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Original Articles
Experience of Medical Personnel Dispatched to Isolated Psychiatric Institution in Korea During COVID-19: Content Analysis
Youngjoo Kim, Jung Hee Hyun, Jacob Lee, Yoonyoung Nam, Eunshil Yim, Kyounga Lee, Baegju Na
J Prev Med Public Health. 2025;58(4):431-439.   Published online June 18, 2025
DOI: https://doi.org/10.3961/jpmph.24.680
  • 1,987 View
  • 251 Download
AbstractAbstract AbstractSummary PDF
Objectives
This study investigates problems related to medical response, and the support system among medical personnel dispatched to the psychiatric hospital when the first cluster of infections occurred in a psychiatric hospital in Korea.
Methods
Contents analysis was conducted for the responses of the medical personnel who responded to the interview. Training about basic quarantine rules, and safety management is not provided in the early dispatch stages.
Results
No guidance is available regarding the human rights protection of medical staff. Additionally, no on-site situation-control tower is available. Participants reported that temporary quarantine measures implemented at Hospital D to restrict the movement of patients and medical staff from the external world are problematic. The most significant problem is the insufficient governmental systemic support and consideration for protecting. Both the human rights of psychiatric patients and the human rights of the medical staff who care for them.
Conclusions
Future responses to new infectious diseases should include the establishment of a continuous support system in the community by changing the collective and closed-room environments as well as isolation-centered mental healthcare systems to protect the human rights of patients with mental disorders. Additionally, response drills for people with mental illness in closed environments should be practiced in response to emerging infectious diseases at ordinary times. Finally, training and emergency measures for medical staff dispatched to these facilities and a manual for the protection of the human rights of medical staff should be prepared.
Summary
Korean summary
이 논문은 COVID-19 초기 확산 시기, 한국 청도군의 한 정신병원에서 집단감염이 발생했을 때 파견된 의료진의 경험을 질적 내용 분석을 통해 조사한 연구입니다. 연구 결과, 정부의 준비 부족, 현장 통제 시스템 부재, 감염병 대응 훈련 미비, 인권 보호 기준 부재 등 여러 문제점이 드러났으며, 향후 정신질환자 대상 감염병 대응을 위해 지역사회 기반의 지속 가능한 지원체계와 의료진 인권 보호 매뉴얼 마련이 필요하다고 제안합니다.
Key Message
This study qualitatively analyzed the experiences of medical personnel dispatched to a psychiatric hospital in Cheongdo-gun, Korea, during a COVID-19 outbreak. It revealed critical issues such as lack of governmental preparedness, absence of on-site control systems, inadequate training, and insufficient protection of human rights for both patients and staff. The findings highlight the need for a sustainable, community-based mental healthcare system and the development of emergency manuals and human rights protection protocols for medical personnel in future infectious disease responses.
The Development of an Assessment Instrument for Behavior Toward Hypoglycemia Risk Among Type 2 Diabetes Mellitus Outpatients in Jakarta, Indonesia
Putu Rika Veryanti, Rani Sauriasari, Ratu Ayu Dewi Sartika, Berna Elya, Muhammad Ikhsan Mokoagow
J Prev Med Public Health. 2025;58(1):31-43.   Published online November 13, 2024
DOI: https://doi.org/10.3961/jpmph.24.313
  • 4,435 View
  • 593 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
The purpose of this study was to develop a valid and reliable instrument for assessing patients’ behavior toward the risk of hypoglycemia through self-assessment. Insufficient education and supervision of type 2 diabetes mellitus (DM) outpatients by healthcare providers is a significant concern, affecting their behavior during the treatment process. Additionally, inappropriate behavior typically increases the risk of hypoglycemia. To mitigate this risk, several studies have recommended evaluating patients’ behavior, necessitating the development of a new instrument.
Methods
The study procedures were conducted in 3 stages: instrument development (face and content validity, stage I), construct validity and reliability test (stage II), and criterion validity (stage III). Stage I involved 5 healthcare practitioners, including internal medicine doctors, nurses, dietitians, and pharmacists in hospitals and community health centers. Stage II included 20 respondents using a 1-shot test method. Stage III involved 237 type 2 DM outpatients at Central General Hospital (RSUP) in Jakarta, employing a cross-sectional design and consecutive sampling.
Results
The results indicated that the developed instrument was valid and reliable, comprising 9 domains (29 questions). These domains included behavior toward blood glucose monitoring, diet, physical activity, medication, assistance from healthcare providers, hypoglycemia management, self-care, family support, and insulin use. Furthermore, poor behavior was found to increase the risk of hypoglycemia by 2.36 times.
Conclusions
Based on these results, the developed instrument could be effectively used to evaluate behavior toward hypoglycemia among type 2 DM outpatients, confirming its validity and reliability.
Summary
Key Message
The development of an assessment instrument for behavior toward hypoglycemia risk among type 2 diabetes mellitus outpatients in Jakarta, Indonesia have been carried out. The instrument contains 9 domains, included behavior toward blood glucose monitoring, diet, physical activity, medication, assistance from healthcare providers, hypoglycemia management, self-care, family support, and insulin use. Poor behavior was found to increase the risk of hypoglycemia by 2.36 times. The instrument developed is valid and reliable.
Brief Report
Drug Prescription Indicators in Outpatient Services in Social Security Organization Facilities in Iran
Afsoon Aeenparast, Ali Asghar Haeri Mehrizi, Farzaneh Maftoon, Faranak Farzadi
J Prev Med Public Health. 2024;57(3):298-303.   Published online April 4, 2024
DOI: https://doi.org/10.3961/jpmph.23.424
  • 5,272 View
  • 300 Download
  • 1 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
The aim of this study was to estimate drug prescription indicators in outpatient services provided at Iran Social Security Organization (SSO) healthcare facilities.
Methods
Data on all prescribed drugs for outpatient visits from 2017 to 2018 were extracted from the SSO database. The data were categorized into 4 main subgroups: patient characteristics, provider characteristics, service characteristics, and type of healthcare facility. Logistic regression models were used to detect risk factors for inappropriate drug prescriptions. SPSS and IBM Modeler software were utilized for data analysis.
Results
In 2017, approximately 150 981 752 drug items were issued to outpatients referred to SSO healthcare facilities in Iran. The average number of drug items per outpatient prescription was estimated at 3.33. The proportion of prescriptions that included an injection was 17.5%, and the rate of prescriptions that included an antibiotic was 37.5%. Factors such as patient sex and age, provider specialty, type of facility, and time of outpatient visit were associated with the risk of inappropriate prescriptions.
Conclusions
In this study, all drug prescription criteria exceeded the recommended limits set by the World Health Organization. To improve the current prescription patterns throughout the country, it would be beneficial to provide providers with monthly and annual reports and to consider implementing some prescription policies for physicians.
Summary
Key Message
In present research all drug prescriptions in Iran Social Security outpatient facilities were assessed. In all 45,312,540 studied prescriptions, the average number of drug items per prescriptions was 3.33 items. 17.5% of prescriptions contained injection and 37.5% contained antibiotic. Patient sex and age, provider specialty, type of facility were associated with the risk of inappropriate prescriptions. It seems that correct policy making and proper supervision alongside health education will be core basis for improving drug prescription and use.

