그룹 내에서 두 개의 이질적인 그룹을 발견하였다. - 지속적으로 고비용인 환자는 일시적으로 고비용인 환자보다 의료비 지출이 유의미하게 더 많았다. - 두 그룹의 특성을 비교한 결과, 건강요인의 차이도 있었지만 그보다는 사회적 요인의 차이가 더 컸다.

Key Message
- High-cost older adults are heterogeneous in terms of health care spending and sample characteristics in Korea. - Persistently high-cost older adults had significantly higher health care spending than transiently high-cost older adults. - Medical risk factors contribute to high health care spending to some extent, but social risk factors may be a source of persistent high-cost status among older adults.

Original Article

Health Behaviors Before and After the Implementation of a Health Community Organization: Gangwon’s Health-Plus Community Program: Joon-Hyeong Kim, Nam-Jun Kim, Soo-Hyeong Kim, Woong-Sub Park; J Prev Med Public Health. 2023;56(6):487-494. Published online August 17, 2023; DOI: https://doi.org/10.3961/jpmph.23.121

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Abstract Summary PDF: Objectives
Community organization is a resident-led movement aimed at creating fundamental social changes in the community by resolving its problems through the organized power of its residents. This study evaluated the effectiveness of health community organization (HCO), Gangwon’s Health-Plus community program, implemented from 2013 to 2019 on residents’ health behaviors.
Methods
This study had a before-and-after design using 2011-2019 Korea Community Health Survey data. To compare the 3-year periods before and after HCO implementation, the study targeted areas where the HCO had been implemented for 4 years or longer. Therefore, a total of 4512 individuals from 11 areas with HCO start years from 2013 to 2016 were included. Complex sample multi-logistic regression analysis adjusting for demographic characteristics (sex, age, residential area, income level, education level, and HCO start year) was conducted.
Results
HCO implementation was associated with decreased current smoking (adjusted odds ratio [aOR], 0.73; 95% confidence interval [CI], 0.57 to 0.95) and subjective stress recognition (aOR, 0.79; 95% CI, 0.64 to 0.97). Additionally, the HCO was associated with increased walking exercise practice (aOR, 1.39; 95% CI, 1.13 to 1.71), and attempts to control weight (aOR, 1.36; 95% CI, 1.12 to 1.64). No significant negative changes were observed in other health behavior variables.
Conclusions
The HCO seems to have contributed to improving community health indicators. In the future, a follow-up study that analyzes only the effectiveness of the HCO through structured quasi-experimental studies will be needed.; Summary

Korean summary
건강주민운동은 지역사회 건강지표 향상에 기여한 것으로 보여진다. 따라서 주민참여형 건강증진사업이 주민들의 건강을 향상하기 위해서는 주민이 주체가 되어 조직화된 힘으로 지역사회의 근본적인 변화를 만들어가는 주민운동의 관점으로 시행될 필요가 있다.

Key Message
The Health Community Organization (HCO) appears to contribute to the enhancement of community health indicators. Therefore, in order to improve the health of residents through community-based participatory health promotion programs, it is necessary to implement them from the perspective of the HCO in which residents organize themselves as a mobilized force to bring about fundamental changes in the community.

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

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Abstract Summary PDF Supplementary 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

Original Articles

Associations Between Conventional Healthy Behaviors and Social Distancing During the COVID-19 Pandemic: Evidence From the 2020 Community Health Survey in Korea: Rang Hee Kwon, Minsoo Jung; J Prev Med Public Health. 2022;55(6):568-577. Published online October 14, 2022; DOI: https://doi.org/10.3961/jpmph.22.351

