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Original Articles
Frailty Index Predicts Future All-cause Mortality and Quality of Life: A 2-Year Follow-up Study Among Korean Older Adults From a Population-based Cohort Study
Woolim Ko, Hyunsuk Jeong, Hyeon Woo Yim
J Prev Med Public Health. 2025;58(6):572-580.   Published online November 10, 2025
DOI: https://doi.org/10.3961/jpmph.25.210
  • 2,061 View
  • 175 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
The frailty index (FI), a proxy measure of accelerated biological aging, predicts adverse outcomes in older adults. We investigated whether the FI predicts mortality in a community-based Korean older adult population and its association with subjective health status over 2 years.
Methods
This prospective cohort study included 936 community-dwelling individuals aged ≥60 years. The FI, calculated from 28 self-reported baseline variables, was scored on a scale from 0 to 1 (<0.25: non-frail; 0.25-0.34: mildly frail; ≥0.35: moderately to severely frail). The primary outcome was 2-year all-cause mortality. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated. Quality of life was assessed using the European Quality of Life Five-Dimension Three-Level (EQ-5D-3L), with the proportions reporting extreme problems and prevalence ratios of problems across frailty groups. Analyses were conducted using the GENMOD procedure in SAS version 9.4.
Results
Of the 936 participants, 111 (11.9%) were non-frail, 230 (24.6%) were mildly frail, and 595 (63.6%) were moderately to severely frail. The prevalence of moderate to severe frailty increased with age. The moderate-severe frailty group had a ≥5-fold increased risk of mortality compared to the non-frail group (adjusted RR, 5.79; 95% CI, 1.39 to 24.07). Among those completing follow-up, the moderate-severe frailty group reported more problems across all EQ-5D-3L domains at 2 years.
Conclusions
Frail older adults are at increased risk of mortality, but this risk was significant only for those in the moderate-to-severe frailty category at 2-year follow-up. The FI is a valuable predictor of premature death and health challenges in older adults.
Summary
Korean summary
2년의 추적 관찰 기간 동안, 기저 시점의 중등도에서 중증의 노쇠 상태에 있던 노인은 노쇠하지 않은 노인에 비해 사망 위험이 5배 이상 높았으며, EQ-5D-3L로 평가한 다양한 삶의 질 영역에서도 더 큰 어려움을 겪는 것으로 나타났다. 이러한 결과는 특히 중등도에서 중증의 노쇠 상태가 임상적 위험뿐만 아니라 주관적 삶의 질을 개선하기 위한 우선적 개입이 필요할 수 있음을 시사한다. 본 연구는 노인의 건강 결과를 향상시키기 위해서는 개별 질환 관리뿐 아니라 노쇠 상태를 체계적으로 평가하고 관리하는 것이 중요함을 제안한다.
Key Message
During the two-year follow-up period, older adults who were moderately to severely frail at baseline had a more than fivefold higher risk of death compared with those who were non-frail, and they also experienced greater difficulties across various quality-of-life domains as measured by the EQ-5D-3L. These findings suggest that moderate to severe frailty may require high-priority interventions to improve not only clinical risks but also subjective quality of life. This study indicates that, to improve health outcomes in older adults, it is important to systematically assess and manage frailty in addition to addressing individual diseases.
From Rich to Poor: A Decomposition Analysis of Socioeconomic Inequality in Health-related Quality of Life in Iran
Satar Rezaei
J Prev Med Public Health. 2025;58(5):538-547.   Published online August 20, 2025
DOI: https://doi.org/10.3961/jpmph.25.383
  • 4,182 View
  • 222 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Socioeconomic status (SES) is a well-established predictor of health outcomes across an individual’s lifespan. People from lower socioeconomic backgrounds generally have shorter life expectancies and lower levels of health-related quality of life (HRQoL) compared with those from higher-income groups. This study aimed to quantify income-related inequalities in HRQoL among adults in Iran.
Methods
A total of 3518 adults aged 18 years and older were selected using a convenience sampling method across 9 provinces in Iran. HRQoL was assessed with the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) instrument, which evaluates 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The concentration index (CI) approach was used to measure income-related inequality in worse HRQoL (disutility=1–utility value) and to identify the socioeconomic factors contributing to the observed inequality.
Results
The CI for worse HRQoL was -0.116, while the CI for the EuroQol visual analogue scale (EQ-VAS) score was 0.027. The CIs for reporting any problems in the EQ-5D-5L dimensions were: mobility (-0.122), self-care (-0.070), usual activities (-0.074), pain/discomfort (-0.139), and anxiety/depression (-0.139). Decomposition analysis showed that income (38.00%), educational level (31.53%), age (8.05%), and physical activity (7.30%) were the main factors contributing to socioeconomic inequality in poorer HRQoL in Iran.
Conclusions
This study identified a pro-poor distribution of poorer HRQoL and reported problems across all dimensions of the EQ-5D-5L in Iran. Targeted interventions should focus on reducing disparities in income, education, and physical activity levels.
Summary
Key Message
The study of 3518 adults across 9 Iranian provinces revealed significant pro-poor socioeconomic inequality in health-related quality of life (HRQoL), with worse HRQoL concentrated among lower-income groups (concentration index: -0.116). Income (38%) and education level (31.53%) were the largest contributors to this inequality, followed by age (8.05%) and physical activity (7.30%) based on decomposition analysis. All five EQ-5D-5L health dimensions showed more reported problems in lower socioeconomic groups, emphasizing the need for targeted interventions addressing income, education, and lifestyle factors to reduce HRQoL disparities in Iran.
Sleep Disturbances in Early Pregnancy and the Risk of Preeclampsia: Qazvin Maternal and Neonatal Metabolic Outcomes Study (QMNMS)
Sima Hashemipour, Fatemeh Lalooha, Milad Badri, Leila Modarresnia, Amirabbas Ghasemi, Sara Esmaeili Kelishomi, Sarah Mirzaeei Chopani, Seyyed Hamidreza Ghafelehbashi, Mahnaz Abbasi, Sepideh Kolaji
J Prev Med Public Health. 2025;58(4):406-414.   Published online April 21, 2025
DOI: https://doi.org/10.3961/jpmph.24.698
  • 5,217 View
  • 313 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
The association between sleep disturbances and hypertension has been reported in numerous studies. However, prospective cohort data on the role of sleep disturbances in the development of preeclampsia remain limited.
Methods
This prospective cohort study was conducted on pregnant women with a in Iran. Sleep quality was assessed at the first prenatal visit (gestational age ≤14 weeks) using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Multivariate logistic regression was run to investigate the independent role of sleep abnormalities in the development of preeclampsia.
Results
The final analysis was performed on 576 participants, of whom 3.5% developed preeclampsia. In the univariate analysis, short sleep duration (< 6 hours) and prolonged sleep latency was associated with a 5.5 times and 3.5 times higher risk of developing preeclampsia (95% confidence interval [CI], 1.5 to 20.9; p=0.011, and 95% CI, 1.2 to 10.1; p=0.019, respectively). Considering the total PSQI score, fairly bad or very bad sleep quality was a risk factor for developing preeclampsia, with a relative risk of 4.9 in the univariate analysis (95% CI, 1.4 to 17.8; p=0.014). In the fully adjusted model, short sleep duration and prolonged sleep latency were associated with 7.2 times and 4.5 times higher risk of preeclampsia, respectivey (95% CI, 1.6 to 33.1; p=0.011 and 95% CI, 1.4 to 14.6; p=0.012, respectively). In this model, pregnant women with fairly bad or very bad sleep quality had 5.9 times higher risk of preeclampsia development (95% CI, 1.5 to 22.8; p=0.011).
Conclusions
This cohort study demonstrated the role of short sleep duration and prolonged sleep latency as the main components of poor sleep quality in the development of preeclampsia.
Summary
Key Message
This cohort study demonstrated that pregnant women with fairly poor or very poor sleep quality had an approximately sixfold increased risk of developing preeclampsia in the fully adjusted model. Among the components of poor sleep quality, short sleep duration and prolonged sleep latency were the most strongly associated with preeclampsia, with relative risks of approximately sevenfold and fourfold, respectively.
Are Non-standard Work Schedules Related to Sleep Difficulty and Health-related Quality of Life in Korea? An Examination of Gender Differences
Seowoo Park, Ji Sun Park, Moo Hyuk Lee, Young Kyung Do
J Prev Med Public Health. 2025;58(4):396-405.   Published online April 15, 2025
DOI: https://doi.org/10.3961/jpmph.24.378
  • 45,070 View
  • 287 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
The rise of flexible and diverse work schedules has become increasingly common in modern society. This study aims to investigate whether non-standard work schedules are related to sleep difficulty and other aspects of health-related quality of life (HRQoL) in Korea, with special attention to gender differences.
Methods
Data from the 2019 and 2021 National Health and Nutrition Examination Survey (Phase 8) were used, with a final sample consisting of 6735 participants. Ordinal logistic regression analysis was performed on sleep difficulty and the other seven items of the Health-related Quality of Life Instrument with 8 items (HINT-8) to examine associations with work schedules. Linear regression analysis was also conducted using the HINT-8 index as a composite measure.
Results
Non-standard work schedules were associated with a higher likelihood of sleep disturbances compared to the standard daytime work schedule. In particular, the negative impact of the night work schedule on sleep was greater for women than for men. Women working under the night work schedule were 12.2 percentage points more likely to report severe sleep difficulty than women under the day work schedule (9.6%). Additionally, the working, happiness, and vitality items of the HINT-8 were negatively associated with the night work schedule, whereas the other HINT-8 items and the HINT-8 index did not exhibit similar results.
Conclusions
Non-standard work schedules are associated with increased sleep difficulty, particularly among women, and negatively affect several aspects of HRQoL, including vitality, happiness, and work performance. Given their rising prevalence and adverse impact on workers’ sleep, health, well-being, as well as workplace safety and performance, non-standard work schedules should be recognized as a significant public health concern.
Summary
Korean summary
저녁 및 밤 시간대 근무는 수면을 포함한 건강 관련 삶의 질에 부정적 영향을 끼치며, 그 영향은 여성에서 더 크게 나타난다. 비표준시간대 근무는 중요한 공중보건학적 문제이다.
Key Message
Non-standard work schedules are associated with increased sleep difficulty, particularly among women, and negatively affect several aspects of health-related quality of life, including vitality, happiness, and work performance. Given their rising prevalence and adverse impact on workers’ sleep, health, well-being, as well as workplace safety and performance, non-standard work schedules should be recognized as a significant public health concern.
Prognostic Scoring Model for the Transition From Acute to Chronic Non-specific Low Back Pain in Primary Health Care Units in Indonesia
Djoko Kuswanto, Riva Satya Radiansyah, Dwinka Syafira Eljatin, Muhammad Nazhif Haykal, Rumman Karimah, Ratri Dwi Indriani, Zain Budi Syulthoni, Erna Furaidah, Andiva Satrio Rinaldi, Hafira Nushifa Putri, Jessica Felina Adi, Anak Agung Bagus Wirayuda
J Prev Med Public Health. 2025;58(4):422-430.   Published online April 12, 2025
DOI: https://doi.org/10.3961/jpmph.24.581
  • 5,320 View
  • 317 Download
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Non-specific low back pain (NSLBP) is a prevalent health issue that can progress from acute to chronic, resulting in prolonged disability and diminished quality of life. This study aimed to develop a prognostic scoring model to predict the transition from acute to chronic NSLBP in primary care settings.
Methods
This prospective cohort study enrolled 112 adults with acute NSLBP from primary health care units in Indonesia. Participants were assessed at baseline and at a 3-month follow-up visit. Bivariate and multivariable analyses were conducted to identify significant predictors of chronicity. A scoring system was then developed based on the final logistic regression model.
Results
Three factors were found to be significant predictors of the transition to chronic NSLBP: age above 30 years, low education level, and moderate to severe pain intensity. The prognostic scoring model demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.705, 70.8% sensitivity, and 62.5% specificity at the optimal cut-off score of 2.5.
Conclusions
This simple prognostic scoring model can help clinicians identify patients at high-risk of developing chronic NSLBP. Early identification of at-risk patients could guide targeted interventions to prevent chronicity. Further validation in diverse populations is necessary to confirm the broader applicability of this model.
Summary
Key Message
This prospective cohort study developed a prognostic scoring model to predict the transition from acute to chronic non-specific low back pain (NSLBP) in primary care settings in Indonesia. The study identified three significant predictors: age above 30 years, low education level, and moderate to severe pain intensity, which formed a simple scoring system with good discrimination ability (AUC = 0.705, sensitivity 70.8%, specificity 62.5%). This practical tool enables clinicians to identify high-risk patients early and implement targeted interventions to prevent chronicity in primary healthcare settings.

