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논문검색은 역시 페이퍼서치

보건정보통계학회지검색

Journal of Health Informatics and Statistics


  • - 주제 : 의약학분야 > 예방의학및보건학
  • - 성격 : 학술지
  • - 간기: 계간
  • - 국내 등재 : KCI 등재
  • - 해외 등재 : -
  • - ISSN : 2465-8014
  • - 간행물명 변경 사항 : 한국보건통계학회지(~2003) → 한국보건정보통계학회지(2004~)
논문제목
수록 범위 : 39권 1호 (2014)

암 발생예측 모형과 유전위험점수에 관한 고찰

정금지 ( Keum Ji Jung ) , 김소리울 ( Soriul Kim ) , 윤미욱 ( Miwuk Yun ) , 전티나 ( Christina Jeon ) , 지선하 ( Sun Ha Jee )
5,400
초록보기
Objectives: In genome-wide association studies (GWASs), single-nucleotide polymorphisms (SNPs) that have been identified as cancer-associated loci are common, but they confer only small increases in risk. The question was whether combining multiple disease-related SNPs and the modest effects within Genetic Risk Score (GRS) may be useful in identifying subgroups that are at high risk of cancer. Methods: In this paper, we first reviewed articles that examined the predictability of GRS on cancer prediction models. Our data sources included a PubMed search of the literature published until February 2014. Secondly, we have calculated the GRS using the data example data with five SNPs related colorectal cancer (CRC) obtained from the Korean cancer prevention study II. Two approaches were used to calculate the GRS: a simple risk alleles count method (counted GRS) and a weighted method based on the genotype frequencies for each SNP and the effect sizes (allelic odds ratio or beta coefficient) from our study (weighted GRS). Results: Of 31 studies initially identified, 16 (135,110 participants) met the inclusion criteria. Among 16 articles, 7 studies were related to prostate cancer, 6 studies to breast cancer, and 3 studies to colon cancer and lung cancer. Fifteen studies except for one study concluded that in general, a genetic score may be helpful or useful in identifying the high risk group and particularly to determining the high risk individual among patients within a ‘‘gray zone’’ of cancer risk. The weighted GRS with age and sex (AUC=0.9333) had higher predictability on the CRC risk than the model with GRS alone (AUC=0.816). Conclusions: Although adding GRS improves prediction model performance, the clinical utility of these genetic risk models is limited. Nonetheless, the modelling suggests public health potential since it is possible to stratify the population into cancer risk categories, thereby informing targeted prevention and management.

유방암 분류 성능 향상을 위한 배깅 서포트 벡터 머신

임진수 ( Jin Soo Lim ) , 오윤식 ( Yoon Sik Oh ) , 임동훈 ( Dong Hoon Lim )
4,500
초록보기
Objectives: We proposed bagging SVM which constructs SVM ensembles using bagging for improving breast cancer classification. Methods: Each individual SVM was trained independently using the randomly chosen training samples via a bootstrap technique. Then, they were aggregated into to make a collective decision in aggregation strategy such as the majority voting. We compared the proposed bagging SVM model with existing single models such as discriminant analysis, logistic regression analysis, decision tree, support vector machines for two UCI data and simulated data. Performance of these techniques was compared through accuracy, positive predictive value, negative predictive value, sensitivity, specificity and F-score. Results: Experimental results for two UCI data and the simulated data showed that the proposed bagging SVM model outperformed single SVM, discriminant analysis, logistic regression analysis, decision tree and neural network in terms of various performance measures. Conclusions: We proposed bagging SVM for improving breast cancer classification. The bagging SVM ensembles outperformed existing single models for all applications in terms of various performance measures.

2012년 흡연으로 인한 건강보험 진료비 추정 연구

지선하 ( Sun Ha Jee ) , 정금지 ( Keum Ji Jung ) , 전티나 ( Christina Jeon ) , 김희진 ( Hee Jin Kim ) , 윤영덕 ( Young Duk Yun ) , 김일순 ( Il Soon Kim )
5,700
초록보기
Objectives: The purpose of the study was to estimate relative risk and attributable risk of 35 tobacco-related diseases and to compute total medical expenses on smoking by providing a cohort study with 20 years follow-up period. Methods: Smoking-attributable medical costs were calculated by applying the percentages of population attributable risks (PARs) to the estimated medical costs by the tobacco related diseases in 2012. In this study, PARs were obtained by using relative risks from the Korean Cancer Prevention Study and the previous studies, and population smoking prevalence surveyed in 1990 conducted by Korean Institute of Tuberculosis. Results: As a result, the medical expenses from tobacco use were 1,846,562,350,000 won (about 3.86% of total medical expenses). The top 5 medical expenses on tobacco-related diseases were ischemic heart diseases, cerebrovascular diseases, lung cancer, diabetes, and chronic obstructive pulmonary disease, respectively. More than a half percent of total medical expenses (about one billion dollars) were spent from these five, tobacco-related diseases. Conclusions: While the harmful effect of smoking is expected to have a steady increase for a while, antismoking policy should be reinforced to reduce the risk of disease incidence, and the medical expenses for treating the tobacco-related diseases.