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Abstract Summary PDF

Objectives
Many studies have shown that social distancing, as a non-pharmaceutical intervention (NPI) that is one of the various measures against coronavirus disease 2019 (COVID-19), is an effective preventive measure to suppress the spread of infectious diseases. This study explored the relationships between traditional health-related behaviors in Korea and social distancing practices during the COVID-19 pandemic.
Methods
Data were obtained from the 2020 Community Health Survey conducted by the Korea Disease Control and Prevention Agency (n=98 149). The dependent variable was the degree of social distancing practice to cope with the COVID-19 epidemic. Independent variables included health-risk behaviors and health-promoting behaviors. The moderators were vaccination and unmet medical needs. Predictors affecting the practice of social distancing were identified through hierarchical multiple logistic regression analysis.
Results
Smokers (adjusted odds ratio [aOR], 0.924) and frequent drinkers (aOR, 0.933) were more likely not to practice social distancing. A greater degree of physical activity was associated with a higher likelihood of practicing social distancing (aOR, 1.029). People who were vaccinated against influenza were more likely to practice social distancing than those who were not (aOR, 1.150). However, people with unmet medical needs were less likely to practice social distancing than those who did not experience unmet medical needs (aOR, 0.757).
Conclusions
Social distancing practices were related to traditional health behaviors such as smoking, drinking, and physical activity. Their patterns showed a clustering effect of health inequality. Therefore, when establishing a strategy to strengthen social distancing, a strategy to protect the vulnerable should be considered concomitantly.

Summary

Korean summary
본 연구는 코로나-19 판데믹 기간 동안 한국사회에서 전통적인 건강 행태와 의료이용 행태가 사회적 거리두기 실천과 어떻게 연관되는지 탐구하였다. 연구 결과에 따르면 흡연과 음주 같은 건강위험 행태는 사회적 거리두기의 실천 가능성을 낮추었고 운동과 같은 건강증진 행태는 사회적 거리두기의 실천 가능성을 높였다. 아울러 인플루엔자 백신 접종을 받은 집단은 미접종 집단에 비하여 사회적 거리두기의 실천 가능성이 높았다. 따라서 사회적 거리두기와 같은 방역정책을 수립할 때 인구집단의 건강행태 특성을 고려할 필요가 있다.

Citations

Citations to this article as recorded by

Behavioral Predictors Associated With COVID-19 Vaccination and Infection Among Men Who Have Sex With Men in Korea
Minsoo Jung
Journal of Preventive Medicine and Public Health.2024; 57(1): 28. CrossRef
Physical Distancing for Gay Men from People Living with HIV During the COVID-19 Pandemic
Minsoo Jung
Journal of Homosexuality.2024; : 1. CrossRef
Non-rigorous versus rigorous home confinement differently impacts mental health, quality of life and behaviors. Which one was better? A cross-sectional study with older Brazilian adults during covid-19 first wave
Lucimere Bohn, Pedro Pugliesi Abdalla, Euripedes Barsanulfo Gonçalves Gomide, Leonardo Santos Lopes da Silva, André Pereira dos Santos
Archives of Public Health.2023;[Epub] CrossRef

The Relationship Between Thiamine Intake and Long Sleep Duration: Results From the Korea National Health and Nutrition Examination Survey: Dongkyu Lee, Kwanghyun Kim, Youngrong Lee, Kyungwon Oh, Sun Jae Jung; J Prev Med Public Health. 2022;55(6):520-528. Published online October 14, 2022; DOI: https://doi.org/10.3961/jpmph.22.313

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Abstract Summary PDF Supplementary Material

