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OBJECTIVE: Many municipal districts in Korea face population decline owing to overall population decreases and aging. We investigated the association between geographic rurality and likelihood of receiving diabetes management education and diabetic retinopathy and diabetes-related kidney disease screenings among adults with diabetes. METHODS: Patient data were obtained from the 2021 Korea Community Health Survey (27,391 individuals; aged ≥19 years and physician-diagnosed with diabetes mellitus). Geographic rurality was categorized based on population decline as follows: with, at risk of, or without population decline. The association between geographic rurality and likelihood of receiving diabetes management education and diabetic retinopathy and diabetes-related kidney disease screenings was examined using multilevel logistic regression analyses. RESULTS: Among 27,391 patients with diabetes, 31.1% received diabetes education; 40.0% and 46.4% were screened for diabetic retinopathy and diabetes-related kidney disease, respectively. Individuals residing in regions with population decline were less likely to receive diabetes education (odds ratio [OR] 0.62, 95% CI 0.50-0.75) and diabetic retinopathy (OR 0.79, 95% CI 0.70-0.90) and diabetes-related kidney disease (OR 0.64, 95% CI 0.55-0.75) screenings, as compared with their counterparts. CONCLUSIONS: Our findings highlight the importance of increased monitoring and providing diabetes education and screenings for patients with diabetes living in rural areas.
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Diabetes Mellitus , Retinopatia Diabética , Nefropatias , Animais , Adulto , Humanos , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/epidemiologia , Escolaridade , Inquéritos Epidemiológicos , República da Coreia/epidemiologia , Nefropatias/complicações , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologiaRESUMO
BACKGROUNDS: The overall screening rate for complication of diabetes kidney disease is improving; however, regional variations are increasing. It is necessary to select regions vulnerable to change and understand their characteristics. METHODS: Group-based trajectory analysis was performed to derive change patterns in the complication of diabetes kidney disease screening rate in 244 regions using Community Health Survey data between 2015 and 2019. ANOVA test was conducted to examine the differences in regional characteristics and CVD in each change pattern. RESULTS: The change patterns in complication of diabetes kidney disease screening rate were classified into four groups: high and rapidly increasing (Group 1, 5.2%), steady high (Group 2, 8.2%), moderate and increasing (Group 3, 52.9%), and low and slightly increasing (Group 4, 23.8%). Group 4 had many rural areas and worse socioeconomic status, healthcare systems, health behaviors, and diabetes management, and these regions had higher CVD mortality rates. CONCLUSIONS: Regions where the screening for complication of diabetes kidney disease rate did not improve compared to other regions were vulnerable not only in socioeconomic status, healthcare system, and health behavior, but also in disease management. This suggests the need for local and environmental support, as well as aggressive health service interventions in relatively vulnerable areas.
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BACKGROUND: Investigating the factors associated with unmet medical needs is important since it can reflect access to healthcare. This study examined the relationship between the unmet medical needs of patients with hypertension and their satisfaction with the healthcare services available in their neighborhoods. METHODS: Data were from the 2021 Korean Community Health Survey. The sample included individuals aged 19 years who were diagnosed with hypertension. The main outcome measure was unmet medical need. The relationship between the outcome measure and independent variables were analyzed using multivariate logistic regressions, along with a subgroup analysis based on whether patients were currently receiving treatment for hypertension. RESULTS: Unmet medical needs were found in 4.3% of the study participants. A higher likelihood of unmet medical needs was found in individuals not satisfied with the healthcare services at proximity (adjusted OR = 1.69, 95% CI: 1.49-1.92) compared to those satisfied with services nearby. Similar tendencies were found regardless of whether individuals were currently receiving treatment for hypertension, although larger differences were found between groups in participants who were currently not receiving treatment. CONCLUSIONS: The findings infer the need to consider patient satisfaction with nearby healthcare services in implementing public health policies that address unmet medical need in patients with hypertension.