Citations

Citations to this article as recorded by  
  • The Role of Dexketoprofen/Tramadol in Multimodal Therapy to Prevent Acute Postsurgical and Acute Low Back Pain from Developing into Chronic Pain: A Delphi Consensus Study
    Giustino Varrassi, Maria Dolma Gudez-Santos, Magdi Hanna, Magdalena Kocot-Kępska, Antonio Montero Matamala, Marco Antonio Narvaez Tamayo, Serge Perrot, Jose Luis Aguilar, Omar Al Hamad, Lu’i Al-Husinat, Raad Al-Khafaji, Abdallah Allam, Ezio Amorizzo, Nadi
    Pain and Therapy.2026; 15(1): 175.     CrossRef
Association Between Non-adherence to Diabetes Management and Poor Sleep Quality Based on the Korean Community Health Survey
Horim A. Hwang, Hyunsuk Jeong, Hyeon Woo Yim
J Prev Med Public Health. 2025;58(3):260-268.   Published online January 14, 2025
DOI: https://doi.org/10.3961/jpmph.24.486
  • 4,333 View
  • 392 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Adhering to management guidelines, including routine follow-up and education, is crucial for the effective management of chronic diseases such as diabetes. Uncontrolled diabetes is linked to poor sleep quality. We used nationally representative data from community-dwelling Koreans to investigate potential associations between non-adherence to diabetes management and poor sleep quality.
Methods
Of the 228 340 participants in the 2018 Korea Community Health Survey, we analyzed data from 68 246 participants aged 65 years and older. Based on their diabetes status and adherence to diabetes-related tests (glycated hemoglobin, fundus examination, and urine microalbuminuria) and management education, study participants were divided into 3 groups: no diabetes, adherence, and non-adherence. Outcome variables included poor overall sleep quality and sleep disturbances, as measured by the Pittsburgh Sleep Quality Index.
Results
The study included 934 participants in the adherence group (2.0%) and 13 420 in the non-adherence group (20.2%). Participants displaying non-adherence were significantly more likely to report poor overall sleep quality (adjusted odds ratio [aOR], 1.09; 95% confidence interval [CI], 1.04 to 1.13) and to experience sleep fragmentation, nocturia, pain during sleep, and difficulty falling asleep compared to participants without diabetes. Even in the earlier stage of diabetes, non-adherent participants were more likely to report poor sleep quality (aOR, 1.06; 95% CI, 1.00 to 1.18).
Conclusions
Patients with diabetes who do not follow management guidelines are more likely to experience poor sleep quality than those without diabetes. Emphasizing diabetes management and increasing awareness of management strategies may improve sleep quality among patients with this disease.
Summary
Korean summary
혈당조절이 되지 않는 당뇨병이 수면 관련 문제의 발생 위험을 높이는 것은 기존 연구에서 알려져 있었으나, 당뇨관리 여부가 지역사회에 거주하는 당뇨환자들의 수면의 질에 미치는 영향은 충분히 탐구 되지 않았었다. 당뇨 관리 (연 2회 이상 당화혈색소 검사, 매년 당뇨합병증 검사, 당뇨관리교육 이수)에 순응하지 않는 당뇨환자들은 당뇨가 없는 일반인들에 비해 수면 문제를 호소할 가능성이 유의하게 높은 것이 확인되었다. 이는 당뇨 유병기간으로 층화분석하였을때도 일관되게 확인되었다.
Key Message
Uncontrolled diabetes is associated with increased risk of sleep-related problems, but the knowledge on the impact of poor diabetes management on the sleep quality of community dwelling patients with diabetes is limited. Diabetes patients who did not adhere to diabetes management (<2 hemoglobin A1c tests, did not take diabetes complication test, or received diabetes management education) were more significantly more likely to report overall poor sleep quality than those without diabetes. The above association remained significant when the patients were stratified by diabetes duration.

Citations

Citations to this article as recorded by  
  • Assessment of Sleep Quality and Its Determinants Among Patients with Type 2 Diabetes Mellitus in Mogadishu, Somalia: A Cross-Sectional Study
    Nur Mohamed, Rahma Haji Mohamud, Fadumo Hilowle, Tigad Ali, Yusuf Abdirisak Mohamed, Adan Gabow, Hawa Mohamed, Nor Sidow, Mohamed Sheikh Hassan, Mohamud Waberi
    Diabetes, Metabolic Syndrome and Obesity.2025; Volume 18: 1949.     CrossRef
Predictors of Quality of Life Among Older Residents in Rural and Urban Areas in Indonesia: An Approach Using the International Classification of Functioning, Disability, and Health
Dwi Rosella Komalasari, Chutima Jalayondeja, Wattana Jalayondeja, Yusuf Alam Romadon
J Prev Med Public Health. 2025;58(2):199-207.   Published online November 29, 2024
DOI: https://doi.org/10.3961/jpmph.24.423
  • 5,598 View
  • 496 Download
  • 1 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
The International Classification of Functioning, Disability, and Health (ICF) model provides a comprehensive framework for understanding health and quality of life (QoL) in older adults in both rural and urban settings, each presenting unique advantages and challenges. This study aimed to explore the relationship between factors based on the ICF model and QoL among older residents of these areas.
Methods
A cross-sectional study was conducted, involving 286 older adults aged 60 years or older from rural and urban areas of Surakarta, Central Java, Indonesia. The WHOQoL-BREF was utilized to assess QoL. The co-factors included personal factors, impairments, and activity limitations.
Results
Multiple linear regression analysis indicated that cardiovascular endurance was the strongest significant factor associated with QoL in rural areas (B=0.027, standard error [SE]=0.013, p=0.050). In urban areas, gender emerged as the most significant factor influencing QoL (B=-13.447, SE=2.360, p<0.001), followed by hemoglobin level (B=-1.842, SE=0.744, p=0.015), age (B=-0.822, SE=0.217, p<0.001), and cognitive function (B=0.396, SE=0.162, p=0.016).
Conclusions
Efforts to improve QoL for older adults in rural areas should focus on enhance physical performance through exercise. In urban areas, the maintenance of QoL is influenced by personal factors. It is crucial to address physical performance through exercise to enhance QoL in rural settings. Meanwhile, focusing on mental health, financial security, and social connections is recommended to improve QoL for older adults in urban areas.
Summary
Key Message
The ICF model offers a comprehensive framework to assess health and QoL in older adults living in rural and urban areas. Both areas highlight the distinct advantages and challenges unique. Cardiovascular endurance is a vital factor in determining the QoL for older adults in rural areas, while hemoglobin levels, age, and cognition shape the well-being of those in urban environments.

Citations

Citations to this article as recorded by  
  • Determinants of Quality of Life among Older Adults Living in Agricultural Communities in Nakhon Si Thammarat, Thailand
    Yodfah Ratmanee
    Community and Social Development Journal.2026; 27(1): 142.     CrossRef
Health Effects of Heavy Metal Exposure Among E-waste Workers and Community-dwelling Adults in Thailand: A Cross-sectional Study
Chonyitree Sangwijit, Parichat Ong-artborirak, Warangkana Naksen, Kraiwuth Kallawicha, Pallop Siewchaisakul
J Prev Med Public Health. 2025;58(2):156-166.   Published online November 21, 2024
DOI: https://doi.org/10.3961/jpmph.24.415
  • 6,575 View
  • 567 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Global concern is increasing about the health effects of electronic waste (e-waste). This study examines the health impacts of heavy metal (HM) exposure among e-waste workers (EWWs) and community-dwelling adults (CDAs) in Northeastern Thailand and identifies factors associated with adverse health outcomes.
Methods
A cross-sectional study was conducted of 164 EWWs and 164 CDAs. A survey was employed to collect data on participant characteristics, symptoms, anxiety, depression, and sleep quality. Urine samples were analyzed for lead (Pb) and cadmium (Cd) levels using atomic absorption spectrometry. Multiple logistic regression analysis was used to identify factors impacting health.
Results
Across all participants, urinary Pb and Cd levels ranged from 5.30 µg/g to 29.50 µg/g creatinine and from 0.60 µg/g to 4.00 µg/g creatinine, respectively. The most frequently reported health issues pertained to musculoskeletal disorders (MSDs) at 38.70%, central nervous system (CNS) issues at 36.60%, and skin disorders at 31.10%. Multivariable analysis indicated that the presence of MSDs was significantly associated with exposure to Pb and Cd. Poor sleep quality (PSQ) was significantly linked to CNS problems, while body mass index was significantly related to skin disorders. Factors including primary education level or below, smoking, cleaning the house more than 3 times weekly, and PSQ were significantly linked to depression. Anxiety was significantly associated with PSQ.
Conclusions
Environmental exposure to Pb and Cd can have adverse health impacts in the form of MSDs. Depression and anxiety are common conditions among CDAs. Public health officials should monitor HM exposure and mental health within the community.
Summary
Key Message
- Pb and Cd level was not significant difference between e-waste workers and community-dwelling adults. - Pb and Cd can adversely affect symptoms in the MSD and PSQ affects the CNS in e-waste workers. - E-waste workers had a higher chance of having musculoskeletal disorder, central nervous system disorder, and skin disorder problems than community-dwelling adults but a lower chance of having depression and anxiety than community-dwelling adults.
Systematic Review
Effects of Physical and Mind-body Exercise on Sleep Quality in Individuals With Diabetes Mellitus: A Systematic Review and Meta‐analysis
Yohanes Andy Rias, Renny Wulan Apriliyasari, Made Satya Nugraha Gautama, Faizul Hasan, Margareta Teli, Hsiao-Yean Chiu, Ratsiri Thato
J Prev Med Public Health. 2025;58(1):1-10.   Published online October 7, 2024
DOI: https://doi.org/10.3961/jpmph.24.354
  • 16,228 View
  • 925 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Physical and mind-body exercises represent distinct intervention strategies that may improve sleep quality by influencing physiological and psychological factors. Nevertheless, their effectiveness in individuals with diabetes is not well-established. This systematic review and meta-analysis aimed to examine the impacts of physical and mind-body exercise interventions on sleep quality in patients with diabetes mellitus.
Methods
Six randomized controlled trials (RCTs) that met the inclusion criteria were identified from PubMed, CINAHL, Embase, Scopus, Web of Science, Cochrane, and Ovid-Medline Library. The effect size for sleep quality was calculated using the standardized mean difference (SMD) with a 95% confidence interval (CI), employing a random-effects model. Heterogeneity and publication bias were also examined, and subgroup, meta-regression, and sensitivity analyses were performed.
Results
Physical and mind-body exercise interventions significantly improved sleep quality, with an SMD of -1.040 (95% CI, -1.686 to -0.394). Subgroup analysis revealed significant differences with respect to the type of intervention (p=0.047), or its duration (p=0.282). Meta-regression analysis indicated that mean hemoglobin A1c level was the only factor to be significantly related to the effect size for sleep quality, demonstrating a negative association (p=0.033). The assessment of publication bias and the sensitivity analysis suggested that the findings were reliable and robust.
Conclusions
Physical and mind-body exercises may serve as effective interventions for patients with diabetes mellitus who experience poor sleep quality. However, to substantiate these findings, additional rigorous RCTs with larger sample sizes, longer follow-up periods, and standardized interventions are required.
Summary
Key Message
This systematic review and meta-analysis reviewed the impact of physical and mind-body exercise interventions on sleep quality in individuals with diabetes mellitus, examining six randomised, controlled trials. The results indicated a notable enhancement in sleep quality. A meta-analysis revealed a negative correlation between haemoglobin A1c levels and improvements in sleep quality. The findings suggest that physical and mind-body exercise are effective methods for improving sleep quality; however, additional rigorous research with larger sample sizes and standardised protocols is necessary.

