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Original Articles
Characteristics of Inpatients Who Survive Suicide Attempts
Sang Mi Kim, Hyun-Sook Lee
Osong Public Health Res Perspect. 2019;10(1):32-38.   Published online February 28, 2019
DOI: https://doi.org/10.24171/j.phrp.2019.10.1.07
  • 3,013 View
  • 149 Download
  • 1 Citations
AbstractAbstract PDF
Objectives

The purpose of this study was to analyze the characteristics and factors affecting the survival of inpatients admitted following a suicide attempt.

Methods

A total of 3,095 cases retrieved from the Korean National Hospital Discharge In-depth Injury Survey data (from 2011 to 2015) were grouped according to survival and death and analyzed using descriptive statistics chi-square and logistic regression analysis.

Results

The following factors had statistically significant risks on reducing survival: female (OR = 2.352, p < 0.001), 40–59 years old (OR = 0.606, p = 0.014), over 60 years old (OR = 0.186, p < 0.001), poisoning (OR = 0.474, p = 0.009), hanging (OR = 0.031, p < 0.001), jumping (OR = 0.144, p < 0.001), conflicts with family (OR = 2.851, p < 0.001), physical diseases (OR = 1.687, p = 0.046), mental health problems (OR = 2.693, p < 0.001), financial problems (OR = 3.314, p = 0.002), 2014 (OR = 2.498, p = < 0.001) and 2015 (OR = 2.942, p = 0.005).

Conclusion

The survival group that had a history of attempted suicide (high-risk suicide group), should be further characterized. It is necessary to identify the suicide methods and risk factors for suicide prevention management policies and to continuously expand the management policy according to these characteristics.

Effects of Physical Activity on Depression in Adults with Diabetes
Deok-Ju Kim
Osong Public Health Res Perspect. 2018;9(4):143-149.   Published online August 31, 2018
DOI: https://doi.org/10.24171/j.phrp.2018.9.4.02
  • 3,629 View
  • 130 Download
  • 4 Citations
AbstractAbstract PDF
Objectives

The purpose of this study was to identify the current state of physical activity in adults with diabetes and to investigate the effect of physical activity on depression.

Methods

The present study was conducted using data from the 2nd year of the 6th Korea National Health and Nutritional Examination Survey. From the total of 7,550 individuals, 418 adults diagnosed with diabetes were selected as participants, and their physical activity and depression levels were examined.

Results

The physical activity status of the participants showed that they did not usually engage in physical activities at work, and only a few participants were involved in moderate intensity physical leisure activity. Apart from walking for 10 minutes each day, which accounted for 1/3 of the participants, most of the participants did not engage in specific forms of exercise. An examination of the effects of physical activity on depression revealed that moderate intensity physical activity at work and leisure influenced depression. In terms of demographic characteristics, gender, occupation, income quintile, and subjective health status were all found to affect depression.

Conclusion

For elderly (60 years or older) patients with diabetes, which accounted for the majority of the diabetic population, a systematic leisure program and professional education are necessary to help them to manage stress and depression in daily life. Additionally, provision of community and family support should encourage regular, moderate intensity exercise and promote lifestyle changes to encourage increased physical activity.

Treatment with Sofosbuvir and Daclatasvir (with or without Ribavirin) Improves Patient Reported Outcomes in Hepatitis C
Lucas Pereira Jorge de Medeiros, Mario Barreto Correa Lima, Marcia Maria Amêndola Pires, Alessandra Mendonça Almeida Maciel, Renata Barboza Vianna Medeiros, Mariana Dermínio Donadel, Isabela Martins Becattini Pereira, Fábio Marchon Leão, Luiz Eduardo Amorim Correa Lima Pires, Helio Rzetelna, Carlos Eduardo Brandão-Mello
Osong Public Health Res Perspect. 2018;9(2):50-58.   Published online April 30, 2018
DOI: https://doi.org/10.24171/j.phrp.2018.9.2.03
  • 3,122 View
  • 34 Download
  • 4 Citations
AbstractAbstract PDF
Objectives

To evaluate the impact of 3 treatment regimens upon health-related quality of life and work productivity using patient-reported outcomes (PROs) in chronic hepatitis C infected patients: sofosbuvir (SOF) + daclatasvir (DCV); SOF + DCV + ribavirin (RBV); SOF + simeprevir (SMV).

