PURPOSE: The purpose of this study was to examine factors influencing new graduate nurse turnover. METHODS: This study was carried out as a secondary analysis of data from the 2010 Graduates Occupational Mobility Survey (GOMS). A total of 323 nurses were selected for analysis concerning reasons for turnover. Data were analyzed using descriptive statistics and multilevel survival analysis. RESULTS: About 24.5% of new nurses left their first job within 1 year of starting their jobs. Significant predictors of turnover among new nurse were job status, monthly income, job satisfaction, the number of hospitals in region, and the number of nurses per 100 beds. CONCLUSION: New graduate nurses are vulnerable to turnover. In order to achieve the best health of the nation, policy approaches and further studies regarding reducing new graduate nurse turnover are needed.
Job Satisfaction ; Multilevel Analysis ; Personnel Turnover ; Survival Analysis*

BACKGROUND: The purpose of this study is comparison of the results between regression and multi-level analysis to find out factors influencing outcome indicators (in-hospital death, length of stay, and medical charges) of stroke patients. METHODS: By using patient sample data of Health Insurance Review & Assessment Service, patients admitted with stroke were selected as survey target and 15,864 patients and 762 hospitals were surveyed. RESULTS: For the results of existing regression analysis and multi-level analysis, models were assessed through model suitability index value and as a result, the value of results of multi-level analysis decreased compared to the results of regression, showing it is a better model. CONCLUSION: Factors influencing in-hospital death of stroke patients were analyzed and as a result, intra-class correlation (ICC) was 13.6%. In factors influencing length of stay, ICC was 11.4%, and medical charges, ICC was 17.7%. It was found that factors influencing the outcome indicators of stroke patients may vary in every hospital. This study could carry out more accurate analysis than existing research findings through analysis of reflecting structure at patient level and hospital level factors and analysis on random effect.
Humans ; Insurance, Health ; Length of Stay ; Multilevel Analysis ; Regression Analysis ; Stroke*

OBJECTIVE: To investigate the relationships of occupational class, educational level and deprivation with mortality in Korea. METHODS: This study used existing South Korean national data on occupation, educational level, and deprivation and death. Mortality was investigated using registered death data from 1993 to 1997 obtained from the Korean National Statistics Office (NSO) with denominators drawn from the 1995 Census. Statistical analysis consisted of poisson regression modeling and multilevel analysis. RESULTS: The lower occupational class (manual workers) group had a higher mortality rate than the higher occupational class (non-manual workers) group. Educational level, and deprivation were both inversely related withand mortality. Occupation was strongly associated with education. Area-based deprivation indicators and individual indices for social class made an independent contribution to the mortality risk. CONCLUSIONS: The findings of this study suggests that the relationships of occupational class, educational level and deprivation with mortality appears to be stronger in Korea than in European countries.
Censuses ; Education ; Korea* ; Mortality* ; Multilevel Analysis ; Occupations ; Social Class

PURPOSE: This study aims to investigate the individual and environmental factors related to emotional/behavioral problems to early adolescence in Korea by applying multilevel modeling. METHODS: From the database of the 2014 Korean Child and Youth Panel Survey (KCYPS), the researchers selected 1,977 adolescents who are in the second year of middle school. Multilevel model analysis was performed to estimate the impact of relevant factors at the individual and environmental levels. RESULTS: At the individual level, the significant factors associated with emotional/behavioral problems included BMI and study tendency in boys, and drinking, study tendency and economic levels in girls. At the environmental level, the significant factor associated with emotional/behavioral problems included relationship with the teacher. CONCLUSION: The emotional/behavioral problems of early adolescence are influenced not only by the individual factors but also by the environment factor. Therefore, the environment surrounding the adolescents should also be considered to prevent emotional/behavioral problems.
Adolescent* ; Child ; Drinking ; Female ; Humans ; Korea ; Multilevel Analysis ; Problem Behavior*

OBJECTIVES: With an increasing number of studies highlighting regional social capital (SC) as a determinant of health, many studies are using multi-level analysis with merged and averaged scores of community residents' survey responses calculated from community SC data. Sufficient examination is required to validate if the merged and averaged data can represent the community. Therefore, this study analyzes the validity of the selected indicators and their applicability in multi-level analysis. METHODS: Within and between analysis (WABA) was performed after creating community variables using merged and averaged data of community residents' responses from the 2013 Community Health Survey in Korea, using subjective self-rated health assessment as a dependent variable. Further analysis was performed following the model suggested by WABA result. RESULTS: Both E-test results (1) and WABA results (2) revealed that single-level analysis needs to be performed using qualitative SC variable with cluster mean centering. Through single-level multivariate regression analysis, qualitative SC with cluster mean centering showed positive effect on self-rated health (0.054, p<0.001), although there was no substantial difference in comparison to analysis using SC variables without cluster mean centering or multi-level analysis. CONCLUSIONS: As modification in qualitative SC was larger within the community than between communities, we validate that relational analysis of individual self-rated health can be performed within the group, using cluster mean centering. Other tests besides the WABA can be performed in the future to confirm the validity of using community variables and their applicability in multi-level analysis.
Health Surveys ; Korea ; Multilevel Analysis ; Self-Assessment ; Social Capital*

OBJECTIVETo analyze the correlation between population characteristics and work ability of employees with a multilevel model, to investigate the important influencing factors for work ability, and to provide a basis for improvement in work ability.

METHODSWork ability index (WAI)was applied to measure the work ability of 1686 subjects from different companies (n=6). MLwi N2.0 software was applied for two-level variance component model fitting.

