1.Income-related Inequalities in Cancer Screening Among Korean Adults Aged 40 and Above: A Cross-sectional Analysis of the Age-varying Mediation of Health Literacy
Hyejin HONG ; Hyun-Jin GOO ; Hyebin CHOI ; Sin KAM ; Jong-Yeon KIM
Journal of Preventive Medicine and Public Health 2026;59(2):184-193
Objectives:
This study investigated how the mediating effect of health literacy (HL) on the association between income and cancer screening participation varies by age among Korean adults aged 40 years and older, with the aim of identifying the optimal timing for HL interventions.
Methods:
Data from 4171 adults aged ≥40 years in the 2023 Korea National Health and Nutrition Examination Survey were analyzed using moderated mediation analysis implemented with the lavaan.survey package, accounting for the complex sampling design. The Johnson–Neyman technique was used to identify age thresholds at which the mediation effect became statistically significant, and the number needed to benefit (NNB) was calculated to estimate the potential efficiency of interventions targeting this pathway.
Results:
Each 1-quintile increase in income was associated with a 16.0% higher likelihood of undergoing cancer screening (odds ratio=1.16, p<0.001). The mediating effect of HL increased significantly with age (index of moderated mediation=0.000438, p=0.048). Mediation became statistically significant from age 54.2 years (Johnson–Neyman threshold), with the proportion of the total effect mediated rising from 0.1% among adults aged 40–49 years to 8.1% among those aged ≥70 years. The NNB for this pathway indicated substantial intervention efficiency in older adults (NNB=372 for ages ≥70), whereas the mediation effect was not statistically significant in the 50–59 age group.
Conclusions
HL significantly mediated the relationship between income and cancer screening participation from the mid-50s onward, with progressively greater contributions at older ages. These findings support age-differentiated strategies, including structural accessibility improvements for adults in their 40s and early 50s and integrated income–HL interventions for individuals aged ≥55 years. Experimental studies are warranted to confirm these associations.
2.Analysis of Factors Related to Delirium in Hospitalized Cancer Patients in General Wards
Sojeong PARK ; Hyangkyu LEE ; Mona CHOI ; Hyejin KIM
Asian Oncology Nursing 2026;26(1):20-30
Purpose:
This study aimed to identify the incidence and related factors of delirium among cancer patients admitted to the general wards of a tertiary hospital.
Methods:
A retrospective analysis was performed on 9,749 adult cancer patients. Patients who screened positive for delirium were assessed using the Korean version of the Nursing Delirium Screening Scale (NuDESC). Data were analyzed using χ² tests, t-tests, and multiple logistic regression.
Results:
The incidence of delirium was 2.5% (n=243) based on screening results. Significant predictors included older age, longer hospital stays, emergency room admission, 90-day readmission, completion of life-sustaining treatment decisions, surgical department admission, altered consciousness (the strongest predictor), elevated white blood cell and blood urea nitrogen levels, and low albumin levels (p<.050).These 10 factors showed high discriminatory power for delirium (AUC=.91, 95% CI: 0.90~0.93).
Conclusion
The Nu-DESC should be actively utilized in clinical practice for early delirium detection. Nursing interventions must prioritize managing modifiable factors such as nutritional status, infection, and dehydration. Furthermore, case-sharing systems and regular education are essential to enhance nursing expertise and ensure patient safety.
3.Variability in the Length of Stay and Daily Medical Expenses in Inpatient Care in Korea, 2010–2019:Hypertension and Pneumonia
Haejong LEE ; Jin-Won NOH ; Sanghee LEE ; Jung-Kyu CHOI ; Jin Yong LEE ; Hyejin LEE ; Jung-Hoe KIM
Journal of Korean Medical Science 2025;40(13):e120-
This study examined the variability in the length of stay (LOS) and daily medical expenses (DME) for hypertension and pneumonia inpatient care. Using 10 years of National Health Insurance Service data (2010–2019), a multilevel analysis assessed variability at the patient and institutional levels. During the study period, the mean LOS decreased, whereas the DME increased for both hypertension and pneumonia. Institutional level variability in the LOS increased during the study period, demonstrating greater variability than that for pneumonia. For both conditions, institutional-level variability was more marked in smaller institutions (hospitals and clinics) than in larger institutions (general and tertiary hospitals).These findings indicate a need for standardized healthcare service protocols to promote consistent and efficient patient care.