Objectives
Thiamine is thought to modify sleeping patterns, while alcohol use diminishes internal thiamine levels. We investigated the association between thiamine intake and sleep duration and explored possible heterogeneity in the effect according to alcohol use.
Methods
In total, 15 384 participants aged 19-64 were obtained from the Korea National Health and Nutrition Examination Survey 2012-2016. Nutrient intake, including thiamine, was measured using a food frequency questionnaire. Sleep duration was measured by a self-reported questionnaire. The highest thiamine intake quartile was set as the reference group. Participants were divided into 3 groups, with 7-8 hours of daily sleep as a reference group and those who slept more or less than that as “oversleeping” and “insufficient sleeping,” respectively. Multivariate logistic regression was used, adjusting for socioeconomic, medical, and nutritional factors. Additionally, participants were stratified according to high-risk alcohol use defined by the World Health Organization standards on alcohol use.
Results
Low thiamine intake was associated with oversleeping (Q3: odds ratio [OR], 1.06; 95% confidence interval [CI], 0.86 to 1.32; Q2: OR, 1.24; 95% CI, 0.99 to 1.55; Q1: OR, 1.49; 95% CI, 1.16 to 1.91) and showed a significant trend for higher ORs at lower intake levels (p-trend<0.001). The effect was stronger in the high-risk alcohol use group (Q1: OR, 1.78; 95% CI, 1.28 to 2.49).
Conclusions
Low thiamine intake was associated with oversleeping, and alcohol use intensified that association. These results were found in a context where overt clinical symptoms due to thiamine deficiency are considered rare. More awareness of the potential relationship of thiamine intake with oversleeping and its related risks should be considered.

Summary

Korean summary
국민건강영양조사 자료에서 낮은 비타민 B1 섭취가 과도한 수면시간과 연관성이 있으며, 고위험 알코올 섭취군에서 더 큰 상관성을 보였다. 현저한 임상 증상이 나타나지 않는 선에서의 섭취부족도 잠재적으로 과도한 수면시간 및 이와 관련된 건강에 대한 부정적 효과들과 관련이 있을 수 있어 주의가 필요하다.

Citations

Citations to this article as recorded by

The Therapeutic Potential of Vitamins B1, B3 and B6 in Charcot–Marie–Tooth Disease with the Compromised Status of Vitamin-Dependent Processes
Victoria Bunik
Biology.2023; 12(7): 897. CrossRef
Enhancing Sleep Quality: Assessing the Efficacy of a Fixed Combination of Linden, Hawthorn, Vitamin B1, and Melatonin
Matteo De Simone, Rosario De Feo, Anis Choucha, Elena Ciaglia, Francis Fezeu
Medical Sciences.2023; 12(1): 2. CrossRef

The Busan Regional CardioCerebroVascular Center Project’s Experience Over a Decade in the Treatment of ST-segment Elevation Myocardial Infarction: Kyunghee Lim, Hyeyeon Moon, Jong Sung Park, Young-Rak Cho, Kyungil Park, Tae-Ho Park, Moo-Hyun Kim, Young-Dae Kim; J Prev Med Public Health. 2022;55(4):351-359. Published online June 24, 2022; DOI: https://doi.org/10.3961/jpmph.22.071

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Abstract Summary PDF Supplementary Material

Objectives
The Regional CardioCerebroVascular Center (RCCVC) project was initiated to improve clinical outcomes for patients with acute myocardial infarction or stroke in non-capital areas of Korea. The purpose of this study was to evaluate the outcomes and issues identified by the Busan RCCVC project in the treatment of ST-segment elevation myocardial infarction (STEMI).
Methods
Among the patients who were registered in the Korean Registry of Acute Myocardial Infarction for the RCCVC project between 2007 and 2019, those who underwent percutaneous coronary intervention (PCI) for STEMI at the Busan RCCVC were selected, and their medical data were compared with a historical cohort.
Results
In total, 1161 patients were selected for the analysis. Ten years after the implementation of the Busan RCCVC project, the median door-to-balloon time was reduced from 86 (interquartile range [IQR], 64-116) to 54 (IQR, 44-61) minutes, and the median symptom-to-balloon time was reduced from 256 (IQR, 180-407) to 189 (IQR, 118-305) minutes (p<0.001). Inversely, the false-positive PCI team activation rate increased from 0.6% to 21.4% (p<0.001). However, the 1-year cardiovascular death and major adverse cardiac event rates did not change. Even after 10 years, approximately 75% of the patients had a symptom-to-balloon time over 120 minutes, and approximately 50% of the patients underwent inter-hospital transfer for primary PCI.
Conclusions
A decade after the implementation of the Busan RCCVC project, although time parameters for early reperfusion therapy for STEMI improved, at the cost of an increased false-positive PCI team activation rate, survival outcomes were unchanged.