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Acessibilidade aos Serviços de Saúde , Hipertensão , Humanos , Necessidades e Demandas de Serviços de Saúde , Satisfação do Paciente , Hipertensão/epidemiologia , Hipertensão/terapia , Satisfação PessoalRESUMO
BACKGROUND: Many municipalities in rural areas of Korea are facing population decline due to the aging population phenomenon. This study examined the relationship between residing in municipalities facing population decline and satisfaction with nearby healthcare infrastructure in older aged adults. METHODS: The 2021 Korea Community Health Survey (KCHS) data were used. Municipalities were classified as those not facing population decline, those at risk, and those facing population decline based on the Population Decline Index. The association between residing in municipalities facing population decline and satisfaction with nearby healthcare infrastructure was examined cross-sectionally using a multi-level logistic regression analysis. Satisfaction with available public transportation was concomitantly examined as it is related to accessing healthcare services. RESULTS: Of the 58,568 individuals aged 65 years or above analyzed, 27,471 (46.9%) adults were residing in municipalities without population decline, 4,640 (7.9%) adults in municipalities at risk of population decline, and 26,457 (45.2%) in municipalities with population decline. Individuals living in municipalities with population decline were more likely to be dissatisfied with nearby healthcare infrastructure (OR 1.76, 95% CI 1.41-2.20). Similar tendencies were found for public transportation infrastructure (OR 1.67, 95% CI 1.38-2.03). CONCLUSIONS: Individuals residing in municipalities with declining populations are more likely to report dissatisfaction with nearby healthcare infrastructure and public transportation. These findings emphasize the importance of providing adequate medical infrastructure to reduce potential health-related disparities.
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Acessibilidade aos Serviços de Saúde , Humanos , Idoso , Masculino , Feminino , República da Coreia , Estudos Transversais , Idoso de 80 Anos ou mais , Cidades , Dinâmica Populacional , Meios de Transporte/estatística & dados numéricos , População Rural/estatística & dados numéricos , Satisfação Pessoal , Inquéritos Epidemiológicos , Infraestrutura de Saúde PúblicaRESUMO
OBJECTIVES: Secondhand smoking may contribute to cognitive decline, but evidence on this subject is limited in the working economically active older adults. This study aimed to investigate the association between cognitive decline and exposure to secondhand smoke at work in economically active adults aged 65 years or above. STUDY DESIGN: Cross-sectional study using nationwide data. METHODS: Data were from the 2022 Korea Community Health Survey. Chi-squared test was used to perform descriptive statistics. The association between cognitive decline and exposure to secondhand smoke at work was analysed using multivariable logistic regression analysis. Subgroup analysis was performed based on to exposure status to secondhand smoke at home and diabetes mellitus. RESULTS: Of a total of 28,197 adults, 8767 (28.5%) individuals reported cognitive decline. Compared to individuals without exposure to passive smoking at work, those with such exposure were more likely to report cognitive decline (odds ratio: 1.30, 95% confidence interval: 1.14-1.47). This association was particularly strong in individuals with exposure to passive smoking at both work and home and in those diagnosed with diabetes mellitus. CONCLUSIONS: Exposure to secondhand smoking at work is associated with a higher likelihood of cognitive decline in older-aged economically active individuals. The findings infer the importance of monitoring passive smoking and implementing public health measures to reduce workplace secondhand smoke exposure.
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This study investigated the association between area deprivation level and performance of handwashing behavior during the COVID-19 pandemic in Korean adults. This study used data from the 2015 Population and Housing Census data to measure area deprivation level. The 2020 Korea Community Health Survey was used for all other variables, including hand hygiene behavior (August through November 2020). The association between area deprivation level and practice of handwashing behavior was examined using multilevel logistic regression analysis. The study population comprised 215,676 adults aged 19 years or above. Compared to the least area deprived group, the most deprived group was more likely to not wash hands after using the restroom (OR 1.43, 95% CI 1.13-1.82), after coming home (OR 1.85, 95% CI 1.43-2.39), and using soap (OR 1.55, 95% CI 1.29-1.84). The findings suggest the importance of considering area deprivation in implementing policies that promote handwashing, particularly during a pandemic.