Citations

Citations to this article as recorded by  
  • Determinants and interrelations of exercise effects on sleep quality: A multimethod meta-analysis
    Zhide Liang, Shiao Zhao, Shudong Tian, Chuanzhi Wang, Meng Zhang, Kai Xu, Mingyue Yin, Sanfan Ng, Ziheng Ning
    Sleep Medicine Reviews.2026; 86: 102239.     CrossRef
  • Assessment of Sleep Quality and Its Determinants Among Patients with Type 2 Diabetes Mellitus in Mogadishu, Somalia: A Cross-Sectional Study
    Nur Mohamed, Rahma Haji Mohamud, Fadumo Hilowle, Tigad Ali, Yusuf Abdirisak Mohamed, Adan Gabow, Hawa Mohamed, Nor Sidow, Mohamed Sheikh Hassan, Mohamud Waberi
    Diabetes, Metabolic Syndrome and Obesity.2025; Volume 18: 1949.     CrossRef
  • Sleep Quality in Patients With Type 2 Diabetes Mellitus
    Sana Khamassi, Emna Bornaz, Haifa Abdesselem, Kamilia Ounaissa, Fatma Boukhayatia, Chiraz Amrouche
    American Journal of Lifestyle Medicine.2025;[Epub]     CrossRef
  • Acute and chronic effects of inspiratory muscle training in patients with type 2 diabetes mellitus: a systematic review of randomized controlled trials
    Zoé Breuil-Marsal, Clémence Godek, Amandine Lotti, Patrick Feiereisen, Isabela Roque Marçal, Patricia Rehder-Santos, Juliana Cristina Milan-Mattos, Raphael Martins de Abreu
    Frontiers in Sports and Active Living.2024;[Epub]     CrossRef
Original Articles
The Effects of Subjective Socioeconomic Status and Social Capital on Self-rated Health and Perceived Quality of Life: A Cross-sectional Survey-based Study in a Minority Group in Iran
Rashid Ahmadifar, Nader Rajabi-Gilan, Shirzad Rostamizadeh, Nsrolah Nadimi, Parviz Sobhani, Adel Irankhah
J Prev Med Public Health. 2025;58(1):11-20.   Published online October 5, 2024
DOI: https://doi.org/10.3961/jpmph.24.210
  • 19,930 View
  • 807 Download
AbstractAbstract AbstractSummary PDF
Objectives
The purpose of this study is to examine the impact of subjective socioeconomic status and social capital on self-rated health and quality of life among a minority group in Iran.
Methods
This cross-sectional study involved 800 individuals from a minority group in Iran. The sampling method was clustering, and data collection was conducted using a questionnaire. Data analysis was performed using SPSS version 18 and Stata version 8.
Results
The results of logistic regression analysis revealed that subjective socioeconomic status (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.34 to 1.61), belonging and empathy (OR, 1.09; 95% CI, 1.03 to 1.15), and trust (OR, 1.06; 95% CI, 1.00 to 1.13) significantly impacted the quality of life. Additionally, the logistic regression analysis for factors influencing self–rated health demonstrated significant effects for the age group of 31-50 years (OR, 0.59; 95% CI, 0.38 to 0.91), gender (OR, 0.65; 95% CI, 0.46 to 0.92), academic education (OR, 2.00; 95% CI, 1.22 to 3.26), subjective socioeconomic status (OR, 1.27; 95% CI, 1.16 to 1.38), chronic disease (OR, 4.52; 95% CI, 2.49 to 8.19), belonging and empathy (OR, 1.06; 95% CI, 1.01 to 1.11), and participation (OR, 1.12; 95% CI, 1.00 to 1.24).
Conclusions
The findings indicate that bonding social capital significantly influences health levels and quality of life. Focusing on delegating local responsibilities to community members and striving to promote participation in health programs, along with increasing the socioeconomic status of minority groups, can effectively improve their health and quality of life.
Summary
Key Message
The overall findings suggest that the dimensions of bonding social capital were more effective in predicting respondents' self-rated health (SRH) and perceived quality of life (QOL). Specifically, the variables of belonging/empathy and trust, were found to increase the likelihood of a positive QOL by 9% and 6%, respectively. The findings also showed that belonging/empathy and participation increase the likelihood of a positive SRH by 6% and 12%, respectively. Additionally, a 1-unit increase in Subjective Socioeconomic Status was associated with a 27% and 47% increase in the likelihood of having a positive SRH and QOL respectively.
Symptoms, Mental Health, and Quality of Life Among Patients After COVID-19 Infection: A Cross-sectional Study in Vietnam
Hai Nguyen Thanh, Duc Cap Minh, Hien Hoang Thu, Duc Nguyen Quang
J Prev Med Public Health. 2024;57(2):128-137.   Published online February 27, 2024
DOI: https://doi.org/10.3961/jpmph.23.511
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AbstractAbstract AbstractSummary PDF
Objectives
This study was conducted to characterize the symptoms, mental health, quality of life (QoL), and associated factors following the coronavirus disease 2019 (COVID-19) infection.
Methods
This cross-sectional study included 394 participants previously infected with COVID-19 in Ho Chi Minh City, Vietnam. Mental health was assessed using the 21-item Depression, Anxiety, and Stress Scale (DASS-21). Participants self-reported health-related QoL was measured with the EuroQol 5-Dimension 5-Level (EQ-5D-5L) scale.
Results
Among the participants, 76.4% reported experiencing at least one symptom following COVID-19 infection. The most common symptoms were fatigue (42.1%), cognitive dysfunction (42.9%), and hair loss (27.9%). According to the DASS-21 results, the proportions of depression, anxiety, and stress were 28.7%, 26.4%, and 20.6%, respectively. The mean scores on the EQ-5D-5L and the EuroQol Visual Analog Scale were 0.94±0.11 and 84.20±13.11, respectively. Regarding QoL issues, the highest proportion of participants (32.7%) reported experiencing anxiety or depression, followed by pain or discomfort (25.4%). Multivariable logistic regression analysis revealed that factors associated with the presence of symptoms following COVID-19 infection included female (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.65 to 4.91) and having QoL issues (OR, 3.25; 95% CI, 1.71 to 6.19).
Conclusions
The study investigated the prevalence rates of various symptoms following COVID-19 infection. These findings underscore the need to prioritize comprehensive care for individuals recovering from COVID-19 and to implement strategies to mitigate the long-term impact of the disease on mental health and QoL.
Summary
Key Message
This cross-sectional study in Vietnam investigated symptoms, mental health, and quality of life among patients recovering from COVID-19. The study found that most participants experienced post-infection symptoms, with fatigue, cognitive dysfunction, and hair loss being the most common. Mental health issues were prevalent, and participants reported varying levels of quality of life. The findings highlight the importance of comprehensive care and strategies to address the long-term impact of COVID-19 on mental health and quality of life.

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  • Prevalence of depression, anxiety, stress, and suicide tendency among individual with long-COVID and determinants: A systematic review and meta-analysis
    Razieh Bidhendi-Yarandi, Akbar Biglarian, Jannike Lie Karlstad, Cathrine Fredriksen Moe, Enayatollah Bakhshi, Mohammad-Reza Khodaei-Ardakani, Samira Behboudi-Gandevani, Shibajee Debbarma
    PLOS ONE.2025; 20(1): e0312351.     CrossRef
  • Health-related quality of life in COVID-19 patients: a systematic review and meta-analysis of EQ-5D studies
    Kidu Gidey, Yirga Legesse Niriayo, Solomon Weldegebreal Asgedom, Erica Lubetkin
    Health and Quality of Life Outcomes.2025;[Epub]     CrossRef
  • Quality of sleep after COVID-19 infection: a cross-sectional study in the Southern Italy
    Vincenza Sansone, Silvia Angelillo, Giovanna Paduano, Claudia Pileggi, Carmelo Giuseppe Angelo Nobile, Gabriella Di Giuseppe
    Frontiers in Psychiatry.2024;[Epub]     CrossRef
Patterns of Health-related Quality of Life in Men Who Inject Drugs: A Survey in Southeast Iran
Marzieh Nojomi, Maysam Rezapour, Neda Soleimanvandi Azar, Mehdi Darabi, Mehran Asadi-Aliabadi
J Prev Med Public Health. 2024;57(2):148-156.   Published online February 23, 2024
DOI: https://doi.org/10.3961/jpmph.23.379
  • 4,768 View
  • 286 Download
AbstractAbstract AbstractSummary PDF
Objectives
Understanding patterns of quality of life in people who inject drugs (PWID) can help healthcare providers plan and manage their health problems in a more focused manner. Therefore, the current study aimed to identify patterns of health-related quality of life in PWID in southeast Iran.
Methods
This cross-sectional study was conducted in southeast Iran on men who had injected drugs at least once during the last year. We used convenience sampling in 2 drop-in centers and venue-based sampling at 85 venues. Demographic characteristics, high-risk behaviors, and health-related quality of life were evaluated using the 5-level EQ-5D version (EQ-5D-5L) questionnaire. Latent profile analysis was used to identify patterns of quality of life.
Results
This study enrolled 398 PWID, who had a mean age of 34.1±11.4 years. About 47.9% reported a prison history in the last 10 years, 59.2% had injected drugs in the last month, and 31.6% had a history of sharing syringes. About 46.3% reported having 2 or more sexual partners in the last 6 months, and 14.7% had a history of sex with men. Out of the 5 EQ-5D-5L profiles, the fifth profile had the most people (36.6%). Most variations in quality of life were related to pain and discomfort.
Conclusions
We showed that the pain and discomfort dimension of EQ-5D-5L had more variation in PWID. This finding will be useful for allocating appropriate interventions and resources to promote health-related quality of life in this population.
Summary
Key Message
People who Inject drugs, as an at-risk population in physical and mental disorders, need support to reduce harm. This study found that the health-related quality of life of these people is affected more by the pain and discomfort dimension. This can be caused by their social exclusion and marginalization. Hence, regular planning is necessary to organize the health status of these people. Due to the hard-to-reach nature of this population, special arrangements such as utilizing peer groups may be effective to provide them with services.
Sleep Quality and Associated Factors Among Firefighters in Bangkok, Thailand: A Cross-sectional Study
Nunnapat Piyachaiseth, Pornchai Sithisarankul, Jate Ratanachina
J Prev Med Public Health. 2024;57(1):83-90.   Published online December 9, 2023
DOI: https://doi.org/10.3961/jpmph.23.305
  • 7,149 View
  • 404 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Professional firefighters face various health hazards and are required to maintain both physical and mental fitness to effectively mitigate crises and respond to emergencies. Moreover, the long working hours and shift work of this profession impact sleep quality. This study investigated the quality of sleep and its associated factors among firefighters in Bangkok, Thailand.
Methods
This was a cross-sectional study of firefighters affiliated with the Bangkok Fire and Rescue Department, Bangkok Metropolitan Administration, Thailand between January 2023 and March 2023. A cluster random sampling technique was utilized to distribute 600 questionnaires to firefighters in 15 fire stations. The questionnaire addressed demographic, work-related, and environmental factors. Sleep quality was assessed using the Thai version of the Pittsburgh Sleep Quality Index (PSQI). Data analysis involved both descriptive and inferential statistics. Bivariate and multiple logistic regressions were performed.
Results
The response rate was 78.7% (n=472), and 44.1% of the firefighters reported poor sleep quality (PSQI score >5). Sleep quality was statistically associated with conflicting family relationships (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1 to 2.9), additional part-time jobs (daytime, OR, 2.4; 95% CI, 1.3 to 4.4; or nighttime, OR, 4.3; 95% CI, 1.1 to 16.7), noisy sleeping areas (OR, 1.7; 95% CI, 1.1 to 2.8), and the availability of adequate bedding (OR, 3.0; 95% CI, 1.8 to 4.9).
Conclusions
Poor sleep quality among firefighters was associated with various personal, work-related, and environmental factors. Organizations should promote policies that improve sleep quality through good sleep hygiene practices and facilities.
Summary
Key Message
This cross-sectional study aimed to investigate sleep quality among firefighters in Bangkok, Thailand its associated factors. 44.1% of the firefighters reported poor sleep quality (the Pittsburgh Sleep Quality Index: PSQI score >5). Sleep quality was statistically associated with conflicting family relationships, additional part-time jobs (daytime or nighttime), noisy sleeping areas, and the availability of adequate bedding.

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  • Psychometric Properties of the Areas of Worklife Survey in an Industrial Context in Thailand
    Jate Ratanachina, Inthuon Hongsiri, Watcharakorn Chuthong, Wiroj Jiamjarasrangsi
    Journal of Preventive Medicine and Public Health.2026; 59(1): 75.     CrossRef
  • A latent profile analysis of health characteristics in relation to sleep among female sex workers in entertainment venues in Wuhan, China
    Weiwei Xiang, Hua Ke, Xiaojia Song, Xiang Liu, Li Dai, Xinwen Min, Handong Yang, Jun Chen, Jishun Chen, Dongfeng Li, Lijuan Zheng, Hao Xu, Wenwen Wu
    BMC Women's Health.2026;[Epub]     CrossRef
  • Burnout, areas of worklife and associated factors among industrial workers: a cross-sectional study from Thailand
    Inthuon Hongsiri, Wiroj Jiamjarasrangsi, Jate Ratanachina
    Psychology, Health & Medicine.2025; : 1.     CrossRef
Health-related Quality of Life of Patients With Diabetes Mellitus Measured With the Bahasa Indonesia Version of EQ-5D in Primary Care Settings in Indonesia
Muhammad Husen Prabowo, Ratih Puspita Febrinasari, Eti Poncorini Pamungkasari, Yodi Mahendradhata, Anni-Maria Pulkki-Brännström, Ari Probandari
J Prev Med Public Health. 2023;56(5):467-474.   Published online September 26, 2023
DOI: https://doi.org/10.3961/jpmph.23.229
  • 8,257 View
  • 253 Download
  • 8 Web of Science
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AbstractAbstract AbstractSummary PDF
Objectives
Diabetes mellitus (DM) is a serious public health issue that places a heavy financial, social, and health-related burden on individuals, families, and healthcare systems. Self-reported health-related quality of life (HRQoL) is extensively used for monitoring the general population’s health conditions and measuring the effectiveness of interventions. Therefore, this study investigated HRQoL and associated factors among patients with type 2 DM at a primary healthcare center in Indonesia.
Methods
A cross-sectional study was conducted in Klaten District, Central Java, Indonesia, from May 2019 to July 2019. In total, 260 patients with DM registered with National Health Insurance were interviewed. HRQoL was measured with the EuroQol Group’s validated Bahasa Indonesia version of the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) with the Indonesian value set. Multivariate regression models were used to identify factors influencing HRQoL.
Results
Data from 24 patients were excluded due to incomplete information. Most participants were men (60.6%), were aged above 50 years (91.5%), had less than a senior high school education (75.0%), and were unemployed (85.6%). The most frequent health problems were reported for the pain/discomfort dimension (64.0%) followed by anxiety (28.4%), mobility (17.8%), usual activities (10.6%), and self-care (6.8%). The average EuroQoL 5-Dimension (EQ-5D) index score was 0.86 (95% confidence interval [CI], 0.83 to 0.88). In the multivariate ordinal regression model, a higher education level (coefficient, 0.08; 95% CI, 0.02 to 0.14) was a significant predictor of the EQ-5D-5L utility score.
Conclusions
Patients with diabetes had poorer EQ-5D-5L utility values than the general population. DM patients experienced pain/discomfort and anxiety. There was a substantial positive relationship between education level and HRQoL.
Summary
Key Message
This study examined Health-Related Quality of Life (HRQoL) in 260 type 2 diabetes patients in Indonesia. Most were male (60.6%), over 50 (91.5%), with low education (75%) and unemployed (85.6%). Pain/discomfort was the most common issue (64%), followed by anxiety (28.4%). The average HRQoL score was 0.86. Higher education positively impacted HRQoL. Diabetes patients face lower HRQoL compared to the general population, with notable issues in pain and anxiety. Education level significantly influences HRQoL. This highlights the importance of education in improving the well-being of diabetes patients in Indonesia.