Citations

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  • A Cross-Sectional Investigation on Drug-Drug Interactions in Prescriptions of Pediatric Outpatient Clinics at a Referral Center in Southern Iran
    Sara Asadi, Omid Moradi, Hossein Amini, MReza Goodarzian, Maryam Babaei, Maral Goodarzian
    Journal of Comprehensive Pediatrics.2024;[Epub]     CrossRef
Original Articles
Risks for Readmission Among Older Patients With Chronic Obstructive Pulmonary Disease: An Analysis Using Korean National Health Insurance Service – Senior Cohort Data
Yu Seong Hwang, Heui Sug Jo
J Prev Med Public Health. 2023;56(6):563-572.   Published online November 10, 2023
DOI: https://doi.org/10.3961/jpmph.23.346
  • 5,508 View
  • 106 Download
AbstractAbstract AbstractSummary PDF
Objectives
The high readmission rate of patients with chronic obstructive pulmonary disease (COPD) has led to the worldwide establishment of proactive measures for identifying and mitigating readmissions. This study aimed to identify factors associated with readmission, as well as groups particularly vulnerable to readmission that require transitional care services.
Methods
To apply transitional care services that are compatible with Korea’s circumstances, targeted groups that are particularly vulnerable to readmission should be identified. Therefore, using the National Health Insurance Service’s Senior Cohort database, we analyzed data from 4874 patients who were first hospitalized with COPD from 2009 to 2019 to define and analyze readmissions within 30 days after discharge. Logistic regression analysis was performed to determine factors correlated with readmission within 30 days.
Results
The likelihood of readmission was associated with older age (for individuals in their 80s vs. those in their 50s: odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19 to 2.12), medical insurance type (for workplace subscribers vs. local subscribers: OR, 0.84; 95% CI, 0.72 to 0.99), type of hospital (those with 300 beds or more vs. fewer beds: OR, 0.77; 95% CI, 0.66 to 0.90), and healthcare organization location (provincial areas vs. the capital area: OR, 1.66; 95% CI, 1.14 to 2.41).
Conclusions
Older patients, patients holding a local subscriber insurance qualification, individuals admitted to hospitals with fewer than 300 beds, and those admitted to provincial hospitals are suggested to be higher-priority for transitional care services.
Summary
Korean summary
국내 만성폐쇄성폐질환(COPD)의 위험도 표준화 재입원율은 12.7%로, 주요 진단군 가운데 재입원율이 가장 높다. 국민건강보험공단 노인코호트를 활용하여 COPD로 입원한 환자의 재입원 위험 요인을 파악한 결과 고령 환자, 국민건강보험 지역가입자, 300병상 미만 규모 병원 또는 도 지역 소재 병원 에 입원한 환자의 경우 재입원 위험이 높았다. 재입원 위험이 높은 환자에 대하여 우선적으로 퇴원환자관리 서비스가 제공될 필요가 있다.
Key Message
The risk-standardized readmission rate for COPD in Korea is 12.7%, the highest among major diagnostic groups. Using the National Health Insurance Service Senior Cohort to identify risk factors for the readmission of patients hospitalized with COPD, it was found that older patients, local health insurance subscribers, those hospitalized in facilities with fewer than 300 beds, or in hospitals located in provincial areas had a higher risk of readmission. It is necessary to prioritize transitional care services for patients at a high risk of readmission.
Construction of the Mobility to Participation Assessment Scale for Stroke (MPASS) and Testing Its Validity and Reliability in Persons With Stroke in Thailand
Jiraphat Nawarat, Kanda Chaipinyo
J Prev Med Public Health. 2022;55(4):334-341.   Published online June 13, 2022
DOI: https://doi.org/10.3961/jpmph.21.605
  • 5,520 View
  • 204 Download
AbstractAbstract PDF
Objectives
This study was conducted to develop the Mobility to Participation Assessment Scale for Stroke (MPASS) and assess its content validity, internal consistency, inter-rater and intra-rater reliability, and convergent validity in people with stroke living in the community.
Methods
The MPASS was developed using published data on mobility-related activity and participation timing in elderly individuals, and then reviewed by community physical therapists. Content validity was established by reaching a consensus of experienced physical therapists in a focus group. The MPASS was scored for 32 participants with stroke (mean age 61.75±4.92 years) by 3 individual testers. Reliability was examined using the intraclass correlation coefficient (ICC), internal consistency using the Cronbach alpha coefficient (α), and convergent validity using the Pearson correlation coefficient (r) to compare the MPASS to the Modified Rivermead Mobility Index as a referent test of mobility.
Results
The MPASS consists of 8 items, and its scoring system provides information on the ability of people with stroke to reach a movement level enabling them to live in society, including interactions with other people and safe living in the community. The inter-rater and intra-rater reliability were excellent (ICC, 0.948; 95% confidence interval [CI], 0.893 to 0.982 and ICC, 0.967; 95% CI, 0.933 to 0.989, respectively). Internal consistency was good (α=0.877). The convergent validity was moderate (r=0.646; p<0.001).
Conclusions
The newly developed MPASS showed acceptable construct validity and high reliability. The MPASS is suitable for use in people with stroke, especially those who have been discharged and live in the community with the ability to initiate sitting.
Summary
Association Between Cohabitation Status and Sleep Quality in Families of Persons With Dementia in Korea: A Cross-sectional Study
Seung Hoon Kim, Minah Park, Sung Hoon Jeong, Sung-In Jang, Eun-Cheol Park
J Prev Med Public Health. 2021;54(5):317-329.   Published online August 14, 2021
DOI: https://doi.org/10.3961/jpmph.21.077
  • 9,235 View
  • 175 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
The aim of this study was to identify the association between cohabitation status and sleep quality in family members of people with dementia (PwDs).
Methods
Data of 190 365 participants aged ≥19 years from the 2018 Korea Community Health Survey were analyzed. Participants were categorized according to their cohabitation status with PwDs. Multiple logistic regression and ordinal logistic regression analyses were performed to evaluate the relationship between the cohabitation status of PwDs’ relatives and sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI) and PSQI subscales.
Results
Compared to participants without PwDs in their families, both cohabitation and non-cohabitation with PwDs were associated with poor sleep quality (cohabitation, male: odds ratio [OR],1.28; 95% confidence interval [CI], 1.08 to 1.52; female: OR, 1.40; 95% CI, 1.20 to 1.64; non-cohabitation, male: OR, 1.14; 95% CI, 1.05 to 1.24; female: OR, 1.23; 95% CI, 1.14 to 1.33). In a subgroup analysis, non-cohabiting family members showed the highest odds of experiencing poor sleep quality when the PwD lived alone (male: OR, 1.48; 95% CI, 1.14 to 1.91; female: OR, 1.58; 95% CI, 1.24 to 2.01). Cohabiting male and female participants had higher odds of poor subjective sleep quality and use of sleeping medications than non-cohabiting male and female participants, respectively.
Conclusions
The residence of PwDs and cohabitation status may contribute to poor sleep quality among PwDs’ family members. The circumstances faced by cohabiting and non-cohabiting family members should be considered when evaluating sleep quality in family members of PwDs, and appropriate interventions may be needed to improve sleep quality in both cohabiting and non-cohabiting family members.
Summary
Korean summary
2018년 지역사회건강조사를 이용하여 190 365명을 대상으로 가족 중 치매환자 유무 및 치매환자와의 동거여부와 수면의 질 사이의 연관성을 분석하였다. 치매환자와의 동거여부와 상관없이 가족 중 치매환자가 존재하는 것은 낮은 수면의 질과 유의한 연관성이 있었다. 가족 중 치매환자가 있지만 동거하지 않는 가족 구성원의 경우 치매환자가 혼자 살 때 낮은 수면의 질과의 연관성이 가장 높게 나타났다.

Citations

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  • Negative Consequences of Sleep Deprivation Experienced by Informal Caregivers of People With Dementia on Caregivers and Care Recipients: A Scoping Review
    Jieyu Mao, Miyae Yamakawa, Xujing Hu, Hitomi Chikama, Toshiyuki Swa, Yasushi Takeya
    International Journal of Nursing Practice.2025;[Epub]     CrossRef
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    I-Ming Chen, Jia-Chi Shan, Tzu-Yun Lin, Jennifer Yi-Ying Chen, Po-Chang Tseng, Yu-Hsuan Lin, Shih-Cheng Liao, Hsi-Chung Chen
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    Glenna Brewster, Irene Yang, Jordan Pelkmans, Melinda Higgins, Drenna Waldrop, Sandra B. Dunbar, Katherine A. Yeager
    Geriatric Nursing.2024; 59: 159.     CrossRef
  • Association Between Sleep Quality and Anxiety in Korean Adolescents
    Hyunkyu Kim, Seung Hoon Kim, Sung-In Jang, Eun-Cheol Park
    Journal of Preventive Medicine and Public Health.2022; 55(2): 173.     CrossRef
  • Association of compliance with COVID-19 public health measures with depression
    Ju An Byun, Tae Jun Sim, Tae Yoon Lim, Sung-In Jang, Seung Hoon Kim
    Scientific Reports.2022;[Epub]     CrossRef
Perspective
Dilemmas Within the Korean Health Insurance System
Donghwi Park, Min Cheol Chang
J Prev Med Public Health. 2020;53(4):285-288.   Published online July 1, 2020
DOI: https://doi.org/10.3961/jpmph.20.074
  • 8,141 View
  • 132 Download
  • 6 Crossref
AbstractAbstract PDF
The health insurance system in Korea is well-established and provides benefits for the entire national population. In Korea, when patients are treated at a hospital, the hospital receives a partial payment for the treatment from the patient, and the remaining amount is provided by the health insurance service. The Health Insurance Review and Assessment Service (HIRA) assesses whether the treatment was appropriate. If HIRA deems the treatment appropriate, the doctor can receive payment from the health insurance service. However, this system has several drawbacks. In this study, we aimed to provide examples of the problems that can occur in relation to HIRA assessments in Korea through actual clinical cases.
Summary

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  • Healthcare affordability and breast cancer screening uptake: an ecological analysis
    Jingmei Li, Serene Si Ning Goh, Mikael Hartman
    Discover Public Health.2025;[Epub]     CrossRef
  • The Paradox of the Ugandan Health Insurance System: Challenges and Opportunities for Health Reform
    Emmanuel Otieno, Josephine Namyalo
    Journal of Preventive Medicine and Public Health.2024; 57(1): 91.     CrossRef
  • Factors Associated with Outcomes of Patients with Veno-Venous Extracorporeal Membrane Oxygenation for COVID-19
    Soojin Lee, Gayeon Kang, Seunghwan Song, Kwangha Lee, Wanho Yoo, Hyojin Jang, Myung Hun Jang
    Journal of Clinical Medicine.2024; 13(19): 5922.     CrossRef
  • Differences in pain treatment between the healthcare systems in South Korea and Quebec and proposals for improvements
    Min Cheol Chang, Mathieu Boudier-Revéret
    Journal of Yeungnam Medical Science.2024; 42: 16.     CrossRef
  • Effect of Income Level on Stroke Incidence and Mediated Effects of Medication Adherence in Newly Diagnosed Hypertensive Patients: A Causal Mediation Analysis Using a Nationwide Cohort Study in South Korea
    Seungmin Jeong, So Yeon Kong, Seung-sik Hwang, Sung-il Cho
    Journal of Health Informatics and Statistics.2022; 47(4): 268.     CrossRef
  • Diagnosis of Duchenne Muscular Dystrophy in a Presymptomatic Infant Using Next-Generation Sequencing and Chromosomal Microarray Analysis: A Case Report
    Eun-Woo Park, Ye-Jee Shim, Jung-Sook Ha, Jin-Hong Shin, Soyoung Lee, Jang-Hyuk Cho
    Children.2021; 8(5): 377.     CrossRef
Original Articles
Patients’ and General Practitioners’ Views About Preventive Care in Family Medicine in Switzerland: A Cross-sectional Study
Christine Cohidon, Fabienne Imhof, Laure Bovy, Priska Birrer, Jacques Cornuz, Nicolas Senn
J Prev Med Public Health. 2019;52(5):323-332.   Published online September 17, 2019
DOI: https://doi.org/10.3961/jpmph.19.184
  • 8,243 View
  • 143 Download
  • 12 Crossref
AbstractAbstract PDF
Objectives
The aim of this study was to describe general practitioners (GPs)’ opinions and practices of preventive care and patients’ opinions, attitudes, and behaviors towards prevention.
Methods
The data stemmed from a cross-sectional national survey on prevention conducted in Switzerland from 2015 to 2016. In total, 170 randomly drawn GPs and 1154 of their patients participated. The GPs answered an online questionnaire and the patients answered a questionnaire administrated by fieldworkers present at their practices.
Results
Both patients and GPs agreed that delivering preventive care is the dedicated role of a GP. It appeared that beyond classical topics of prevention such as cardiovascular risk factors, other prevention areas (e.g., cannabis consumption, immunization, occupational risks) were scarcely covered by GPs and reported as little-known by patients. In addition, GPs seemed to use a selective approach to prevention, responding to the clinical context, rather than a systematic approach to health promotion. The results also highlight possibilities to improve prevention in family medicine through options such as more supportive tools and public advertising, more time and more delegated tasks and, finally, a more recognized role.
Conclusions
Despite an unfavorable context of prevention within the healthcare system, preventive care in family medicine is reasonably good in Switzerland. However, some limitations appear regarding the topics and the circumstances of preventive care delivery. A global effort is needed to implement necessary changes, and the responsibility should be broadened to other stakeholders.
Summary

