Peripheral arterial disease(PAD) is a major health problem in the elderly population, so prevalence of PAD is investigated using Edinburgh claudication questionnaire. Subjects were over 65 years old in the kyeongsan county. The prevalence of PAD was 9.0% in total population(8.5% in men, 9.3% in women). definite claudication was 3.9%, atypical claudication was 5.l%. and, grade 1 was 4.4%, grade 2 was 4.6%. The prevalence of PAD was increased with age but not statistically significant. There was no difference of PAD by gender and smoking. PAD was significantly associated with systolic blood pressure positively. But, unexpectedly, PAD was significantly associated with BMl negatively. PAD are important elderly health problem in the our country. so the etiology and preventive methods of PAD will be researched on our country population.
Aged* ; Blood Pressure ; Humans ; Male ; Prevalence* ; Surveys and Questionnaires* ; Rural Population* ; Smoke ; Smoking

This study was conducted to compare the maternal characteristics, and birth weight of infants delivered at five different categories of medical facility in Taegu to examine the risk level of pregnant women and children by the medical facility for delivery. The study population included 1,410 pregnant women who delivered a baby at one of nine medical facilities (3 university hospitals, 2 general hospitals, 2 private clinics, 1 midwife clinic, 1 MCH center) in Taegu in April, 1987(April and May, 1987 for K university hospital). Pregnant women were interviewed to ask the age and educational level of woman, payment of medical fee, birth order, delivery method. Birth weight of infant was obtained from medical record. Mean ages of the women delivering at the university hospitals(27.5 years) and at general hospitals(26.7 years) were higher than those at midwife clinic(25.4 years) and at MCH center(26.1 years). Also, mean years of school education were higher in women of university hospitals(12.7 years) and general hospitals(12.2 years) than in women of midwife clinic(9.2 years) and MCH center (9.3 years). The percentages of women covered by the medical insurance were far greater in the university hospitals(78.1%) and general hospitals(82.9%) than in private clinics(44.3%), midwife clinic(29.1%) and MCH center (5.4%). Infants born at the MCH center were mostly the second birth (47.3%) while 56.0% to 61.7% of infants born at all the other medical facilities were the first birth more women delivering at the university hospitals had history of spontaneous abortion as well as still birth than the women delivering at the other medical facilities. The preterm birth rate (11.4%) and low birthweight incidence rates(5.8-13.0%) in university hospitals were significantly higher than those of other medical facilities. Accordingly, c-section rates showed a wide variation among the medical facilities. Study findings revealed that most of women delivering at the university hospitals and general hospitals are in the middle of or upper socio-economic class and obstetrically high risk group regardless of socioeconomic class while the women delivering at the midwife clinic and MCH center are low risk group of low socioeconomic class. Therefore, the data of a specific medical facility are highly limited in interpretation and can not be generalized.
Abortion, Spontaneous ; Birth Order ; Birth Weight* ; Child ; Daegu* ; Education ; Fees, Medical ; Female ; Hospitals, General ; Hospitals, University ; Humans ; Incidence ; Infant ; Insurance ; Medical Records ; Midwifery ; Parturition* ; Pregnancy ; Pregnant Women ; Premature Birth

