OBJECTIVE: The rates of participation in the Korean nationwide cervical cancer screening program and the rates of abnormal test results were determined. METHODS: The database of the National Health Insurance Service (NHIS) was used during the study period (2009–2014). RESULTS: The participation rate increased from 41.10% in 2009 to 51.52% in 2014 (annual percentage change, 4.126%; 95% confidence interval [CI]=2.253–6.034). During the study period, women ≥70 years of age had the lowest rate of participation (range, 21.7%–31.9%) and those 30–39 years of age the second-lowest (27.7%–44.9%). The participation rates of National Health Insurance beneficiaries (range, 48.6%–52.5%) were higher than those of Medical Aid Program (MAP) recipients (29.6%–33.2%). The rates of abnormal results were 0.65% in 2009 and 0.52% in 2014, with a decreasing tendency in all age groups except the youngest (30–39 years). Every year the abnormal result rates tended to decrease with age, from the age groups of 30–39 years to 60–69 years but increased in women ≥70 years of age. The ratio of patients with atypical squamous cells of undetermined significance compared with those with squamous intraepithelial lesions increased from 2.71 in 2009 to 4.91 in 2014. CONCLUSION: Differences related to age and occurring over time were found in the rates of participation and abnormal results. Further efforts are needed to encourage participation in cervical cancer screening, especially for MAP recipients, elderly women and women 30–39 years of age. Quality control measures for cervical cancer screening programs should be enforced consistently.
Aged ; Atypical Squamous Cells of the Cervix ; Early Detection of Cancer* ; Female ; Humans ; Korea* ; Mass Screening* ; National Health Programs* ; Papanicolaou Test ; Quality Control ; Squamous Intraepithelial Lesions of the Cervix ; Uterine Cervical Neoplasms*

PURPOSE: The purpose of this study was to investigate the factors affecting suicidal ideation and suicidal attempts of older adults aged 65 years and older. METHODS: A part of the 2014 Community Health Survey data were used for analysis. Responses of 3,287 older adults living in Chungbuk province were analyzed using complex sample multiple logistic regression analysis. RESULTS: The percentages of older people who experienced suicidal ideation and attempt during the past year were 21.7% and 0.8%, respectively. Limitation of daily living activities, pain/discomfort, stress and depression were significant risk factors of older adults' suicidal ideation. The significant risk factor of suicidal attempt was suicidal ideation, followed by depression and limitation of daily activities. The frequencies of elderly people using professional counseling related to the stress, depression or suicidal ideation were very low showing 2.1%, 1.8%, and 1.4% respectively. The protective impact of counselling on suicidal ideation and attempt were not able to be identified because of the low rate of participation of counselling program in this study. CONCLUSION: The common risk factors of suicidal ideation and attempt were depression and the limitation of daily activity; therefore, community services for them should be emphasized. In addition, there should be an effort to increase the utilization rate of professional counselling and to identify the effects of counselling on the prevention of suicidal behaviors.
Activities of Daily Living ; Adult* ; Aged ; Chungcheongbuk-do ; Counseling ; Depression ; Health Surveys* ; Humans ; Independent Living* ; Logistic Models ; Risk Factors* ; Social Welfare ; Suicidal Ideation* ; Suicide, Attempted

BACKGROUND: This study was conducted to analyze the influence of socioeconomic characteristics of community on the food insecurity under the control of personal socioeconomic factors which may be influence to the food security. METHODS: Food insecurity and individual socioeconomic characteristics were obtained from 2012 community health survey. Socioeconomic characteristics of communities were extracted from the data of Statistics Korea and local governments. Personal socioeconomic factors were sex, age, educational status, job, and monthly family income. Socioeconomic characteristics of communities were administrative district (urban vs. rural), senior population rate, degree of financial self reliance, degree of financial independence, portion of welfare budget, number of welfare facilities, and unemployment rate. We analysed the relationships between the food insecurity and socioeconomic characteristics of community using multi-level analysis under the control of personal characteristics. RESULTS: On personal level age, sex, education status, and monthly family income were related with food insecurity. On community level administrative district (urban vs. rural), degree of financial independence, unemployment rate, and proportion of welfare budget among local general government accounts were related to individual food insecurity. Rural area, district with low levels of financial independence, low portion of welfare budget, and greater unemployment rate showed a higher level of food insecurity. CONCLUSION: To reduce the level of food insecurity in a community it is necessary to decrease the unemployment rate, in addition to providing support from the central government by increasing the proportion of the welfare budget so that both factors contribute to raising the degree of financial independence.
Adult* ; Budgets ; Education ; Educational Status ; Food Supply* ; Health Surveys ; Humans ; Korea ; Socioeconomic Factors ; Unemployment