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  • Análise das Expectativas em Consultas de Rotina: Estudo Transversal em Portugal
    Maria Manuel Bica Tavares, Inês Rosendo Carvalho e Silva, Luiz Miguel Santiago
    Acta Médica Portuguesa.2024; 37(12): 838.     CrossRef
  • Inadequate health literacy and higher healthcare utilisation among older adults in Switzerland: cross-sectional evidence from a population-based study
    Giuliano Pigazzini, Maud Wieczorek, Clément Meier, Jürgen Maurer
    Swiss Medical Weekly.2024; 154(10): 3515.     CrossRef
  • Factors for the integration of prevention in primary care: an overview of reviews
    Estelle Clet, Pierre Leblanc, François Alla, Christine Cohidon
    BJGP Open.2024; 8(3): BJGPO.2023.0141.     CrossRef
  • Effectiveness of General Practitioners’ Involvement in Adult Vaccination Practices: A Systematic Review and Meta-Analysis of International Evidence
    Andrea Ceccarelli, Gabriele Munafò, Francesco Sintoni, Christian Cintori, Davide Gori, Marco Montalti
    Vaccines.2024; 12(12): 1438.     CrossRef
  • Attitudes of primary care physicians toward bariatric surgery: a free word association networks analysis
    Daniel Gero, Vanessa Müller, Bálint File, Marco Bueter, Jeannette Widmer, Andreas Thalheimer
    Surgery for Obesity and Related Diseases.2023; 19(10): 1177.     CrossRef
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    Adrien Maire, Nicolas Chapet, Sylvain Aguilhon, Marie-Lucie Laugier, Paul Laffont-Lozes, Mélinda Rigoni, Betty Mathieu, Yohan Audurier, Cyril Breuker, Gaëlle de Barry, Anne Jalabert, Florence Leclercq, Jean-Luc Pasquié, François Roubille, Audrey Castet-Ni
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    Juliane Messer, Konstantinos Tzartzas, Régis Marion-Veyron, Christine Cohidon
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Exploratory Study of Dimensions of Health-related Quality of Life in the General Population of South Korea
Seon-Ha Kim, Min-Woo Jo, Minsu Ock, Sang-il Lee
J Prev Med Public Health. 2017;50(6):361-368.   Published online November 2, 2017
DOI: https://doi.org/10.3961/jpmph.16.076
  • 12,653 View
  • 239 Download
  • 16 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
This study aimed to explore dimensions in addition to the 5 dimensions of the 5-level EQ-5D version (EQ-5D-5L) that could satisfactorily explain variation in health-related quality of life (HRQoL) in the general population of South Korea.
Methods
Domains related to HRQoL were searched through a review of existing HRQoL instruments. Among the 28 potential dimensions, the 5 dimensions of the EQ-5D-5L and 7 additional dimensions (vision, hearing, communication, cognitive function, social relationships, vitality, and sleep) were included. A representative sample of 600 subjects was selected for the survey, which was administered through face-to-face interviews. Subjects were asked to report problems in 12 health dimensions at 5 levels, as well as their self-rated health status using the EuroQol visual analogue scale (EQ-VAS) and a 5-point Likert scale. Among subjects who reported no problems for any of the parameters in the EQ-5D-5L, we analyzed the frequencies of problems in the additional dimensions. A linear regression model with the EQ-VAS as the dependent variable was performed to identify additional significant dimensions.
Results
Among respondents who reported full health on the EQ-5D-5L (n=365), 32% reported a problem for at least 1 additional dimension, and 14% reported worse than moderate self-rated health. Regression analysis revealed a R2 of 0.228 for the original EQ-5D-5L dimensions, 0.200 for the new dimensions, and 0.263 for the 12 dimensions together. Among the added dimensions, vitality and sleep were significantly associated with EQ-VAS scores.
Conclusions
This study identified significant dimensions for assessing self-rated health among members of the general public, in addition to the 5 dimensions of the EQ-5D-5L. These dimensions could be considered for inclusion in a new preference-based instrument or for developing a country-specific HRQoL instrument.
Summary

Citations

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  • Developing and testing a patient-reported outcome measure for patients with sleep disturbances using EQ-5D and condition-specific bolt-ons: a mixed method study
    Ai-Ping Chua, Aureliano Paolo Finch, Shaffinaz Abd Rahman, Mary Anne Relimbo Dela Cruz, Emelita Naval Montaniel, Kaayathiri Ravichandran, Nan Luo
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Review
Frequency, Expected Effects, Obstacles, and Facilitators of Disclosure of Patient Safety Incidents: A Systematic Review
Minsu Ock, So Yun Lim, Min-Woo Jo, Sang-il Lee
J Prev Med Public Health. 2017;50(2):68-82.   Published online January 26, 2017
DOI: https://doi.org/10.3961/jpmph.16.105
  • 17,718 View
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AbstractAbstract PDFSupplementary Material
Objectives
We performed a systematic review to assess and aggregate the available evidence on the frequency, expected effects, obstacles, and facilitators of disclosure of patient safety incidents (DPSI).
Methods
We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for this systematic review and searched PubMed, Scopus, and the Cochrane Library for English articles published between 1990 and 2014. Two authors independently conducted the title screening and abstract review. Ninety-nine articles were selected for full-text reviews. One author extracted the data and another verified them.
Results
There was considerable variation in the reported frequency of DPSI among medical professionals. The main expected effects of DPSI were decreased intention of the general public to file medical lawsuits and punish medical professionals, increased credibility of medical professionals, increased intention of patients to revisit and recommend physicians or hospitals, higher ratings of quality of care, and alleviation of feelings of guilt among medical professionals. The obstacles to DPSI were fear of medical lawsuits and punishment, fear of a damaged professional reputation among colleagues and patients, diminished patient trust, the complexity of the situation, and the absence of a patient safety culture. However, the factors facilitating DPSI included the creation of a safe environment for reporting patient safety incidents, as well as guidelines and education for DPSI.
Conclusions
The reported frequency of the experience of the general public with DPSI was somewhat lower than the reported frequency of DPSI among medical professionals. Although we identified various expected effects of DPSI, more empirical evidence from real cases is required.
Summary

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Special Article
Primary Care Physicians’ Action Plans for Responding to Results of Screening Tests Based on the Concept of Quaternary Prevention
Jong-Myon Bae, Marc Jamoulle
J Prev Med Public Health. 2016;49(6):343-348.   Published online October 13, 2016
DOI: https://doi.org/10.3961/jpmph.16.059
  • 12,969 View
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  • 6 Crossref
AbstractAbstract PDF
Since noncommunicable diseases (NCDs) are generally controllable rather than curable, more emphasis is placed on prevention than on treatment. For the early detection of diseases, primary care physicians (PCPs), as well as general practitioners and family physicians, should interpret screening results accurately and provide screenees with appropriate information about prevention and treatment, including potential harms. The concept of quaternary prevention (QP), which was introduced by Jamoulle and Roland in 1995, has been applied to screening results. This article summarizes situations that PCPs encounter during screening tests according to the concept of QP, and suggests measures to face such situations. It is suggested that screening tests be customized to fit individual characteristics instead of being performed based on general guidelines. Since screening tests should not be carried out in some circumstances, further studies based on the concept of prevention levels proposed by Jamoulle and Roland are required for the development of strategies to prevent NCDs, including cancers. Thus, applying the concept of QP helps PCPs gain better insights into screening tests aimed at preventing NCDs and also helps improve the doctor-patient relationship by helping screenees understand medical uncertainties.
Summary

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Perspective
Implementation of Quaternary Prevention in the Korean Healthcare System: Lessons From the 2015 Middle East Respiratory Syndrome Coronavirus Outbreak in the Republic of Korea
Jong-Myon Bae
J Prev Med Public Health. 2015;48(6):271-273.   Published online November 24, 2015
DOI: https://doi.org/10.3961/jpmph.15.059
  • 14,918 View
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  • 4 Crossref
AbstractAbstract PDF
Quaternary prevention should be implemented to minimize harm to patients because the ultimate goal of medicine is to prevent disease and promote health. Primary care physicians have a major responsibility in quaternary prevention, and the establishment of clinical epidemiology as a distinct field of study would create a role charged with minimizing patient harm arising from over-medicalization.
Summary

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Original Articles
Prevalence of Depressive Disorder of Outpatients Visiting Two Primary Care Settings
Sun-Jin Jo, Hyeon Woo Yim, Hyunsuk Jeong, Hoo Rim Song, Sang Yhun Ju, Jong Lyul Kim, Tae-Youn Jun
J Prev Med Public Health. 2015;48(5):257-263.   Published online September 21, 2015
DOI: https://doi.org/10.3961/jpmph.15.009
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  • 7 Crossref
AbstractAbstract PDF
Objectives
Although the prevalence of depressive disorders in South Korea’s general population is known, no reports on the prevalence of depression among patients who visit primary care facilities have been published. This preliminary study was conducted to identify the prevalence of depressive disorder in patients that visit two primary care facilities.
Methods
Among 231 consecutive eligible patients who visited two primary care settings, 184 patients consented to a diagnostic interview for depression by psychiatrists following the Diagnostic and Statistical Manual of Mental Disorders-IV criteria. There were no significant differences in sociodemographic characteristics such as gender, age, or level of education between the groups that consented and declined the diagnostic examination. The prevalence of depressive disorder and the proportion of newly diagnosed patients among depressive disorder patients were calculated.
Results
The prevalence of depressive disorder of patients in the two primary care facilities was 14.1% (95% confidence interval [CI], 9.1 to 19.2), with major depressive disorder 5.4% (95% CI, 2.1 to 8.7), dysthymia 1.1% (95% CI, 0.0 to 2.6), and depressive disorder, not otherwise specified 7.6% (95% CI, 3.7 to 11.5). Among the 26 patients with depressive disorder, 19 patients were newly diagnosed.
Conclusions
As compared to the general population, a higher prevalence of depressive disorders was observed among patients at two primary care facilities. Further study is needed with larger samples to inform the development of a primary care setting-based depression screening, management, and referral system to increase the efficiency of limited health care resources.
Summary

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Assessing Reliability of Medical Record Reviews for the Detection of Hospital Adverse Events
Minsu Ock, Sang-il Lee, Min-Woo Jo, Jin Yong Lee, Seon-Ha Kim
J Prev Med Public Health. 2015;48(5):239-248.   Published online September 11, 2015
DOI: https://doi.org/10.3961/jpmph.14.049
  • 12,343 View
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  • 14 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
The purpose of this study was to assess the inter-rater reliability and intra-rater reliability of medical record review for the detection of hospital adverse events.
Methods
We conducted two stages retrospective medical records review of a random sample of 96 patients from one acute-care general hospital. The first stage was an explicit patient record review by two nurses to detect the presence of 41 screening criteria (SC). The second stage was an implicit structured review by two physicians to identify the occurrence of adverse events from the positive cases on the SC. The inter-rater reliability of two nurses and that of two physicians were assessed. The intra-rater reliability was also evaluated by using test-retest method at approximately two weeks later.
Results
In 84.2% of the patient medical records, the nurses agreed as to the necessity for the second stage review (kappa, 0.68; 95% confidence interval [CI], 0.54 to 0.83). In 93.0% of the patient medical records screened by nurses, the physicians agreed about the absence or presence of adverse events (kappa, 0.71; 95% CI, 0.44 to 0.97). When assessing intra-rater reliability, the kappa indices of two nurses were 0.54 (95% CI, 0.31 to 0.77) and 0.67 (95% CI, 0.47 to 0.87), whereas those of two physicians were 0.87 (95% CI, 0.62 to 1.00) and 0.37 (95% CI, -0.16 to 0.89).
Conclusions
In this study, the medical record review for detecting adverse events showed intermediate to good level of inter-rater and intra-rater reliability. Well organized training program for reviewers and clearly defining SC are required to get more reliable results in the hospital adverse event study.
Summary