No abstract available.
Hyperthyroidism*

To measure the fertility rate and pregnancy wastage of women in rural area, 3,780 married women under 50 years old who were not sterilized either woman or husband in Gunwee county were followed up for 2 years. Seventeen Myun health workers visited these women periodically to check the status of their family planning practice and menstruation. Pregnant women were interviewed for their past obstetric history and followed up to the time of delivery. Family planning was practiced in 51.6% of the 6,826 women-years observed during the period from April 1, 1985 to March 31, 1987. Pregnancy, abortion and delivery covered 7.6% of the observed women years and family planning was not practiced in 36.5% of the women-years. When sterilized women at the beginning of the study were included, the family planning practice rate was 72.1% which was slightly higher than the national family planning practice rate. However, 28% of the women of 30-39 years old had not practiced family planning although they had 2-3 children and they used more such less effective methods as safe-period method and condom than the women of 20-29 years old. Overall pregnancy rate was 14.3 per 100 woman-years. Women of 25-29 years old had the highest pregnancy rate of 27.4 per 100 woman-years. Pregnancy wastage including spontaneous and induced abortions and still births was 22.0% of all pregnancies and it increased with the age of women; 15.8% in women less than 30 years old and 43.7% in women of 30 years and over. Women who terminated the pregnancy with induced abortion had more pregnancies, more previous induced and spontaneous abortions and shorter pregnancy interval than those women who terminated with live birth. Pregnant women terminated with a live birth had received 4.2 prenatal cares on the average. Eighty-five percent of deliveries occurred at a medical facility and 15% at home which was substantially lower home delivery rate than the other rural area of Korea. This may be due to the effects of the demonstration project for the primary health care in 1970s in Gunwee county. These findings suggest that family planning service in rural area should be strengthened by promoting the use of more effective contraceptive method among women over 30 years of age.
Abortion, Induced ; Abortion, Spontaneous ; Adult ; Birth Intervals ; Birth Rate ; Child ; Condoms ; Contraception ; Family Planning Services ; Female ; Fertility* ; Follow-Up Studies* ; Humans ; Korea ; Live Birth ; Menstruation ; Middle Aged ; Parturition ; Pregnancy Rate ; Pregnancy* ; Pregnant Women ; Primary Health Care ; Spouses

BACKGROUND: Recently in Korea, the rate of addictive drug abuse is rapidly increasing in men on salary, housewives, and even in adolescents, who have been considered to be free from drugs, which presents a serious problem to the society. Especially, the habituation to gateway drug, such as cigarettes and alcohol, before 15 years old, would lead to the increased possibility of other drug abuse, including illicit drugs. Thereupon in this study, we intended toreview the effect of adolescents smoking an the drug abuse and deviated behaviors. METHODS: On September, 1997, randomly selected were 12 classes, an the basis of 2 classes per grade, from the two schools which was located each in Seoul and Buchean. And survey was dane on 610 students with non non-nominl, self-reported questionnaire. RESULTS: The rate of adolescent smoking was 28.1% in male students and had increasing tendency of "the higher the grades, the higher the smoking rate"(17.0% in the 1st gade, 31.5% in the 2nd grade, 35.9% in the 3rd grade). The smoking rate of female students was 12.3%. From the 2nd grade of middle school to the 2nd grade of high school was the critical period when the smoking habit was initiated in almost 90% of the students. The experiencing rates of drug abuse in studied subjects were as follows : drinking(79.0%), stimulants(4.8%), sedatives(4.1%), hypnotics(3.1%), glue sniffing(1.5%), butane gas(0.7%), marijuana/hemp(0.2%). They were higher in the smoking group than in the nansMoking group, showing statistical significances in most items except hypnotics and marijuana/hemp. Also simihr results were shown in deviated behaviors between the groups. CONCLUSIONS: With the concerted efforts of family, school, society and natian, we as family physicians should make efforts to delay and prevent adolescent's smoking, which is a gateway to drug abuse and deviated behaviors, and to increase people's recognition of health risks caused by smoking, and to provide proper program for adolescents to stop smoking.
Adhesives ; Adolescent ; Critical Period (Psychology) ; Female ; Humans ; Hypnotics and Sedatives ; Korea ; Male ; Physicians, Family ; Salaries and Fringe Benefits ; Seoul ; Smoke* ; Smoking* ; Street Drugs ; Substance-Related Disorders* ; Tobacco Products ; Surveys and Questionnaires