BACKGROUND: This study aimed at assessing the number of red blood cell (RBC) units transfused at different types of medical institution and examining the characteristics of transfusion recipients. METHODS: We calculated and compared the number of transfusion recipients, total RBC units transfused, and RBC units transfused per recipient. Study data were extracted from insurance benefits reimbursement claims for RBC units at the Health Insurance Review & Assessment Service from 2006 to 2010. RESULTS: Between 2006 and 2010, the number of recipients of RBC units increased from 298,049 to 376,445, the number of RBC units transfused increased from 1,460,799 to 1,841,695, and the number of RBC units transfused per recipient changed from 4.90 to 4.89. The number of recipients aged > or =65 yr increased from 133,833 (44.9%) in 2006 to 196,127 (52.1%) in 2010. The highest number of RBC units was transfused to patients with neoplastic diseases (31.9%) and diseases of the musculoskeletal system and connective tissue (14.4%). More than 80% of the total number of RBC units were transfused at tertiary and general hospitals. However, this composition rate was slightly decreasing, with the composition rate for hospitals increasing from 12.6% to 16.3%. CONCLUSIONS: This study revealed an increase in the number of RBC units transfused over a 5-yr period due to an increase in the number of transfused recipients, especially recipients aged > or =65 yr; moreover, the number of RBC units transfused differed based on medical institution type. These results provide fundamental data on RBC transfusions required for future research.
Adolescent ; Adult ; Age Factors ; Aged ; Child ; Child, Preschool ; Connective Tissue Diseases/therapy ; Databases, Factual ; Erythrocyte Transfusion/*statistics & numerical data/*trends ; Female ; Hospitals, General/statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Insurance, Health, Reimbursement/*statistics & numerical data ; Male ; Middle Aged ; Musculoskeletal Diseases/therapy ; Neoplasms/therapy ; Republic of Korea ; Sex Factors ; Tertiary Care Centers/statistics & numerical data ; Young Adult

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

PURPOSE: As a follow-up for the validity study of Community Health Surveys (CHSs), the purpose of this study was to evaluate the factors affecting the accuracy of CHSs by investigating subjects' characteristics. MATERIALS AND METHODS: We used data from 11,217 participants (aged 19 years or older) who had participated in the CHS, conducted by a local government in 2008 and analyzed the variables affecting the sensitivity and specificity of hospitalization and outpatient visit. RESULTS: Multivariate logistic regression analysis showed that, factors related with the sensitivity of hospitalization and outpatient visit questions were gender, age, marital status, chronic diseases, medical checkup, the subjective health status and necessary medical services. Factors related with the specificity were gender, marital status, educational background, chronic diseases, medical checkup, alcohol consumption, necessary medical services and sadness. CONCLUSION: This study revealed the subject-related factors associated with the validity of the CHS. Efforts to improve the sensitivity and the specificity from self-report questionnaires should consider how the characteristics of subjects may affect their responses.
Adult ; Age Factors ; Ambulatory Care ; Female ; Health Care Surveys ; Health Services/*utilization ; Health Status ; *Health Surveys ; Hospitalization ; Humans ; Logistic Models ; Male ; Middle Aged ; Questionnaires ; Reproducibility of Results ; Republic of Korea ; Residence Characteristics ; *Self Report ; Young Adult

BACKGROUND: Hepatitis B remains the most common transfusion-transmitted viral infection. We explored the current status of pre-transfusion screening and post-transfusion follow-up testing for hepatitis B virus (HBV) surface antigen (HBsAg) and antibodies (anti-HBs) in blood recipients from an area of high HBV endemicity. METHODS: A total of 7,780 blood recipients were transfused with at least 1 unit of blood component at a single university hospital in Korea between January 2006 and December 2009. Their medical records were reviewed, and their demographic and transfusion-related data were analyzed. RESULTS: Pre-transfusion HBsAg and anti-HBs levels were tested in 77.6% (6,037/7,780) of the recipients. The results varied widely according to recipient age. In all, 32.8% (1,982/6,037) of the recipients who were tested had dual negative pre-transfusion results for HBsAg and anti-HBs and, therefore, were at increased risk of HBV transmission. Post-transfusion follow-up testing for HBsAg and/or anti-HBs was performed in 22% (436/1,982) of the increased-risk group. CONCLUSIONS: Our data show that current transfusion-related laboratory testing practice is not sufficient to properly investigate possible post-transfusion infections. Routine laboratory tests, including HBsAg and anti-HBs, should be recommended in transfusion guidelines.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; *Blood Transfusion ; Child ; Child, Preschool ; Cohort Studies ; Demography ; Endemic Diseases ; Female ; Hepatitis B/*diagnosis/epidemiology/*transmission ; Hepatitis B Antibodies/*blood ; Hepatitis B Surface Antigens/*blood ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Retrospective Studies ; Risk