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  • The Korea National Patient Safety Incidents Inquiry Survey: Characteristics of Adverse Events Identified Through Medical Records Review in Regional Public Hospitals
    Min Ji Kim, Hee Jung Seo, Hong Mo Koo, Minsu Ock, Jee-In Hwang, Sang-Il Lee
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  • Feasibility of Capturing Adverse Events From Insurance Claims Data Using International Classification of Diseases, Tenth Revision, Codes Coupled to Present on Admission Indicators
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Nurse-perceived Patient Adverse Events and Nursing Practice Environment
Jeong-Hee Kang, Chul-Woung Kim, Sang-Yi Lee
J Prev Med Public Health. 2014;47(5):273-280.   Published online September 12, 2014
DOI: https://doi.org/10.3961/jpmph.14.019
  • 15,189 View
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AbstractAbstract PDF
Objectives
To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. Methods: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. Results: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, ‘physician- nurse relationship’ correlated with medication errors while ‘education for improving quality of care’ affected patient falls. Conclusions: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.
Summary

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  • Effect of Nursing Practice Environment, Nurse Staffing, Overtime and Hand Hygiene on Hospital‐Acquired Infections in a Tertiary Teaching Hospital
    Tamer Al‐Ghraiybah, Luise Lago, Ritin Fernandez, Luke Molloy, Jenny Sim
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Selecting the Best Prediction Model for Readmission
Eun Whan Lee
J Prev Med Public Health. 2012;45(4):259-266.   Published online July 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.4.259
  • 15,389 View
  • 108 Download
  • 38 Crossref
AbstractAbstract PDF
Objectives

This study aims to determine the risk factors predicting rehospitalization by comparing three models and selecting the most successful model.

Methods

In order to predict the risk of rehospitalization within 28 days after discharge, 11 951 inpatients were recruited into this study between January and December 2009. Predictive models were constructed with three methods, logistic regression analysis, a decision tree, and a neural network, and the models were compared and evaluated in light of their misclassification rate, root asymptotic standard error, lift chart, and receiver operating characteristic curve.

Results

The decision tree was selected as the final model. The risk of rehospitalization was higher when the length of stay (LOS) was less than 2 days, route of admission was through the out-patient department (OPD), medical department was in internal medicine, 10th revision of the International Classification of Diseases code was neoplasm, LOS was relatively shorter, and the frequency of OPD visit was greater.

Conclusions

When a patient is to be discharged within 2 days, the appropriateness of discharge should be considered, with special concern of undiscovered complications and co-morbidities. In particular, if the patient is admitted through the OPD, any suspected disease should be appropriately examined and prompt outcomes of tests should be secured. Moreover, for patients of internal medicine practitioners, co-morbidity and complications caused by chronic illness should be given greater attention.

Summary

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English Abstracts
The Effect of Outpatient Cost Sharing on Health Care Utilization of the Elderly.
Myunghwa Kim, Soonman Kwon
J Prev Med Public Health. 2010;43(6):496-504.
DOI: https://doi.org/10.3961/jpmph.2010.43.6.496
  • 6,665 View
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AbstractAbstract PDF
OBJECTIVES
The purpose of this study was to analyze the effect of outpatient cost-sharing on health care utilization by the elderly. METHODS: The data in this analysis was the health insurance claims data between July 1999 and December 2008 (114 months). The study group was divided into two age groups, namely 60-64 years old and 65-69 years old. This study evaluated the impact of policy change on office visits, the office visits per person, and the percentage of the copayment-paid visits in total visits. Interrupted time series and segmented regression model were used for statistical analysis. RESULTS: The results showed that outpatient cost-sharing decreased office visits, but it also decreased the percentage of copayment-paid visits, implying that the intensity of care increased. There was little difference in the results between the two age groups. But after the introduction of the coinsurance system for those patients under age 65, office visits and the percentage of copayment-paid visits decreased, and the 60-64 years old group had a larger decrease than the 65-69 years old group. CONCLUSIONS: This study evaluated the effects of outpatient cost-sharing on health care utilization by the aged. Cost sharing of the elderly had little effect on controlling health care utilization.
Summary

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Analysis of the Factors Related to the Needs of Patients with Cancer.
Jung A Lee, Sun Hee Lee, Jong Hyock Park, Jae Hyun Park, Sung Gyeong Kim, Ju Hyun Seo
J Prev Med Public Health. 2010;43(3):222-234.
DOI: https://doi.org/10.3961/jpmph.2010.43.3.222
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AbstractAbstract PDF
OBJECTIVES
Limited research has investigated the specific needs of patients with cancer. This study was performed to explore patients needs and the related factors. METHODS: The data were collected by 1 National Cancer Center and 9 regional cancer centers in Korea. An interview survey was performed with using a structured questionnaire for the subjects(2661 patients who gave written informed consent to particiate) survey 4 months after diagnosis and review of medical records. Data were analyzed using t-test, ANOVA and multiple regression analysis. RESULTS: When comparing the relating factors related with patient needs to the sociodemographic characteristics, the female group showed a higher level of recognition for physical symptoms, social support needs. The younger group showed a significantly higher level of recognition for health care staff, psychological problems, information and education, social support, hospital services needs. In addition, the higher educated group showed a higher level of recognition for health care staff, physical symptoms, social support needs. The higher income and office workers group showed a higher level of recognition for hospital services needs. When comparing the relating factors related with patient needs to the cancer, the breast cancer group showed a higher level of recognition for all needs excluding physical symptoms, accessibility and financial support needs. The combined radiotherapy with surgery and chemotherapy group showed a higher level of recognition for psychological problems, information and education, social support needs. CONCLUSIONS: This study showed that needs on patient with cancer was significantly influenced by female, higher educagion, lower income, having religion, office worker, liver cancer, breast cancer, colon cancer, chemotherapy, and combined therapy.
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Impact of Shared-Decision Making on Patient Satisfaction.
Won S Suh, Chae Kyung Lee
J Prev Med Public Health. 2010;43(1):26-34.
DOI: https://doi.org/10.3961/jpmph.2010.43.1.26
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  • 570 Download
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AbstractAbstract PDF
OBJECTIVES
The purpose of this research is to analyze the impact of shared-decision making on patient satisfaction. The study is significant since it focuses on developing appropriate methodologies and analyzing data to identify patient preferences, with the goals of optimizing treatment selection, and substantiating the relationship between such preferences and their impact on outcomes. METHODS: A thorough literature review that developed the framework illustrating key dimensions of shared decision making was followed by a quantitative assessment and regression analysis of patient-perceived satisfaction, and the degree of shared-decision making. RESULTS: A positive association was evident between shared-decision making and patient satisfaction. The impact of shared decision making on patient satisfaction was greater than other variable including gender, education, and number of visits. CONCLUSIONS: Patients who participate in care-related decisions and who are given an explanation of their health problems are more likely to be satisfied with their care. It would benefit health care organizations to train their medical professionals in this communication method, and to include it in their practice guidelines.
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Medical Care Utilization Status and Associated Factors with Extended Hospitalization of Psychiatric Patients in Korea.
Soo Kyung Suh, Yoon Kim, Jong Ik Park, Myung Soo Lee, Hong Suk Jang, Sun Young Lee, Jin Seok Lee
J Prev Med Public Health. 2009;42(6):416-423.
DOI: https://doi.org/10.3961/jpmph.2009.42.6.416
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AbstractAbstract PDF
OBJECTIVES
This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. METHODS: Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. RESULTS: The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. CONCLUSIONS: The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.
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Mumps Transmission Control Status and Inapparent Infection Rate among Middle and High School Students during the 2007-2008 Mumps Outbreak in Daegu.
Kyo Hyun Kim, Chang Hwi Kim, Bo Youl Choi, Un Yeong Go, Dong Han Lee, Moran Ki
J Prev Med Public Health. 2009;42(6):408-415.
DOI: https://doi.org/10.3961/jpmph.2009.42.6.408
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AbstractAbstract PDF
OBJECTIVES
This study was performed to investigate the mumps transmission control status and inapparent infection rate among middle and high school students in Daegu City during a mumps outbreak. METHODS: Nine schools (two middle schools and seven high schools), which reported a number of mumps cases between 2007 and 2008 were selected for investigation. During March-May 2008, a standard questionnaire was distributed to gather information about case identification, instructed isolation measure, isolation status of mumps cases and related factors, and outdoor activities of non-isolated mumps case. Inapparent infection rate was estimated by serum mumps IgM and IgG antibodies status and self-reported mumps symptoms in three of the nine schools. RESULTS: Among 2,560 respondents, more than half of students answered that they did not receive instructions in mumps transmission control measures during the outbreak. Among the 327 mumps cases identified by the questionnaire, 131 cases (40.1%) were considered as isolated and the isolation rates were significantly different among schools, grades, and gender. Of the non-isolated cases, 88.3% continued attending school. Inapparent mumps infection rates were between 56.3% and 70.2%. CONCLUSIONS: Mumps transmission control was inadequate to control the mumps outbreak. Although high inapparent infection rate would mitigate the transmission control effect of case isolation, this measure is fundamental for infection control. The reasons of this inadequate status need to be explored to develop an effective intervention strategy.
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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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AbstractAbstract PDF
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
The Knowledge, Attitude and Practice of Blood Pressure Management from the Patient's Viewpoint: A Qualitative Study.
Sok Goo Lee, So Youn Jeon
J Prev Med Public Health. 2008;41(4):255-264.
DOI: https://doi.org/10.3961/jpmph.2008.41.4.255
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  • 155 Download
  • 7 Crossref
AbstractAbstract PDF
OBJECTIVES
This study adopted a qualitative method to explore the layman's beliefs and experience concerning high blood pressure and its management in order to develop a strategy to increase adherence to proper medical treatment. METHODS: Semi-structured interviews that focused on personal experiences with hypertension and its management were conducted with 26 hypertensive patients. The participants were selected according to a BP above 140/90 mmHg (hypertension stage 1), based on the seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure (JNC-VII). The interviews lasted for approximately 30 minutes (range: 20-60 minutes). The resulting questions were formulated into open-ended questions. The interview questionnaire was composed 17 items to examine non-adherence to treatment and 19 items to examine adherence to treatment. RESULTS: Most participants recognized that the direct cause of high blood pressure was unhealthy behavior rather than inheritance. Thus, the hypertensive patient believed they could recover their blood pressure to a normal level through removing the direct cause of hypertension (weight reduction, diet, exercise) instead of taking drugs. The reasons for these statements were that the drugs for controlling hypertension are not natural or they are artificial, and they may have side effects, and drugs are not treatment for the root cause of hypertension. Most of the hypertensive patients chose to manage their behaviors as soon as they knew their blood pressure was high. Therefore, we should not divide the subjects into two groups according to their taking drugs or not, but they should be divided into two groups according to their willingness or not to manage their condition. CONCLUSIONS: For developing a strategy for an individual approach to hypertension management, we need to develop a client-centered attitude and strategy. That is, we need to tailor our approach to individual cases to avoid generalizations and stereotyping when developing an adherence increasing strategy.
Summary

