Primary care physicians who can deliver high quality primary care services are essential for strengthening the primary health care system. In Korea, primary care was regarded as substandard services practiced by any medical doctor without postgraduate education in primary care. The current and future health care systems are challenged by increasing complexity and co-morbidity and healthcare costs in medical care. The developed countries are preparing for the future by increasing support for basic, postgraduate, and continuing medical education in primary care. To strengthen the primary care in Korea, basic medical education programs should require experience in primary care clinics with a teaching and education function. Postgraduate primary care medical education must be enhanced to be qualified to practice in the community. The recognition of the importance of primary care and the need for changes in the current education and healthcare system among medical professionals and other stakeholders and support systems such as legislation and finance for primary care medical education.
Delivery of Health Care ; Developed Countries ; Education, Medical ; Education, Medical, Continuing ; Health Care Costs ; Humans ; Korea ; Physicians, Primary Care ; Primary Health Care ; Residence Characteristics

Lively discussion has been underway regarding primary care in South Korea as an alternative medical policy in the face of rising medical costs and health care disparities. However, the lack of research about primary care in South Korea makes it difficult to move policymakers, so it is time to enhance primary care research in South Korea. Primary care research can be defined as research directed toward the better understanding and practice of the primary care function. Primary care research traditionally has included basic research, clinical research, health services research related to primary care, health systems research, and research on primary care training; and each field is complementary. In primary care research, participation of primary care physicians is essential because primary care research is different from other conventional studies of disease prevalence, patient characteristics, diagnostic methods, and the treatment environment. Primary care research findings in other countries cannot be applied to South Korea as the characteristics of the health system and medical practice are different. To enhance the research on primary care in South Korea, financial assistance, promoting the research capacity of primary care physicians, and more attention from primary care physicians to research are needed.
Health Services Research ; Healthcare Disparities ; Humans ; Physicians, Primary Care ; Prevalence ; Primary Health Care ; Republic of Korea

OBJECTIVESThe mechanism of the adverse health effects of ambient particulate matter on humans has not been well-investigated despite many epidemiologic association studies. Measurement of personal exposure to particulate pollutants and relevant biological effect markers are necessary in order to investigate the mechanism of adverse health effects, particularly in fragile populations considered to be more susceptible to the effects of pollutants.

METHODSWe measured personal exposure to PM(2.5) and examined oxidative stress using urinary malondialdehyde three times in 51 preschoolers and 38 elderly subjects. A linear mixed-effects model was used to estimate PM(2.5) effects on urinary MDA levels.

RESULTSAverage personal exposure of the children and elderly to PM(2.5) was 80.5 +/- 29.9 and 20.7 +/- 12.7 mug/m(3), respectively. Mean urinary MDA level in the children and the elderly was 3.6 +/- 1.9 and 4.0 +/- 1.6 mumol/g creatinine. For elderly subjects the PM(2.5) level was significantly associated with urinary MDA after adjusting for age, sex, BMI, passive smoking, day-care facility site, alcohol consumption, cigarette smoking, and medical history (heart disease, hypertension and bronchial asthma). However, there was no significant relationship for children.

CONCLUSIONSThe elderly were more susceptible than young children to oxidative stress as a result of ambient exposure to PM(2.5). Identification of oxidative stress induced by PM(2.5) explains the mechanism of adverse health effects such as cardiovascular or respiratory diseases, particularly in the elderly.

BACKGROUND: In South Korea, major health care problems have been occurred under the structural background that medical services are mainly provided by private medical institutions. Primary health care, which is very crucial in public health, has been overlooked, and is disorganized and fragmented. In the mean time, health cooperative movement was initiated by local residents and medical doctors to overcome health care problems in 1987. We conducted this study to evaluate the role of health cooperative clinics and obtain lessons for the future primary care policy. METHODS: During April to June in 2007, survey was performed by a trained interviewer at the waiting rooms of 3 health cooperative clinics, in the process of development of the Korean Primary Care Assessment Tool (KPCAT). The KPCAT consists of 5 domains (21 items): first contact (5), coordination function (3), comprehensiveness (4), family/community orientation (4), and personalized care (5). Subjects were patients (or guardians) who had visited their health cooperative clinics on six or more occasions over a period of more than 6 months. We compared primary care scores of each domain between members and non-members of health cooperative clinics by student t-test. Effect of having a membership on each primary care domains was examined by multiple regression analysis. RESULTS: Among the participants (N = 100), members of health cooperatives were 48, and non-members 52. Total average scores of 5 primary care domains of the KPCAT were 78.0 +/- 13.5 on 100 point scale. (82.0 +/- 13.1 in members, and 74.3 +/- 13.0 in nonmembers; P = 0.004) Among primary care domains, personalized care was the highest (91.4 +/- 11.0), and coordination function the lowest (61.0 +/- 33.1) in score. Significant differences between members and nonmembers were noted in coordination function (68.9 vs. 53.7, P = 0.021) and comprehensiveness (78.4 vs. 67.2, P = 0.008). These differences were continued after adjusting by multiple regression analysis for socio-demographic variables including age, sex, income, education, number of disease, and duration since the first visit. CONCLUSION: In the health cooperative clinics whose primary care performance has been considered exemplary in the context of health care in South Korea, primary care scores assessed by members were higher than those by non-members. The significant differences of scores in coordination function and comprehensiveness between members and nonmembers suggest that the future primary care policy should be focused to strengthen these two domains of primary care.
Delivery of Health Care ; Humans ; Orientation ; Primary Health Care ; Public Health ; Republic of Korea