To test the validity of referral of high risk pregnancy in the MCH Center, 6,017 pregnant women who visited MCH Center of South District Health Center for delivery between 1 April 1985 and 31 March 1987 were interviewed on arrival to obtain the data for demographic characteristics and obstetric history and traced to check the delivery outcome. Out of 5,820 women whose delivery outcomes were confirmed, 704 women(12.1%) were referred to other hospital or clinic for high risk factors. The proportion of poor delivery outcome(stillbirth, low birth weight and neonatal death) among referred cases was 4.4% while that of the women delivered at the MCH Center was 2.2%(p<0.01). Decision of the midwives for the referral of high risk pregnancy based on their clinical assessment was consistent with the delivery outcome (good or poor) in 86.5%. Major reasons for referral were premature rupture of membrane(46.5%) and cephalopelvic disproportion(20.0%) and the C-section rates for these cases were 10.1%, 17.6%, respectively. Discriminant analysis of the demographic characteristics and obstetric history for the discrimination of delivery outcome showed that gestational age had the highest discriminant function coefficient(0.88) and it was followed by parity(0.37) and maternal education(0.30). Referral of high risk pregnancy by the midwives based on their clinical assessment was considered to be reasonably valid. However, a risk scoring system for an MCH Center which can improve the validity may be developed if one applies the discriminant analysis for more comprehensive independent variable(including clinical assessment of midwife, demographic characteristics and obstetric history) and dependent variable (including medically indicated C-section, complication of pregnancy and delivery, stillbirth, low birth weight, neonatal death and maternal death).
Discrimination (Psychology) ; Female ; Gestational Age ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Midwifery ; Pregnancy ; Pregnancy, High-Risk* ; Pregnant Women ; Referral and Consultation* ; Risk Factors ; Rupture ; Stillbirth

Purpose: The purpose of this study was to compare patients who had undergone spine surgery (SS) and hip arthroplasty surgery (HAS) and to analyze how medical policies drawn from “The Evaluation of the Appropriate Use of Prophylactic Antibiotics” have affected length of hospital stay (LOS), direct medical costs (DMC), and the duration of antibiotics use in Korea. Materials and Methods: This retrospective nationwide study identified subjects from the Korean National Health Insurance Review and Assessment Service database from January, 2011 to December, 2018. Evaluation of HAS (control group) was implemented in 2007, and that for SS (case group) was conducted for the first time in 2014 (intervention time). In our comparative interrupted time series analysis, we compared DMC, LOS, and use of antibiotics between both groups. Results: 177468 patients who underwent SS and 89372 patients who underwent HAS were included in the study. In 2016, DMC increased for HAS, compared to SS, by 1.03 times (p=0.041). However, cost changes during other observational periods for SS were not higher than those for HAS (p>0.05). SS incurred a reduced LOS of 3% in the first 2 years (p<0.05). Thereafter, LOS changes in SS were not smaller than those in HAS. A decrease in the usage of total antibiotics and broad spectrum antibiotics was observed for 5 years. Conclusion This medical policy was effective in terms of reducing usage and duration of antibiotics use, especially in the first 2 years after the implementation of the policy.

Background: The purpose of our study was to analyze the effects of hospital volume and region on in-hospital and long-term mortality, direct medical costs (DMCs), and length of hospital stay (LOS) in elderly patients following hip fracture, utilizing nationwide claims data. Methods: This retrospective nationwide study sourced its subjects from the Korean National Health Insurance Review and Assessment Service database spanning from January 2011 to December 2018. A generalized estimating equation model with a Poisson distribution and logarithmic link function was used to estimate adjusted odds ratios (aORs) and 95% CIs to assess the association of hospital volume with in-hospital and 1-year mortality, DMCs, and LOS . Results: A total of 172,144 patients were included. Comparing the risk of in-hospital death between high-volume and low-volume hospitals, the risk of in-hospital death was 1.2 times higher at low-volume hospitals (aOR, 1.20; 95% CI, 1.07–1.33; p = 0.002).Additionally, the risk of death at 1 year was 1.05 times higher at low-volume hospitals (aOR, 1.05; 95% CI, 1.01–1.09; p = 0.008) compared to high-volume hospitals. DMCs were 0.84 times lower at low-volume hospitals for in-hospital period (aOR, 0.84; 95% CI, 0.84–0.85; p < 0.001) and 0.87 times lower for 1 year (aOR, 0.87; 95% CI, 0.86–0.88; p < 0.001) compared to high-volume hospitals. In-hospital LOS was 1.21 times longer at low-volume hospitals (aOR, 1.21; 95% CI, 1.20–1.22; p < 0.001) than at high-volume hospitals. In addition, the risk of in-hospital death was 1.22 times higher (aOR, 1.22; 95% CI, 1.12–1.33; p < 0.001) and the risk of 1-year death was 1.07 times higher (aOR, 1.07; 95% CI, 1.04–1.10; p < 0.001) at rural hospitals compared to urban hospitals. Conclusions Clinicians should focus on improving clinical outcomes for hip fracture patients in low-volume and rural hospital settings, with a specific emphasis on reducing mortality rates.