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COVID-19 , Desinfecção das Mãos , Adulto , Humanos , Pandemias/prevenção & controle , COVID-19/prevenção & controle , Análise Multinível , República da Coreia/epidemiologiaRESUMO
BACKGROUND: This study investigated the association between various types of coronavirus disease 2019 (COVID-19)-related fear and the level of area deprivation in Korea. METHODS: Different types of COVID-19-related fear were examined, namely fear of infection, fear of dying from infection, fear of public criticism, fear of a family member getting infected and fear of economic loss. The level of area deprivation was measured based on the Area Deprivation Index, which was calculated based on population census data. The association between various types of COVID-19-related fear and the level of area deprivation was analyzed using multivariable logistic regression analysis. RESULTS: This study included 199 859 individuals from the 253 administrative divisions in South Korea. Findings indicated that fear was most common in individuals residing in the most deprived areas, followed by those in the mediocre and least deprived areas (fear of infection: odds ratio (OR) 1.05, 95% confidence interval (CI) 1.01-1.09; fear of dying from infection: OR 1.23, 95% CI 1.19-1.28; fear of public criticism: OR 1.20, 95% CI 1.15-1.24; fear of a family member getting infected: OR 1.12, 95% CI 1.07-1.18). CONCLUSIONS: The findings suggest the need to monitor and account for area deprivation in managing the psychological health effects of the COVID-19 crisis.
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COVID-19 , Humanos , Medo , Saúde Mental , República da Coreia/epidemiologiaRESUMO
PURPOSE: Quality of life may be influenced by the presence of eating disorders. This study investigated the association between night eating syndrome (NES) and health-related quality of life in the general population. METHODS: Data were from the 2019 Korea Community Health Survey. The presence of NES was determined using the Night Eating Questionnaire. Health-related quality of life was measured using the 3-level EuroQoL-5 Dimension Index. Multivariable linear regression analyses assessed the association between NES and health-related quality of life. Subgroup analyses were performed based on daily sleep duration. RESULTS: A total of 34,434 individuals aged 19 years or older were included in the study population. Participants with NES (ß = - 4.85, p < 0.001) reported poorer health-related quality of life scores than those without NES. Decreases in health-related quality of life scores among those with NES were greatest in those who slept over 8 h daily (ß = - 12.03, p = 0.004), followed by those who slept less than 6 h (ß = - 5.90, p = 0.006) and participants who slept between 6 and 8 h (ß = - 3.40, p = 0.026) daily. CONCLUSION: Individuals with NES were more likely to have a lower health-related quality of life than those without NES. These findings highlight the potential importance of considering NES in investigating the health-related quality of life. LEVEL OF EVIDENCE: Level III, well-designed case-control analytic studies.
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Transtornos da Alimentação e da Ingestão de Alimentos , Síndrome do Comer Noturno , Humanos , Adulto , Qualidade de Vida , Sono , República da Coreia , Ritmo Circadiano , Comportamento AlimentarRESUMO
OBJECTIVES: Due to the increasing cost of cancer treatment, the demand for value-based healthcare is increasing. Although several value frameworks have been developed recently in the field of oncology, the nononcological benefits of minimally invasive surgery have not been addressed. This study aimed to estimate how patients value nononcological benefits in minimally invasive cancer surgery. METHODS: The value that patients placed on various benefits of cancer surgery was termed throughout the study as patient value (PV). To quantize PVs for the benefits of cancer surgery, a one-tiered analytic hierarchy process model was constructed. The model includes 6 well-known surgical outcomes, including nononcological benefits. The study participants included 303 patients with cancer and family caregivers who participated in a questionnaire survey. RESULTS: The PVs for "decreased operation time," "reduced length of hospital stay," and "improved cosmetic results" were 0.050, 0.044, and 0.045, respectively, whereas the PVs for "increased survival," "prevention of disease recurrence," and "avoidance of complications" were 0.366, 0.292, and 0.203, respectively. The PV placed on nononcological benefits from minimally invasive surgery was one-tenth (10.2%) of the total value. CONCLUSIONS: Nononcological benefits arising from minimally invasive surgery were relatively small but nonnegligible. This value should be considered in the process of developing a value framework for cancer surgery and shared decision making.
