The purpose of this study are to find useful knowledge through discovering relations and patterns of unknown facts from large data using data mining technique and to introduce a scheme of knowledge management concept in medical field. The application areas of data mining in medical fields include the medical utilization review analysis, disease pattern analysis, analysis related with health promotion and hospital management analysis. Among those areas, we selected the disease pattern analysis and studied on prediction of the diagnosis of hypertension patients. Three data mining techniques of the statistical analysis, decision tree analysis and C4.5 were performed on the health examination data from Korea Medical Insurance Corporation. From the experiments, the levels of importance of factors to hypertension were inferred and the specifications between hypertensive group and normotensive group was classified and identified. These results can be applied not only to the prediction of the diagnosis of hypertension patients but also to the medical decision support system for the management of hypertension. From now on, the data mining techniques that reproduce valuable information to help decision support will provide and be applied to various areas; clinical epidemiological study, useful information of health promotion project, health care policy support information. And the technique will also give the additional efficiency of national projects related health and the realization of scientific health social management resulting the much more national welfare service.
Data Mining* ; Decision Support Techniques ; Delivery of Health Care ; Diagnosis ; Health Promotion ; Humans ; Hypertension ; Insurance ; Knowledge Management* ; Korea ; Utilization Review

OBJECTIVES: Both organized and opportunistic screening programs have been widely used in Korea. This paper examined the determinants of the use of opportunistic screening programs in Korea. METHODS: The subjects were a national stratified random sample of 10,254 people aged 45 or older from the first wave of the Korean Longitudinal Study of Ageing in 2006. A logit model was used to examine the determinants of the use of opportunistic screening programs in terms of the demographic and socioeconomic characteristics, the type of health insurance and the health status. RESULTS: Thirteen point seven percent of the individuals received opportunistic screening programs within 2 years from the time the survey was conducted in 2006. The individuals who graduated from college or who had even more education were 3.0 times more likely to use opportunistic screening programs compared with the individuals who were illiterate. The individuals who resided in urban areas and who had religious beliefs were more likely to receive opportunistic screening programs compared with their counterparts. Those who were in the first quartile for the total household assets were 2.6 times more likely to use opportunistic screening programs than those who were in the fourth quartile for the total household assets. Privately insured people were 1.6 times more likely to use opportunistic screening programs than those who were not insured. Finally, the individuals who self-assessed their health status as worst were 2.1 times more likely to use opportunistic screening programs compared individuals who self-assessed their health status as best. CONCLUSIONS: This study suggests that opportunistic screening programs can be an indicator for whether or not an individual is among the advantaged group in terms of their socioeconomic characteristics and type of health insurance.
Aged ; Female ; Health Promotion ; Humans ; Korea ; Logistic Models ; Longitudinal Studies ; Male ; Mass Screening/*utilization ; Middle Aged ; Social Class

INTRODUCTION Although the benefits of physical activity and exercise are widely acknowledged, many middle-aged and elderly individuals remain sedentary. This cross-sectional study aimed to identify the external and internal barriers to physical activity and exercise participation among middle-aged and elderly individuals, as well as identify any differences in these barriers between the two groups. METHODS Recruited individuals were categorised into either the middle-aged (age 45-59 years, n = 60) or elderly (age ≥ 60 years, n = 60) group. Data on demographics, anthropometry, as well as external and internal barriers to participation in physical activity and exercise were collected. RESULTS Analysis showed no significant differences in the total scores of all internal barriers between the two groups (p > 0.05). The total scores for most external barriers between the two groups also showed no significant differences (p > 0.05); only 'cost' (p = 0.045) and 'exercise interferes with social/family activities' (p = 0.011) showed significant differences. The most common external barriers among the middle-aged and elderly respondents were 'not enough time' (46.7% vs. 48.4%), 'no one to exercise with' (40.0% vs. 28.3%) and 'lack of facilities' (33.4% vs. 35.0%). The most common internal barriers for middle-aged respondents were 'too tired' (48.3%), 'already active enough' (38.3%), 'do not know how to do it' (36.7%) and 'too lazy' (36.7%), while those for elderly respondents were 'too tired' (51.7%), 'lack of motivation' (38.4%) and 'already active enough' (38.4%). CONCLUSION Middle-aged and elderly respondents presented with similar external and internal barriers to physical activity and exercise participation. These factors should be taken into account when healthcare policies are being designed and when interventions such as the provision of facilities to promote physical activity and exercise among older people are being considered.
Age Factors ; Aged ; Cross-Sectional Studies ; Exercise ; physiology ; Female ; Follow-Up Studies ; Health Promotion ; utilization ; Health Status ; Humans ; Malaysia ; Male ; Middle Aged ; Motivation ; Motor Activity ; physiology ; Patient Participation ; utilization ; Retrospective Studies

INTRODUCTIONThis study aims to determine the association of geriatric syndromes and depressed mood among respondents with diabetes in a lower income community; and their association with self-management, lifestyle behaviour, and healthcare utilisation. This paper focuses primarily on the 114 respondents with diabetes aged 50+ to inform policy formulation at the community level.