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  • Effects of Comorbid Sleep Disorders on Cardiovascular Complications of Hypertension Among Patients With Newly-diagnosed Hypertension: An Analysis of the Korean National Health Insurance Service-National Sample Cohort
    Jeongmook Kang, Yoon-Hyung Park, Kwang Ik Yang, Jose Rene Bagani Cruz, Young Hwangbo
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  • Psychometric Properties of a Short Self-Reported Measure of Medication Adherence Among Patients With Hypertension Treated in a Busy Clinical Setting in Korea
    Jeung-Hee Kim, Weon-Young Lee, Yeon-Pyo Hong, Wang-Seong Ryu, Kwang Je Lee, Wang-Soo Lee, Donald E. Morisky
    Journal of Epidemiology.2014; 24(2): 132.     CrossRef
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    Fredrik Hultgren, Grethe Jonasson, Annika Billhult
    Scandinavian Journal of Primary Health Care.2014; 32(4): 163.     CrossRef
  • The Effects of Adherence on Hypertension Control among Newly Diagnosed Hypertension Patients
    Jin-Ok Han, Dae-Kyu Oh, Jun Yim, Kwang-Pil Ko, Hee Young Lee, Jong Heon Park, Jeong-Soo Im
    Health Policy and Management.2014; 24(2): 136.     CrossRef
  • Impact of Health Literacy on Disease-related Knowledge and Adherence to Self-care in Patients with Hypertension
    Youn-Jung Son, Eun-Kyeung Song
    Journal of Korean Academy of Fundamentals of Nursing.2012; 19(1): 6.     CrossRef
  • Patients' Perspectives of a Multifaceted Intervention With a Focus on Technology
    Anne Lambert-Kerzner, Edward P. Havranek, Mary E. Plomondon, Karen Albright, Ashley Moore, Kelsey Gryniewicz, David Magid, P. Michael Ho
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Trend of Socioeconomic Inequality in Participation in Cervical Cancer Screening among Korean Women.
Soong Nang Jang, Sung il Cho, Seung Sik Hwang, Kyunghee Jung-Choi, So Young Im, Ji Ae Lee, Minah Kang Kim
J Prev Med Public Health. 2007;40(6):505-511.
DOI: https://doi.org/10.3961/jpmph.2007.40.6.505
  • 6,808 View
  • 82 Download
  • 15 Crossref
AbstractAbstract PDF
OBJECTIVES
While cervical cancer is one of the leading cancers among women worldwide, there are a number of effective early detection tests available. However, the participation rates in cervical cancer screening among Korean women remain low. After the nationwide efforts in 1988 and thereafter to encourage participation in cervical cancer screening, few studies have investigated the effects of socioeconomic inequality on participation in cervical cancer screening. The purpose of this study was to investigate 1) the level of socioeconomic disparities in receiving cervical cancer screening by age group and 2) if there was an improvement in reducing these disparities between 1995 and 2001. METHODS: Using data from the Korean National Health Status, Health Behavior and Belief Survey in 1995, and the Korean National Health and Nutrition Examination Surveys from 1998 and 2001 (sample sizes of 2,297, 3,738, and 3,283), age-standardized participation rates were calculated according to education level, equivalized household income, and job status. Odds ratios and the relative inequality index (RII) were also calculated after controlling for age. RESULTS: Women with lower education levels were less likely to attend the screening test, and the disparities by education level were most pronounced among women aged 60 years and older. The RIIs among women 60 years and older were 3.64, 4.46, and 8.64 in 1995, 1998, and 2001, respectively. Higher rates of participation were reported among those in the highest income category, which was more notable among the middle aged women (40s and 50s). An inconsistent trend in the rate of participation in cervical cancer screening by occupational level was found. CONCLUSIONS: Indicators of socioeconomic position seem to have varying impacts on the inequalities in the rates of participation in cervical cancer screening according to age group. These results demonstrate the need for more aggressive and age-based interventions and policy programs to eliminate the remaining inequalities.
Summary

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    Geum-Ja Park, Kyoung-Min Lim, Sook-Nam Kim
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    Mi-Hyun Kim, Kyunghee Jung-Choi, Hyoeun Kim, Yun-Mi Song
    Journal of Korean Medical Science.2015; 30(1): 1.     CrossRef
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    Mi-Hyun Kim, Yun-Mi Song, Bo-Kyoung Kim, Sung-Min Park, Gwang Pyo Ko
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    Ji-Yeon Shin, Duk-Hee Lee
    Asian Pacific Journal of Cancer Prevention.2012; 13(8): 3773.     CrossRef
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    Seung Cheol Kim, Yong Sang Song, Young-Tae Kim, Young Tak Kim, Ki-Sung Ryu, Bhavyashree Gunapalaiah, Dan Bi, Hans L Bock, Jong-Sup Park
    Journal of Gynecologic Oncology.2011; 22(2): 67.     CrossRef
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    Young Min Kwon, Hyung Taek Lim, Kiheon Lee, Be Long Cho, Min Sun Park, Ki Young Son, Sang Min Park
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    A. Fernandez, G. Noël
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    Jaeyoung Kim, Soong-Nang Jang
    Journal of Preventive Medicine and Public Health.2008; 41(3): 186.     CrossRef
Antihypertensive Drug Medication Adherence of People with Disabilities and its Affecting Factors in Korea.
Jong Hyock Park, Youngsoo Shin, Sang Yi Lee, Jae Hyun Park
J Prev Med Public Health. 2007;40(3):249-258.
DOI: https://doi.org/10.3961/jpmph.2007.40.3.249
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  • 9 Crossref
AbstractAbstract PDF
OBJECTIVES
The aims of this study were to estimate the antihypertensive medication adherence in people with a disability and a history of taking antihypertensive medication, and to identify the factors affecting medication adherence. METHODS: The National Health Insurance claims data were linked with the National Disability Registry. People with a disability, who received a prescription of antihypertensives, were identified from a total of 85,098 cases. Cumulative medication adherence (CMA) was used as an indicator of medication adherence. A CMA > 80% was defined as appropriate medication adherence. Multiple logistic regression analysis was used to identify the factors affecting medication adherence. RESULTS: The average CMA in a total of 85,098 patients was 79.5%. The appropriate adherence (CMA > or =80%) rate was 54.5% and 20.5% of patients had a CMA < 50%. Multiple logistic regression analysis revealed that the probability of appropriate adherence decreased with decreasing number of prescription days per visit, increasing number of providers, the patients' residential area moving from urban to rural areas, and when patients have an internal organ disability, auditory impairment, mobility impairment. CONCLUSIONS: The adherence to antihypertensive medication in people with a disability is influenced by various socio-economic, clinical and regional factors. In particular, the disabled who have locomotive and communication disabilities and internal organ impairments have a higher probability of under-adherence to antihypertensive medication adherence in Korea.
Summary