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Procedimentos Cirúrgicos Minimamente Invasivos , Neoplasias , Humanos , Tempo de Internação , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Neoplasias/cirurgia , Duração da Cirurgia , Estudos RetrospectivosRESUMO
OBJECTIVE: Research has suggested that a correlation may exist between depressive mood and episodes of night eating. This study aimed to examine whether having episodes of night eating was associated with increased levels of depression. METHOD: This study used data from the 2019 Korea Community Health Survey and the study population consisted of adults aged ≥19 years. Depression levels were measured using the Patient Health Questionnaire-9. We investigated the patients' general characteristics using t-tests and analysis of variance. The association between depression levels and episodes of night eating was analyzed using a multivariable linear regression analysis. Subgroup analysis was conducted based on daily sleep duration. RESULTS: We analyzed 34,358 individuals and found higher average depression scores (ß: 4.99, p < .001) in those with episodes of night eating than those without. Large effect sizes were found for differences in depression scores between participants with and without episodes of night eating. The magnitude of this increase was particularly pronounced in individuals who reported 9 or more hours of sleep per day. DISCUSSION: An association was found between levels of depression and episodes of night eating as individuals with episodes of night eating were more likely to have higher depression scores. Our findings suggest the potential need to consider night eating when addressing the mental health of the general population.
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Depressão , Transtornos da Alimentação e da Ingestão de Alimentos , Adulto , Afeto , Depressão/complicações , Depressão/epidemiologia , Comportamento Alimentar/psicologia , Humanos , República da Coreia/epidemiologia , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVES: despite the extensive literature on the effectiveness of cognitive training, its effectiveness has not been demonstrated within a population-based long-term care system. To provide cognitive training services to older people with mild dementia, Korea introduced a special dementia rating, as a long-term care grades, in the national long-term care insurance in July 2014. These services are only offered to those with the special dementia rating. This study evaluated the national long-term care insurance-funded cognitive function training programme for older people with mild dementia. METHODS: data were derived from the Korean National Health Insurance Elderly Cohort database between 2008 and 2015. We compared changes in function between the intervention (n = 352) and control (n = 1952) groups before (2014) and after (2015) introduction of the cognitive function training programme. Difference-in-differences analysis was performed, to compare changes in each score between the intervention and control groups before and after introduction of the cognitive function training programme. RESULTS: introduction of the cognitive function training programme was associated with significantly less cognitive function decline in the intervention group than in the control groups (ß = -3.39; standard errors [SE] = 1.14; P = 0.003). A subgroup analysis revealed that this effect increased in subjects in the youngest group, low income bracket, who had a primary caregiver, who were supported in multiple activities of daily living by the primary caregiver, or who were not living alone. CONCLUSIONS: introduction of the cognitive function training programme was associated with positive effects on cognitive function.
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Atividades Cotidianas , Cognição/fisiologia , Demência/reabilitação , Seguro de Assistência de Longo Prazo/economia , Assistência de Longa Duração/métodos , Educação de Pacientes como Assunto/organização & administração , Avaliação de Programas e Projetos de Saúde , Idoso , Idoso de 80 Anos ou mais , Demência/economia , Demência/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , República da Coreia/epidemiologia , Estudos RetrospectivosRESUMO
OBJECTIVE: To examine the association between hospital volume and the unplanned 30-day readmission rate as a quality measure. DESIGN: A retrospective cross-sectional study. SETTING: The Korea healthcare system is operated by a single payer under the National Health Insurance Service. PARTICIPANTS: Using national health claims data of the Health Insurance Review and Assessment in South Korea, we examined 1 296 275 adult discharges (≥18 years old) from 90 hospitals (≥500 beds) in the 2013 calendar year. MAIN OUTCOME MEASURES: We analysed the 30-day, unplanned, observed-to-expected standardized readmission rate for hospitals and for five specialty cohorts: medicine, surgery/gynaecology, cardiovascular, cardiorespiratory, and neurology. We assessed the association between hospital volume by tertiles and the 30-day standardized readmission rates with and without adjustment for hospital characteristics. RESULTS: The rate for the lowest-volume hospitals was 6.10 compared with 6.20 for the highest-volume hospitals. We observed the standardized readmission rates did not differ significantly between the lowest- and highest-volume groups, except for the neurology cohort, which remained significant after adjusting for hospital characteristics. CONCLUSIONS: The standardized readmission rates were not associated with hospital volume, except for the neurology cohort, in which the standardized readmission rate was significantly higher in the highest-volume hospitals than in lowest- and intermediate-volume hospitals, which was not consistent with the typical association of greater hospital volume with better outcomes. This association was independent of hospital characteristics. Therefore, the rate of readmissions should be used with caution when gauging the quality of hospital care according to hospital volume.