PURPOSE: Longitudinal changes in the prevalence of self-reported physician-diagnosed allergic rhinitis (AR) in Korea and the association between the prevalence of AR and type of residence area among Korean males and females in 1998, 2001, 2005 and 2007-2009 were evaluated. METHODS: Age-standardized prevalence was calculated using the Korea National Health and Nutrition Examination Survey (KNHANES) I-IV. Stratified factors of sex, age, and socioeconomic status were adjusted to compare the prevalence of AR in relation to residential area by multiple logistic analysis. RESULTS: The prevalence of AR increased by tenfolds from 1.2 % in 1998 to 12.0 % in 2007-2009. The trends for prevalence of AR were also statistically significant (p < .05). The age-standardized prevalence of AR among urban females was higher (13.9%) than that in rural females (11.5%). After adjustment for survey years, age, socioeconomic levels and asthma, the odds of AR were higher in urban than rural residents, except for males in 1998. CONCLUSION: The prevalence of AR in Korea has increased over the past decade, and living in an urban area may be a susceptible factor. For prevention and management of AR, further evaluations of contributing factors and mechanisms underlying differences in AR are needed.
Asthma ; Female ; Health Surveys ; Humans ; Korea ; Male ; Nutrition Surveys ; Prevalence ; Rhinitis ; Rhinitis, Allergic, Perennial ; Social Class ; Urbanization

PURPOSE: This study was done to investigate factors affecting preparation stage to quit smoking in men. METHODS: Based on data from the Community Health Survey conducted in Chungbuk Province in 2008, we estimated rates and odds ratio (OR) of smoking cessation intention for 2,639 men who were current smokers. Multivariate logistic regression analyses were used to identify factors affecting preparation stage to quit smoking. RESULTS: Among current male smokers, the rate of smoking cessation intention was 17.1%. The OR of factors affecting smoking cessation was as follows: Compared to men with middle school education, the OR for rate of smoking cessation intention in men with high school education was 1.47 (p=.018), and for college or higher, 1.55 (p=.017). Compared to being single, the OR for cohabitation after marriage was 1.61 (p=.011) and living alone after marriage, 2.23 (p=.005). The OR for attempt to quit smoking, exposure to secondhand smoke and participation in smoking education were 6.80 (p<.001), 1.32 (p=.020) and 1.69 (p=.005), respectively. CONCLUSION: Results of this study show that it is necessary to decrease exposure to secondhand smoke and to increase participation in smoking cessation education targeting current smokers to move them from precontemplation or contemplation stage to preparation stage.
Adult ; Age Factors ; Aged ; Demography ; Humans ; Logistic Models ; Male ; Marriage ; Middle Aged ; Odds Ratio ; Smoking/*psychology ; *Smoking Cessation ; Tobacco Smoke Pollution ; Young Adult

PURPOSE: No precise data are available showing how magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) can be applied to diagnosis for the first attack of a suspected cerebrovascular disease in Korea. The purpose of this study was to evaluate the application level of MRI and MRA as diagnostic tools and the related factors to the use of these techniques. MATERIALS AND METHODS: This study used the health benefit claim data of 89,890 patients who were hospitalized for the first time due to suspected cerebrovascular disease in 2007 without having visited medical institutions as an outpatient or inpatient from 2003 to 2006. RESULTS: Of the 89,890 cases, 28.4% took both MRI and MRA, 10.7% took only MRI and 6.9% took only MRA. The related factors identified in the multivariate logistic regression analysis were gender, type of insurance, type of medical institution, type of department, duration of hospitalization, and type of disease. CONCLUSION: This study showed that the application level of MRI and MRA as diagnostic measures for the first attack of a suspected cerebrovascular diseases varied depending on several factors. It is necessary to study more accurate levels of computerized tomography (CT), computerized tomography angiography (CTA), MRI or MRA as measures to diagnose a first attack of suspected cerebrovascular disease.
Adolescent ; Adult ; Aged ; Cerebral Angiography ; Cerebrovascular Disorders/*diagnosis/radiography ; Female ; Humans ; Magnetic Resonance Angiography/*utilization ; Magnetic Resonance Imaging/*utilization ; Male ; Middle Aged ; Odds Ratio ; Republic of Korea ; Tomography, X-Ray Computed ; Young Adult