Methods

4 questionnaires were used to evaluate PROs before, during and after treatment: Short Form-36 (SF-36), Chronic Liver Disease Questionnaire (CLDQ) - hepatitis C virus (HCV), Work Productivity and Activity Index, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F).

Results

Of the global sample of 55 patients included in this study; SOF + DCV (n = 10); SOF + DCV + RBV (n = 29); SOF + SMV (n = 16) all had a statistically significant improvement in SF-36, CLDQ and FACIT-F scores during and post-treatment. No statistically significant differences in the PRO questionnaire values were observed between the distinct treatment regimens. The SOF and SMV patient groups presented higher mean PRO variations during and post-treatment, compared to the other groups: SF-36 functional capacity (16.1); SF-36 mental health (21.4); CLDQ activity (1.8); CLDQ emotional function (1.2); FACIT-F physical well-being (8.0); Total FACIT-F (21.6).

Conclusion

Treatment with SOF + DCV, with or without RBV, results in an improved PRO similar to treatment with SOF + SMV in chronic hepatitis C patients.

Comparative Analysis of the Trends in Medical Utilization of Cancer Inpatients in Korea
Hyun-Ju Lee, Sung-Soo Kim
Osong Public Health Res Perspect. 2017;8(5):342-350.   Published online October 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.5.08
  • 2,201 View
  • 30 Download
AbstractAbstract PDF
Objectives

Cancer has attracted worldwide attention. The incidence and prevalence are increasing, and it is the main cause of death. The purpose of this study was to identify the characteristics of hospitalized cancer patients.

Methods

This study is a secondary data study using the Korean National Hospital Discharge In-depth Injury Survey Data conducted annually by the Korea Centers for Disease Control and Prevention. Using these data, we extracted inpatients who principal diagnosis is cancer for nine years from 2005 to 2013.

Results

According to the analysis, the annual trend of cancer inpatients is steadily increasing. In 2025, it is expected to increase to about 670,000 inpatients. A cancer diagnosis created a change in medical utilization depending on the characteristics of patients and hospital. Men are more at risk of cancer than women. The number of hospital beds and hospital days were inversely proportional to cancer inpatients. There was also a difference in the equity of medical utilization by region. Other cancer management policies should be based on sex.

Conclusion

Populations between the ages of 45 and 64 years should be a priority in cancer policy. Because of the long-term hospitalization of patients with death as the outcome, a terminal cancer patient care facility is needed. These conclusions can provide a basis for various health policies.

Quality of Life of Chronic Hepatitis C Patients and Its Associated Factors
Hoo Jeung Cho, Euna Park
Osong Public Health Res Perspect. 2017;8(2):124-129.   Published online April 30, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.2.04
  • 2,857 View
  • 27 Download
  • 7 Citations
AbstractAbstract PDF
Objectives

This study aimed to investigate the factors affecting the health-related quality of life (HRQOL) of patients with chronic hepatitis C (CHC).

Methods

This study is based on a descriptive survey and involved 125 gastroenterology outpatients visiting a university hospital in South Korea as the participants. HRQOL was assessed using the Liver Disease Quality of Life 1.0, which consisted of Short Form-36 (SF-36) and the Liver Disease Targeted Scale. Data were collected from December 2015 to April 2016, which were then analyzed through multiple regression analysis.

Results

HRQOL had a statistically significant correlation with age, sex, educational level, living type, employment status, monthly income level, and comorbidity status. This study showed that age > 51 years, female sex, high educational level, living alone, unemployment status, low monthly income, and presence of comorbidity had negative effects on the HRQOL of patients with CHC (R2 = 8.7%–34.6%).

Conclusion

Based on the result of this study, intervention for patients with CHC needs to be developed to enhance their HRQOL. The findings can serve as a useful reference for nursing personnel in the development of therapeutic plans to upgrade the care of CHC patients.