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Hospitais com Alto Volume de Atendimentos/estatística & dados numéricos , Hospitais com Baixo Volume de Atendimentos/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Indicadores de Qualidade em Assistência à Saúde , Adulto , Estudos Transversais , Humanos , Neurologia/estatística & dados numéricos , República da Coreia/epidemiologia , Estudos RetrospectivosRESUMO
OBJECTIVES: The objective of our study was to investigate the relationship between catastrophic health expenditure (CHE) and health-related quality of life (HRQoL) in general population. METHODS: We used Korean Health Panel Survey data from 2011 to 2013, which included data from 8850 baseline participants of 19 years of age or older. We defined CHE as total annual out-of-pocket health payment that was 40% greater than the household's capacity to pay. HRQoL was measured using the EuroQol-visual analogue scale (EQ-VAS). We used generalized estimating equations to perform a longitudinal regression analysis. RESULTS: A total of 4.5% of the participants (n = 398) experienced CHE. Those with CHE tended to have a lower EQ-VAS index score compared with those without CHE (ß: - 1.34, p = 0.013). A subgroup analysis revealed that individuals experiencing CHE had significant decreases as the number of chronic diseases increased (three or more, ß: - 1.85, p = 0.014). CONCLUSIONS: Catastrophic health expenditure influences HRQoL, which was more pronounced in patient with chronic disease. The efforts should focus on people who suffer from excessive health expenditures and chronic diseases.
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Doença Catastrófica/economia , Financiamento Pessoal/economia , Qualidade de Vida/psicologia , Adulto , Idoso , Doença Crônica , Características da Família , Feminino , Financiamento Pessoal/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos , Humanos , Seguro Saúde/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Adulto JovemRESUMO
BACKGROUND: To discover the association between eating alone and diet quality among Korean adults who eat alone measured by the mean adequacy ratio (MAR), METHODS: The cross-sectional study in diet quality which was measured by nutrient intakes, indicated as MAR and nutrient adequacy ratio (NAR) with the Korean National Health and Nutrition Examination Survey (KNHANES) VI 2013-2015 data. Study population was 8523 Korean adults. Multiple linear regression was performed to identify the association between eating behaviour and MAR and further study analysed how socioeconomic factors influence the diet quality of those who eat alone. RESULTS: We found that the diet quality of people who eat alone was lower than that of people who eat together in both male (ß: - 0.110, p = 0.002) and female participants (ß: - 0.069, p = 0.005). Among who eats alone, the socioeconomic factors that negatively influenced MAR with the living arrangement, education level, income levels, and various occupation classifications. CONCLUSIONS: People who eat alone have nutrition intake below the recommended amount. This could lead to serious health problems not only to those who are socially disadvantaged but also those who are in a higher social stratum. Policy-makers should develop strategies to enhance diet quality to prevent potential risk factors.
