It is well known that a physician's personal characteristic affects his practice pattern. Furthermore, a physician's specialty has powerful influences on his practice pattern. However, despite the fact specialization has received the most attention for its influence on physician's service behavior, few studies have been conducted on the variations of contents and volume of physician's services. This study has intended to identify factors influencing the practice variations according to various physician characteristics. There are some other evidences that medical care providers are different in using of health services and resources in Korea. Four physician characteristics were selected for the analysis, two demographical factors, age and sex, and two practice factors, place of practice and medical specialty. Also, three indicators of service amount(total amount of insurance claim bill, number of visits per case, number of prescriptions per case) were selected. From the pool of insurance claims for ambulatory care received by the Korean National Federation of Medical Insurance(NFMI), 84,898 cases were randomly sampled. In the meantime using physician database of NFMI, 613 general practitioners(GP), 107 regular family physicians(FP), 483 'grandfather' family physicians(GFP), and 1,157 specialist practitioners(SP) were randomly sampled. Their different practice contents were compared concerning the specialty, age groups, sex, and practice sites(urban-rural). Specialist physicians tend to provide more costly care than do generalists. General practitioners and family physicians usually make fewer following visits and prescriptions. Age is also the important factor in determining the amount of services, which is highest at the physician's age group of 40's. Female doctors and urban practitioners use much more resources than their counterparts respectively. Research findings suggest that physician's characteristics particularly the specialty can affect practice patterns and resource utilizations. Other characteristics such as age and sex are not controllable but physician's specialty is relatively easily controllable during the entire phases of policy implementation. This is all the more true in the individual's initial decision of his specialty. Specialization therefore should receive policymaker's attention for its potential influence on medical care utilization and health care expenditure.
Age Factors ; Ambulatory Care ; Delivery of Health Care ; Female ; General Practitioners ; Health Expenditures ; Health Services ; Humans ; Insurance ; Korea ; Physicians, Family ; Prescriptions ; Specialization

No abstract available.
Anemia, Hemolytic, Autoimmune* ; Child* ; Hepatitis, Chronic* ; Humans

PURPOSE: To investigate the status of health education courses in elementary schools. METHOD: From September to December in 2003, 607 school nurses were surveyed by questionnaires. RESULTS: 1) Of the schools, 32.1% had health education programs as part of the school health service. A higher proportion was found in schools in suburban and rural areas. Mass media in health education was used by 75% of school nurses. Regular classes were more frequently utilized in schools in rural areas, while the classes in health-related subjects were utilized in urban areas. For 20.6% of school nurses, there was a substitute person to provide health care while the nurse was in health education classed, but 94.2% of school nurses found they had to give up health education due to pressure from other health services. 2) Of the nurses, 97.0% felt the need to provide health education courses, but 60.6% insisted that their work load needed to be modified and supplemental personnel were necessary if health education courses were to be provided. 3) More than 30% school nurses responded that educational materials and media, and concern by teachers and administrators were insufficient. 4) School nurses suggested that the content for health education courses should include healthy life and dental health care for students in lower grades, dental health care, sex education and safety for students in middle grades, and sex education and drug abuse prevention for students in higher grades. CONCLUSION: There is an urgent need to provide health education courses in elementary schools but conditions in the schools are not satisfactory. For successful school health services, personnel supplement, modified work loads and sufficient educational materials and media should be in place before health education courses are provided.
Administrative Personnel ; Delivery of Health Care ; Health Education* ; Health Services ; Humans ; Mass Media ; Surveys and Questionnaires ; School Health Services ; Sex Education ; Substance-Related Disorders

The aim of this paper was to provide an overview of mortality and disease prevalence related to occupational diseases among agricultural workers in Korea. We evaluated the age-standardized mortality rates and the prevalence of chronic diseases and compared them with those of other populations using death registration data from 2004 through 2008 and the 2005 Korean National Health and Nutrition Examination Survey. In addition, we conducted a literature review on published articles examining the health status of farmers in Korea. Agricultural workers have a significantly higher mortality of cancer, tuberculosis, chronic respiratory diseases, liver diseases, suicide, motor and non-motor vehicle accidents. Compared to other populations, farmers have higher prevalence rates of arthritis and intervertebral disc disorders. The literature review revealed a number of work-related diseases among farmers, such as musculoskeletal diseases, pesticide poisoning, infections, and respiratory and neurologic diseases. Korean farmers demonstrate a distinct pattern of mortality and disease prevalence compared to other populations. Although lifestyle factors remain important contributors to those deaths and diseases, our study suggests that occupation is a major determinant as well. Intensive programs such as surveillance systems, therefore, should be developed in order to identify and prevent work-related diseases among agricultural workers in Korea.
Agricultural Workers' Diseases/*epidemiology/mortality ; Bacterial Infections/epidemiology/mortality ; Humans ; Life Style ; Musculoskeletal Diseases/epidemiology/mortality ; Mycoses/epidemiology/mortality ; Neoplasms/epidemiology/mortality ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Virus Diseases/epidemiology/mortality