Summary

Korean summary
이번 연구에서는 부산권역심뇌혈관질환센터사업 시작 후 10여년간의 ST분절상습심근경색 환자 치료성적의 변화를 살펴보았다. 사업 시작 후 관상동맥중재시술팀의 위양성소집률이 크게 증가한 대신 ST분절상승심근경색 환자의 조기재관류 치료의 시간지표는 의미 있게 개선되었다. 그러나 생존지표는 사업 시작 전과 비교해 차이가 없었는데 중재시술이 불가능한 병원을 경우하는 사례가 많아 골든타임 이내에 조기 재관류치료를 받은 환자의 비율이 전체 환자의 1/4에 불과한 것이 그 원인으로 보인다.

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Relevance Index Regional Variation by Each Disease and Its Essential Medical Field: A Retrospective Data Analysis From 2016-2020 in Korea
Young-Eun Kim, Jeehee Pyo, Haneul Lee, HyeRan Jeong, Young-Kwon Park, Jeong-Wook Seo, Minsu Ock, Seok-Jun Yoon
Journal of Korean Medical Science.2023;[Epub] CrossRef

Evaluation of the Public Health Emergency Response to the COVID-19 Pandemic in Daegu, Korea During the First Half of 2020: Hwajin Lee, Keon-Yeop Kim, Jong-Yeon Kim, Sin Kam, Kyeong Soo Lee, Jung Jeung Lee, Nam Soo Hong, Tae-Yoon Hwang; J Prev Med Public Health. 2022;55(4):360-370. Published online June 22, 2022; DOI: https://doi.org/10.3961/jpmph.22.068

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Abstract Summary PDF Supplementary Material

Objectives
This study evaluated the response in Daegu, Korea to the first wave of the coronavirus disease 2019 (COVID-19) pandemic according to a public health emergency response model.
Methods
After an examination of the official data reported by the city of Daegu and the Korea Centers for Disease Control and Prevention, as well as a literature review and advisory meetings, we chose a response model. Daegu’s responses were organized into 4 phases and evaluated by applying the response model.
Results
In phase 1, efforts were made to block further transmission of the virus through preemptive testing of a religious group. In phase 2, efforts were concentrated on responding to mass infections in high-risk facilities. Phase 3 involved a transition from a high-intensity social distancing campaign to a citizen participation–based quarantine system. The evaluation using the response model revealed insufficient systematic preparation for a medical surge. In addition, an incorporated health-related management system and protection measures for responders were absent. Nevertheless, the city encouraged the participation of private hospitals and developed a severity classification system. Citizens also played active roles in the pandemic response by practicing social distancing.
Conclusions
This study employed the response model to evaluate the early response in Daegu to the COVID-19 pandemic and revealed areas in need of improvement or maintenance. Based on the study results, creation of a systematic model is necessary to prepare for and respond to future public health emergencies like the COVID-19 pandemic.

Summary

Korean summary
이 연구는 공중보건 위기대응 모형을 적용하여 코로나19 1차 유행에 대한 대구시의 대응을 평가하였습니다. 모형의 세부적 요소인 15개 역량에 따른 평가 결과, 대구의 대응에서 개선 또는 유지해야 할 영역들이 확인되었습니다. 이 결과를 바탕으로, 한국형 공중보건 위기대응 모형을 체계적으로 구축해야 할 것입니다.