4.The Effects of Semi-Occluded Vocal Tract Exercises on Presbyphonia in Elderly Women: Two Case Reports
HyeJin LIM ; Dong Won LEE ; Jeong Kyu KIM ; Seong-Hee CHOI
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2025;36(1):32-38
This case report investigates the effects of semi-occluded vocal tract exercises (SOVTEs) on voice improvement in elderly female patients with presbyphonia. Elderly female patients with presbyphonia commonly present with symptoms such as hoarseness, decreased vocal intensity, and phonatory difficulties. These symptoms are often associated with age-related vocal fold atrophy, leading to compensatory muscle tension and inefficient phonation, which necessitate targeted therapeutic interventions. In this study, two elderly female patients, aged 73 years and 71 years, participated in a voice therapy program centered on SOVTEs designed to promote vocal fold vibration efficiency and reduce compensatory tension. Case 1 underwent five therapy sessions, while Case 2 completed sixteen sessions. Pre- and post-treatment voice assessments revealed notable improvements in vocal quality, suggesting that SOVTEs may be an effective therapeutic approach for managing presbyphonia in elderly women.
5.Variability in the Length of Stay and Daily Medical Expenses in Inpatient Care in Korea, 2010–2019:Hypertension and Pneumonia
Haejong LEE ; Jin-Won NOH ; Sanghee LEE ; Jung-Kyu CHOI ; Jin Yong LEE ; Hyejin LEE ; Jung-Hoe KIM
Journal of Korean Medical Science 2025;40(13):e120-
This study examined the variability in the length of stay (LOS) and daily medical expenses (DME) for hypertension and pneumonia inpatient care. Using 10 years of National Health Insurance Service data (2010–2019), a multilevel analysis assessed variability at the patient and institutional levels. During the study period, the mean LOS decreased, whereas the DME increased for both hypertension and pneumonia. Institutional level variability in the LOS increased during the study period, demonstrating greater variability than that for pneumonia. For both conditions, institutional-level variability was more marked in smaller institutions (hospitals and clinics) than in larger institutions (general and tertiary hospitals).These findings indicate a need for standardized healthcare service protocols to promote consistent and efficient patient care.
6.The Effects of Semi-Occluded Vocal Tract Exercises on Presbyphonia in Elderly Women: Two Case Reports
HyeJin LIM ; Dong Won LEE ; Jeong Kyu KIM ; Seong-Hee CHOI
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2025;36(1):32-38
This case report investigates the effects of semi-occluded vocal tract exercises (SOVTEs) on voice improvement in elderly female patients with presbyphonia. Elderly female patients with presbyphonia commonly present with symptoms such as hoarseness, decreased vocal intensity, and phonatory difficulties. These symptoms are often associated with age-related vocal fold atrophy, leading to compensatory muscle tension and inefficient phonation, which necessitate targeted therapeutic interventions. In this study, two elderly female patients, aged 73 years and 71 years, participated in a voice therapy program centered on SOVTEs designed to promote vocal fold vibration efficiency and reduce compensatory tension. Case 1 underwent five therapy sessions, while Case 2 completed sixteen sessions. Pre- and post-treatment voice assessments revealed notable improvements in vocal quality, suggesting that SOVTEs may be an effective therapeutic approach for managing presbyphonia in elderly women.
7.Variability in the Length of Stay and Daily Medical Expenses in Inpatient Care in Korea, 2010–2019:Hypertension and Pneumonia
Haejong LEE ; Jin-Won NOH ; Sanghee LEE ; Jung-Kyu CHOI ; Jin Yong LEE ; Hyejin LEE ; Jung-Hoe KIM
Journal of Korean Medical Science 2025;40(13):e120-
This study examined the variability in the length of stay (LOS) and daily medical expenses (DME) for hypertension and pneumonia inpatient care. Using 10 years of National Health Insurance Service data (2010–2019), a multilevel analysis assessed variability at the patient and institutional levels. During the study period, the mean LOS decreased, whereas the DME increased for both hypertension and pneumonia. Institutional level variability in the LOS increased during the study period, demonstrating greater variability than that for pneumonia. For both conditions, institutional-level variability was more marked in smaller institutions (hospitals and clinics) than in larger institutions (general and tertiary hospitals).These findings indicate a need for standardized healthcare service protocols to promote consistent and efficient patient care.