MATERIALS AND METHODSA pilot community health assessment was conducted in 4 blocks of 1- and 2-room apartments in Toa Payoh district from July to November 2009. Using a standard questionnaire, interviewers conducted face-to-face interviews with household members on chronic diseases, geriatric syndromes and health-related behaviour. Data were analysed using SPSSv15.

RESULTSA total of 795 respondents were assessed with a response rate of 61.8%. Of 515 (64.8%) aged 50+ analysed in this study, 22.1% reported having diabetes, of whom 31.6% reported being depressed. Respondents with diabetes who reported being depressed had a higher prevalence of geriatric syndromes compared with those non-depressed; i.e. functional decline (30.6% vs 5.1%, P <0.001); falls (33.3% vs 10.3%, P = 0.003); stumbling (30.6% vs 10.3%, P = 0.007); urinary incontinence (33.3% vs 5.1%, P <0.001), progressive forgetfulness (27.8% vs 6.4%, P = 0.002) and poor eyesight (22.2% vs 6.4%, P = 0.014). They were less likely to comply with medications (86.1% vs 97.3%, P = 0.026) and performed exercise (13.9% vs 53.8%, P <0.001). More had hospital admissions (13.9% vs 7.7%); and they had more outpatient visits per person (2.4 visits vs 0.9 visits, P = 0.03) at Specialist Outpatient Clinics.

CONCLUSIONGeriatric syndromes were associated with the presence of depressed mood among persons with diabetes in the lower income group. As those with depressed mood had more unfavourable self-management and lifestyle behaviour, and utilise higher healthcare services, diabetes management must take these findings into consideration.

Activities of Daily Living ; Aged ; Depression ; epidemiology ; Diabetes Mellitus ; drug therapy ; psychology ; Disease Management ; Female ; Health Behavior ; Health Promotion ; Health Services ; utilization ; Humans ; Interviews as Topic ; Life Style ; Male ; Middle Aged ; Patient Acceptance of Health Care ; Poverty ; Singapore ; epidemiology ; Surveys and Questionnaires

BACKGROUND: The primary preventive services of TSeKaP promote disease prevention among marginalized groups. The threat of non-utilization, however, undermines the effective implementation of the program. To fill in the knowledge gap regarding utilization of primary preventive services, rate of utilization and factors associated with utilization of primary preventive services must be determined.

OBJECTIVE: To determine the rate of utilization and the association of selected factors with utilization of primary preventive services of TSeKaP among PhilHealth Indigent Member of Manila.

METHODS: Using a two-stage cluster sampling, 145 PhilHealth Indigent Members were randomly selected and interviewed. Chi-square test and Fisher's exact test were used to determine associations. FGDs were also conducted to gather reasons related to utilization.

RESULTS AND CONCLUSION: Among those surveyed, 68.28% were found to have utilized at least one primary preventive service. Age (p-value=0.021), knowledge (p-value=0.015), familiarity (p-value=0.029), and accessibility (p-value=0.013) were found to be associated with utilization. Utilization generally increases as the age group increases. Those with satisfactory knowledge on TSeKaP, those familiar with their health center, and those who report that their health center is accessible were 1.45 times, 2.12 times and 2.83 times more likely to utilize than their counterparts, respectively. Results showing a significant proportion of non-utilization emphasize the need to improve implementation strategies by improving not only the knowledge of respondents' on TSeKaP but also their familiarity with their health centers. The use of various communication channels, such as barangay bulletin, public address system, radio or television, may aid the dissemination of pertinent information regarding the program as perceived by the respondents.

Human ; Male ; Female ; Aged 80 And Over ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Health Promotion ; Preventive Health Services ; Health Services, Indigenous ; Facilities And Services Utilization

OBJECTIVETo assess the effectiveness of an educational intervention program in sexually transmitted disease (STD) and condom-related knowledge and promoting condom use among STD patients.

METHODSSTD clinic patients were randomly assigned to three groups (A, control group; B, video viewing group; group C, video viewing plus education with talk) after administered with baseline questionnaire. Each patient was then scheduled to complete the questionnaire regarding the change of STD knowledge and use of condom in two weeks and 3 months.

RESULTSSix hundred and forty-eight patients entered the study. More than half of the patients were aware of STD-related knowledge. However the rate of condom use was very low. When having intercourse with the casual sexual partners the percentage of condom use was only 20%. Seventeen per cent of the patients knew nothing about how to use condom correctly. Follow up results showed that the education program increased the knowledge about STD to some degree. However the percentage of condom use in the latest sexual intercourse increased greatly both in intervention and control groups, but more in intervention groups (P < 0.05).

CONCLUSIONSTD education should be focused on advocating and correcting condom use.