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    Ji Young Kim, Ju Young Yoon
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    Han-Kil Kang, Nak-Jin Sung
    Korean Journal of Family Medicine.2024; 45(2): 82.     CrossRef
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    Hyemin Cho, Sohyun Jeong, Cinoo Kang, Hee-Jin Kang, Suhyun Jang, Sunmee Jang
    Patient Preference and Adherence.2020; Volume 14: 2123.     CrossRef
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    International Journal on Disability and Human Development.2015;[Epub]     CrossRef
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    Journal of the Korean Medical Association.2013; 56(3): 184.     CrossRef
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    Jong-Yeon Kim, Soon-Woo Park
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Original Articles
Predictors of Smoking Cessation in Outpatients.
Yune Sik Kang, Jang Rak Kim, Joung Soon Jang, Young Sil Hwang, Dae Yong Hong
Korean J Prev Med. 2003;36(3):248-254.
  • 14,848 View
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AbstractAbstract PDF
OBJECTIVE
This study was conducted in order to investigate predictors of smoking cessation in outpatients. METHOD: Subjects were 401 adult smoking patients who saw their doctors in the outpatient setting at a university hospital, regardless of their willingness of otherwise in smoking cessation. Physicians delivered a brief, stop smoking prompt to all patients who smoked one or more cigarettes a day. Then they referred to on-site counselors who provided a brief, nurse assisted intervention with a survey to a randomly assigned intervention group (200 smoking patients), whom the counselors telephoned later to prevent relapse or promote the motivation to quit, or gave only a survey to a control group (201 smoking patients). After at least 5 months, self-reported current smoking cessation was confirmed later using cut-off values of 7 ppm or less in expired alveolar air after breath holding portable CO analyzer. RESULTS: After 5 months, subjects in the intervention group were 1.56 times (95% C.I. 0.89-2.73) more likely to quit smoking than those in the non-intervention group (14.0% vs. 9.0%). Willingness to quit smoking in a month, scheduled admission in a month, self efficacy score and FTND (Fagerstrom Test for Nicotine Dependence) score were all significantly related with smoking cessation. In stepwise multiple logistic regression, previous attempts to quit smoking were significant instead of self efficacy score. In the intervention group who had willingness to quit smoking in a month (132 smoking patients), FTND score, whether quit date was today, and whether quit promise paper was submitting were all significantly related with smoking cessation. In stepwise multiple logistic regression, scheduled admission in a month and whether quit date was today were significant predictor variables. Smoking cessation treatment should be tailored to individual smoking patients considering these predictors.
Summary
Therapeutic Compliance and Its Related Factors of Lung Cancer Patients.
Si Hyun Nam, Sin Kam, Jae Yong Park, Sang Chul Chae, Moon Seob Bae, Moo Chul Shin, Min Hae Yeh
Korean J Prev Med. 2002;35(1):13-23.
  • 2,928 View
  • 34 Download
AbstractAbstract PDF
OBJECTIVES
To investigate the therapeutic compliance and its related factors in lung cancer patients. METHODS: The subjects of this study comprised 277 patients first diagnosed with lung cancer at Kyungpook National University Hospital between Jan 1999 and Sept 1999. Of these, 141 (50.9%) participated in the study by properly replying to structured questionnaires. The data was analyzed using a simplified Health Decision Model. This model includes categories of variables covering therapeutic compliance, health beliefs, patient preferences, knowledge and experience, social interaction, sociodemographic and clinical characteristics. RESULTS: The therapeutic compliance rate of the 141 study subjects was 78.0%. An analysis of health beliefs and patient preferences revealed health concern (p<0.05), dependency on medicine (p<0.05), perceived susceptibility and severity (p<0.05) as well as preferred treatment (p<0.01) as factors related to therapeutic compliance. Factors from the sociodemographic characteristics and clinical factors that were related to therapeutic compliance were age (p<0.01), monthly income (p<0.05), histological type (p<0.05) and clinical stage (p<0.05) of cancer. CONCLUSIONS: In order to improve therapeutic compliance in lung cancer patients it is necessary to educate the aged, low-income patients, or patients who have small cell lung cancer or lung cancer of an advanced stage for which surgery is not indicated. Additionally, it is essential for medical personnel to have a deep concern about patients who have poor lifestyles, a low dependency on medicine, or a high perceived susceptibility and severity. Practically, early diagnosis of lung cancer and thoughtful considerations of low-income patients are important. By means of population-based education in a community, we may promote attention to health and enhance the early diagnosis of lung cancer.
Summary
Time Series Observations of Outcome Variables and the Factors Associated with the Improvement in the Patient Outcomes of Cataract Surgery.
Han Joong Kim, Eun Cheol Park, Yoon Jung Choi, Hyung Gon Kang
Korean J Prev Med. 2001;34(2):175-181.
  • 2,535 View
  • 23 Download
AbstractAbstract PDF
OBJECTIVES
To compare the multiple outcomes of patients with cataract surgery at perioperative time, 3-4 months and 12 months after surgery and to assess patient outcomes associated with visual improvement(visual acuity of operated eye, visual function-14(VF-14), symptom score). METHODS: For this assessment, a prospective study was conducted with 389 patients who had undergone cataract surgery for either one eye or both eyes. The surgery was performed by 20 ophthalmologists who were practicing at university hospitals and general hospitals. Patients were interviewed and clinical data were obtained. Doctors were questioned with self-reported questionnaire forms. Medical records were examined in order to measure variables related to the surgical process such as surgical methods and ocular comorbidity. The survey was conducted at 4 stages : preoperative time(389 cases), perioperative time(344 cases, 88.4%), postoperative 3-4 months (343 cases, 88.2%), and postoperative 12 months (281 cases, 72.2%). After excluding cases with incomplete data, 198 cases were enrolled in the study. Patient outcomes was measured for any improvement in the functional outcomes(visual acuity of operated eye, visual function, symptom score) at postoperative 3-4 months. RESULTS: The visual acuity(operated, weighted average), symptom score, VF-14 score, satisfaction with vision, and subjective health status were shown to be improved at the perioperative time, postoperative 3-4 months and 12 months. An improvement in the Snellen visual acuity score was observed in 190 patients(96.0%), whereas improvements of the VF-14 score and cataract symptom score were observed in 151 patients(76.3%) and 179 patients(90.4%), respectively. All three outcome measures demonstrated improvement in 137 patients(69.2%). The improvement of the three functional outcomes at 3-4 months after receiving surgery was associated with a lower level of visual function and a higher level of cataract symptom score at perioperative time, as well as a greater experience level of the surgeon. CONCLUSIONS: In this study, the estimates of the proportion of patients benefiting from cataract surgery varied with the outcome measure of benefit. Preoperative VF-14 score, a measure of functional impairment related to vision, and symptom score may be better measures of the benefit derived from cataract surgery than the change in visual acuity.
Summary
Job Stress and Its Related Factors in South Korean Doctors.
Yune Sik Kang, Sin Kam, Sang Won Lee, Byung Yeol Chun, Min Hae Yeh
Korean J Prev Med. 2001;34(2):141-148.
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AbstractAbstract PDF
OBJECTIVE
To investigate the sources, extent and related factors in South Korean doctors. METHODS: The study subjects were 934 doctors in Taegu, Kyungpook Province, Korea(540 independent practitioners, 105 employed at hospitals and 289 residents in training). Information concerning job stress was obtained using a 9-item questionnaire. Information regarding related factors such as demographic characteristics(age, sex, marital status), perceptions on the socioeconomic status of doctors and working conditions(work time, on-call days per week) was also obtained by self-administered questionnaire during April and May, 2000. RESULTS: Major sources of job stress included clnical responsibility/judgement factor, patient factor and work loading factor. The job stress score of residents was the highest among three groups. The score was lower in older doctors. The score was low among those who thought doctors socioeconomic status was not good. The longer the work time, the higher the job stress score was. Multiple regression analysis was conducted to control for the mutual influence of independent variables. In regression analysis, the score of residents was higher than practitioners. Work time and socioeconomic status perception had negative effects on job stress score. CONCLUSION: The average job stress score of the doctors was high. Age, work type, working conditions and perceptions of socioeconomic status were found to besignificantly related to job stress score. Although the job stress of doctors is somewhat inevitable due to the nature of the doctor's job, control of work time, development of coping tools and other intervention methods are needed to reduce job stress of doctors. Further studies are required to understand the characteristics of job stress and reduce the job stress of doctors.
Summary
The Study of Prescription Behaviors of Practicing Pharmacists with Simulated Patients of Arthritis.
Hong Jun Cho, Kwang Su Uh, Jin Wook Choi
Korean J Prev Med. 1999;32(3):343-346.
  • 2,459 View
  • 19 Download
AbstractAbstract PDF
OBJECTIVES
In Korea, pharmacists can dispense medicines without doctor's prescription. This causes the high proportion of pharmaceutical expenditures. The study shows the prescribing behaviors of practicing pharmacists with the simulated patient of arthritis. We select the arthritis as a subject of simulation, because the arthritis is one of the major health problems and the abuse of cortico-steroids is usual in treatment of arthritis patients. METHODS: Twenty drug stores among the 320 drug stores in a district, Seoul, Korea were randomly selected. One of the researchers visited the drug stores and received the medicines from the pharmacists after explaining standardized scenario of arthritis. The simulated patient recorded the practice behaviors of pharmacists. RESULTS: The mean number of prescribed drugs are four and half. Among the twenty pharmacists, the nineteen prescribed non-steroidal anti-inflammatory drugs and the seven(35%) prescribed the cortico-steroids. The antacids were prescribed by the fourteen(70%) pharmacists. The five(25%) pharmacists only recommended the simulated patients to visit the medical doctors, and the three(15%) performed physical examination to the simulated patients. The three pharmacists(15%) asked the past history of the drug adverse effects and no pharmacist explained the adverse effects of prescribed medicines. CONCLUSIONS: The research shows that the cortico-steroids are frequently prescribed and the pharmacists commonly do not give the explanations of the prescribed medicines to the arthritis patients.
Summary
Patient Compliance and Associated Factors in the Community-based Hypertension Control Program.
Sangsoo Bae, Jee Kim, Kyungbok Min, Soonho Kwon, Dalsun Han
Korean J Prev Med. 1999;32(2):215-227.
  • 2,696 View
  • 43 Download
AbstractAbstract PDF
OBJECTIVES
To investigate compliance of hypertension patients using modified Theory of Reasoned Action(TRA). METHODS: The data were collected for 7-12 April 1997, by interviewing 190 hypertension patients in Hwachon, Kangwon-do. The analytical techniques employed include contingency table analysis and logit analysis. RESULTS: 15.1% of patients were unaware of the fact that he/she has hypertension and 11.2% did not know that he/she should take drug. 26.8% of patients took drug continuously, 20.1% had drug intermittently, and 53.1% had never have treatment. In the contingency table analysis, several variables were found to be significantly related to patient compliance. They included variables for attitude towards the consequences of taking drugs, normative beliefs, systolic BP at the enrollment, knowledge of how to take hypertensive drugs, variables for general health behavior and experience with having health worker's home visit. The logit analysis was performed by two steps. First step uses experience with drug treatment of hypertension as the dependent variable, and second step uses continuity of treatment. Included in the predictors that are significantly related to the former analysis are subjected norms produced by combining normative beliefs and motivation to comply, knowledge of how to take hypertensive drugs, and opinion about natural recovery of diseases. The only significant determinant of continuous treatment was knowledge of how to take hypertensive drugs. CONCLUSIONS: The results of analysis suggest the usefulness of TRA as a framework for the study of compliance of hypertensive patients. The findings have some practical implication as well. One is that efforts for enhancing compliance should be directed not only patients but also to other persons influencing patient's attitude and behavior. It also suggest that correct understanding of hypertension treatment is essential to perform the appropriate patient role.
Summary
The Difference in Attitude toward Medical Care between Patients and Physicians.
Myung Geun Kang, Jong Ku Park, Han Joong Kim, Myong Sei Sohn, Dal Rae Kim
Korean J Prev Med. 1998;31(3):516-539.
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AbstractAbstract PDF