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  • Time series analysis of the impact of ambient temperature influence on healthcare service utilization by diabetes patients in the Special Capital Region of Jakarta, Indonesia: A study using Indonesian National Health Insurance data
    Helen Andriani, Chairina Suci Andhisa, Paul LC. Chua, Miftahul Arsyi
    Global Transitions.2026; 8(1): 64.     CrossRef
  • Socio-demographic disparities in health-related quality of life in hypertensive patients in Bangladesh: a comprehensive survey analysis
    Md. Mizanur Rahman, Md. Nesar Uddin Sorkar, Ryota Nakamura, Md. Monirul Islam, Md. Ashraful Alam, Syed Khurram Azmat, Motohiro Sato
    Quality of Life Research.2025; 34(5): 1457.     CrossRef
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    Zongbo Sun, Yuanyuan Li, Xueli Qu, Luguang Wang, Shengyin Zhu, Xuejing Sun, Li Yang, Xiaonan Sun
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  • Is the pay-for-performance program associated with better quality of life among type 2 diabetes patients, including those with gastrointestinal conditions, in Taiwan? A cross-sectional survey
    Shao-Hua Kuang, Tsung-Tai Chen, Wen-Ya Ma, Szu-Tah Chen, Meng-Han Shih, Ching-Chieh Su, Wei-Chih Su, Li Ying Huang, Ya-Seng (Arthur) Hsueh, Vinchi Wang, Alexandre Morais Nunes
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  • Health-related quality of life and disease activity in rheumatoid arthritis: a cross-sectional study in West Java, Indonesia
    Yudisia Ausi, Rano K. Sinuraya, Sumartini Dewi, Melisa I. Barliana, Maarten J. Postma, Auliya A. Suwantika
    Frontiers in Medicine.2025;[Epub]     CrossRef
  • Effective Education Methods to Improve Glycemic Control in Type 2 Diabetes Mellitus Patients: A Systematic Review
    Ika Mustikaningtias, Anna Wahyuni Widayanti, Pugud Samodro, Nanang Munif Yasin
    Journal of Preventive Medicine and Public Health.2025; 58(5): 453.     CrossRef
  • Cost-effectiveness of community-based type 2 diabetes prevention and control in Indonesia: a health economics modelling study
    Rachmadianti Sukma Hanifa, M Rifqi Rokhman, Manuela Fritz, Vitri Widyaningsih, Ratih Puspita Febrinasari, Jaap A R Koot, Maarten J Postma, Jurjen van der Schans
    BMJ Public Health.2025; 3(2): e002161.     CrossRef
  • Quality of life and prevalence of prehypertension/hypertension among patients with diabetes mellitus: A cross-sectional study in a tertiary care hospital of Gandaki Province, Nepal
    Sushila Baral, Rajesh Kumar Yadav, Srijana Paudel, Yadunath Baral, Pawan Pandeya, Sweta Silwal, Santosh Poudel, Roshan Dhakal, Roshan Kumar Mahato
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Health-related Quality of Life in Elderly Asian American and Non-Hispanic White Cancer Survivors
Suzanne Vang
J Prev Med Public Health. 2023;56(5):440-448.   Published online September 13, 2023
DOI: https://doi.org/10.3961/jpmph.22.464
  • 5,662 View
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AbstractAbstract AbstractSummary PDF
Objectives
The purpose of this study was to assess predictors of health-related quality of life (HRQoL) in elderly Asian American and non-Hispanic White cancer survivors.
Methods
We conducted cross-sectional secondary data analyses using the combined datasets from the Surveillance, Epidemiology, and End Results program and the Medicare Health Outcomes Survey.
Results
Elderly Asian American cancer survivors reported a lower mental HRQoL but a comparable physical HRQoL relative to elderly non-Hispanic White cancer survivors. Stress factors, such as comorbidities, difficulties with activities of daily living, and a history of depressive symptoms, along with coping resources like self-rated health and the ability to take the survey in English, were significantly associated with mental and physical HRQoL. Among elderly Asian American cancer survivors, a significantly lower mental HRQoL was observed among those taking the survey in the Chinese language.
Conclusions
The findings suggest that race exerts a differential impact on HRQoL. Interventions should be designed to address the distinct cultural, linguistic, and systemic needs of elderly Asian American cancer survivors. Such an approach could assist in reducing cancer-related health disparities.
Summary
Key Message
Secondary data analyses of the Surveillance, Epidemiology, and End Results program and the Medicare Health Outcomes Survey combined datasets reveal that elderly Asian American cancer survivors had poorer mental health-related quality of life (HRQoL) compared to their non-Hispanic White counterparts. Elderly Asian American cancer survivors who did not complete the survey in English had significantly worse mental HRQoL than their Asian American counterparts who did. These findings point to the need for increased research to identify and address the distinct cultural, linguistic, and system-related needs of elderly Asian American cancer survivors in order to optimize HRQoL in this population.

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  • Association of quality of life in older patients with breast cancer: a cross-sectional study from China
    Min Xiao, Lei Ji, Xiaoyan Qian, Xi Chen, Meng Xiu, Zhuoran Li, Heng Cao, Shanshan Chen, Qing Li, Qiao Li, Xiang Wang, Jiani Wang, Yiqun Li, Xiaojuan Zheng, Jintao Zhang, Pin Zhang
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  • Quality of life in older patients with cancer and related unmet needs: a scoping review
    Franziska Springer, Ayumu Matsuoka, Kyoko Obama, Anja Mehnert-Theuerkauf, Yosuke Uchitomi, Maiko Fujimori
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    Areej Al-Hamad, Yasin M. Yasin, Sepali Guruge, Kateryna Metersky, Lu Wang, Cristina Catallo, Hasina Amanzai, Zhixi Cecilia Zhuang, Rezwana Rahman, Andy Zhang
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    Cheolkyung Sin, Dong Yeop Lee, Hyeyeong Kim, Hyeon-Su Im, Su-Jin Koh, Dong Yoon Kang
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Sleep Quality and Poor Sleep-related Factors Among Healthcare Workers During the COVID-19 Pandemic in Vietnam
Thang Phan, Ha Phan Ai Nguyen, Cao Khoa Dang, Minh Tri Phan, Vu Thanh Nguyen, Van Tuan Le, Binh Thang Tran, Chinh Van Dang, Tinh Huu Ho, Minh Tu Nguyen, Thang Van Dinh, Van Trong Phan, Binh Thai Dang, Huynh Ho Ngoc Quynh, Minh Tran Le, Nhan Phuc Thanh Nguyen
J Prev Med Public Health. 2023;56(4):319-326.   Published online May 31, 2023
DOI: https://doi.org/10.3961/jpmph.22.528
  • 8,965 View
  • 324 Download
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AbstractAbstract PDF
Objectives
The coronavirus disease 2019 (COVID-19) pandemic has increased the workload of healthcare workers (HCWs), impacting their health. This study aimed to assess sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and identify factors associated with poor sleep among HCWs in Vietnam during the COVID-19 pandemic.
Methods
In this cross-sectional study, 1000 frontline HCWs were recruited from various healthcare facilities in Vietnam between October 2021 and November 2021. Data were collected using a 3-part self-administered questionnaire, which covered demographics, sleep quality, and factors related to poor sleep. Poor sleep quality was defined as a total PSQI score of 5 or higher.
Results
Participants’ mean age was 33.20±6.81 years (range, 20.0-61.0), and 63.0% were women. The median work experience was 8.54±6.30 years. Approximately 6.3% had chronic comorbidities, such as hypertension and diabetes mellitus. About 59.5% were directly responsible for patient care and treatment, while 7.1% worked in tracing and sampling. A total of 73.8% reported poor sleep quality. Multivariate logistic regression revealed significant associations between poor sleep quality and the presence of chronic comorbidities (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.17 to 5.24), being a frontline HCW directly involved in patient care and treatment (OR, 1.59; 95% CI, 1.16 to 2.16), increased working hours (OR, 1.84; 95% CI,1.37 to 2.48), and a higher frequency of encountering critically ill and dying patients (OR, 1.42; 95% CI, 1.03 to 1.95).
Conclusions
The high prevalence of poor sleep among HCWs in Vietnam during the COVID-19 pandemic was similar to that in other countries. Working conditions should be adjusted to improve sleep quality among this population.
Summary

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  • Sleep quality by clinical training status among medical students and its associated factors: a cross-sectional study in Da Nang, Vietnam
    Nguyet Truong, Hung Nguyen, Tung Pham, Duyen Chu, Linh Bui
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Annual Endovascular Thrombectomy Case Volume and Thrombectomy-capable Hospitals of Korea in Acute Stroke Care
Eun Hye Park, Seung-sik Hwang, Juhwan Oh, Beom-Joon Kim, Hee-Joon Bae, Ki-Hwa Yang, Ah-Rum Choi, Mi-Yeon Kang, S.V. Subramanian
J Prev Med Public Health. 2023;56(2):145-153.   Published online March 31, 2023
DOI: https://doi.org/10.3961/jpmph.22.318
  • 7,126 View
  • 159 Download
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AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Although it is difficult to define the quality of stroke care, acute ischemic stroke (AIS) patients with moderate-to-severe neurological deficits may benefit from thrombectomy-capable hospitals (TCHs) that have a stroke unit, stroke specialists, and a substantial endovascular thrombectomy (EVT) case volume.
Methods
From national audit data collected between 2013 and 2016, potential EVT candidates arriving within 24 hours with a baseline National Institutes of Health Stroke Scale score ≥6 were identified. Hospitals were classified as TCHs (≥15 EVT case/y, stroke unit, and stroke specialists), primary stroke hospitals (PSHs) without EVT (PSHs-without-EVT, 0 case/y), and PSHs-with-EVT. Thirty-day and 1-year case-fatality rates (CFRs) were analyzed using random intercept multilevel logistic regression.
Results
Out of 35 004 AIS patients, 7954 (22.7%) EVT candidates were included in this study. The average 30-day CFR was 16.3% in PSHs-without-EVT, 14.8% in PSHs-with-EVT, and 11.0% in TCHs. The average 1-year CFR was 37.5% in PSHs-without-EVT, 31.3% in PSHs-with-EVT, and 26.2% in TCHs. In TCHs, a significant reduction was not found in the 30-day CFR (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.76 to 1.12), but was found in the 1-year CFR (OR, 0.84; 95% CI, 0.73 to 0.96).
Conclusions
The 1-year CFR was significantly reduced when EVT candidates were treated at TCHs. TCHs are not defined based solely on the number of EVTs, but also based on the presence of a stroke unit and stroke specialists. This supports the need for TCH certification in Korea and suggests that annual EVT case volume could be used to qualify TCHs.
Summary
Korean summary
급성 허혈성 뇌졸중 환자에서 “혈관 내 혈전제거술(endovascular treatment, EVT)”의 치료효과는 여러 연구를 통해 증명되었으나, EVT 후보군에서 EVT를 제공하기 위한 의료서비스 연구는 부족한 실정이다. 5~7차 뇌졸중 적정성 평가 자료를 활용하여 연간 EVT 시행횟수와 EVT후보군의 30일, 1년 후 치명률 간의 연관성을 다수준 분석을 통해 확인하였다. 연간 15회 이상 EVT를 시행하면서 뇌졸중 전문치료실과 뇌줄중 관련 전문분과(신경과, 신경외과, 재활의학과) 전문의가 모두 있는 병원(TCHs)에서 치료받은 환자는 EVT를 시행하지 않는 병원(PSHs-without-EVT)에서 치료받는 환자에 비해 치명률이 감소하는 경향을 보였다. 이는 뇌졸중 치료체계에서 EVT가능병원을 정의할 필요성을 잘 보여주고, “연간 EVT 시행횟수”는 TCHs를 정의하는 중요한 지표로 사용될 수 있을 것이다.