Evaluating Service Quality from Patients' Perceptions: Application of Importance–performance Analysis Method
Rafat Mohebifar, Hana Hasani, Ameneh Barikani, Sima Rafiei
Osong Public Health Res Perspect. 2016;7(4):233-238.   Published online August 31, 2016
DOI: https://doi.org/10.1016/j.phrp.2016.05.002
  • 2,029 View
  • 17 Download
  • 33 Citations
AbstractAbstract PDF
Objectives
Providing high service quality is one of the main functions of health systems. Measuring service quality is the basic prerequisite for improving quality. The aim of this study was to evaluate the quality of service in teaching hospitals using importance–performance analysis matrix.
Methods
A descriptive–analytic study was conducted through a cross-sectional method in six academic hospitals of Qazvin, Iran, in 2012. A total of 360 patients contributed to the study. The sampling technique was stratified random sampling. Required data were collected based on a standard questionnaire (SERVQUAL). Data analysis was done through SPSS version 18 statistical software and importance–performance analysis matrix.
Results
The results showed a significant gap between importance and performance in all five dimensions of service quality (p < 0.05). In reviewing the gap, “reliability” (2.36) and “assurance” (2.24) dimensions had the highest quality gap and “responsiveness” had the lowest gap (1.97). Also, according to findings, reliability and assurance were in Quadrant (I), empathy was in Quadrant (II), and tangibles and responsiveness were in Quadrant (IV) of the importance–performance matrix.
Conclusion
The negative gap in all dimensions of quality shows that quality improvement is necessary in all dimensions. Using quality and diagnosis measurement instruments such as importance–performance analysis will help hospital managers with planning of service quality improvement and achieving long-term goals.
Factors associated with health services utilization between the years 2010 and 2012 in Korea: using Andersen's Behavioral model
Han-Kyoul Kim, Munjae Lee
Osong Public Health Res Perspect. 2016;7(1):18-25.   Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2015.11.007
  • 2,001 View
  • 21 Download
  • 43 Citations
AbstractAbstract PDF
Objectives
This study aimed to examine the factors associated with health services utilization using Andersen's behavioral model.
Methods
We collected Korea Health Panel data between the years 2010 and 2012 from the consortium of the National Health Insurance Service and the Korea Institute for Health and Social Affairs, and analyzed the data to determine the outpatients and inpatients of health services utilization.
Results
Health services utilization was more significantly explained by predisposing and need factors than enabling factors. The outpatients were examined more specifically; sex, age, and marital status as predisposing factors, and chronic illness as a need factor were the variables that had significant effects on health-services-utilization experience. The inpatients were examined more specifically: sex, age, and marital status in predisposing factors; education level, economic activities, and insurance type in enabling factors; and chronic illness and disability status in need factors were the significant variables having greater effects on health-services-utilization experience.
Conclusion
This study suggests the practical implications for providing health services for outpatients and inpatients. Moreover, verifying the general characteristics of outpatients and inpatients by focusing on their health services utilization provides the baseline data for establishing health service policies and programs with regard to the recently increasing interest in health services.
Nurse-Perceived Patient Adverse Events depend on Nursing Workload
Jeong-Hee Kang, Chul-Woung Kim, Sang-Yi Lee
Osong Public Health Res Perspect. 2016;7(1):56-62.   Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2015.10.015
  • 1,645 View
  • 17 Download
  • 25 Citations
AbstractAbstract PDF
Objectives
The purpose of this study was to investigate the correlation between nursing workload and nurse-perceived patient adverse events.
Methods
A total of 1,816 nurses working in general inpatient units of 23 tertiary general hospitals in South Korea were surveyed, and collected data were analyzed through multilevel logistic regression analysis.
Results