8.Variability in the Length of Stay and Daily Medical Expenses in Inpatient Care in Korea, 2010–2019:Hypertension and Pneumonia
Haejong LEE ; Jin-Won NOH ; Sanghee LEE ; Jung-Kyu CHOI ; Jin Yong LEE ; Hyejin LEE ; Jung-Hoe KIM
Journal of Korean Medical Science 2025;40(13):e120-
This study examined the variability in the length of stay (LOS) and daily medical expenses (DME) for hypertension and pneumonia inpatient care. Using 10 years of National Health Insurance Service data (2010–2019), a multilevel analysis assessed variability at the patient and institutional levels. During the study period, the mean LOS decreased, whereas the DME increased for both hypertension and pneumonia. Institutional level variability in the LOS increased during the study period, demonstrating greater variability than that for pneumonia. For both conditions, institutional-level variability was more marked in smaller institutions (hospitals and clinics) than in larger institutions (general and tertiary hospitals).These findings indicate a need for standardized healthcare service protocols to promote consistent and efficient patient care.
9.The Effects of Semi-Occluded Vocal Tract Exercises on Presbyphonia in Elderly Women: Two Case Reports
HyeJin LIM ; Dong Won LEE ; Jeong Kyu KIM ; Seong-Hee CHOI
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2025;36(1):32-38
This case report investigates the effects of semi-occluded vocal tract exercises (SOVTEs) on voice improvement in elderly female patients with presbyphonia. Elderly female patients with presbyphonia commonly present with symptoms such as hoarseness, decreased vocal intensity, and phonatory difficulties. These symptoms are often associated with age-related vocal fold atrophy, leading to compensatory muscle tension and inefficient phonation, which necessitate targeted therapeutic interventions. In this study, two elderly female patients, aged 73 years and 71 years, participated in a voice therapy program centered on SOVTEs designed to promote vocal fold vibration efficiency and reduce compensatory tension. Case 1 underwent five therapy sessions, while Case 2 completed sixteen sessions. Pre- and post-treatment voice assessments revealed notable improvements in vocal quality, suggesting that SOVTEs may be an effective therapeutic approach for managing presbyphonia in elderly women.
10.Preliminary evaluation of the effect of revised reimbursement scheme in outpatient hemodialysis for medical aid recipients in Korea
Heenyun KIM ; Yongseok CHOI ; Soontack KWON ; Kook Young JANG ; Do Kyung RYUK ; Hyejin LEE ; Jin Yong LEE
Kidney Research and Clinical Practice 2025;44(3):444-451
South Korea has universal health coverage guaranteeing equitable healthcare for all. However, equity issues have been raised regarding hemodialysis reimbursement for medical aid recipients with chronic kidney disease. Physicians and civic groups demanded a revision of the discriminatory policy, and in response, the Ministry of Health and Welfare amended the hemodialysis case payment scheme. This study aims to evaluate the effectiveness of the reform and detect any unintended policy outcomes. Methods: Data from the Health Insurance Review and Assessment Service of Korea was used. All subjects were patients with chronic kidney disease who received outpatient hemodialysis and medical aid from April 2017 to March 2022. The dzata was analyzed with descriptive statistics, and the generalized estimation equation was used to control for covariates and identify policy effects. Results: The reform of the case payment scheme in 2021 raised the compensation level per hemodialysis case, which was fixed for 7 years from 2014, by approximately 2,000 Korean won. There was no negative effect such as additional expenditure resulting from an unintentional increase in medical use. Conclusion: A year has passed since the implementation of the outpatient hemodialysis rate system reform for medical aid recipients. Our results indicate that the reform has gone smoothly, and we anticipate continuous efforts by the government to guarantee universal health coverage to medical aid recipients. Through such consistent endeavors to correct the discriminatory aspects of policies, South Korea will achieve true universal health coverage.

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