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Factors influencing psychological concerns about COVID-19 in South Korea: direct and indirect damage during the early stages of pandemic
Min-sung Kim, Sung-il Cho
BMC Public Health.2024;[Epub] CrossRef
Estimation of the Effectiveness of a Tighter, Reinforced Quarantine for the Coronavirus Disease 2019 (COVID-19) Outbreak: Analysis of the Third Wave in South Korea
Marn Joon Park, Ji Ho Choi, Jae Hoon Cho
Journal of Personalized Medicine.2023; 13(3): 402. CrossRef

Special Articles

Perceptions of the General Public About Health-related Quality of Life and the EQ-5D Questionnaire: A Qualitative Study in Korea: Minsu Ock, Jeehee Pyo, Min-Woo Jo, Michael Herdman, Nan Luo; J Prev Med Public Health. 2022;55(3):213-225. Published online May 31, 2022; DOI: https://doi.org/10.3961/jpmph.22.151

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175 Download
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Abstract Summary PDF

Objectives
The aim of this qualitative study was to investigate how members of the general public in Korea interpret the concept of health, and which dimensions of health are most important to them. We also explored their perceptions of the EuroQoL 5-Dimension (EQ-5D), including the EuroQoL visual analogue scale (EQ-VAS).
Methods
We conducted face-to-face, in-depth interviews with 20 individuals from the general population, using a semi-structured interview guide. Content analysis was performed with verbatim transcripts and field notes to identify codes and categorize them according to their similarities and associations.
Results
In total, 734 different codes were derived and classified into 4 categories. Participants cited the importance of both the mental and physical aspects of health, although they emphasized that the physical aspects appeared to play a larger role in their conceptualization of health. Participants noted that the EQ-5D has the advantage of being composed of 5 dimensions that are simple and contain both physical and mental areas necessary to describe health. However, some of them mentioned the need to add more dimensions of mental health and social health. Participants showed great satisfaction with the visually well-presented EQ-VAS. However, participants opined that the EQ-VAS scores might not be comparable across respondents because of different ways of responding to the scale.
Conclusions
While physical health is a fundamental aspect of health, mental and social aspects are also important to Koreans. The content of the EQ-5D broadly matched the attributes of health considered important by Koreans.

Summary

Korean summary
이번 연구에서는 질적 연구 방법론을 활용하여 한국인이 건강을 이해하고 개념화하는 방법과 건강의 어떤 차원을 중요하게 여기는지 살펴보면서 EQ-5D에 대한 인식을 살펴보았다. 이번 연구를 통하여 EQ-5D와 EQ VAS가 전반적으로 한국인의 건강 관련 삶의 질을 잘 측정할 수 있지만, 정신적 및 사회적 측면에 대한 항목을 추가하면 한국인의 건강 관련 삶의 질을 더 잘 반영할 수 있음을 확인하였다.

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How Well Does the EQ-5D-Y-5L Describe Children With Intellectual Disability?: “There’s a Lot More to My Child Than That She Can’t Wash or Dress Herself.”
A. Marie Blackmore, Brendan Mulhern, Richard Norman, Dinah Reddihough, Catherine S. Choong, Peter Jacoby, Jenny Downs
Value in Health.2024; 27(2): 190. CrossRef
Acceptability of the routine use and collection of a generic patient reported outcome measure from the perspective of healthcare staff: a qualitative study
David A Snowdon, Velandai Srikanth, Richard Beare, Kate E Noeske, Elizabeth Le, Bridget O’Bree, Nadine E Andrew
Journal of Patient-Reported Outcomes.2023;[Epub] CrossRef

Well-being Index Scores and Subjective Health Status of Korean Healthcare Workers: Yoonhee Shin, Bohyun Park, Nam-eun Kim, Eun Jeong Choi, Minsu Ock, Sun Ha Jee, Sue K. Park, Hyeong Sik Ahn, Hyesook Park; J Prev Med Public Health. 2022;55(3):226-233. Published online May 31, 2022; DOI: https://doi.org/10.3961/jpmph.22.114