Adult ; Condoms ; statistics & numerical data ; utilization ; Female ; Health Knowledge, Attitudes, Practice ; Health Promotion ; methods ; statistics & numerical data ; Humans ; Male ; Patient Education as Topic ; methods ; Sexually Transmitted Diseases ; prevention & control ; Videotape Recording

This study was to evaluate the effectiveness of the first proactive Quitline service for smoking cessation in Korea and determine the predictors of successful smoking cessation. Smoking participants were voluntarily recruited from 18 community health centers. The participants were proactively counseled for smoking cessation via 7 sessions conducted for 30 days from November 1, 2005 to January 31, 2006. Of the 649 smoking participants, 522 completed 30 days at the end of the study and were included in the final analysis. The continuous abstinence rate at 30 days of follow-up was found to be 38.3% (200/522), in the intention-to-treat analysis. Compared with non-quitters, quitters were mostly male, smoked <20 cigarettes/ day, had started smoking at the age of > or =20 yr, and were less dependent on nicotine. Based on the stepwise multiple logistic regression analysis, the significant predictors of successful smoking cessation were determined to be male sex, low cigarette consumption, and older age at smoking initiation. We investigated the short-term effectiveness of the Quitline service and determined the predictors of successful smoking cessation.
Adult ; Aged ; Female ; Health Promotion ; Hotlines/*utilization ; Humans ; Korea ; Life Style ; Male ; Middle Aged ; Regression Analysis ; Smoking/epidemiology/*prevention & control ; Smoking Cessation/methods/psychology/*statistics & numerical data ; Telephone ; Treatment Outcome

PURPOSE: With the continuous spread of the AIDS virus and other sexually transmitted diseases (STDs) throughout Asia, it has become imperative for HIV/AIDS prevention outreach programs to stress the need for using prophylactics as one form of protection. This is particularly true for commercial sex workers. This pilot study was conducted to investigate the rate of condom use among the commercial sex workers in Korea and reasons why they frequently do not wear condoms during sexual intercourse. METHODS: Fifty female commercial sex workers who worked in the Yong San area were recruited while outreach was performed and forty eight responses were analyzed due to two incomplete questionnaires. The data were collected on June 28, 2004 as part of an outreach program for condom use promotion. RESULTS: The subjects ranged in age from 21 to 45 years. Nearly half of the subjects (47.9%) did not consistently use condoms. The major reason for not using protection was clients'reluctances for using condoms. When condoms were used, the subjects preferred lubricant-rich and less painful condom during intercourse. CONCLUSION: Due to the inconsistent use of condoms, it is clear that many commercial sex workers and clients are susceptible to sexually transmitted diseases. Therefore, it is important to not only educate commercial sex workers, but also to educate their pimps and clientele about the importance of condom use. In general, it is recommended that practical strategies and a policy for condom use promotion be developed.
Adult ; Community-Institutional Relations ; Condoms/*utilization ; Cross-Sectional Studies ; Decision Making ; Female ; HIV Infections/epidemiology/prevention & control ; *Health Knowledge, Attitudes, Practice ; Health Policy ; Health Promotion ; Health Services Needs and Demand ; Humans ; Korea/epidemiology ; Middle Aged ; Pilot Projects ; Prostitution/*psychology/statistics & numerical data ; Questionnaires ; Risk-Taking ; Safe Sex/ethnology/*psychology/statistics & numerical data ; Sex Education ; Sexual Partners/psychology ; Sexually Transmitted Diseases/epidemiology/prevention & control ; Time Factors

This study was done to evaluate the efficacy of health check-ups in children in detecting metabolic syndrome and non-alcoholic fatty liver disease (NAFLD) by comparing the pediatric health promotion center with the pediatric obesity clinic. Children who visited a pediatric health promotion center (n=218) or a pediatric obesity clinic (n=178) were included. Anthropometric data, blood pressure, laboratory tests, and abdominal ultrasonography were evaluated. Two different criteria were applied to diagnose metabolic syndrome. The prevalence of metabolic syndrome in the 2 units was 3.2%-3.7% in a pediatric health promotion center and 23%-33.2% in a pediatric obesity clinic. Significant differences were observed in the prevalence of each component of metabolic syndrome between the 2 units including abdominal adiposity, blood pressure, serum triglycerides, and fasting blood glucose (P<0.05). The prevalence of NAFLD was 8.7% and 71.9% in the 2 units according to liver enzymes and 5.9% and 61.8% according to ultrasonography (P<0.05). The prevalence of metabolic syndrome and NAFLD was higher among patients visiting the obesity clinic targeting obese children than that among patients visiting the health promotion center offering routine check-ups. An obesity-oriented approach is required to prevent obesity-related health problems in children.
Adolescent ; Causality ; Child ; Child, Preschool ; Comorbidity ; Female ; Health Promotion/*utilization ; Humans ; Male ; Metabolic Syndrome X/*diagnosis/epidemiology ; Non-alcoholic Fatty Liver Disease/*diagnosis/epidemiology ; Obesity/*diagnosis/epidemiology ; Physical Examination/*statistics & numerical data ; Prevalence ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Factors ; Sensitivity and Specificity ; Young Adult