BACKGROUND: Many studies have reported that adolescents living with single parent have a high risk of obesity. However, those studies did not explore the implication of the gender of single parent living with adolescents. This study investigated the differences in obesity rates according to status of co-residence with their parents in Korean adolescents. The family living with single parent was classified into the family living with single father and the family living with single mother. METHODS: This cross-sectional study involved 59,602 adolescents who participated in the 2017 Korea Youth Risk Behavior Web-based Survey. The data on height, weight, status of co-residence with parents, and the other variables were obtained through online questionnaires. RESULTS: In male adolescents, the family living with single mother was related to a high proportion of obesity (odds ratio [OR] 1.24, 95% confidence interval [CI] 1.09–1.40) and overweight (OR 1.17, 95% CI 1.03–1.34). However, in female adolescents, the family living with single father was related to a high proportion of obesity (OR 1.49, 95% CI 1.23–1.82). In addition, female adolescents living with neither parent were more likely to be obese (OR 1.47, 95% CI 1.13–1.91) and overweight (OR 1.31, 95% CI 1.00–1.70). CONCLUSIONS: This study showed a risk of obesity in adolescents living with single parent differs according to the gender of single parent living with adolescents. Not adolescents living with a same-gender parent, but those living with an opposite-gender parent have a high risk of obesity.
Adolescent ; Cross-Sectional Studies ; Fathers ; Humans ; Korea ; Mothers ; Obesity ; Overweight ; Parents ; Risk-Taking ; Single Parent ; Single-Parent Family

BACKGROUND: Many studies have reported that adolescents living with single parent have a high risk of obesity. However, those studies did not explore the implication of the gender of single parent living with adolescents. This study investigated the differences in obesity rates according to status of co-residence with their parents in Korean adolescents. The family living with single parent was classified into the family living with single father and the family living with single mother. METHODS: This cross-sectional study involved 59,602 adolescents who participated in the 2017 Korea Youth Risk Behavior Web-based Survey. The data on height, weight, status of co-residence with parents, and the other variables were obtained through online questionnaires. RESULTS: In male adolescents, the family living with single mother was related to a high proportion of obesity (odds ratio [OR] 1.24, 95% confidence interval [CI] 1.09–1.40) and overweight (OR 1.17, 95% CI 1.03–1.34). However, in female adolescents, the family living with single father was related to a high proportion of obesity (OR 1.49, 95% CI 1.23–1.82). In addition, female adolescents living with neither parent were more likely to be obese (OR 1.47, 95% CI 1.13–1.91) and overweight (OR 1.31, 95% CI 1.00–1.70). CONCLUSIONS This study showed a risk of obesity in adolescents living with single parent differs according to the gender of single parent living with adolescents. Not adolescents living with a same-gender parent, but those living with an opposite-gender parent have a high risk of obesity.

BACKGROUND: Youth suicide is increasingly being recognized as a major social problem in South Korea. In this study, we aimed to explore the effects of parental support on the relationship between life stress and suicidal ideation among middle-school students. METHODS: This study analyzed data from a cross-sectional study on mental health conducted by the South Korea National Youth Policy Institute between May and July of 2013. Questionnaire responses from 3,007 middle-school students regarding stress factors, thoughts of suicide during the past year, and parental support were analyzed in terms of 3 subscale elements: emotional, academic, and financial support. RESULTS: Among the participants, 234 male students (7.8%) and 476 female students (15.8%) reported experiencing suicidal ideation in the past year. Life stress significantly influenced suicidal ideation (P<0.001), and parental support and all of the subscale elements had a significant influence on decreasing suicidal ideation. As shown in model 1, life stress increased suicidal ideation (adjusted odds ratio [aOR], 1.318; P<0.001), and, in model 2, the effect of life stress on suicidal ideation decreased with parental support (aOR, 1.238; P<0.001). CONCLUSION: Parental support was independently related to a decrease in suicidal ideation, and life stress was independently related to an increase in suicidal ideation. Parental support buffered the relationship between life stress and suicidal ideation.
Adolescent ; Cross-Sectional Studies ; Female ; Financial Support ; Humans ; Korea ; Male ; Mental Health ; Negotiating* ; Odds Ratio ; Parent-Child Relations ; Parents* ; Social Problems ; Stress, Psychological* ; Suicidal Ideation* ; Suicide