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    Zafar Ali, Sayyeda Aleena Mufarrih, Amjad Ali, Michael G. Abraham, Gokul Ramani, Kamal Gupta
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Changes in the Hospital Standardized Mortality Ratio Before and During the COVID-19 Pandemic: A Disaggregated Analysis by Region and Hospital Type in Korea
EunKyo Kang, Won Mo Jang, Min Sun Shin, Hyejin Lee, Jin Yong Lee
J Prev Med Public Health. 2023;56(2):180-189.   Published online March 20, 2023
DOI: https://doi.org/10.3961/jpmph.22.479
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AbstractAbstract AbstractSummary PDF
Objectives
The coronavirus disease 2019 (COVID-19) pandemic has led to a global shortage of medical resources; therefore, we investigated whether COVID-19 impacted the quality of non-COVID-19 hospital care in Korea by comparing hospital standardized mortality rates (HSMRs) before and during the pandemic.
Methods
This retrospective cohort study analyzed Korean National Health Insurance discharge claim data obtained from January to June in 2017, 2018, 2019, and 2020. Patients’ in-hospital deaths were classified according to the most responsible diagnosis categories. The HSMR is calculated as the ratio of expected deaths to actual deaths. The time trend in the overall HSMR was analyzed by region and hospital type.
Results
The final analysis included 2 252 824 patients. In 2020, the HSMR increased nationwide (HSMR, 99.3; 95% confidence interval [CI], 97.7 to 101.0) in comparison to 2019 (HSMR, 97.3; 95% CI, 95.8 to 98.8). In the COVID-19 pandemic zone, the HSMR increased significantly in 2020 (HSMR, 112.7; 95% CI, 107.0 to 118.7) compared to 2019 (HSMR, 101.7; 95% CI, 96.9 to 106.6). The HSMR in all general hospitals increased significantly in 2020 (HSMR, 106.4; 95% CI, 104.3 to 108.5) compared to 2019 (HSMR, 100.3; 95% CI, 98.4 to 102.2). Hospitals participating in the COVID-19 response had a lower HSMR (HSMR, 95.6; 95% CI, 93.9 to 97.4) than hospitals not participating in the COVID-19 response (HSMR, 124.3; 95% CI, 119.3 to 129.4).
Conclusions
This study suggests that the COVID-19 pandemic may have negatively impacted the quality of care in hospitals, especially general hospitals with relatively few beds. In light of the COVID-19 pandemic, it is necessary to prevent excessive workloads in hospitals and to properly employ and coordinate the workforce.
Summary
Korean summary
코로나19 대유행 지역은 비감염 지역과 달리 2019년에 비해 2020년에 HSMR이 크게 증가했고, 상대적으로 병상 수가 적은 종합병원에서 HSMR이 증가했다. 코로나19 대응에 참여하는 병원은 병원 규모와 관계없이 HSMR이 낮은 경향을 보였다. 감염병 유행 시 병원의 과도한 업무량이 부여되지 않게하고 인력을 적절하게 고용하여 조정하는 것이 필요하다.

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  • National Expenditures on Anticancer and Immunomodulating Agents During 2013–2022 in Korea
    Jieun Yun, Youngs Chang, Minsol Jo, Yerin Heo, Dong-Sook Kim
    Journal of Korean Medical Science.2025;[Epub]     CrossRef
  • The Impact of COVID-19 on Admissions and In-hospital Mortality of Patients With Stroke in Korea: An Interrupted Time Series Analysis
    Youngs Chang, Soo-Hee Hwang, Haibin Bai, Seowoo Park, Eunbyul Cho, Dohoung Kim, Hyejin Lee, Jin Yong Lee
    Journal of Preventive Medicine and Public Health.2025; 58(1): 60.     CrossRef
  • Impact of COVID-19 on admission and in-hospital mortality of patients with acute myocardial infarction in Korea: An interrupted time series analysis
    Soo-Hee Hwang, Youngs Chang, Haibin Bai, Jieun Yun, Hyejin Lee, Jin Yong Lee, Dong Keon Yon
    PLOS ONE.2025; 20(2): e0316943.     CrossRef
  • 국내 호흡기세포융합바이러스의 동절기 유행 규모 예측모형 개발
    경덕 민, 현경 김, 보영 류, 민규 유, 재훈 김
    Public Health Weekly Report.2025; 18(21): 771.     CrossRef
  • Variations in length of stay and cost of pediatric pneumonia hospitalizations according to patient and institutional factors
    Hyejin Lee, Jin-Won Noh, Sanghee Lee, Jung-Kyu Choi, Jung-Hoe Kim, Hae-jong Lee, Jin Yong Lee, Erica Barbazza
    International Journal For Quality In Health Care.2025;[Epub]     CrossRef
Measurement and Decomposition of Socioeconomic Inequality in Metabolic Syndrome: A Cross-sectional Analysis of the RaNCD Cohort Study in the West of Iran
Moslem Soofi, Farid Najafi, Shahin Soltani, Behzad Karamimatin
J Prev Med Public Health. 2023;56(1):50-58.   Published online January 6, 2023
DOI: https://doi.org/10.3961/jpmph.22.373
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AbstractAbstract PDF
Objectives
Socioeconomic inequality in metabolic syndrome (MetS) remains poorly understood in Iran. The present study examined the extent of the socioeconomic inequalities in MetS and quantified the contribution of its determinants to explain the observed inequality, with a focus on middle-aged adults in Iran.
Methods
This cross-sectional study used data from the Ravansar Non-Communicable Disease cohort study. A sample of 9975 middle-aged adults aged 35-65 years was analyzed. MetS was assessed based on the International Diabetes Federation definition. Principal component analysis was used to construct socioeconomic status (SES). The Wagstaff normalized concentration index (CIn) was employed to measure the magnitude of socioeconomic inequalities in MetS. Decomposition analysis was performed to identify and calculate the contribution of the MetS inequality determinants.
Results
The proportion of MetS in the sample was 41.1%. The CIn of having MetS was 0.043 (95% confidence interval, 0.020 to 0.066), indicating that MetS was more concentrated among individuals with high SES. The main contributors to the observed inequality in MetS were SES (72.0%), residence (rural or urban, 46.9%), and physical activity (31.5%).
Conclusions
Our findings indicated a pro-poor inequality in MetS among Iranian middle-aged adults. These results highlight the importance of persuading middle-aged adults to be physically active, particularly those in an urban setting. In addition to targeting physically inactive individuals and those with low levels of education, policy interventions aimed at mitigating socioeconomic inequality in MetS should increase the focus on high-SES individuals and the urban population.
Summary

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  • Prevalence of metabolic syndrome and its components in Iran: an updated meta-analysis
    Asra Moradkhani, Pardis Mohammadzadeh, Srwa Assadi, Lotfolah Saed, Hamid Reza Baradaran, Yousef Moradi
    BMC Endocrine Disorders.2025;[Epub]     CrossRef
  • The prevalence of metabolic syndrome and its economic inequality in an elderly population
    Farid Fotouhi, Hassan Hashemi, Abbasali Yekta, Mahtab Niroomand, Mehrdad Esmaeili, Reza Norouzirad, Nasim Vaghefi, Mehdi Khabazkhoob
    Scientific Reports.2025;[Epub]     CrossRef
  • Sleep Quality, Nutrient Intake, and Social Development Index Predict Metabolic Syndrome in the Tlalpan 2020 Cohort: A Machine Learning and Synthetic Data Study
    Guadalupe Gutiérrez-Esparza, Mireya Martinez-Garcia, Tania Ramírez-delReal, Lucero Elizabeth Groves-Miralrio, Manlio F. Marquez, Tomás Pulido, Luis M. Amezcua-Guerra, Enrique Hernández-Lemus
    Nutrients.2024; 16(5): 612.     CrossRef
  • Socioeconomic inequalities in metabolic syndrome and its components in a sample of Iranian Kurdish adults
    Pardis Mohammadzadeh, Farhad Moradpour, Bijan Nouri, Farideh Mostafavi, Farid Najafi, Ghobad Moradi
    Epidemiology and Health.2023; 45: e2023083.     CrossRef
SWOT Analysis and Expert Assessment of the Effectiveness of the Introduction of Healthcare Information Systems in Polyclinics in Aktobe, Kazakhstan
Lyudmila Yermukhanova, Zhanar Buribayeva, Indira Abdikadirova, Anar Tursynbekova, Meruyert Kurganbekova
J Prev Med Public Health. 2022;55(6):539-548.   Published online October 11, 2022
DOI: https://doi.org/10.3961/jpmph.22.360
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AbstractAbstract PDF
Objectives
The purpose of this study was to assess the organizational effectiveness of the introduction of a healthcare information system (electronic medical records and databases) in healthcare in Kazakhstan.
Methods
The authors used a combination of 2 methods: expert assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis. SWOT analysis is a necessary element of research, constituting a mandatory preliminary stage both when drawing up strategic plans and for taking corrective measures in the future. The expert survey was conducted using 2 questionnaires.
Results
The study involved 40 experts drawn from specialists in primary healthcare in Aktobe: 15 representatives of administrative and managerial personnel (chief doctors and their deputies, heads of medical statistics offices, organizational and methodological offices, and internal audit services) and 25 general practitioners.
Conclusions
The following functional indicators of the medical and organizational effectiveness of the introduction of information systems in polyclinics were highlighted: first, improvement of administrative control, followed in descending order by registration and movement of medical documentation, statistical reporting and process results, and the cost of employees’ working time. There has been no reduction in financial costs, namely in terms of the costs of copying, delivery of information in paper form, technical equipment, and paper.
Summary

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    Ainur B. Qumar, Kamila Faizullina, Laura Seiduanova, Ayaulym Yelibay, Nurila Zhamankulova, Nurzhan Mukashev
    Central Asian Journal of Medical Hypotheses and Ethics.2025; 6(2): 125.     CrossRef
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Associations of Socioeconomic Status With Depression and Quality of Life in Patients With Hypertension: An Analysis of Data From the 2019 Community Health Survey in Korea
Hye Ri Kim, Mia Son
J Prev Med Public Health. 2022;55(5):444-454.   Published online August 24, 2022
DOI: https://doi.org/10.3961/jpmph.22.214
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AbstractAbstract AbstractSummary PDF
Objectives
We aimed to identify the factors related to depression and quality of life in patients with hypertension by using multilevel regression analysis.
Methods
In 2019, 229 043 participants in the Korean Community Health Survey were selected as the study group. Individual factors were identified using data from the 2019 Community Health Survey. Regional factors were identified using data from the National Statistical Office of Korea. Multilevel regression analysis was conducted to find individual and local factors affecting depression and quality of life in patients with hypertension and to determine any associated interactions.
Results
As individual factors in patients with hypertension, women, those with lower education-levels, recipients of basic livelihood benefits, and those with poor dietary conditions showed stronger associations with depression and quality of life. As regional factors and individual-level variables in patients with hypertension, lower gross regional personal income, fewer doctors at medical institutions, and lower rates of participation in volunteer activities presented stronger associations with depression and quality of life. In addition, the associations of depression with gross regional personal income, the number of doctors at medical institutions, and dietary conditions were significantly stronger in patients with hypertension than in patients without hypertension. The associations of gender and employment status with quality of life were also significantly greater.
Conclusions
Policy interventions are needed to adjust health behaviors, prevent depression, and improve quality of life for patients with hypertension, especially for those with the risk factors identified in this study.
Summary
Korean summary
2019년 지역사회건강조사, 대한민국 통계청 자료를 통해, 다수준 회귀분석을 이용하여 고혈압 환자의 우울 및 삶의 질과 관련된 요인을 파악한 결과, 비고혈압 집단 대비 고혈압 환자의 지역총소득, 의료기관 종사 의사수, 식생활 형편이 우울과 연관성이 유의미하게 컸고, 성별, 직업수준이 삶의 질과 연관성이 유의미하게 컸다.

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    Seowoo Park, Haibin Bai, Jae-ryun Lee, Soomin Kim, Hyemin Jung, Jin Yong Lee
    Journal of Preventive Medicine and Public Health.2025; 58(1): 83.     CrossRef
  • The Mediating Effect of Physical Activity on the Relationship between Depression and Health-related Quality of Life among Patients with Hypertension and Diabetes in Seoul
    In-Young Yoo
    Journal of The Korean Society of Living Environmental System.2025; 32(2): 179.     CrossRef
  • The effect of self-care, self-efficacy, and health literacy on health-related quality of life in patients with hypertension: a cross-sectional study
    Nastaran Salmanpour, Alireza Salehi, Sadaf Nemati, Mahdi Rahmanian, Alireza Zakeri, Hamed Bazrafshan drissi, Mohammad Reza Shadzi
    BMC Public Health.2025;[Epub]     CrossRef
  • Socioeconomic inequality in health-related quality of life among Korean adults with chronic disease: an analysis of the Korean Community Health Survey
    Thi Huyen Trang Nguyen, Thi Tra Bui, Jinhee Lee, Kui Son Choi, Hyunsoon Cho, Jin-Kyoung Oh
    Epidemiology and Health.2024; 46: e2024018.     CrossRef
Special Articles
The Primary Process and Key Concepts of Economic Evaluation in Healthcare
Younhee Kim, Yunjung Kim, Hyeon-Jeong Lee, Seulki Lee, Sun-Young Park, Sung-Hee Oh, Suhyun Jang, Taejin Lee, Jeonghoon Ahn, Sangjin Shin
J Prev Med Public Health. 2022;55(5):415-423.   Published online August 24, 2022
DOI: https://doi.org/10.3961/jpmph.22.195
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AbstractAbstract AbstractSummary PDF
Economic evaluations in the healthcare are used to assess economic efficiency of pharmaceuticals and medical interventions such as diagnoses and medical procedures. This study introduces the main concepts of economic evaluation across its key steps: planning, outcome and cost calculation, modeling, cost-effectiveness results, uncertainty analysis, and decision-making. When planning an economic evaluation, we determine the study population, intervention, comparators, perspectives, time horizon, discount rates, and type of economic evaluation. In healthcare economic evaluations, outcomes include changes in mortality, the survival rate, life years, and quality-adjusted life years, while costs include medical, non-medical, and productivity costs. Model-based economic evaluations, including decision tree and Markov models, are mainly used to calculate the total costs and total effects. In cost-effectiveness or costutility analyses, cost-effectiveness is evaluated using the incremental cost-effectiveness ratio, which is the additional cost per one additional unit of effectiveness gained by an intervention compared with a comparator. All outcomes have uncertainties owing to limited evidence, diverse methodologies, and unexplained variation. Thus, researchers should review these uncertainties and confirm their robustness. We hope to contribute to the establishment and dissemination of economic evaluation methodologies that reflect Korean clinical and research environment and ultimately improve the rationality of healthcare policies.
Summary
Korean summary
보건의료분야에서 경제성 평가는 의약품과 진단검사 및 치료법 등 의료기술에 대한 평가에서 널리 활용되고 있다. 본 연구에서는 경제성 평가절차를 경제성 평가 설계, 결과 산출, 비용산출, 모형 구축 및 분석, 비용-효과성 결과 제시 및 불확실성 평가와 의사 결정 단계로 나누어 주요 개념과 쟁점들을 소개하였다.