The objective of this study is to identify the difference in attitude toward medical care between patients who visited a university hospital or an oriental medical hospital of oriental medical college, and physicians who engaged in the same hospitals. The subjects of this study were 397 cases who agreed to respond the prepared questionnaire, including 288 patients(146 university hospital utilizers and 142 utilizers for an oriental medical hospital) and 109 physicians(76 physicians and 33 oriental medical doctors). The attitude toward medical care was measured by the structured questionnaire developed for this study, which had high validity and reliability according to factor analysis, item discriminant validity, and Cronbach's alpha coefficients. On the criteria of mean value of care and cure score, the attitude toward medical care was classified into 4 groups encompassing a group with dependent attitude on medical care, a group with skeptical attitude toward it, a group with cure-oriented attitude, and a group with care- preferred attitude. The results of chi-square test, discriminant analysis, and logistic regression analysis were as follows; patients who visited a university hospital, patients who visited an oriental hospital, physicians, and oriental medical doctors included in the group with dependent attitude, the group with cure-oriented attitude, the group with skeptical attitude, and the group with care-preferred attitude, retrospectively. Among the subdomains of care and cure domains, which classified in reference to the result of factor analysis on pilot study, those that patients ranked more importantly than physicians were 'the importance of medical equipment for diagnosis and treatment', 'authority of physician, 'aggressiveness of treatment', 'information giving', 'personal interest' in the case of western medicine. In the case of oriental medicine, those were 'the importance of equipment for diagnosis and treatment', 'aggressiveness of treatment', 'amenities and accessibility', 'coordination of medical staff'. Both physicans and patients put the subdomain, 'physicians' medical knowledge and skillfulness' on the highest rank. The differences in ranking the important attributes of medical care between patients and physicians were apparent in the area of an 'importance of medical equipment for diagnosis and treatment' and so on. It meant that patient had over-expectation on medical care and suggested that the policy on demand side such as the development and dissemination of an evidence-based recommendation protocol for health care consumers might be important in Korea. In addition, regarding the attitude of physicians, during the medical education and training it may be necessary to emphasize the aspect of 'care' of medical care rather than 'cure'. In planning on heath care delivery system, it should be considered that there is a difference in the attitude toward medical care between western medicine and oriental medicine as well as between health care providers and consumers. We expect that more valid measurement tool be developed in this area, which may be major limitation of this study and that this kind of research be expanded into the non-academic settings.
Summary
Determinants of Patient Satisfaction : Allergic Rhinitis Patients Treated with Laser Therapy.
Kinam Jin, Woo Kyung Chung, Seung Yon Jang
Korean J Prev Med. 1997;30(2):402-412.
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AbstractAbstract PDF
The purpose of this study is to examine the factors influencing the allergic rhinitis patients' satisfaction with laser surgery. The data were collected by telephone interviews with 211 patients who visited E university hospital. The statistical methods used for the analysis were factor analysis, reliability test, and hierarchical multiple regression. We find that satisfaction level is a function of not only the surgery outcome but also the socio-psychological experience during treatment. With the improvement in nasal allergic condition, patients were more likely to be satisfied with medical services. And patients who had positive experience with physicians and facilities reported higher satisfaction level. While the surgery outcome explained 68% of the variation of satisfaction level, socio-psychological experience explained 23% of it. This result clearly shows that physicians need to pay attention to the socio-psychological aspect as well as the technical aspect of medical services.
Summary
Comparison of Weighted Needle Pinprick Sensory Thresholds and Sensory Nerve Conduction Studies in Diabetic Patients.
Jae Kwan Yoo, Seong Ah Kim, Jong Young Lee
Korean J Prev Med. 1995;28(4):899-910.
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This study was conducted to determine the correlation between weighted needle pinprick sensory threshold(PPT) and sensory nerve conduction tests. The subjects were 53 healthy controls, 31 diabetic patients without peripheral neuropathic symptoms(DM) and 36 diabetic patients with peripheral neuropathic symptoms(DN). PPT was measured on the index and little fingers, bilaterally, as well as under the lateral malleolus, bilaterally. In electrophysiologic assessment the left and right median, ulnar and sural nerves were studied. Each mean PPTs was high in order of controls, DM and DN. Age adjusted PPT was significantly different among three groups on right little finger(p<0.05) and left malleolus(p<(0.05), but not significantly different between DN and DM on other sites. Each sensory nerve conduction velocity and amplitude was statistically significantly different among three groups(p<0.05). Correlations of PPT with sensory nerve conduction velocity and amplitude were statistically significant on each site and ranged from -0.4203(left malleolus) to -0.5649(right index finger) and from -0.3897(left index finger) to -0.6200(right index finger), respectively. When electrophysiological study is not feasible, measurement of PPT may be helpful for the assessment of peripheral sensory neurological function.
Summary
Impacts of Implementation of Patient Referral System in terms of Medical Expenditures and Medical Utilization.
Sang Hyuk Jung, Han Joong Kim
Korean J Prev Med. 1995;28(1):207-224.
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A new medical delivery system which regulated outpatient department(OPD) use from tertiary care hospitals was adopted in 1989. Under the new system, patients using tertiary care hospital OPD without referral slip from clinics or hospital could not get any insuranced benefit for the services received from the tertiary care hospital. This study was conducted to evaluate the Patient Referral System(PRS) with respect to health care expenditures and utilization. Two data sets were used in this study. One was monthly data set(from January 1986 to December 1992)from the Annual Report of Korea Medical Insurance Corporation(KMIC). The other was monthly joint data set composed of personal data of which 10% were selected randomly with their utilization data of KMIC from January 1988 to December 1992. The data were analyzed by time-series intervention model of SAS-ETS. The results of this study were as follows: 1. There was no statistically significant changes in per capita expenditures following PRS. 2. Utilization episodes per capita was increased statistically significantly after implementation of PRS. The use of clinics and hospitals increased significantly, whereas in tertiary care hospitals the use decreased significantly immediately after implementation of PRS and increased afterwards. 3. Follow-up visits per episode were decreased statistically significantly after implementation of PRS. The decrease of follow-up visits per episode were remarkable in clinics and hospitals, whereas in tertiary care hospitals it was increased significantly after implementation of PRS. 4. There was no statistically significant changes in prescribing days per episode following PRS. Futhermore, clinics and hospitals showed a statistically significant decrease in prescribing days per episode, whereas in tertiary care hospital it shower statistically significant increase after implementation of PRS. 5. Except high income class, the use of tertiary care hospitals showed statistically significant decrease after implementation of PRS. The degree of decrease in the use of tertiary card hospitals was inversely proportional to income. These results suggest that the PRS policy was not efficient because per capita expenditures did not decrease, and was not effective because utilization episodes per capita, follow-up visits per episode, and prescribing days per episode were not predictable and failed to show proper utilization. It was somewhat positive that utilization episodes per capita were decreased temporarily in tertiary card hospitals. And PRS policy was not appropriate because utilization episodes per capita was different among income groups. In conclusion, the PRS should be revised for initial goal attainment of cost containment and proper health care utilization.
Summary
Measurement of Ambulatory Patients' Satisfaction and Its Influencing Factors in a Tertiary Hospital.
Sang Il Lee
Korean J Prev Med. 1994;27(2):366-376.
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Patients' evaluation of hospital care is one of the most important aspects of quality assessment. Survey allows patients to judge subjectively the events that occur during their hospital visit if performed properly. This study describes the result of a research effort to develop outpatient questionnaire that has sufficient validity and reliability to be used to measure patients' perception of satisfaction in Korea and to investigate influencing factors on patients' satisfaction. Self-administered questionnaire was developed for outpatient and the survey was conducted covering 827 outpatients in a tertiary hospital. It was confirmed by factor analysis that patients evaluate several components of ambulatory care distinctly ;hospital environment, administration and ancillary services, and medical care. We found strong evidence of construct validity and internal consistency for the above three dimensions of hospital process. On the contrary, reliability of overall outcome measures was low. It suggests that three items concerning overall outcome measures have some different meanings in patients' perception. Using logistic regression analysis it was found that previous health status, cost evaluation, and improvement in health status have significant influences on the level of patients' overall satisfaction and that patient's sex, experience of previous visit, expectation for improvement, cost evaluation, and improvement in health status are strongly related with intention to recommend hospital. In spite of some limitations the results of this study can be used helpfully as baseline informations for developing self-administered questionnaire and for exploring the influencing factors on patients' satisfaction. Further comprehensive research efforts should be made on the measurement of ambulatory patients' satisfaction and its related factors in current Korean situation.
Summary
Development And Evaluation Of Korean Diagnosis Related Groups: Medical Service Utilization Of Inpatients.
Young Soo Shin, Young Seong Lee, Ha Young Park, Yong Kwon Yeom
Korean J Prev Med. 1993;26(2):293-309.
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With expanded and extended coverage of the national medical insurance and fast growing health care expenditures, appropriateness of health service utilization and quality of care are concerns of both health care providers and insurers as well as patients. An accurate patient classification system is a basic tool for effective health care policies and efficient health services management. A classification system applicable to Korean medical information-Korean Diagnosis Related Groups (K-DRGs)-was developed based on the U. S. Refined DRGs, and the performance of the developed system was assessed in this study. In the process of the development, first the Korean coding systems for diagnoses and procedures were converted to the systems used in the definition of the U. S. Refined DRGs using the mapping tables formulated by physician panels. Then physician panels reviewed the group definition, and identified medical practice patterns different in two countries. The definition was modified for the difference in K-DRGs. The process resulted in 1,199 groups in the system. Several groups in Refined DRGs could not be differentiated in K-DRGs due to insufficient medical information, and several groups could not be defined due to procedures which were not practiced in Korea. However, the classification structure of Refined DRGs was retained in K-DRGs. The developed system was evaluated for its performance in explaining variations in resource use as measured by charges and length of stay(LOS), for both all and non-extreme discharges. The data base used in this evaluation included 373,322 discharges which was a random sample of discharges reviewed ad payed by the medical insurance during the five-month period from September 1990. The proportion of variance in resource use which was reduced by classifying patients into K-DRGs-r-square-was comparable to the performance of the U. S. Refined DRGs: .39 for charges and .25 for LOS for all discharges, and .53 for charges and .31 for LOS for non-extreme discharges. Another measure analyzed to assess the performance was the coefficient of variation of charges within individual K-DRGs. A total of 966 K-DRGs (87.7%) showed a coefficient below 100%, and the highest coefficient among K-DRGs with more than 30 discharges was 159%.
Summary
A Comparative Study on the Pattern of Outpatient Department Utilization at a Tertiary Level Hospital before and after Implementation of the Patient Referral System.
Kyeong Soo Lee, Chang Yoon Kim, Pock Soo Kang
Korean J Prev Med. 1992;25(1):88-100.
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This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1. 1988 to June 30, 1989 and the post-implementation period was from July 1. 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respcetively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased form 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Department of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments (form 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 22. to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased form 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.
Summary
A Study on the Regional Self-sufficiency for In-patient Care Services.
Dal Sun Han, Soon Ho Kwon
Korean J Prev Med. 1990;23(3):285-295.
