1.The Association Among Individual and Contextual Factors and Unmet Healthcare Needs in South Korea: A Multilevel Study Using National Data.
Seung Eun LEE ; Miyeon YEON ; Chul Woung KIM ; Tae Ho YOON
Journal of Preventive Medicine and Public Health 2016;49(5):308-322
OBJECTIVES: The objective of this study is to investigate associations between contextual characteristics and unmet healthcare needs in South Korea after accounting for individual factors. METHODS: The present study used data from the 2012 Korean Community Health Survey (KCHS) of 228 902 adults residing within 253 municipal districts in South Korea. A multilevel analysis was conducted to investigate how contextual characteristics, defined by variables that describe the regional deprivation, degree of urbanity, and healthcare supply, are associated with unmet needs after controlling for individual-level variables. RESULTS: Of the surveyed Korean adults, 12.1% reported experiencing unmet healthcare needs in the past. This figure varied with the 253 districts surveyed, ranging from 2.6% to 26.2%. A multilevel analysis found that the association between contextual characteristics and unmet needs varied according to the factors that caused the unmet needs. The degree of urbanity was associated with unmet need due to "financial burden" (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.42 to 0.66 for rural vs. metropolitan), but not unmet need due to "service not available when needed." There were no significant associations between these unmet need measures and regional deprivation. Among individual-level variables, income level showed the highest association with unmet need due to "financial burden" (OR, 5.63; 95% CI, 4.76 to 6.66), while employment status showed a strong association with unmet need due to "service not available when needed." CONCLUSIONS: Our finding suggests that different policy interventions should be considered for each at-risk population group to address the root cause of unmet healthcare needs.
Adult
;
Delivery of Health Care*
;
Employment
;
Health Services Accessibility
;
Health Surveys
;
Humans
;
Korea*
;
Multilevel Analysis
;
Population Groups
;
Residence Characteristics
3.Neighborhood Deprivation and Unmet Health Care Needs: A Multilevel Analysis of Older Individuals in South Korea
Seung Eun LEE ; Miyeon YEON ; Chul Woung KIM ; Tae Ho YOON ; Dongjin KIM ; Jihee CHOI
Osong Public Health and Research Perspectives 2019;10(5):295-306
OBJECTIVES: In this study the relationship between neighborhood deprivation and the unmet health care needs of elderly individuals (≥ 65 years) was examined. Some previous studies suggested that neighborhood characteristics affect access to health care, yet research on the unmet needs of older individuals is limited. METHODS: Multilevel logistic regression analysis was used to assess the relationship of neighborhood-level factors with unmet health care needs due to costs, adjusting for individual-level factors, in individuals ≥ 65 years in the 2017 Korean Community Health Survey (n = 63,388). RESULTS: There were 2.6% of elderly individuals who experienced unmet health care needs due to costs. Following adjustment for individual and neighborhood characteristics, the neighborhood deprivation in urban areas was found to have an inverse association with unmet needs (odds ratio = 0.50; 95% confidence interval = 0.24–1.06) for the most deprived quartile versus the least deprived quartile). However, in rural areas neighborhood deprivation was not a significant variable. Among the individual-level variables, household income was one of the strongest correlates with unmet needs in both urban and rural areas. CONCLUSION: The present findings suggest that targeted policy interventions reflecting both neighborhood and individual characteristics, should be implemented to reduce the unmet health care needs of elderly individuals.
Aged
;
Delivery of Health Care
;
Family Characteristics
;
Health Services Accessibility
;
Health Surveys
;
Humans
;
Korea
;
Logistic Models
;
Multilevel Analysis
;
Residence Characteristics
4.Evaluation of Hazardous Chemicals with Material Safety Data Sheet and By-products of a Photoresist Used in the Semiconductor-Manufacturing Industry
Miyeon JANG ; Chungsik YOON ; Jihoon PARK ; Ohhun KWON
Safety and Health at Work 2019;10(1):114-121
BACKGROUND: The photolithography process in the semiconductor industry uses various chemicals with little information on their constitution. This study aimed to identify the chemical constituents of photoresist (PR) products and their by-products and to compare these constituents with material safety data sheets (MSDSs) and analytical results. METHODS: A total of 51 PRs with 48 MSDSs were collected. Analysis consisted of two parts: First, the constituents of the chemical products were identified and analyzed using MSDS data; second, for verification of the by-products of PR, volatile organic compounds were analyzed. The chemical constituents were categorized according to hazards. RESULTS: Forty-five of 48 products contained trade secrets in amounts ranging from 1 to 65%. A total of 238 ingredients with multiple counting (35 ingredients without multiple counting) were identified in the MSDS data, and 48.7% of ingredients were labeled as trade secrets under the Korea Occupational Safety and Health Act. The concordance rate between the MSDS data and the analytical result was 41.7%. The by-product analysis identified 129 chemicals classified according to Chemical Abstracts Service No., with 17 chemicals that are carcinogenic, mutagenic, and reprotoxic substances. Formaldehyde was found to be released from 12 of 21 products that use novolak resin. CONCLUSION: We confirmed that several PRs contain carcinogens, and some were not specified in the toxicological information in the MSDS. Hazardous chemicals, including benzene and formaldehyde, are released from PRs products as by-products. Therefore, it is necessary to establish a systematic management system for chemical compounds and the working environment.
Benzene
;
Carcinogens
;
Constitution and Bylaws
;
Formaldehyde
;
Hazardous Substances
;
Korea
;
Material Safety Data Sheets
;
Occupational Health
;
Semiconductors
;
Volatile Organic Compounds
5.Severe Hyponatremia during Acyclovir Treatment in Shingles
Jiyong SHIN ; Miyeon KIM ; Jeong Rae YOO ; Sa Yoon KANG ; Jung Hwan OH
Korean Journal of Neuromuscular Disorders 2019;11(2):55-58
Acyclovir is effective in treating the herpes virus infection, especially chickenpox and shingles. Hyponatremia caused by acyclovir has been rarely reported. We present a shingles patient with symptomatic hyponatremia that was presumably caused by acyclovir affecting the hypothalamus or posterior pituitary gland. This case demonstrates that the serum electrolyte levels should be checked regularly and careful observation of symptoms such as nausea, convulsions, or mentality change is necessary in patients treated with acyclovir.