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Perceptions of the General Public About Health-related Quality of Life and the EQ-5D Questionnaire: A Qualitative Study in Korea
Minsu Ock, Jeehee Pyo, Min-Woo Jo, Michael Herdman, Nan Luo
J Prev Med Public Health. 2022;55(3):213-225.   Published online May 31, 2022
DOI: https://doi.org/10.3961/jpmph.22.151
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AbstractAbstract AbstractSummary PDF
Objectives
The aim of this qualitative study was to investigate how members of the general public in Korea interpret the concept of health, and which dimensions of health are most important to them. We also explored their perceptions of the EuroQoL 5-Dimension (EQ-5D), including the EuroQoL visual analogue scale (EQ-VAS).
Methods
We conducted face-to-face, in-depth interviews with 20 individuals from the general population, using a semi-structured interview guide. Content analysis was performed with verbatim transcripts and field notes to identify codes and categorize them according to their similarities and associations.
Results
In total, 734 different codes were derived and classified into 4 categories. Participants cited the importance of both the mental and physical aspects of health, although they emphasized that the physical aspects appeared to play a larger role in their conceptualization of health. Participants noted that the EQ-5D has the advantage of being composed of 5 dimensions that are simple and contain both physical and mental areas necessary to describe health. However, some of them mentioned the need to add more dimensions of mental health and social health. Participants showed great satisfaction with the visually well-presented EQ-VAS. However, participants opined that the EQ-VAS scores might not be comparable across respondents because of different ways of responding to the scale.
Conclusions
While physical health is a fundamental aspect of health, mental and social aspects are also important to Koreans. The content of the EQ-5D broadly matched the attributes of health considered important by Koreans.
Summary
Korean summary
이번 연구에서는 질적 연구 방법론을 활용하여 한국인이 건강을 이해하고 개념화하는 방법과 건강의 어떤 차원을 중요하게 여기는지 살펴보면서 EQ-5D에 대한 인식을 살펴보았다. 이번 연구를 통하여 EQ-5D와 EQ VAS가 전반적으로 한국인의 건강 관련 삶의 질을 잘 측정할 수 있지만, 정신적 및 사회적 측면에 대한 항목을 추가하면 한국인의 건강 관련 삶의 질을 더 잘 반영할 수 있음을 확인하였다.

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Well-being Index Scores and Subjective Health Status of Korean Healthcare Workers
Yoonhee Shin, Bohyun Park, Nam-eun Kim, Eun Jeong Choi, Minsu Ock, Sun Ha Jee, Sue K. Park, Hyeong Sik Ahn, Hyesook Park
J Prev Med Public Health. 2022;55(3):226-233.   Published online May 31, 2022
DOI: https://doi.org/10.3961/jpmph.22.114
  • 7,831 View
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AbstractAbstract AbstractSummary PDF
Objectives
The aim of this study was to evaluate the subjective level of health-related quality of life of Korean healthcare workers using various quality-of-life instruments.
Methods
This study included 992 participants, who were doctors and nurses. A survey was conducted between November 28 and December 4, 2019. Data from 954 participants divided into 3 groups (physicians, residents, and nurses) were analyzed. Four measurement tools (29 questions) were used in the survey to evaluate subjective health status and well-being.
Results
In the Mayo Well-being Index, burnout during work (88.5%) and emotional difficulties caused by work (84.0%) were frequently cited by the respondents. Regarding questions on burnout and emotional difficulties, residents and nurses had the highest scores (91.0 and 89.6%, respectively). Emotional problems, such as anxiety, depression, and irritability, accounted for a high percentage (73.1%) of the total, while 82.2% of respondents reported that their work schedules interfered with their leisure and family time. There was no significant difference among the groups in subjective health status. However, 10.1% of the residents experienced very low quality of life, which was a higher proportion than that of physicians (2.7%) and nurses (5.2%).
Conclusions
The level of well-being that Korean medical workers experienced in relation to work was lower than the results of the United States healthcare workers surveyed using the same tool. This study was unique in that it conducted a subjective quality-of-life survey on Korean healthcare workers.
Summary
Korean summary
본 연구의 목적은 다양한 삶의 질 도구를 사용하여 한국 의료종사자들의 건강과 관련된 삶의 질에 대한 주관적인 수준을 평가하는 것이다. 피로와 정서적 어려움, 업무로 인한 일상생활의 방해 등 한국 의료종사자의 일부 삶의 질 점수가 낮았다. 의료 종사자의 소진 경험이 환자의 치료에 부정적인 영향을 미친다는 것을 고려할 때 의료 종사자들의 삶의 질을 향상시키는 정책이 마련되어야하며, 건강과 관련된 직업적 위험요인 연구도 추가적으로 필요하다.

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Original Articles
Health-related Quality of Life Instrument With 8 Items for Use in Patients With Type 2 Diabetes Mellitus: A Validation Study in Korea
Juyoung Kim, Hyeon-Jeong Lee, Min-Woo Jo
J Prev Med Public Health. 2022;55(3):234-242.   Published online May 12, 2022
DOI: https://doi.org/10.3961/jpmph.22.020
  • 10,836 View
  • 229 Download
  • 16 Web of Science
  • 19 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study assessed the validity and reliability of the Health-related Quality of Life Instrument with 8 Items (HINT-8) in patients with diabetes. HINT-8 is a newly-developed, generic health-related quality of life (HRQoL) instrument.
Methods
Three HRQoL instruments—HINT-8, EuroQoL 5-Dimension 5-Level (EQ-5D-5L), and Short Form Health Survey version 2.0 (SF-36v2)—were provided to 300 patients with diabetes visiting a tertiary hospital for follow-up visits in Korea. The HRQoL scores obtained using the HINT-8 were evaluated for subgroups with known differences based on demographics and diabetes-related characteristics (known-group validity). The mean scores of the instruments were compared between groups segmented by their responses to the HINT-8 (discriminatory ability). Correlation coefficients of the HINT-8 with other instruments were calculated (convergent and divergent validity). The Cohen kappa and intra-class correlation coefficient (ICC) were also evaluated (test-retest reliability).
Results
The average HINT-8 indexes were lower among women, older, and less-educated subjects. Subjects who did not list any problems on the HINT-8 had significantly higher HRQoL scores than those who did. The correlation coefficients of the HINT-8 with the EQ-5D-5L index and EuroQoL visual analogue scale were 0.715 (p<0.001) and 0.517 (p<0.001), respectively. The correlation coefficients between the HINT-8 index and the scores of 8 domains of the SF-36v2 ranged from 0.478 (p<0.001) to 0.669 (p<0.001). The Cohen kappa values for the HINT-8 ranged from 0.268 to 0.601, and the ICC of the HINT-8 index was 0.800 (95% confidence interval [CI], 0.720 to 0.860).
Conclusions
This study showed that the HINT-8 is a valid and reliable HRQoL instrument for patients with diabetes.
Summary
Korean summary
이 연구는 한국인의 사회문화적 특성을 반영하여 개발된 건강관련 삶의 질 도구인 HINT-8의 타당도 및 신뢰도를 대표적인 만성 질환인 제2형 당뇨 환자를 대상으로 검증하였다. 연구결과는 제2형 당뇨 환자에서 HINT-8의 활용 가능성을 보여주었을 뿐만 아니라 일반적 건강관련 삶의 질 도구 중 가장 널리 사용되고 있는 EQ-5D-5L보다 HINT-8이 삶의 질 상태를 더욱 정교하게 구분하고 있음을 보여주었다.

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  • Association between obstructive sleep Apnea–Related factors and HINT-8 utility scores in adults: a secondary analysis of the 2023 Korea National health and nutrition examination survey (KNHANES)
    Mima Park, Seon-Ha Kim
    Quality of Life Research.2026;[Epub]     CrossRef
  • Type of Work and Subjective Health Components: A Nationwide Cross-Sectional Survey Among Workers in Korea
    Min Kyung Hyun
    Perspectives on Integrative Medicine.2026; 5(1): 36.     CrossRef
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    Tai-Kyung Lee, So-Young Lee, Eun Cho
    Health and Quality of Life Outcomes.2026;[Epub]     CrossRef
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    Young Il Kim, In Ja Park, Jun-Soo Ro, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Yura Lee, Yae Won Tak, Seockhoon Chung, Kyung Won Kim, Yousun Ko, Sung-Cheol Yun, Min-Woo Jo, Jong Won Lee
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    Byung Soo Kang, Jin Yu, Kyuho Kim, Jae-Seung Yun, Youn Ju Lee, Hyun Sun Ko, Yoon-Hee Choi
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    Health and Quality of Life Outcomes.2025;[Epub]     CrossRef
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    Chiwook Chung, Ah-Ram Kim, Do-Yoon Kang, Sunmok Kim, Jinyoung Oh, Hui Jung Kim, Byongjo Park, Seong Ho Lee, Dongbum Kim, Hee Kwon, Min-Woo Jo, Sei Won Lee
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    Journal of The Korean Society of Living Environmental System.2025; 32(6): 753.     CrossRef
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    Chiwook Chung, Ah-Ram Kim, Dongbum Kim, Hee Kwon, Seong Ho Lee, Il-Young Jang, Min-Woo Jo, Do-Yoon Kang, Sei Won Lee
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    Mi-Sun Lee, Hooyeon Lee
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Estimation of Utility Weights for Prostate-related Health States in Korea
Seon-Ha Kim, Minsu Ock, Min-Woo Jo, Sungchan Park
J Prev Med Public Health. 2022;55(3):243-252.   Published online May 4, 2022
DOI: https://doi.org/10.3961/jpmph.21.426
  • 6,423 View
  • 119 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Very limited previous research has investigated the utility weights of prostate-related diseases in the general population in Korea. The purpose of this study was to calculate the utility of prostate-related health states in the Korean general public using the standard gamble (SG) method.
Methods
Seven health states for hypothetical prostate cancers, 1 for benign prostate hyperplasia, and 1 for erectile dysfunction were developed based on patient education material and previous publications. In total, 460 responses from the Korean general population were used to analyze the utility of prostate-related health states. Computer-assisted personal interviews were conducted, and utility values were measured using a visual analogue scale (VAS) and SG. Mean utility values were calculated for each prostate-related health state.
Results
The mean utility values of prostate cancer derived from SG ranged from 0.281 (metastatic castration-refractory prostate cancer) to 0.779 (localized prostate cancer requiring prostatectomy). The utility value of benign prostate hyperplasia was 0.871, and that of erectile dysfunction was 0.812. The utility values obtained using the SG method in all conditions were higher than the values obtained by VAS. There were no significant demographic variables affecting utility values in multivariate analysis.
Conclusions
Our findings might be useful for economic evaluation and utility calculation of screening and interventions for prostate-related conditions in the general population.
Summary
Korean summary
이 연구는 일반인구집단을 대상으로 7개의 전립선 암 상태와 전립선 비대증, 발기부전상태의 효용값을 표준기회선택법을 이용하여 산출하였다. 전립선암 상태에 따라 평균 효용값은 0.281에서 0.779범위였다. 연구 결과는 전립선 관련 상태의 중재의 효용 계산이나 경제성 평가에 활용할 수 있을 것이다.