BACKGROUND: This study purposed to analyze and understand how spatial accessibility of patients influenced the number of outpatient visits for the internal medicine of a hospital. METHODS: A hospital with 100 beds in Seoul, South Korea provided data from 2013 January 1 to 2013 June 30. Euclidean distance and road ares were used to represent the spatial accessibility. Patient level data and dong level data were collected and used in spatial analysis. Dong level data was converted into grid level (500×500 m) for the multivariate analysis. Hot-spot analysis and generalized linear model were applied to the data collected. RESULTS: Hot-spots of outpatient visits were found around the study hospital, and cold-spots were not found. Number of outpatient visits was varied by the distance between patient resident and hospitals, and about 80% of total outpatient visits was occurred in within the 5 km from study hospital, and 50% was occurred in within 1.6 km. Spatial accessibility had significant influences on the outpatient visits. CONCLUSION: Findings provide evidences that spatial accessibility had influences on the patients' behaviors in utilizing the outpatient care of internal medicine in a hospital. Results can provide useful information to health policy makers as well as hospital managers for their decision making.
Ambulatory Care ; Decision Making ; Health Policy ; Humans ; Internal Medicine* ; Korea ; Linear Models ; Multivariate Analysis ; Outpatients* ; Seoul ; Spatial Analysis

No abstract available.
Child* ; Humans ; Immunoglobulin G* ; Measles*

No abstract available.
Mucocele*

OBJECTIVE: To evaluate the mixed nerve action potential of the medial and lateral plantar nerve conduction studies in diabetic patients with the various factors. METHOD: 69 healthy adults without foot trauma as control group and 78 diabetic patients without foot trauma as subject group were studied. The study was performed by using the orthodromic surface stimulation and recording method of evaluating of the mixed nerve action potential of the medial and lateral plantar nerve conduction studies. RESULTS: The differences in the distal latency (p<0.05), amplitude (p<0.05) and nerve conduction velocity (p<0.05) of the mixed nerve action potential of the medial and lateral plantar nerve conduction studies were statistically significant between the diabetic group and the normal control group. Same results also could be obtained in diabetic patients relating to longer duration of diabetes, presence of diabetic retinopathy, higher blood glucose level, longer duration of oral hypoglycemic agent and insulin treatment (p<0.05). CONCLUSION: The mixed nerve action potential of the medial and lateral plantar nerve conduction studies are useful for the detection of diabetic neuropathic foot.
Action Potentials* ; Adult ; Blood Glucose ; Diabetes Mellitus ; Diabetic Retinopathy ; Foot ; Humans ; Insulin ; Neural Conduction*

To examine the relationship between birth characteristics and childhood cancer mortality, a retrospective cohort study of Korean children was conducted using data collected by the national birth register between 1995 and 2006, which were then individually linked to death data. A cohort of 6,479,406 children was followed from birth until their death or until December 31, 2006. Poisson regression analyses were used to calculate rate ratios of childhood cancer deaths according to birth characteristics. A total of 1,469 cancer deaths were noted and the childhood cancer mortality rate was found to be 3.43 per 100,000 person-years in Korea during the period of 1995-2006. The birth characteristics examined in this study (i.e. , birth weight, gestational age, multiple births, parental ages, and number of siblings) were generally found to be not significantly associated with childhood cancer mortality, and the associations did not vary meaningfully with gender nor with cancer sites. However, among children aged 5-11 yr, higher birth weight was associated with elevated childhood cancer mortality (rate ratio = 1.28, 95% confidence interval 1.04-1.58). Our results offer no overall associations between childhood cancer mortality and birth characteristics, but suggest that the association may be specific to age group.
Birth Weight ; Child ; Child, Preschool ; Cohort Studies ; Gestational Age ; Humans ; Multiple Birth Offspring ; Neoplasms/*mortality ; Parents ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Siblings ; Socioeconomic Factors

Background: Prediction of mortality in patients with coronavirus disease 2019 (COVID-19) is a key to improving the clinical outcomes, considering that the COVID-19 pandemic has led to the collapse of healthcare systems in many regions worldwide. This study aimed to identify the factors associated with COVID-19 mortality and to develop a nomogram for predicting mortality using clinical parameters and underlying diseases. Methods: This study was performed in 5,626 patients with confirmed COVID-19 between February 1 and April 30, 2020 in South Korea. A Cox proportional hazards model and logistic regression model were used to construct a nomogram for predicting 30-day and 60-day survival probabilities and overall mortality, respectively in the train set. Calibration and discrimination were performed to validate the nomograms in the test set. Results: Age ≥ 70 years, male, presence of fever and dyspnea at the time of COVID-19 diagnosis, and diabetes mellitus, cancer, or dementia as underling diseases were significantly related to 30-day and 60-day survival and mortality in COVID-19 patients. The nomogram showed good calibration for survival probabilities and mortality. In the train set, the areas under the curve (AUCs) for 30-day and 60-day survival was 0.914 and 0.954, respectively; the AUC for mortality of 0.959. In the test set, AUCs for 30-day and 60-day survival was 0.876 and 0.660, respectively, and that for mortality was 0.926. The online calculators can be found at https://koreastat.shinyapps.io/RiskofCOVID19/. Conclusion The prediction model could accurately predict COVID-19-related mortality; thus, it would be helpful for identifying the risk of mortality and establishing medical policies during the pandemic to improve the clinical outcomes.