Among variables related to nursing workload, the non-nursing task experience had an influence on all four types of patient adverse events. Nurses with non-nursing tasks experienced patient adverse events—falls [odds ratio (OR) = 1.31], nosocomial infections (OR = 1.23), pressure sores (OR = 1.16), and medication errors (OR = 1.23)—more often than occasionally. In addition, when the bed to nurse ratio was higher, nurses experienced cases of pressure sores more often (OR = 1.35). By contrast, nurses who said the nursing workforce is sufficient were less likely than others to experience cases of pressure sores (OR = 0.78). Hospitals with a relatively high proportion of nurses who perceived the nursing workforce to be sufficient showed a low rate of medication error (OR = 0.28).
Conclusion
The study suggested that the high level of nursing workload in South Korea increases the possibility of patient adverse events.
Phenotypic Assays to Determine Virulence Factors of Uropathogenic Escherichia coli (UPEC) Isolates and their Correlation with Antibiotic Resistance Pattern
Mohsen Tabasi, Mohammad Reza Asadi Karam, Mehri Habibi, Mir Saeed Yekaninejad, Saeid Bouzari
Osong Public Health Res Perspect. 2015;6(4):261-268.   Published online August 31, 2015
DOI: https://doi.org/10.1016/j.phrp.2015.08.002
  • 2,086 View
  • 18 Download
  • 39 Citations
AbstractAbstract PDF
Objectives
Urinary tract infection caused by uropathogenic Escherichia coli (UPEC) strains is one of the most important infections in the world. UPEC encode widespread virulence factors closely related with pathogenesis of the bacteria. The purpose of this study was to evaluate the presence of different phenotypic virulence markers in UPEC isolates and determine their correlation with antibiotic resistance pattern.
Methods
UPEC isolates from patients with different clinical symptoms of UTI were collected and screened for biofilm and hemolysin production, mannose resistant, and mannose sensitive hemagglutination (MRHA and MSHA, respectively). In addition, antimicrobial resistance pattern and ESBL-producing isolates were recorded.
Results
Of the 156 UPEC isolates, biofilm and hemolysin formation was seen in 133 (85.3%) and 53 (34%) isolates, respectively. Moreover, 98 (62.8%) and 58 (37.2%) isolates showed the presence of Types 1 fimbriae (MSHA) and P fimbriae (MRHA), respectively. Our results also showed a relationship between biofilm formation in UPEC isolated from acute cystitis patients and recurrent UTI cases. Occurrence of UTI was dramatically correlated with the patients' profiles. We observed that the difference in antimicrobial susceptibilities of the biofilm and nonbiofilm former isolates was statistically significant. The UPEC isolates showed the highest resistance to ampicillin, tetracycline, amoxicillin, and cotrimoxazole. Moreover, 26.9% of isolates were ESBL producers.
Conclusion
This study indicated that there is a relationship between the phenotypic virulence traits of the UPEC isolates, patients' profiles, and antibiotic resistance. Detection of the phenotypic virulence factors could help to improve understanding of pathogenesis of UPEC isolates and better medical intervention.
A Study on the Characteristics of Infrequent and Frequent Outpatients Visiting Korean Traditional Medical Facilities
Jinwon Yoon, Haemo Park, Chaeshin Chu, Sung-Yong Choi, Kibum Lee, Sundong Lee
Osong Public Health Res Perspect. 2015;6(3):170-183.   Published online June 30, 2015
DOI: https://doi.org/10.1016/j.phrp.2015.06.001
  • 1,644 View
  • 16 Download
  • 2 Citations
AbstractAbstract PDF
Objectives
This study was intended to analyze the characteristics of infrequent and frequent outpatients visiting Korean medical facilities, and find the related variables of frequent users.
Methods
The data source was the Report on the Usage and Consumption of Korean Medicine (2011) published by the Ministry of Health and Welfare and Korea Institute for Health and Social Affairs. We analyzed outpatient data using SAS 9.2.
Results
As much as 46.6% of the patients used Korean medical services over 11 times in 3 months. The proportion of frequent users increased depending on age, and their proportion was high in the low-income and low-education group. People with musculoskeletal disease, stroke, hypertension, and obesity were more likely to use Korean medical services. In general, patients were satisfied with their treatment, with frequent outpatients being more satisfied than infrequent outpatients. In logistic regression analysis, age and musculoskeletal disease were significant determinants of frequency of use of Korean medical services.