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  • Improving Collaborative Engagement in Health State Valuation: A Scoping Review of Current Practices and Emerging Recommendations
    Philip A. Powell, Victoria Gale, Gurdas Singh, Anthea Sutton, Janine Verstraete, Nancy Devlin, Michael Herdman, Simone Schieskow, Jill Carlton
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Association Between Sleep Quality and Anxiety in Korean Adolescents
Hyunkyu Kim, Seung Hoon Kim, Sung-In Jang, Eun-Cheol Park
J Prev Med Public Health. 2022;55(2):173-181.   Published online February 10, 2022
DOI: https://doi.org/10.3961/jpmph.21.498
  • 13,764 View
  • 362 Download
  • 29 Web of Science
  • 38 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
Anxiety disorder is among the most prevalent mental illnesses among adolescents. Early detection and proper treatment are important for preventing sequelae such as suicide and substance use disorder. Studies have suggested that sleep duration is associated with anxiety disorder in adolescents. In the present study, we investigated the association between sleep quality and anxiety in a nationally representative sample of Korean adolescents.
Methods
This cross-sectional study was conducted using data from the 2020 Korea Youth Risk Behavior Web-based Survey. The Generalized Anxiety Disorder-7 questionnaire was used to evaluate anxiety. The chi-square test was used to investigate and compare the general characteristics of the study population, and multiple logistic regression analysis was used to analyze the relationship between sleep quality and anxiety.
Results
In both sexes, anxiety was highly prevalent in participants with poor sleep quality (adjusted odds ratio [aOR], 1.56; 95% confidence interval [CI], 1.43 to 1.71 in boys; aOR, 1.30; 95% CI, 1.19 to 1.42 in girls). Regardless of sleep duration, participants with poor sleep quality showed a high aOR for anxiety.
Conclusions
This study identified a consistent relationship between sleep quality and anxiety in Korean adolescents regardless of sleep duration.
Summary
Korean summary
청소년건강행태조사를 이용하여 청소년들의 수면의 질과 불안과의 연관성을 분석하였다. 좋지 않은 수면의 질은 불안감과 연관성이 있었으며 이 연관성은 대상자들의 수면시간과 상관없이 나타났다.

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Measuring Trends in the Socioeconomic Burden of Disease in Korea, 2007-2015
Tae Eung Kim, Ru-Gyeom Lee, So-Youn Park, In-Hwan Oh
J Prev Med Public Health. 2022;55(1):19-27.   Published online January 31, 2022
DOI: https://doi.org/10.3961/jpmph.21.594
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AbstractAbstract AbstractSummary PDFSupplementary Material
This study estimated the direct and indirect socioeconomic costs of 238 diseases and 22 injuries from a social perspective in Korea from 2007 to 2015. The socioeconomic cost of each disease group was calculated based on the Korean Standard Disease Classification System. Direct costs were estimated using health insurance claims data provided by the National Health Insurance Service. The numbers of outpatients and inpatients with the main diagnostic codes for each disease were selected as a proxy indicator for estimating patients’ medical use behavior by disease. The economic burden of disease from 2007 to 2015 showed an approximately 20% increase in total costs. From 2007 to 2015, communicable diseases (including infectious, maternal, pediatric, and nutritional diseases) accounted for 8.9-12.2% of the socioeconomic burden, while non-infectious diseases accounted for 65.7-70.7% and injuries accounted for 19.1-22.8%. The top 5 diseases in terms of the socioeconomic burden were self-harm (which took the top spot for 8 years), followed by cirrhosis of the liver, liver cancer, ischemic heart disease, and upper respiratory infections in 2007. Since 2010, the economic burden of conditions such as low back pain, falls, and acute bronchitis has been included in this ranking. This study expanded the scope of calculating the burden of disease at the national level by calculating the burden of disease in Koreans by gender and disease. These findings can be used as indicators of health equality and as useful data for establishing community-centered (or customized) health promotion policies, projects, and national health policy goals.
Summary
Korean summary
2007년에서 2015년 기간의 건강보험 자료 등을 이용하여, 해당기간의 경제적 질병부담을 측정하였으며, 해당 기간동안 경제적 질병부담은 20%의 증가를 나타내었다. 동 기간동안 비감염성 질환의 경제적 질병부담의 비율은 약 70%로 나타났으며, 감염성 질환은 약 10%, 손상은 20%로 나타났다. 한편 개별 질병군 기준으로는 자살을 포함한 자해가 1위를 차지한 해가 가장 많았다.

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Review
A Review of the Types and Characteristics of Healthy Life Expectancy and Methodological Issues
Young-Eun Kim, Yoon-Sun Jung, Minsu Ock, Seok-Jun Yoon
J Prev Med Public Health. 2022;55(1):1-9.   Published online January 16, 2022
DOI: https://doi.org/10.3961/jpmph.21.580
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AbstractAbstract AbstractSummary PDF
An index that evaluates the health level of a population group considering both death and loss of function due to disease is called a summary measure of population health (SMPH). SMPHs are broadly divided into life year indices and life expectancy indices, the latter of which comprise healthy life expectancy (HLE). HLE is included as a policy target in various national and regional level healthcare plans, and the term “HLE” is commonly used in academia and by the public. However, the overall level of understanding of HLE—such as the precise definition of HLE and methods of calculating HLE—still seems to be low. As discussed in this study, the types of HLE are classified into disability-free life expectancy, disease-free life expectancy, quality-adjusted life expectancy, self-rated HLE, and disability-adjusted life expectancy. Their characteristics are examined to facilitate a correct understanding and appropriate utilization of HLE. In addition, the Sullivan method, as a representative method for calculating HLE, is presented in detail, and major issues in the process of calculating HLE, such as selection of the population group and age group, estimation of death probability, calculation of life years, and incorporation of health weights, are reviewed. This study will help researchers to select an appropriate HLE type and evaluate the validity of HLE research results, and it is expected to contribute to the vitalization of HLE research.
Summary
Korean summary
건강수명의 유형은 무장애기대수명, 질병 없는 기대수명, 질보정기대수명, 자가평가보정 기대수명, 장애보정기대수명으로 분류된다. 건강수명의 올바른 이해와 적절한 활용을 돕기 위해 이들의 특성을 검토하였다. 이번 연구는 연구자들이 적절한 건강수명 유형을 선택하고 건강수명 연구 결과의 타당성을 평가하는 데 도움이 될 것이며, 건강수명 연구의 활성화에 기여할 것으로 기대된다.

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Original Articles
Mediating Effect of Cognitive Function on the Relationship Between Geriatric Oral Health and Quality of Life Among Korean Seniors
Eun Jee Chang, Hyun-Jae Woo, Kyu-Hyoung Jeong
J Prev Med Public Health. 2022;55(1):106-113.   Published online January 12, 2022
DOI: https://doi.org/10.3961/jpmph.21.536
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AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Previous studies have found that the oral health of seniors can affect their physical nutrition and quality of life (QoL). Additionally, poor oral health can lead to the development of dementia, which is associated with decreased cognitive function. This study aimed to examine the impact of geriatric oral health (GOH) on the QoL of Korean seniors and the mediating effects of cognitive function.
Methods
We used data from the seventh Korean Longitudinal Study of Aging conducted in 2018. In total, 4049 seniors were included in our study. We analyzed the impact of GOH on QoL according to 5 mediating domains of cognitive function and control variables. To examine each path of mediating effects, bootstrapping with 5000 iterations was performed with 95% confidence intervals.
Results
Our findings revealed that good GOH had a positive effect on the QoL of seniors. Also, better GOH corresponded to a higher degree of cognitive function within all 5 domains: orientation, memory registration, attention/calculation, memory recall, and language and visuospatial ability. In addition, 3 domains of the 5 domains (attention/calculation, memory recall, and language and visuospatial ability) had significant mediating effects on the relationship between GOH and QoL.
Conclusions
This study suggests that adequate management of GOH is crucial for promoting a better QoL and a high degree of cognitive function among seniors. To prevent cognitive impairment, such as dementia, future studies should take a more targeted approach by examining data according to each cognitive domain and various socio-demographic factors.
Summary
Korean summary
본 연구는 2018년도 7차 한국고령화연구패널조사(KLoSA) 자료를 이용하여 65세 이상 노인4,049명을 대상으로 노인 구강건강 수준(GOHAI, Geriatric Oral Health Assessment Index)이 삶의 질에 미치는 영향을 확인하였다. 또한 K-MMSE(Korean Mini-Mental State Examination) 점수를 매개변수로 활용하여 인지기능을 시간 및 장소 지남력, 기억등록, 주의집중 및 계산력, 기억회상, 언어 및 시공간 구성력의 5가지 하위영역의 다중매개효과를 분석하였다. 그 결과, 노인의 구강건강은 삶의 질과 인지기능의 모든 하위영역에 영향을 미치는 것으로 나타났으며, 특히 인지기능 하위영역 중 주의집중 및 계산력, 기억회상, 언어 및 시공간 구성력이 구강건강과 삶의 질의 관계에서 유의한 매개효과를 보였다. 향후 노인의 삶의 질을 악화하는 주요 질환인 치주질환 및 구강건조증 등을 예방할 수 있도록 국가 차원의 구강보건사업을 확대하고, 인지기능 하위영역별 저하 양상에 따라 세분화된 약물적/비약물적 중재를 시행해야 한다.

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  • Association Between Geriatric Oral Health Assessment Index and Cardiovascular Disease in Korean Older Adults
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Association Between Cohabitation Status and Sleep Quality in Families of Persons With Dementia in Korea: A Cross-sectional Study
Seung Hoon Kim, Minah Park, Sung Hoon Jeong, Sung-In Jang, Eun-Cheol Park
J Prev Med Public Health. 2021;54(5):317-329.   Published online August 14, 2021
DOI: https://doi.org/10.3961/jpmph.21.077
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AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
The aim of this study was to identify the association between cohabitation status and sleep quality in family members of people with dementia (PwDs).
Methods
Data of 190 365 participants aged ≥19 years from the 2018 Korea Community Health Survey were analyzed. Participants were categorized according to their cohabitation status with PwDs. Multiple logistic regression and ordinal logistic regression analyses were performed to evaluate the relationship between the cohabitation status of PwDs’ relatives and sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI) and PSQI subscales.
Results
Compared to participants without PwDs in their families, both cohabitation and non-cohabitation with PwDs were associated with poor sleep quality (cohabitation, male: odds ratio [OR],1.28; 95% confidence interval [CI], 1.08 to 1.52; female: OR, 1.40; 95% CI, 1.20 to 1.64; non-cohabitation, male: OR, 1.14; 95% CI, 1.05 to 1.24; female: OR, 1.23; 95% CI, 1.14 to 1.33). In a subgroup analysis, non-cohabiting family members showed the highest odds of experiencing poor sleep quality when the PwD lived alone (male: OR, 1.48; 95% CI, 1.14 to 1.91; female: OR, 1.58; 95% CI, 1.24 to 2.01). Cohabiting male and female participants had higher odds of poor subjective sleep quality and use of sleeping medications than non-cohabiting male and female participants, respectively.
Conclusions
The residence of PwDs and cohabitation status may contribute to poor sleep quality among PwDs’ family members. The circumstances faced by cohabiting and non-cohabiting family members should be considered when evaluating sleep quality in family members of PwDs, and appropriate interventions may be needed to improve sleep quality in both cohabiting and non-cohabiting family members.
Summary
Korean summary
2018년 지역사회건강조사를 이용하여 190 365명을 대상으로 가족 중 치매환자 유무 및 치매환자와의 동거여부와 수면의 질 사이의 연관성을 분석하였다. 치매환자와의 동거여부와 상관없이 가족 중 치매환자가 존재하는 것은 낮은 수면의 질과 유의한 연관성이 있었다. 가족 중 치매환자가 있지만 동거하지 않는 가족 구성원의 경우 치매환자가 혼자 살 때 낮은 수면의 질과의 연관성이 가장 높게 나타났다.

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COVID-19: Original Article
Social Determinants of COVID-19 in Massachusetts, United States: An Ecological Study
Devan Hawkins
J Prev Med Public Health. 2020;53(4):220-227.   Published online June 24, 2020
DOI: https://doi.org/10.3961/jpmph.20.256
  • 12,955 View
  • 373 Download
  • 72 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
The aim of this study was to assess how different social determinants of health (SDoH) may be related to variability in coronavirus disease 2019 (COVID-19) rates in cities and towns in Massachusetts (MA).
Methods
Data about the total number of cases, tests, and rates of COVID-19 as of June 10, 2020 were obtained for cities and towns in MA. The data on COVID-19 were matched with data on various SDoH variables at the city and town level from the American Community Survey. These variables included information about income, poverty, employment, renting, and insurance coverage. We compared COVID-19 rates according to these SDoH variables.
Results
There were clear gradients in the rates of COVID-19 according to SDoH variables. Communities with more poverty, lower income, lower insurance coverage, more unemployment, and a higher percentage of the workforce employed in essential services, including healthcare, had higher rates of COVID-19. Most of these differences were not accounted for by different rates of testing in these cities and towns.
Conclusions
SDoH variables may explain some of the variability in the risk of COVID-19 across cities and towns in MA. Data about SDoH should be part of the standard surveillance for COVID-19. Efforts should be made to address social factors that may be putting communities at an elevated risk.
Summary