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Dieta/métodos , Comportamento Alimentar , Inquéritos Nutricionais/estatística & dados numéricos , Adulto , Estudos Transversais , Dieta/estatística & dados numéricos , Ingestão de Energia , Feminino , Humanos , Coreia (Geográfico) , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais/métodos , Estado Nutricional , Fatores Socioeconômicos , Adulto JovemRESUMO
BACKGROUND: A more sedentary lifestyle can result in insulin resistance. However, few research studies have assessed the association between insulin resistance and sedentary lifestyle in Asian populations. Therefore, this study aimed to investigate the association of sedentary time with insulin resistance. In addition, we also investigate the moderate effect of employment status, moderate-to-vigorous physical activity (MVPA), and body mass index (BMI) in this association. METHODS: Data from 2573 individuals who participated in the 2015 Korean National Health and Nutrition Examination Survey were analyzed. Sedentary time was measured using self-administered questionnaires, and IR data were estimated using the homeostasis model assessment-insulin resistance index (HOMA-IR). Adjusted odds ratio (OR) and 95% confidence intervals (CIs) from a multivariable logistic regression model were generated for all participants. Subgroup analysis was only performed between sedentary time and HOMA-IR stratified by employment status, because moderate effects were not significant in the tests for interaction for MVPA and BMI. For all analyses, the individuals were categorized as having high or normal HOMA-IR values (> 1.6 and ≤ 1.6, respectively). RESULTS: A HOMA-IR > 1.6 was observed in 40.3% of the sedentary time Q1 (low) group (< 5.0 h/day), 41.4% of the sedentary time Q2 (middle-low) group, 44.2% of the sedentary time Q3 (middle-high) group, and 48.4% of the sedentary time Q4 (high) group (≥10.0 h/day). When the low level sedentary time group was used as the reference group, the high level sedentary time group was significantly associated with high IR value (HOMA-IR > 1.6) (OR = 1.40, 95% CI: 1.060-1.838). However, this association was not significant across the other sedentary time groups. Moreover, participants reporting a high sedentary time and were employed had 1.67 times the odds of having a high IR value (HOMA-IR > 1.6) compared to those who reported having a low sedentary time and were employed (OR = 1.67, 95% CI: 1.184-2.344). In the unemployed participants, sedentary time was not associated with IR. CONCLUSIONS: High sedentary time (≥10.0 h/day) was associated with elevated HOMA-IR among Korean adults without diabetes mellitus. Furthermore, the association between high sedentary time and HOMA-IR values was more pronounced in the employed population.
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Resistência à Insulina/fisiologia , Comportamento Sedentário , Adulto , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Autorrelato , Fatores de TempoRESUMO
In the present study, researchers examined the association between depressive symptoms and family stress and conflict from multiple roles, along with the combined effect of family stress and family-work conflict. We used data from the 2008-2012 Korean Welfare Panel Study, consisting of 4,663 baseline participants. We measured depressive symptoms using the 11-item Center for Epidemiologic Studies Depression Scale. There was a significant relationship between depressive symptoms and family stress and conflict among working married women. With regard to the combined analysis, working married women who reported both family stress and family-work conflict exhibited the highest odds of depressive symptoms.
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Depressão/epidemiologia , Conflito Familiar/psicologia , Casamento/psicologia , Estresse Psicológico/complicações , Mulheres Trabalhadoras/psicologia , Local de Trabalho/psicologia , Adulto , Estudos Transversais , Depressão/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Inquéritos e Questionários , Equilíbrio Trabalho-Vida/estatística & dados numéricosRESUMO
PURPOSE: To investigate the impact of different living arrangements on quality of life (QoL) and health-related quality of life (HRQoL) in the elderly. METHODS: We used data from the first to fourth wave of the Korean Longitudinal Study of Aging. Using the first wave as a baseline, the data included 5050 individuals aged 60 years and older with at least one living child. QoL and HRQoL were measured using a visual analogue scale developed by the Korean Labor Institute that bears similarity to the EQ-VAS. Living arrangements were categorized based on household composition (single household, one-generation household, two-generation household, and three-generation household) and the marital status of a cohabiting adult child. A generalized estimating equation was used to examine the association between living arrangements and QoL/HRQoL. RESULTS: Compared to elderly individuals living in three-generation families with a married child, those in a single household (QoL: ß = -2.67 [P = 0.001]; HRQoL: ß = -2.24 [P = 0.007]), those living in a three-generation family with an unmarried adult child (QoL: ß = -5.19 [P < 0.0001]; HRQoL: ß = -3.41 [P < 0.0001]), and those living in a two-generation family with an unmarried adult child (QoL: ß = -2.88 [P < 0.0001]; HRQoL: ß = -2.80 [P < 0.0001]) were more likely to have lower QoL and HRQoL. These associations were particularly strong for women and individuals in the lowest equivalent household income group. CONCLUSION: It is necessary to devise government programs not only for elderly individuals living alone, but also for those living with an unmarried adult child; elderly persons who are female and part of the lowest equivalent household income group must receive particular attention.