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The utilization of medical care services has been partly regionalized with the implementation of referral requirement by the government since July 1, 1989 when the health insurance coverage was extended to all the people. For the purpose of regionalization, the whole country has been primarily divided into tertiary care regions, and each of them again into secondary care regions. This study investigates the self-sufficiency for in-patient care services of secondary care regions focusing on why it varies among the regions. In doing so, analysis is performed to examine a model which embodies three sets of hypotheses as follows: 1) The regional self-sufficiency for medical care services would be subject to direct influences of regional characteristics, amount of available services and structural properties of regional medical care system ; 2) The regional characteristics would have indirect effects on the self-sufficiency which are mediated by medical care services ; and 3) The amount of available services would indirectly affect the self-sufficiency by influencing the structure of regional medical care system. The results of analysis were generally consistent with the model. The findings have some practical implications. The regional self-sufficiency for medical care services partly depends upon basic properties of each region which cannot be changed in a short period of time. Thus the self-sufficiency for medical care services can be improved by health policy measure. In some of the regions the self-sufficiency for in-patient care services was much higher or lower than can be predicted from the bed-population ratio. Indication is that the allocation of health resources should be made considering a variety of factors bearing upon the supply of and demand for health care ; not on the basis of just a single criterion like the availability. The self-sufficiency of a certain region is related to not only its own characteristics but also the characteristics of neighboring regions. Therefore, attention should be also directed to the inter-regional relationships in health care when the needs for investment of health resources in a region are assessed. However, it should be noted that this study used the data collected before the referral requirement was imposed. A replication of this analysis using recent data would provide an evaluation of the impact on the self-sufficiency of the referral requirement as well as a confirmation of the findings of this study.
Summary
A Study on the Efficient Management of Long-term Inpatient Flow in a General Hospital.
Chun Bae Kim, Young Moon Chae, Seung Hum Yu, Hee Chul Oh
Korean J Prev Med. 1990;23(1):11-21.
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This study refers to the problem of long-term inpatient flow in a general hospital. In this study, a queueing simulation model was developed for the two departments in the hospital with a homogenous case mix and relatively many long-term inpatients in order to increase the tumover rate and hospital charges. Before the simulation run, the model was verified by the Kolmogorov-Smirmov test. The following results were generated by three alternative models of the special bed policies. 1. Alternative I: When long term inpatients were admitted to the wards belonging to departments A and B without transfer to other departments and special beds, the average turn-over rate decreased by 2-4% and the average hospital charges decreased by 70 million won. 2. Alternative II: When long-term inpatients were transferred to department C but the transfer of wards was determined by department C in order of clinical need, the average turnover rate increased by 4-13% but the average hospital charges decreased by 30 million won. This result was not greatly different from the present state. 3. Alternative III: When long-term inpatients were transferred to the special wards and department C simultaneously, the increase in the average turnover rate and hospital charges was equivalent to the increase of two beds in the special wards. When the special wards were allocated 16 beds, the average turnover rate of departments A and B increased by about 55% and 20% respectively. Also, the hospital charges increased by about 0.44 billion won. As a result, trasfer to department C and the use of 16 beds in the special wards for long-term inpatients of departments A and B is expected to maximize the hospital revenue. However, as the above special bed policy can not increase the turnover rate above 60%, there is a need for a more comprehensive policy to further increase the rate. The development of an elaborate model should include the number of long-term inpatients in all clinical departments, the special wards system or an increase of hospital beds to handle admission needs, and the resources of the hospital by department. When the alternative are evaluated, a cost-benefit analysis in addition to the turnover rate and the hospital charges should be considered.
Summary
Change of FVC, FEV1 after Discontinuance of Bronchodilator in Coal Workers' Pneumoconiosis Patients.
Yong Hee Cheon
Korean J Prev Med. 1988;21(2):245-250.
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For the evaluation of change of FVC and FEV1 after discontinuance of bronchodilator in the coal workers' pneumoconiosis patients, 17 pairs of patients were selected. They were matched by the age(+/-5 y.o.) and the type of ventilatory impairment. Pulmonary function was measured 2 times bimonthly before and after the drug discontinuance discontinued after measurement of PFT for 2 times. In case group the bronchodilator was discontinued after measurement of PFT for 2 times. In control group there was no interruption of medication. FVC, FEV1 decreased in both group as measurement progress. Simple linear regression coefficients against the month of measurement were calculated in both group and tested for parallelism between two groups. The results of test revealed that both regression coefficients were parallel. So in conclusively, discontinuance of medication of bronchodilator for coal workers pneumoconiosis patients has no effect on the decreasing rate of FVC, FEV1.
Summary
Causes of Burn and Emergency Care on the Spot for the Patients Admitted to Three Hospitals in Taegu.
Min Chu, Jung Han Park
Korean J Prev Med. 1988;21(2):238-244.
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This study was conducted to investigate the causes of burn and emergency cares taken on the spot for the burn patient. study population included 161 burn patients admitted to 2 university hospitals and 1 general hospital in Taegu from November 1, 1987 to April 30, 1988. Patients or guardians were interviewed with a structured questionnaire. Out of 161 burn patients 111(69.8%) were males and 50(31.1%) females. Preschool children of 1-4 years old accounted for 29.8% of the total patients. Burns of children under 15 years of age took place at home in 91.0%, while 48.3% of burns of adult (15 years and over) males occurred at the working place, and 68.0% of adult females occurred at the home. Out of total burns occurred at home 39.8% took place at kitchen/dining room and 24.1% in the room. The most common cause of burns in children was the boiling water or hot food (74.3%). In adults the common causes were electrical burn(22.4%), hot water or food(19.0%) and explosion(12.1%) for males, and hot water or food(32.0%) and explosion(20.0%) for females. Common emergency cares for the burn taken on the spot were undressing(64.6%), pouring Soju(liquor)(13.7%), and pouring cold water(5.0%). There were a few cases who applied ash, soy or salt. To prevent burn, it is recommended to remodel the traditional kitchen and coal-briquet hole, to strengthen the safety control of LP Gas and LN Gas supply, to educate the public for the handling method for such gases, to strengthen the occupational safety control, to improve the safety device for the electric wire and socket, and to limit the temperature of hot water at home and public baths.
Summary
Comparision of medical care utilization between newly detected hypertensive patients and known hypertensive patients.
Byung Yool Cheon
Korean J Prev Med. 1988;21(1):47-60.
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AbstractAbstract PDF
The monthly ambulatory treatment days in newly detected hypertensive group and known hypertension group were analyzed. The population was identified through the records of screening examination given by Korea Medical Insurance Corporation during the period from April to July, 1986. From the records of screening examination, 11,614 hypertensive patients were identified. By random sampling, 959 patients were selected ; among them, 554 fell under the category of known hypertension group and the other 415 fell under the newly detected hypertension group. The monthly ambulatory treatment days of theses patients during the period from the April, 1985 to September, 1987 were analyzed in order to compare the exents of medical care utilization as well as to define and analyze the determinants responsible for the ambulatory treatment days between the two groups. The following results were obtained. 1) In the known hypertension group, no statistically significant changes in the ambulatory treatment days was observed after, in comparison to before, the screening examination. However, in the newly detected hypertension group the medical care utilization increased after the screening examination because of hypertension. 2) The ambulatory treatment days for hypertension of the known hypertension was statistically significant and higher than that of the newly detected hypertension group after screening examination. 3) There was no statistically significant change in the ambulatory treatment days in association with diseases other than hypertension in either group before and after the screening examination. 4) There was no statistically significant change in the ambulatory treatment days in the known hypertension group. However, the income was a statistically significant variable in the newly detected hypertension group. 5) After the screening examination, the variables determining the ambulatory treatment days were the age of the patient and the diastolic blood pressure in the known hypertension group. These variables responsible for 2.02% of the total ambulatory treatment days. In the newly detected hypertension group, the income was a statistically significant variable which was responsible for 2.10% of total ambulatory treatment days. The above results satisfied the hypothesis that there would be no significant changes in the ambulatory treatment days before and after the screening examination in the known hypertension group. Also the hypothesis that there would be no significant change in the exents of medical care utilization for the diseases other than hypertension before and after the screening examination in either group was satisfied. Also the medical care utilization was significantly higher in the known hypertension group than the newly detected hypertension group after the screening examination. This finding satisfied the hypothesis. This study was limited by the lack of considering fully the variables responsible for the clinical symptoms of hypertension as well as for the individual characteristics. Thus, the result of this study are not fully adequate to define the determinants responsible for the exents of medical care utilization. In the future studies on medical care utilization, additional variables should be considered.
Summary
Assessing the Factors Influencing Patient Satisfaction after Receiving Laser in situ Keratomileusis (LASIK) .
Woohyun Cho, Hye Young Kang, Ji Yoon Kim, Yoon Chung, Jongho Lee, Jemyung Lee
J Prev Med Public Health. 2004;37(2):111-119.
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PURPOSE
To identify those factors influencing the post-operative satisfaction in myopia patients receiving laser in situ keratomileusis (LASIK) METHODS: This study included 288 consecutive patients who received LASIK between July and December 2001 from two eye clinics located in Seoul and Pusan. Factors that were considered to influence post-operative satisfaction included pre-operative baseline characteristics, pre-operative expectation for treatment outcomes, and treatment outcomes. Before undergoing LASIK, study subjects were asked to rate the degree of their expectation for the improvement of visual functions and symptoms after LASIK on a 5-point Likert-type scale: where 1 referred to 'somewhat worse, ' 2 to 'no change, ' 3 to 'somewhat improved, ' 4 to 'improved, ' and 5 to 'very improved.' Self-administered questionnaire was used to evaluate baseline visual functions and symptoms on a 5-point scale before LASIK. At 6 months after LASIK, the evaluation was repeated to measure treatment outcomes in terms of the difference in the score before and after LASIK. Post-operative satisfaction was also measured at 6 months on a 5-point scale. Multiple regression analysis was performed to examine the independent relationship between influencing factors and postoperative satisfaction. RESULTS: A total of 171 patients (59.4%) participated in the 6-month follow-up investigation. The average expectation scores for the improvement in visual functions and symptoms were 3.8 and 3.4, respectively. The average score for the 7 questions assessing satisfaction was 4.0. The results of the regression analysis showed that the post-operative satisfaction increased with improvement in the visual function (beta=0.16, p< 0.05) and symptoms (beta=0.25, p< 0.05), the degree of preoperative refractive error (beta=0.26-0.67, p< 0.05) and in male patients (beta=0.31, p< 0.1). The pre-operative expectation was not a statistically significant factor in explaining postoperative satisfaction in the regression model. CONCLUSION: The finding from this study was that patients with very severe myopia tended to be more satisfied with the treatment than those with mild myopia, which implies that LASIK can be more beneficial to those suffering from a severe visual condition. Patient satisfaction was also significantly affected by the treatment outcomes experienced after LASIK. This suggests that improving the clinical outcome is the most fundamental requirement for the improvement of patient satisfaction.
Summary

JPMPH : Journal of Preventive Medicine and Public Health
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