Conclusion
Age, musculoskeletal disease, and specific diseases were highly associated with frequent Korean medical utilization.
Determinants of the Length of Stay in Stroke Patients
Sang Mi Kim, Sung Wan Hwang, Eun-Hwan Oh, Jung-Kyu Kang
Osong Public Health Res Perspect. 2013;4(6):329-341.   Published online December 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.10.008
  • 1,807 View
  • 12 Download
  • 11 Citations
AbstractAbstract PDF
Objectives
The study objective was to identify the factors that influence the length of stay (LOS) in hospital for stroke patients and to provide data for managing hospital costs by managing the LOS.
Methods
This study used data from the Discharge Injury Survey of the Korea Centers for Disease Control and Prevention, which included 17,364 cases from 2005 to 2008.
Result
The LOS for stroke, cerebral infarction, intracerebral hemorrhage, and subarachnoid hemorrhage was 18.6, 15.0, 28.9, and 25.3 days, respectively. Patients who underwent surgery had longer LOS. When patients were divided based on whether they had surgery, there was a 2.4-time difference in the LOS for patients with subarachnoid hemorrhage, 2.0-time difference for patients with cerebral infarction, and 1.4-time difference for patients with intracerebral hemorrhage. The emergency route of admission and other diagnosis increased LOS, whereas hypertension and diabetic mellitus reduced LOS.
Conclusion
In the present rapidly changing hospital environments, hospitals approach an efficient policy for LOS, to maintain their revenues and quality of assessment. If LOS is used as the indicator of treatment expenses, there is a need to tackle factors that influence the LOS of stroke patients for each disease group who are divided based on whether surgery is performed or not for the proper management of the LOS.
The Impact of Emergency Room Utilization by Depression Patients on Medical Treatment Expense in Korea
Hyun Sook Lee
Osong Public Health Res Perspect. 2013;4(5):240-245.   Published online October 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.09.007
  • 1,619 View
  • 13 Download
  • 2 Citations
AbstractAbstract PDF
Objectives
To investigate the determinants of total medical expense for depression patients admitted through the emergency room (ER).
Methods
Data were selected from the Korean National Health Insurance sample data for 2009. SPSS version 18 was used for the statistical analysis such as descriptive analysis, correlation analysis, and multiple regression analysis. Data included 1203 cases admitted through the ER with ICD-10 codes (F31–F39).
Results
In the multiple regression analysis, significant variables affecting total payment were gender (p < 0.001), age (p < 0.001), main illness (p < 0.001), course of admission to the ER (p < 0.05), and length of stay (p < 0.001).
Conclusion
It is necessary to build a long-term program and system for high-risk depression groups.
Modeling for Estimating Influenza Patients from ILI Surveillance Data in Korea
Joo-Sun Lee, Sun-Hee Park, Jin-Woong Moon, Jacob Lee, Yong Gyu Park, Yong Kyun Roh
Osong Public Health Res Perspect. 2011;2(2):89-93.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.08.001
  • 1,828 View
  • 17 Download
  • 7 Citations
AbstractAbstract PDF
Objective Prediction of influenza incidence among outpatients from an influenza surveillance system is important for public influenza strategy.
Methods
We developed two influenza prediction models through influenza surveillance data of the Korea Centers for Disease Control and Prevention (each year, each province and metropolitan city; total reported patients with influenza-like illness stratified by age) for 6 years from 2005 to 2010 and disease-specific data (influenza code J09-J11, monthly number of influenza patients, total number of outpatients and hospital visits) from the Health Insurance Review and Assessment service.
Results
Incidence of influenza in each area, year, and month was estimated from our prediction models, which were validated by simulation processes. For example, in November 2009, Seoul and Joenbuk, the final number of influenza patients calculated by prediction models A and B underestimated actual reported cases by 64 and 833 patients, respectively, in Seoul and 6 and 9 patients, respectively, in Joenbuk. R-square demonstrated that prediction model A was more suitable than model B for estimating the number of influenza patients.
Conclusion
