Baek-Geun Jeong

Inequalities in Medical Care Utilization by South Korean Cancer Patients According to Income: A Retrospective Cohort Study

This study explores income inequalities in the utilization of medical care by cancer patients in South Korea, according to type of medical facilities and survival duration. The five-year retrospective cohort study used data drawn from the Korean Cancer Registry, the National Health Insurance database, and the death database of the Korean National Statistical Office. The sample consisted of 43,433 patients diagnosed with cancer in 1999. The authors found significant quantitative inequalities as a function of income in the patients utilization of medical care. Cancer patients from the highest income class used inpatient and outpatient care more frequently than did patients from the lowest income class. Those with higher incomes tended to use more inpatient and outpatient services at major tertiary hospitals, which were known as providing better medical care than other types of hospitals and clinics. Moreover, horizontal inequality in cancer-care expenditures favoring those with higher incomes was observed during earlier periods of treatment. In conclusion, income substantially affects the utilization of inpatient and outpatient services, amount of medical expenditures, and type of medical facilities.

The relationship between depressive symptoms among female workers and job stress and sleep quality

ObjectiveRecently, workers mental health has become important focus in the field of occupational health management. Depression is a psychiatric illness with a high prevalence. The association between job stress and depressive symptoms has been demonstrated in many studies. Recently, studies about the association between sleep quality and depressive symptoms have been reported, but there has been no large-scaled study in Korean female workers. Therefore, this study was designed to investigate the relationship between job stress and sleep quality, and depressive symptoms in female workers.MethodsFrom Mar 2011 to Aug 2011, 4,833 female workers in the manufacturing, finance, and service fields at 16 workplaces in Yeungnam province participated in this study, conducted in combination with a worksite-based health checkup initiated by the National Health Insurance Service (NHIS). In this study, a questionnaire survey was carried out using the Korean Occupational Stress Scale-Short Form(KOSS-SF), Pittsburgh Sleep Quality Index(PSQI) and Center for Epidemiological Studies-Depression Scale(CES-D). The collected data was entered in the system and analyzed using the PASW (version 18.0) program. A correlation analysis, cross analysis, multivariate logistic regression analysis, and hierarchical multiple regression analysis were conducted.ResultsAmong the 4,883 subjects, 978 subjects (20.0%) were in the depression group. Job stress(OR=3.58, 95% CI=3.06-4.21) and sleep quality(OR=3.81, 95% CI=3.18-4.56) were strongly associated with depressive symptoms. Hierarchical multiple regression analysis revealed that job stress displayed explanatory powers of 15.6% on depression while sleep quality displayed explanatory powers of 16.2%, showing that job stress and sleep quality had a closer relationship with depressive symptoms, compared to the other factors. The multivariate logistic regression analysis yielded odds ratios between the 7 subscales of job stress and depressive symptoms in the range of 1.30-2.72 and the odds ratio for the lack of reward was the highest(OR=2.72, 95% CI=2.32-3.19). In the partial correlation analysis between each of the 7 subscales of sleep quality (PSQI) and depressive symptoms, the correlation coefficient of subjective sleep quality and daytime dysfunction were 0.352 and 0.362, respectively.ConclusionThis study showed that the depressive symptoms of female workers are closely related to their job stress and sleep quality. In particular, the lack of reward and subjective sleep factors are the greatest contributors to depression. In the future, a large-scale study should be performed to augment the current study and to reflect all age groups in a balanced manner. The findings on job stress, sleep, and depression can be utilized as source data to establish standards for mental health management of the ever increasing numbers of female members of the workplace.

Application of revised nursing work index to hospital nurses of South Korea.

PURPOSEnBased on the Revised Nursing Work Index (NWI-R), this research aimed to develop a Korean Hospital General Inpatient Unit-Nursing Work Index (KGU-NWI). This study also aimed to compare the common points and differences between the subfactors of the KGU-NWI and the subfactors from previous studies.nnnMETHODSnBased on opinions from 3,151 nurses in Korean hospital general inpatient unit, this research used 57 items of NWI-R and the principal axis factor analysis for deriving subfactors. We evaluated the convergent validity through factor analysis and the content validity of KGU-NWI in terms of the association between nurses job outcome and the subfactors derived.nnnRESULTSnSix subfactors and 26 items for KGU-NWI were derived from NWI-R. Among them, physician-nurse relationship, adequate nurse staffing and organizational support and management of hospital were the same with results from previous studies. In addition, two subfactors, participation of decision-making processes and education for improving quality of care, which were similar with results from previous Korean studies, were newly added by using Korean hospital cases. In contrast to previous Korean studies, a unique subfactor this study found was nursing processes. This research confirmed that the six subfactors were highly correlated with job satisfaction, intention to leave, and quality of health care, which represented a nurses job outcome.nnnCONCLUSIONnKGU-NWI including six subfactors and 26 items is an applicable instrument to investigate nurse work environment in Korean hospital general inpatient unit.

Association of social capital at the individual level with physical activity in communities with high mortality in Korea

The aim of this study was to investigate the association of various dimensions of social capital at the individual level with physical activity. We used data from community health interviews conducted in 40 sub-municipal-level administrative units with high mortality from August to October in 2010, 2011 or 2012 for health projects in South Korea. The 8800 study subjects included 220 adults from each administrative unit, who were sampled systematically using the resident registration database. The physical activity level was defined according to the intensity, duration and frequency of self-reported physical activity. Social capital indicators were assessed with measures used in other health surveys or studies. Adjusting for gender, age, marital status, educational level, occupation, food security (a proxy for socio-economic status), administrative unit and self-rated health, we calculated the adjusted odds ratio (AOR) with a 95% confidence interval (CI) of participating in physical activity based on various measures of social capital using multivariate logistic regression analysis. Social participation in both informal and formal organizations compared with no social participation, higher generalized trust compared with lower trust and higher perceived control at both the community and individual levels compared with lower perceived control at both levels increased the odds of being physically active [AOR = 1.25 (95% CI: 1.10-1.41), 1.36 (95% CI: 1.19-1.54) and 1.31 (95% CI: 1.17-1.48), respectively]. Various social capital measures at the individual level were found to be associated with physical activity independently of each other and of confounders in communities with high mortality in Korea.