건강보험과 의료급여 암 환자의 의료이용 행태와 치료결과 비교

윤경일 ( Kyung Ii Youn )
5,800
초록보기
Objectives: To investigate the differences in heath care utilization and treatment outcome between National Health Insurance and Medical Aid Program cancer patients. Methods: From National Patient Survey database prepared by Korean Institute for Health and Social Affair 183,796 cancer patients discharge summary data are extracted and analyzed. Two Logistic regression models, one with health insurance status as dependent variable and the other with treatment outcome as dependant variable, were used to determine the differences in outcome and utilization between health insurance types. Results: A Chi-Square test results showed that Medical Aid Program cancer patients used less tertiary care hospitals, more emergency services, and had higher severity level and longer length of stay. However, the logistic regression analysis results showed no significant association between treatment outcome and health insurance status. Conclusions: When the severity related factors such as Charlson Comorbidity Index, length of stay, emergency admission were controled, there were no significant differences in treatment outcome between National Health Insurance and Medical Aid Program cancer patients. However, Medical Aid Program cancer patients were disadvantaged in access to tertiary care hospitals which produced better outcome for cancer patients. Therefore, current policy that requires two stage verifications to access to tertiary care should be reconsidered.

병원 원무행정근무자의 직무소진이 직무만족과 이직의도에 미치는 영향

남진영 ( Jin Young Nam ) , 손명세 ( Myong Sei Sohn ) , 강대용 ( Dae Ryong Kang ) , 유승흠 ( Seung Hum Yu )
6,100
초록보기
Objectives: The purpose of study was to find the influence of job burnout on job satisfaction and turnover intention among admission and discharging employees working in hospital. Methods: The 241 employees who work at the admission and discharging department in 8 general hospital with more than 500 beds in Seoul and Gyeounggi province were surveyed from October 18, 2010 for 4 weeks. Descriptive statistics was used to understand general characteristics of subjects; the t-test and one way ANOVA followed by Tukey’s HSD test were used for analysis of the job burnout according to the general characteristics, and multiple regression was employed to find the factors of job burnout afecting job satisfaction and turnover intention, respectively. Results: First, the degrees of job burnout differ according to the general characteristics. The level of job burnout tends to be high among the population of younger age, college graduates, and employees whose number of years of service is between 3 and 10. Second, the level of job satisfaction decreases as the level of job burnout increases. Third, The level of turnover intention tends to increase as the level of job burnout increases. Conclusions: Based on the result of this study, hospitals may make an effort to lower the job burnout by improving the system of human resource management. Such effort may include prevention of falling into a routine through job rotation and continuing education, and creation of sense of belonging through timely promotion.

우리나라 월별 출생 빈도의 변동에 관한 연구, 2000-2012

박상화 ( Sang Hwa Park ) , 한정호 ( Jung Ho Han ) , 임달오 ( Dar Oh Lim )
4,500
초록보기
Objectives: The objective of this study was to analyze the monthly variation of birth by year of birth (2000-2012), birth order and marital status. Methods: The analysis was based on birth data of Korea (634,501 births in 2000, 435,301 births in 2005, 470,171 births in 2010 and 484,550 births in 2012). As the percent distribution in monthly number of births appears to be influenced by the different number of day of month, we used the index of birth occurrence (IBO) for analyzing of monthly variation in birth. IBO is defined as a ratio of the average number of births per day of the month to the average number of births per day of the year, with the base set at 100. Results: The monthly distribution of births was bimodal, with a major peak extending from January to March, a minor peak from October to September, and a major trough in December. During the 2000-2012, IBO was highest for January (111), and lowest for December (89). The IBO in first birth order was highest for January (112), and lowest for June (89), and the variations of IBO in first birth order showed wide fluctuation as compared with the IBO of non-first birth order. The monthly pattern of IBO for extramarital births showed lower fluctuation from a peak of 107 to a trough of 92 than for the marital births. The pattern of the IBO for first births, showed a major peak in January-February (wedding in April-May: index of marriage occurrence: 126-127) and a minor peak in October-November (wedding in September-December: 126-143). The monthly distribution of first births appeared to be influenced to some extent by a monthly pattern of marriage. Conclusions: There was a bimodal pattern in birth seasonality: a major peak in January-March, a trough in June-July, a minor peak in October-September, and a trough around December.