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Qualidade de Vida/psicologia , Características de Residência , Idoso , Envelhecimento , Povo Asiático , Feminino , Humanos , Estudos Longitudinais , Estado Civil , Pessoa de Meia-IdadeRESUMO
PURPOSE: Work-related factors are one of the known risk factors for depression. Given that the ability to work is considered an important aspect of well-being and health status, we investigated the association between the loss of work ability and depression. We further examined the association stratified by employment status. METHODS: We used data from the Korea Welfare Panel Study. The dependent variable of the present study was depression, which is measured by the Center for Epidemiologic Studies Depression Scale. Work ability transition from the previous year was divided into three categories: maintained, loss, and complete loss. A linear mixed-effects model was performed for the analysis. RESULTS: The work ability loss group (ß = 2.071, p < 0.0002) and the work ability completely loss group (ß = 2.651, p = 0.015) had higher depression scores compared to those who maintained their work ability from the previous year. Specifically, those who lost their work ability and their job (ß = 3.685, p = 0.0068) had the highest depression scores compared to those who maintained their work ability and job. CONCLUSIONS: We found that those who lost their ability to work may be at risk of depression, and this finding was particularly prominent among those who also became unemployed. Therefore, psychological support is needed for these individuals to overcome the negative influence of the loss of work ability.
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Depressão/psicologia , Emprego/psicologia , Trabalho/psicologia , Adulto , Idoso , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , República da Coreia , Fatores de Risco , Avaliação da Capacidade de Trabalho , Adulto JovemRESUMO
Background: The risk of pressure ulcers in beneficiaries of long-term care insurance is expected to increase in South Korea's aging society. However, those who stay at home may not be managed appropriately with regard to pressure ulcer development. Here, we examined the relationship between home-visit nursing services and hospitalization related to pressure ulcers among beneficiaries with pressure ulcers in home-care settings. Methods: We analyzed National Aging Cohort data from 2008 to 2013. The study population was defined as those who required nursing care for pressure ulcers and received home-care services at least once under long-term care insurance. Logistic regression analysis using generalized estimating equation models was performed to examine the association between home-visit nursing services and hospitalization related to pressure ulcers. Results: Among 4,807 beneficiaries with pressure ulcers, 859 (17.9%) were admitted to hospitals during the study period. The use of home-visit nursing services was associated significantly with a lower risk of hospitalization (odds ratio = 0.68, 95% confidence interval = 0.49-0.93; reference, no use). This association was especially strong in beneficiaries with mildly impaired mobility and cognitive function. Conclusions: Given the protective role of home-visit nursing services in the management of long-term care insurance beneficiaries with pressure ulcers who stay at home, healthcare professionals need to consider effective strategies for the activation of home-visit nursing services in South Korea.
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Serviços de Assistência Domiciliar/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Úlcera por Pressão/enfermagem , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Razão de Chances , República da Coreia , Medição de RiscoRESUMO
Background: The rates of Cesarean delivery in South Korea are high among the Organization for Economic Cooperation and Development countries. We analyzed the relationship between hospital characteristics, in particular hospital volume and market competition and Cesarean delivery. Methods: We used data from National Health Insurance claims (n = 53 591) at 51 hospitals to analyze the relationship between hospital characteristics and Cesarean delivery between 2010 and 2013. We performed logistic regression analysis using generalized estimating equations models that included both inpatient and hospital variables to examine factors associated with Cesarean delivery. Results: Among 53 591 hospitalization cases, 14 425 (26.9%) patients underwent Cesarean delivery. Hospital volumes for deliveries were inversely associated with Cesarean delivery (per increases 100 deliveries = OR 0.896, 95% CI 0.887-0.905). Market competition had inverse relationship with Cesarean delivery (per increase in 10 Hirschmann-Herfindal index points; OR 0.982, 95% CI 0.979-0.985). Conclusions: Our findings suggest that hospital characteristics affect Cesarean delivery. These situations might be caused by maintaining profit with regard to survival or competition, and protecting themselves against unexpected delivery risks. Therefore, based on our findings, health policy makers must make an effort to implement effective strategies for the optimal management of excessive Cesarean rates in South Korea.