Our prediction models from the influenza surveillance system could estimate the nationwide incidence of influenza. This prediction will provide important basic data for national quarantine activities and distributing medical resources in future pandemics.
Prevalence of Antibiotic Resistance in Escherichia coli Fecal Isolates From Healthy Persons and Patients With Diarrhea
Seung-Hak Cho, Yeong-Sik Lim, Mi-Sun Park, Seong-Han Kim, Yeon-Ho Kang
Osong Public Health Res Perspect. 2011;2(1):41-45.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.05.003
  • 1,642 View
  • 16 Download
  • 10 Citations
AbstractAbstract PDF
Objectives
This study aimed to investigate the prevalence of antibiotic resistance in fecal Escherichia coli isolates from healthy persons and patients with diarrhea.
Methods
E. coli isolates (n = 428) were obtained from fecal samples of apparently healthy volunteers and hospitalized patients with diarrhea. Susceptibility patterns of isolates to 16 antimicrobial agents were determined by agar disc diffusion.
Results
Most E. coli isolates exhibited less than 10% resistance against imipenem, cefotetan, aztreonam, cefepime, cefoxitin, amikacin and netilamicin, although greater than 65% were resistant to ampicillin and tetracycline. No significant difference in resistance rates for all tested antibiotics was found between isolates from the healthy-and diarrheal-patient groups, including for multi-drug resistance (p = 0.22). The highest number of resistant antibiotics was 12 antibiotics. No significant differences in antibiotic resistance were found among the sex and age strata for isolates from healthy individuals. However, antibiotic resistance rates to cefoxitin, cefotaxime, amikacin, and netilamicin were significantly higher in the isolates of men than those of women (p < 0.05) in isolates from patients with diarrhea. Furthermore, isolates from patients with diarrhea older than 40-years of age showed higher resistance to cefepime and aztreonam (p < 0.05).
Conclusion
High resistance to the antibiotics most frequently prescribed for diarrhea was found in isolates from patients with diarrhea and apparently healthy individuals without any significant difference.
Distribution of Virulence Genes and Their Association of Serotypes in Pathogenic Escherichia coli Isolates From Diarrheal Patients in Korea
Seung-Hak Cho, Kyung-Hwan Oh, Seong-Han Kim, Hee-Bok Oh, Mi-Sun Park
Osong Public Health Res Perspect. 2010;1(1):29-35.   Published online December 31, 2010
DOI: https://doi.org/10.1016/j.phrp.2010.12.008
  • 1,916 View
  • 15 Download
  • 5 Citations
AbstractAbstract PDF
Objectives
To characterise the genetic and serological diversity of pathogenic Escherichia coli, we tested 111 E coli strains isolated from diarrhoeal patients in Korea between 2003 and 2006.
Methods
The isolates were tested through polymerase chain reaction (PCR) and slide agglutination method for the detection of virulence genes and serotypes, respectively. To compare the expression of Shiga toxin (stx)-1 and stx2 genes, real-time quantitative reverse-transcriptase PCR and rapid exprssion assay, reversed-passive latex agglutination, were performed.
Results
Forty-nine Shiga toxin-producing E coli (STEC) strains and 62 non-STEC strains, including 20 enteropathogenic E coli, 20 enterotoxigenic E coli, 20 enteroaggregative E coli, and 2 enteroinvasive E coli were randomly chosen from the strains isolated from diarrhoeal patients in Korea between 2003 and 2006. PCR analysis indicated that locus of enterocyte effacement pathogenicity island, that is, eaeA, espADB, and tir genes were present in STEC, enteropathogenic E coli, and enteroinvasive E coli. Quorum sensing-related gene luxS was detected in most of pathogenic E coli strains. Major serotypes of the STEC strains were O157 (26%) and O26 (20%), whereas the non-STEC strains possessed various serotypes. Especially, all the strains with serotype O157 carried stx2 and the tested virulence factors. Of the STEC strains, the data of real-time quantitative reverse-transcriptase PCR and reversed-passive latex agglutination tests showed that messenger RNA- and protein expression of stx2 gene were higher than those of stx1 gene.
Conclusion
Our results provide the epidemiological information regarding the trend of STEC and non-STEC infections in the general population and show the fundamental data in association of serotypes with virulence genes in diarrhoeagenic E coli strains from Korea.

PHRP : Osong Public Health and Research Perspectives