Background: The purpose of our study was to analyze the effects of hospital volume and region on in-hospital and long-term mortality, direct medical costs (DMCs), and length of hospital stay (LOS) in elderly patients following hip fracture, utilizing nationwide claims data. Methods: This retrospective nationwide study sourced its subjects from the Korean National Health Insurance Review and Assessment Service database spanning from January 2011 to December 2018. A generalized estimating equation model with a Poisson distribution and logarithmic link function was used to estimate adjusted odds ratios (aORs) and 95% CIs to assess the association of hospital volume with in-hospital and 1-year mortality, DMCs, and LOS . Results: A total of 172,144 patients were included. Comparing the risk of in-hospital death between high-volume and low-volume hospitals, the risk of in-hospital death was 1.2 times higher at low-volume hospitals (aOR, 1.20; 95% CI, 1.07–1.33; p = 0.002).Additionally, the risk of death at 1 year was 1.05 times higher at low-volume hospitals (aOR, 1.05; 95% CI, 1.01–1.09; p = 0.008) compared to high-volume hospitals. DMCs were 0.84 times lower at low-volume hospitals for in-hospital period (aOR, 0.84; 95% CI, 0.84–0.85; p < 0.001) and 0.87 times lower for 1 year (aOR, 0.87; 95% CI, 0.86–0.88; p < 0.001) compared to high-volume hospitals. In-hospital LOS was 1.21 times longer at low-volume hospitals (aOR, 1.21; 95% CI, 1.20–1.22; p < 0.001) than at high-volume hospitals. In addition, the risk of in-hospital death was 1.22 times higher (aOR, 1.22; 95% CI, 1.12–1.33; p < 0.001) and the risk of 1-year death was 1.07 times higher (aOR, 1.07; 95% CI, 1.04–1.10; p < 0.001) at rural hospitals compared to urban hospitals. Conclusions Clinicians should focus on improving clinical outcomes for hip fracture patients in low-volume and rural hospital settings, with a specific emphasis on reducing mortality rates.

Background: The purpose of our study was to analyze the effects of hospital volume and region on in-hospital and long-term mortality, direct medical costs (DMCs), and length of hospital stay (LOS) in elderly patients following hip fracture, utilizing nationwide claims data. Methods: This retrospective nationwide study sourced its subjects from the Korean National Health Insurance Review and Assessment Service database spanning from January 2011 to December 2018. A generalized estimating equation model with a Poisson distribution and logarithmic link function was used to estimate adjusted odds ratios (aORs) and 95% CIs to assess the association of hospital volume with in-hospital and 1-year mortality, DMCs, and LOS . Results: A total of 172,144 patients were included. Comparing the risk of in-hospital death between high-volume and low-volume hospitals, the risk of in-hospital death was 1.2 times higher at low-volume hospitals (aOR, 1.20; 95% CI, 1.07–1.33; p = 0.002).Additionally, the risk of death at 1 year was 1.05 times higher at low-volume hospitals (aOR, 1.05; 95% CI, 1.01–1.09; p = 0.008) compared to high-volume hospitals. DMCs were 0.84 times lower at low-volume hospitals for in-hospital period (aOR, 0.84; 95% CI, 0.84–0.85; p < 0.001) and 0.87 times lower for 1 year (aOR, 0.87; 95% CI, 0.86–0.88; p < 0.001) compared to high-volume hospitals. In-hospital LOS was 1.21 times longer at low-volume hospitals (aOR, 1.21; 95% CI, 1.20–1.22; p < 0.001) than at high-volume hospitals. In addition, the risk of in-hospital death was 1.22 times higher (aOR, 1.22; 95% CI, 1.12–1.33; p < 0.001) and the risk of 1-year death was 1.07 times higher (aOR, 1.07; 95% CI, 1.04–1.10; p < 0.001) at rural hospitals compared to urban hospitals. Conclusions Clinicians should focus on improving clinical outcomes for hip fracture patients in low-volume and rural hospital settings, with a specific emphasis on reducing mortality rates.