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Abstract Summary PDF: Objectives
The aim of this study was to evaluate the subjective level of health-related quality of life of Korean healthcare workers using various quality-of-life instruments.
Methods
This study included 992 participants, who were doctors and nurses. A survey was conducted between November 28 and December 4, 2019. Data from 954 participants divided into 3 groups (physicians, residents, and nurses) were analyzed. Four measurement tools (29 questions) were used in the survey to evaluate subjective health status and well-being.
Results
In the Mayo Well-being Index, burnout during work (88.5%) and emotional difficulties caused by work (84.0%) were frequently cited by the respondents. Regarding questions on burnout and emotional difficulties, residents and nurses had the highest scores (91.0 and 89.6%, respectively). Emotional problems, such as anxiety, depression, and irritability, accounted for a high percentage (73.1%) of the total, while 82.2% of respondents reported that their work schedules interfered with their leisure and family time. There was no significant difference among the groups in subjective health status. However, 10.1% of the residents experienced very low quality of life, which was a higher proportion than that of physicians (2.7%) and nurses (5.2%).
Conclusions
The level of well-being that Korean medical workers experienced in relation to work was lower than the results of the United States healthcare workers surveyed using the same tool. This study was unique in that it conducted a subjective quality-of-life survey on Korean healthcare workers.; Summary

Korean summary
본 연구의 목적은 다양한 삶의 질 도구를 사용하여 한국 의료종사자들의 건강과 관련된 삶의 질에 대한 주관적인 수준을 평가하는 것이다. 피로와 정서적 어려움, 업무로 인한 일상생활의 방해 등 한국 의료종사자의 일부 삶의 질 점수가 낮았다. 의료 종사자의 소진 경험이 환자의 치료에 부정적인 영향을 미친다는 것을 고려할 때 의료 종사자들의 삶의 질을 향상시키는 정책이 마련되어야하며, 건강과 관련된 직업적 위험요인 연구도 추가적으로 필요하다.

Original Articles

Estimation of Utility Weights for Prostate-related Health States in Korea: Seon-Ha Kim, Minsu Ock, Min-Woo Jo, Sungchan Park; J Prev Med Public Health. 2022;55(3):243-252. Published online May 4, 2022; DOI: https://doi.org/10.3961/jpmph.21.426

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Abstract Summary PDF Supplementary Material: Objectives
Very limited previous research has investigated the utility weights of prostate-related diseases in the general population in Korea. The purpose of this study was to calculate the utility of prostate-related health states in the Korean general public using the standard gamble (SG) method.
Methods
Seven health states for hypothetical prostate cancers, 1 for benign prostate hyperplasia, and 1 for erectile dysfunction were developed based on patient education material and previous publications. In total, 460 responses from the Korean general population were used to analyze the utility of prostate-related health states. Computer-assisted personal interviews were conducted, and utility values were measured using a visual analogue scale (VAS) and SG. Mean utility values were calculated for each prostate-related health state.
Results
The mean utility values of prostate cancer derived from SG ranged from 0.281 (metastatic castration-refractory prostate cancer) to 0.779 (localized prostate cancer requiring prostatectomy). The utility value of benign prostate hyperplasia was 0.871, and that of erectile dysfunction was 0.812. The utility values obtained using the SG method in all conditions were higher than the values obtained by VAS. There were no significant demographic variables affecting utility values in multivariate analysis.
Conclusions
Our findings might be useful for economic evaluation and utility calculation of screening and interventions for prostate-related conditions in the general population.; Summary

Korean summary
이 연구는 일반인구집단을 대상으로 7개의 전립선 암 상태와 전립선 비대증, 발기부전상태의 효용값을 표준기회선택법을 이용하여 산출하였다. 전립선암 상태에 따라 평균 효용값은 0.281에서 0.779범위였다. 연구 결과는 전립선 관련 상태의 중재의 효용 계산이나 경제성 평가에 활용할 수 있을 것이다.