RESULTSThe WAI of employees showed differences between various companies (χ2=3.378 6, P=0.0660); working years was negatively correlated with WAI (χ2=38.229 2, P=0.0001), and the WAI of the employees with 20 or more working years was 1.63 lower than that of the employees with less than 20 working years; the work ability of manual workers was lower than that of mental-manual workers (χ2=8.2726, P=0.0040), and the work ability showed no significant difference between mental workers and mental-manual workers (χ2=2.086 0, P=0.148 7).

CONCLUSIONFrom the perspective of probability, the multilevel model analysis reveals the differences in work ability of employees between different companies, and suggests that company, work type, and working years are the important influencing factors for work ability of employees. These factors should be improved and adjusted to protect or enhance the work ability of employees.

PURPOSE: The purpose of this study is to examine the factors associated with neurological outcome and to provide ideas for improving the operation of the emergency medical system in Korea. METHODS: A total of 95,911 out-of-hospital cardiac arrests (OHCAs) with cardiac etiology who were transported by 119 EMS ambulances for seven years from 2006 to 2012 in Korea were analyzed. According to these data there is a multilevel structure, so that patient's neurological outcome in the same region is not independent but interrelated, therefore two-level (patient-region) logistic regression analysis was applied to adjust this correlation. RESULTS: The adjusted odds ratio (OR) in the group in which Cardiopulmonary Resuscitation (CPR) was performed by a bystander was 1.27 for good neurological outcome. The adjusted OR in the group with implementation of an automated external defibrillator (AED) before arrival at the hospital was 4.11 for good neurological outcome. The adjusted OR in the numbers of emergency physicians compared with <3 was 2.76 (3-4), 4.24 (≥5) and the adjusted OR in OHCAs volume of each hospital compared with <50 was 2.31 (50-64), 2.51 (65-102), and 2.94 (≥103). The adjusted OR in deprivation level compared with <2 was 0.72 (≥2). CONCLUSION: The neurological outcome was significantly better in the group in which CPR was performed by a bystander and AED was applied early. The neurological outcome tended to be significantly better in hospitals with higher numbers of emergency physicians and higher volume of OHCAs, in less deprived districts.
Ambulances ; Cardiopulmonary Resuscitation ; Defibrillators ; Emergencies ; Korea ; Logistic Models ; Multilevel Analysis ; Odds Ratio ; Out-of-Hospital Cardiac Arrest*

PURPOSE: The purpose of this study is to examine factors affecting quality of life among grandparents raising their grandchildren. METHODS: This study carried out a secondary analysis of data from the 2014 Korean Longitudinal Study of Aging (KLoSA) and Statistics Korea. Data collected from 224 grandparents who reported raising their grandchildren were analyzed using descriptive statistics, independent t-test, ANOVA, pearson correlation coefficient, and multilevel regression analysis. RESULTS: The mean score of the participants' quality of life was 62.63. Significant predictors of quality of life of the grandparents included subjective health status, last year's total house income, number of last year's travels, frequency of last year's movie seeing, and number of children's parks per 100,000 population. CONCLUSION: These results suggest that public health nurses in improving quality of life of grandparents focus on children's parks and formal social supports as community factors as well as regular exercise as an individual factor in order to be more effective.
Aging ; Diagnostic Self Evaluation ; Grandparents* ; Korea ; Longitudinal Studies ; Multilevel Analysis ; Nurses, Public Health ; Quality of Life*

To compare two commonly used statistical approaches:the multilevel model and the latent growth curve model in analyzing longitudinal data. A longitudinal data set, obtained from the quality of life in patients with colorectal cancer after operation, was used to illustrate the similarities and differences between the two methods. Results from the study indicated that the latent growth curve modeling was equivalent to multilevel modeling with regards to longitudinal data which could yield identical results for the estimates of parameters. Multilevel model approach seemed easier for model specification. However, latent growth curve model had the advantage of providing model evaluation and was more flexible in statistical modeling by allowing the incorporation of latent variables. Both multilevel and latent growth curve models were suitable for analyzing longitudinal data with advantages on their own, they could be chosen by researchers under different situation to be chosen accordingly by researchers under different situation.
Colorectal Neoplasms ; surgery ; Humans ; Longitudinal Studies ; Models, Statistical ; Multilevel Analysis ; Postoperative Period ; Quality of Life

PURPOSE: We investigated the role of individual and community level factors on diabetes screening test behavior. METHODS: We used individual-level data from 170,193 adults aged 30 years or older who were not diagnosed with diabetes and participated in the 2009 community health survey. Community-level data includes 253 communities and were collected from various national statistics. Multilevel logistic regression analysis was conducted. RESULTS: The rate of diabetes screening within the year prior to this study was 53.2%. Community variance of Model I, Model II and Model III was 0.236, 0.252 and 0.238, respectively. The proportional change in variance of Model II and Model III was -6.8% and -1.2%. The odds ratio for participation of diabetic screening of areas with bottom financial independence compared to areas with top was 0.84 (95% confidence interval, 0.74-0.96); the odds ratio of areas with top internist compared to areas with bottom was 1.15 (95% confidence interval, 1.01-1.31). CONCLUSION: This study identified a contextual effect influencing the participation of Korean adults in diabetes screening. It is necessary to develop specific policies that consider not only individual factors, but also community factors relating to individual behaviors to increase the likelihood of diabetes screening.
Adult ; Aged ; Diabetes Mellitus ; Health Surveys ; Humans ; Logistic Models ; Mass Screening ; Multilevel Analysis ; Odds Ratio