민간의료보험과 미충족 의료와의 관계

이주은 ( Joo Eun Lee ) , 김태현 ( Tae Hyun Kim )
5,400
초록보기
Objectives: Although Korea has universal health coverage, many patients still pay high out-of-pocket (OOP) payments because of the lower level of public health insurance benefits. Recent increase in the rate of purchasing private health insurance (PHI) schemes may have lessened the burden of OOP, and thus, may have reduced barriers to accessing health care. This study aims to examine whether there exits an association between supplementary PHI and experiencing unmet health care needs. Methods: Data were obtained from the community health survey (CHS) of Korea Centers for Disease Control and Prevention. Estimates were drawn from combined cross-sectional survey data from the five study years (2008-2012). Total sample consists of 1,138,349 individuals. Multiple binary logistic regressions were performed to assess the statistical significance of various factors, including PHI, on the likelihood of experiencing unmet health care needs. Results: Those who have PHI are less likely to experience unmet health care needs (OR=0.91, 95% CI=0.90- 0.92). In addition, among those who reported that they had unmet health care needs because of financial barriers, the likelihood of experiencing unmet health care needs is much lower, if they had PHI (OR=0.56, 95% CI=0.54-0.58). Other variables that exhibit statistically significant, negative associations with the likelihood of experiencing unmet health care needs include education and income levels. Conclusions: The results of this study suggest that having PHI may have reduced potential access barriers to health care, particularly for those who have financial barriers. More research is needed to understand the direct causal relationship between PHI and unmet health care needs.

구조방정식을 활용한 병원선택요인에 대한병원 및 고객 집단 간 차이 분석

이해종 ( Hae Jong Lee ) , 이현숙 ( Hyun Sook Lee ) , 윤장호 ( Jang Ho Yoon )
5,400
초록보기
Objectives: This study is to identify the difference of hospital choice factors between internal and external customers at metropolitan and non-metropolitan hospitals. Methods: The questionnaires are used to collect data from internal customers(hospital employees) and external customers (patients). That is classified with 4 latent variables- such as, physical, human, accessibility, and connection factors. Total used cases are 98 patients and 96 employees on 2 hospitals-Hospital S, located in Seoul and 116 patients and 97 employees in Hospital C, located in non-metropolitan province. Multi group analysis and mean analysis in structural equation model (SEM) is used for analysis of difference between groups. Results: The hospital choice factors are different significantly between internal and external customers of Hospital C, while there is no gaps in Hospital S. And there is a gap of choice factor between external customers of Hospital S and Hospital C, but not between internal customers of the two hospitals. The internal customers in Hospital S have more accurate information about patient’s hospital choice factors than those in Hospital C. Specially, the internal customers in Hospital C are aware of that the human factor is more important choice factor than other factors. Conclusions: There are many hospital choice gaps between customers or hospital locations. So each hospital need to make more accurate measurement about customer need/behavior for higher customer satisfaction.

타이치운동과 행동수정요법이 비만중년여성의 신체조성, 혈청지질 및 자기효능감에 미치는 영향

장미영 ( Mi Young Chang ) , 이혜영 ( Hea Young Lee ) , 엄애용 ( Ae Yong Eom )
5,300
초록보기
Objectives: The purpose of this study was to evaluate the effects of the Tai Chi exercise and combined behavior therapy on body composition, blood lipids level and self efficacy in obese middle-aged women. Methods: A quasi-experimental design was used. Subjects were 63 middle-aged women whose body mass index (BMI) is over 25 kg/m². A pretest-posttest design was used with the experimental group (n=30) who participated in the Tai Chi combined with behavior therapy for 12 weeks, and the control group (n=33) who did not. Results: The experiment group showed significant decreases in waist circumference, body weight, BMI, Waist-hip ratio, and diastolic blood pressure. Moreover, the experiment group showed significant decreases in Total cholesterol (TC), Triglycoride (TG), and increase in High lipoprotein cholesterol (HDL-C) compared to the control group. The self efficacy was significantly improved for the experimental group compared to the control group. Conclusions: This study was provided an evidence that Tai Chi combined with behavior therapy can be useful to manage body composition, blood lipid profiles for obese middle-aged women.

한국인의 지난 10년간 자살률 분석, 2003-2012

지용호 ( Yong Ho Jee ) , 조해인 ( Hae In Jo )
5,100
키워드보기
초록보기
Objectives: Korea has been the leading country in suicide rate among the Organization for Economy Co-operation and Development (OECD) member countries since 2002. To reduce the growth in suicide rate, precise analysis on the suicide is required. This paper examined the suicide trend in Korean men and women from 2003 to 2012. Methods: The data were extracted from the statistical year book and Korean Statistical Information Service (KOSIS). The paper examined the suicide trend in Korea from 2003 to 2012 in regarding to sex, year, age, and suicide method. Age-standardized suicide rates were calculated using the population in 2005. Results: In both men and women, suicide rates from intentional self-harm by hanging have been increased between 2003 and 2012, while the rates from intentional self-poisoning by and exposure to pesticides have decreased. Overall, suicide rates have increased with age increased and were higher in men than in women. Young women aged 20 to 39 between 2007 and 2009 had an especially high suicide rate by hanging. Conclusions: The findings in this study provide a need for prevention strategy and policy making for reducing suicide rate in elderly and especially in young women with high suicide rates by hanging.
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