Association Between Sleep Quality and Anxiety in Korean Adolescents: Hyunkyu Kim, Seung Hoon Kim, Sung-In Jang, Eun-Cheol Park; J Prev Med Public Health. 2022;55(2):173-181. Published online February 10, 2022; DOI: https://doi.org/10.3961/jpmph.21.498

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Abstract Summary PDF

Objectives
Anxiety disorder is among the most prevalent mental illnesses among adolescents. Early detection and proper treatment are important for preventing sequelae such as suicide and substance use disorder. Studies have suggested that sleep duration is associated with anxiety disorder in adolescents. In the present study, we investigated the association between sleep quality and anxiety in a nationally representative sample of Korean adolescents.
Methods
This cross-sectional study was conducted using data from the 2020 Korea Youth Risk Behavior Web-based Survey. The Generalized Anxiety Disorder-7 questionnaire was used to evaluate anxiety. The chi-square test was used to investigate and compare the general characteristics of the study population, and multiple logistic regression analysis was used to analyze the relationship between sleep quality and anxiety.
Results
In both sexes, anxiety was highly prevalent in participants with poor sleep quality (adjusted odds ratio [aOR], 1.56; 95% confidence interval [CI], 1.43 to 1.71 in boys; aOR, 1.30; 95% CI, 1.19 to 1.42 in girls). Regardless of sleep duration, participants with poor sleep quality showed a high aOR for anxiety.
Conclusions
This study identified a consistent relationship between sleep quality and anxiety in Korean adolescents regardless of sleep duration.

Summary

Korean summary
청소년건강행태조사를 이용하여 청소년들의 수면의 질과 불안과의 연관성을 분석하였다. 좋지 않은 수면의 질은 불안감과 연관성이 있었으며 이 연관성은 대상자들의 수면시간과 상관없이 나타났다.

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Special Article

Measuring Trends in the Socioeconomic Burden of Disease in Korea, 2007-2015: Tae Eung Kim, Ru-Gyeom Lee, So-Youn Park, In-Hwan Oh; J Prev Med Public Health. 2022;55(1):19-27. Published online January 31, 2022; DOI: https://doi.org/10.3961/jpmph.21.594

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Abstract Summary PDF Supplementary Material

This study estimated the direct and indirect socioeconomic costs of 238 diseases and 22 injuries from a social perspective in Korea from 2007 to 2015. The socioeconomic cost of each disease group was calculated based on the Korean Standard Disease Classification System. Direct costs were estimated using health insurance claims data provided by the National Health Insurance Service. The numbers of outpatients and inpatients with the main diagnostic codes for each disease were selected as a proxy indicator for estimating patients’ medical use behavior by disease. The economic burden of disease from 2007 to 2015 showed an approximately 20% increase in total costs. From 2007 to 2015, communicable diseases (including infectious, maternal, pediatric, and nutritional diseases) accounted for 8.9-12.2% of the socioeconomic burden, while non-infectious diseases accounted for 65.7-70.7% and injuries accounted for 19.1-22.8%. The top 5 diseases in terms of the socioeconomic burden were self-harm (which took the top spot for 8 years), followed by cirrhosis of the liver, liver cancer, ischemic heart disease, and upper respiratory infections in 2007. Since 2010, the economic burden of conditions such as low back pain, falls, and acute bronchitis has been included in this ranking. This study expanded the scope of calculating the burden of disease at the national level by calculating the burden of disease in Koreans by gender and disease. These findings can be used as indicators of health equality and as useful data for establishing community-centered (or customized) health promotion policies, projects, and national health policy goals.

Summary

Korean summary
2007년에서 2015년 기간의 건강보험 자료 등을 이용하여, 해당기간의 경제적 질병부담을 측정하였으며, 해당 기간동안 경제적 질병부담은 20%의 증가를 나타내었다. 동 기간동안 비감염성 질환의 경제적 질병부담의 비율은 약 70%로 나타났으며, 감염성 질환은 약 10%, 손상은 20%로 나타났다. 한편 개별 질병군 기준으로는 자살을 포함한 자해가 1위를 차지한 해가 가장 많았다.

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