BACKGROUND: This study aims to evaluate the importance of snacks to a balanced diet by assessing snack consumption patterns and factors associated with eating snacks of Korean elders of 60 years or more. METHODS: This analysis is based on participants from the 2013-2014 Korea National Health and Nutrition Examination Survey. Meal or snack consumption was based on a 24 hours recall data, and the adequacy of each nutrient intake was based on the Dietary Reference Intakes by the Korea Nutrition Society. The cutoff for snack consumption valued as meaningful was more than 200 kcal/day of snack energy intake. RESULTS: Korean male elders of age 60 years or more are consuming 333.6±11.1 kcal of snack and 271.7±7.4 kcal for females. When consumed together with meals, snack consumption increased the adequacy of all nutrients intake, except sodium. Based on energy contribution, male Korean elders are consuming snack food group in order of beverage and alcohols, grains, and fruits, while for females the order was grains, fruits, and dairy. Older age (men and women), joblessness (men), and chronic disease (women) were positively associated with having snack of 200 kcal or more per day, whereas ‘living with a partner (men)’, alcohol intake frequency of more than twice per week (men), and ‘doing regular aerobic physical activity (women)’ showed negative association. CONCLUSIONS: Snack consumption of Korean elders contributed to more adequate nutritional status, but improvement of food groups is needed because they were mainly concentrated on grains.
Aged* ; Alcohols ; Beverages ; Chronic Disease ; Diet ; Eating ; Energy Intake ; Female ; Fruit ; Humans ; Korea* ; Male ; Meals ; Motor Activity ; Nutrition Surveys* ; Nutritional Status ; Recommended Dietary Allowances ; Snacks* ; Sodium

BACKGROUND: The influence of socioeconomic status (SES) on weight status varies depending on the countries' levels of social and economic development. There are many studies on a risk of adolescent obesity according to familial SES in Korea. However, it is not clarified what effects familial SES has on a risk of underweight in Korean adolescents. This study investigated the distribution of weight status including obesity and underweight according to familial SES in Korean adolescents. METHODS: This cross-sectional study involved 63,741 adolescents who participated in the 2016 Korea Youth Risk Behavior Wed-based Survey. The data on height, weight, familial SES, current smoking status, current alcohol intake, physical activity, breakfast skipping, perceived stress, depressive mood, and living with family were obtained through online questionnaires. The assessment of familial SES was based on perceived household economic status and parental education level. RESULTS: In boys, low household economic status was related to a high proportion of obesity (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04–1.25) and underweight (OR 1.31, 95% CI 1.14–1.51). Girls with low household economic status were more likely to be obese (OR 1.81, 95% CI 1.61–2.03) and overweight (OR 1.41, 95% CI 1.23–1.60) but, although not statistically significant, less likely to be underweight (OR 0.88, 95% CI 0.75–1.04). CONCLUSIONS: This study showed that adolescents with low familial SES were at a high risk of obesity and underweight. A risk of underweight was increased in boys with low familial SES but in girls with high familial SES.
Adolescent ; Breakfast ; Cross-Sectional Studies ; Economic Development ; Education ; Family Characteristics ; Female ; Humans ; Korea ; Motor Activity ; Obesity ; Overweight ; Parents ; Pediatric Obesity ; Risk-Taking ; Smoke ; Smoking ; Social Class ; Thinness

BACKGROUND: The influence of socioeconomic status (SES) on weight status varies depending on the countries' levels of social and economic development. There are many studies on a risk of adolescent obesity according to familial SES in Korea. However, it is not clarified what effects familial SES has on a risk of underweight in Korean adolescents. This study investigated the distribution of weight status including obesity and underweight according to familial SES in Korean adolescents. METHODS: This cross-sectional study involved 63,741 adolescents who participated in the 2016 Korea Youth Risk Behavior Wed-based Survey. The data on height, weight, familial SES, current smoking status, current alcohol intake, physical activity, breakfast skipping, perceived stress, depressive mood, and living with family were obtained through online questionnaires. The assessment of familial SES was based on perceived household economic status and parental education level. RESULTS: In boys, low household economic status was related to a high proportion of obesity (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04–1.25) and underweight (OR 1.31, 95% CI 1.14–1.51). Girls with low household economic status were more likely to be obese (OR 1.81, 95% CI 1.61–2.03) and overweight (OR 1.41, 95% CI 1.23–1.60) but, although not statistically significant, less likely to be underweight (OR 0.88, 95% CI 0.75–1.04). CONCLUSIONS This study showed that adolescents with low familial SES were at a high risk of obesity and underweight. A risk of underweight was increased in boys with low familial SES but in girls with high familial SES.