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Original Articles
Verification of the Reliability and Validity of the Short Form 36 Scale in Indonesian Middle-aged and Older Adults
Novita Intan Arovah, Kristiann C. Heesch
J Prev Med Public Health. 2020;53(3):180-188.   Published online April 14, 2020
DOI: https://doi.org/10.3961/jpmph.19.324
  • 14,247 View
  • 316 Download
  • 13 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
The Short Form 36 (SF-36) questionnaire is increasingly being used to measure health-related quality of life (HRQoL) in Indonesia. However, evidence that it is valid for use in Indonesian adults is lacking. This study assessed the validity and reliability of the SF-36 in Indonesian middle-aged and older adults.
Methods
Adults aged 46-81 years (n=206) in Yogyakarta, Indonesia completed the SF-36, another measure of HRQoL (the EuroQoL visual analogue scale [EQ-VAS]), and measures assessing their demographic characteristics. Fifty-four percent (n=121) completed the SF-36 measure again 1 week later. Confirmatory factor analysis was conducted to confirm the factor structure of the SF-36. Internal consistency reliability was estimated using Cronbach’s alpha, and test-retest reliability was assessed using intraclass correlations. Convergent and discriminant validity were assessed by computing correlations among SF-36 subscales, between subscales and the 2 component scores, and between component scores and EQ-VAS scores.
Results
Most scaling assumptions were met. The hypothetical factor structure fit the data poorly (root mean square error of approximation [RMSEA]=0.108) and modification was required for a good fit (RMSEA=0.060). Scores on all subscales demonstrated acceptable internal consistency (α>0.70) and test-retest reliability (r>0.70). Divergent validity was supported by weak to moderate interscale correlations (r=0.19 to 0.64). As expected, the 2 summary scores were moderately to strongly correlated with the EQ-VAS (r>0.60).
Conclusions
The findings adequately support the use of SF-36 in Indonesian middle-aged and older adults, although the optimal algorithm for computing component scores in Indonesia warrants further investigation.
Summary

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The Impact of Abuse on the Quality of Life of the Elderly: A Population-based Survey in Iran
Behnam Honarvar, Zahra Gheibi, Abdolrahim Asadollahi, Farzaneh Bahadori, Elahe Khaksar, Maryam Rabiey Faradonbeh, Mohammad Farjami
J Prev Med Public Health. 2020;53(2):89-97.   Published online December 30, 2019
DOI: https://doi.org/10.3961/jpmph.19.210
  • 9,545 View
  • 251 Download
  • 20 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
The quality of life (QoL) of the elderly and elder abuse are growing public health concerns. This study aimed to evaluate the prevalence of abuse and the association between QoL and abuse in older adults.
Methods
Multistage random cluster sampling, along with valid QoL (LEIPAD: LEIden, the Netherlands; PADua, Italy; Helsinki, Finland) and abuse questionnaires, were used to assess QoL and elder abuse. Path analysis was performed using Mplus. SPSS and AMOS were used for the other analyses.
Results
A total of 386 elderly individuals with a mean age of 68.00±6.10 years were interviewed, of whom 200 (51.8%), 289 (74.9%), and 376 (97.4%) were women, educated, and married, respectively. Moreover, 167 (43.2%) had low-to-moderate QoL, and 108 (27.9%) had experienced a moderate level of abuse. QoL and abuse were inversely associated (r=-0.253), with men (β=-0.24) more affected than women (β=-0.21). Musculoskeletal disorders were also strong determinants of QoL in the elderly. QoL was strongly associated with emotional abuse, while abuse was highly related to the social component of QoL. Furthermore, emotional abuse was the type of abuse most significantly associated with the self-care, depression/anxiety, cognitive, and social components of QoL. Sexual abuse, violation of personal rights, and neglect were the main determinants of the physical functioning, life satisfaction, and sexual domains of QoL, respectively.
Conclusions
Nearly half of the elderly individuals lacked a high QoL, and at least one-fourth had experienced some form of abuse. Elder abuse was correlated inversely with QoL. Therefore, preventive interventions are recommended to decrease elder abuse in the family, community, and other settings.
Summary

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Associations of Ambient Air Pollutant Concentrations With Respiratory Symptoms and Perceived Health Status in Japanese Adults With and Without Chronic Respiratory Diseases: A Panel Study
Motoyuki Nakao, Keiko Yamauchi, Satoshi Mitsuma, Tetsuro Odaira, Hideto Obata, Yoichi Chijimatsu, Yoko Ishihara
J Prev Med Public Health. 2019;52(6):416-426.   Published online November 13, 2019
DOI: https://doi.org/10.3961/jpmph.19.180
  • 9,217 View
  • 113 Download
  • 6 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
In recent years, transboundary air pollution from mainland East Asia has led to growing concerns about air pollution in Japan. Air pollution is reportedly associated with the exacerbation of respiratory diseases. In this study, we assessed the effects of air pollution on respiratory symptoms and the health status of participants with and without chronic respiratory diseases.
Methods
Participants (n=2753) with and without chronic respiratory diseases who visited healthcare facilities in Japan during February from 2010 to 2015 filled out a self-report questionnaire regarding their symptoms and perceived health status. Participants were followed up during April-May and June-July.
Results
Oxidant concentrations were associated with respiratory symptoms, overall health, and quality of life (QoL). Suspended particulate matter (SPM) and particulate matter <2.5 μm levels were associated with physical fitness; SPM was also associated with QoL. Recent experience of an Asian sand dust event had a significant effect on allergic symptoms, change in health, and QoL.
Conclusions
Respiratory symptoms were more strongly affected by oxidants than by other pollutants. Significant associations of air pollutants were found with a comprehensive range of items related to perceived health status, including overall health and QoL. Although the effects of air pollutants on respiratory symptoms and health status were more apparent among patients with respiratory diseases, the adverse effects of air pollutants were significant even among participants without such conditions.
Summary

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    Se-Jin Lee, So-Won Pak, Woong-Il Kim, Sin-Hyang Park, Young-Kwon Cho, Tae-Won Kim, Je-Won Ko, Joong-Sun Kim, Jong-Choon Kim, In-Hyeon Kim, Sung-Hwan Kim, In-Sik Shin
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An Exploratory Study of Health Inequality Discourse Using Korean Newspaper Articles: A Topic Modeling Approach
Jin-Hwan Kim
J Prev Med Public Health. 2019;52(6):384-392.   Published online October 25, 2019
DOI: https://doi.org/10.3961/jpmph.19.221
  • 21,488 View
  • 100 Download
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study aimed to explore the health inequality discourse in the Korean press by analyzing newspaper articles using a relatively new content analysis technique.
Methods
This study used the search term “health inequality” to collect articles containing that term that were published between 2000 and 2018. The collected articles went through pre-processing and topic modeling, and the contents and temporal trends of the extracted topics were analyzed.
Results
A total of 1038 articles were identified, and 5 topics were extracted. As the number of studies on health inequality has increased over the past 2 decades, so too has the number of news articles regarding health inequality. The extracted topics were public health policies, social inequalities in health, inequality as a social problem, healthcare policies, and regional health gaps. The total number of occurrences of each topic increased every year, and the trend observed for each theme was influenced by events related to its contents, such as elections. Finally, the frequency of appearance of each topic differed depending on the type of news source.
Conclusions
The results of this study can be used as preliminary data for future attempts to address health inequality in Korea. To make addressing health inequality part of the public agenda, the media’s perspective and discourse regarding health inequality should be monitored to facilitate further strategic action.
Summary
Korean summary
건강불평등 해소는 한국사회의 중요한 목표이다. 이 연구에서는 건강불평등을 다룬 신문기사를 추출, 토픽모델링 기법을 적용해 공공의료, 사회경제적 요인에 따른 건강불평등, 사회문제로 불평등, 보건의료정책, 지역건강격차의 다섯 가지 주제를 도출하였다. 언론이 건강불평등을 다루는 방식은 학술적 연구에서 건강불평등을 다루는 방식과는 유사하였으나, 건강취약지역의 저소득층의 인식과는 차이가 있었다.

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The Impact of Air Pollution, Including Asian Sand Dust, on Respiratory Symptoms and Health-related Quality of Life in Outpatients With Chronic Respiratory Disease in Korea: A Panel Study
Motoyuki Nakao, Yoko Ishihara, Cheol-Hong Kim, In-Gyu Hyun
J Prev Med Public Health. 2018;51(3):130-139.   Published online May 9, 2018
DOI: https://doi.org/10.3961/jpmph.18.021
  • 12,940 View
  • 263 Download
  • 37 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Air pollution is a growing concern in Korea because of transboundary air pollution from mainland China. A panel study was conducted to clarify the effects of air pollution on respiratory symptoms and health-related quality of life (HR-QoL) in outpatients with and without chronic obstructive pulmonary disease (COPD) in Korea.
Methods
Patients filled out a questionnaire including self-reported HR-QoL in February and were followed up in May and July. The study was conducted from 2013 to 2015, with different participants each year. Air quality parameters were applied in a generalized estimating equation as independent variables to predict factors affecting HR-QoL.
Results
Lower physical fitness scores were associated with Asian sand dust events. Daily activity scores were worse when there were high concentrations of particulate matter (PM) less than 10 μm in diameter (PM10). Lower social functioning scores were associated with high PM less than 2.5 μm in diameter and nitrogen dioxide (NO2) concentrations. High NO2 concentrations also showed a significant association with mental health scores. Weather-related cough was prevalent when PM10, NO2, or ozone (O3) concentrations were high, regardless of COPD severity. High PM10 concentrations were associated with worsened wheezing, particularly in COPD patients.
Conclusions
The results suggest that PM, NO2, and O3 cause respiratory symptoms leading to HR-QoL deterioration. While some adverse effects of air pollution appeared to occur regardless of COPD, others occurred more often and more intensely in COPD patients. The public sector, therefore, needs to consider tailoring air pollution countermeasures to people with different conditions to minimize adverse health effects.
Summary

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Effects of Iranian Economic Reforms on Equity in Social and Healthcare Financing: A Segmented Regression Analysis
Hamed Zandian, Amirhossein Takian, Arash Rashidian, Mohsen Bayati, Telma Zahirian Moghadam, Satar Rezaei, Alireza Olyaeemanesh
J Prev Med Public Health. 2018;51(2):83-91.   Published online February 6, 2018
DOI: https://doi.org/10.3961/jpmph.17.050
  • 14,188 View
  • 206 Download
  • 13 Crossref
AbstractAbstract PDF
Objectives
One of the main objectives of the Targeted Subsidies Law (TSL) in Iran was to improve equity in healthcare financing. This study aimed at measuring the effects of the TSL, which was implemented in Iran in 2010, on equity in healthcare financing. Methods: Segmented regression analysis was applied to assess the effects of TSL implementation on the Gini and Kakwani indices of outcome variables in Iranian households. Data for the years 1977-2014 were retrieved from formal databases. Changes in the levels and trends of the outcome variables before and after TSL implementation were assessed using Stata version 13. Results: In the 33 years before the implementation of the TSL, the Gini index decreased from 0.401 to 0.381. The Gini index and its intercept significantly decreased to 0.362 (p<0.001) 5 years after the implementation of the TSL. There was no statistically significant change in the gross domestic product or inflation rate after TSL implementation. The Kakwani index significantly increased from -0.020 to 0.007 (p<0.001) before the implementation of the TSL, while we observed no statistically significant change (p=0.81) in the Kakwani index after TSL implementation. Conclusions: The TSL reform, which was introduced as part of an economic development plan in Iran in 2010, led to a significant reduction in households’ income inequality. However, the TSL did not significantly affect equity in healthcare financing. Hence, while measuring the long-term impact of TSL is paramount, healthcare decision-makers need to consider the efficacy of the TSL in order to develop plans for achieving the desired equity in healthcare financing.
Summary

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Exploratory Study of Dimensions of Health-related Quality of Life in the General Population of South Korea
Seon-Ha Kim, Min-Woo Jo, Minsu Ock, Sang-il Lee
J Prev Med Public Health. 2017;50(6):361-368.   Published online November 2, 2017
DOI: https://doi.org/10.3961/jpmph.16.076
  • 13,239 View
  • 240 Download
  • 18 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
This study aimed to explore dimensions in addition to the 5 dimensions of the 5-level EQ-5D version (EQ-5D-5L) that could satisfactorily explain variation in health-related quality of life (HRQoL) in the general population of South Korea.
Methods
Domains related to HRQoL were searched through a review of existing HRQoL instruments. Among the 28 potential dimensions, the 5 dimensions of the EQ-5D-5L and 7 additional dimensions (vision, hearing, communication, cognitive function, social relationships, vitality, and sleep) were included. A representative sample of 600 subjects was selected for the survey, which was administered through face-to-face interviews. Subjects were asked to report problems in 12 health dimensions at 5 levels, as well as their self-rated health status using the EuroQol visual analogue scale (EQ-VAS) and a 5-point Likert scale. Among subjects who reported no problems for any of the parameters in the EQ-5D-5L, we analyzed the frequencies of problems in the additional dimensions. A linear regression model with the EQ-VAS as the dependent variable was performed to identify additional significant dimensions.
Results
Among respondents who reported full health on the EQ-5D-5L (n=365), 32% reported a problem for at least 1 additional dimension, and 14% reported worse than moderate self-rated health. Regression analysis revealed a R2 of 0.228 for the original EQ-5D-5L dimensions, 0.200 for the new dimensions, and 0.263 for the 12 dimensions together. Among the added dimensions, vitality and sleep were significantly associated with EQ-VAS scores.
Conclusions
This study identified significant dimensions for assessing self-rated health among members of the general public, in addition to the 5 dimensions of the EQ-5D-5L. These dimensions could be considered for inclusion in a new preference-based instrument or for developing a country-specific HRQoL instrument.
Summary

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Special Article
Strategies for Appropriate Patient-centered Care to Decrease the Nationwide Cost of Cancers in Korea
Jong-Myon Bae
J Prev Med Public Health. 2017;50(4):217-227.   Published online June 16, 2017
DOI: https://doi.org/10.3961/jpmph.17.069
  • 10,802 View
  • 161 Download
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.
Summary

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Original Articles
Development and Validation of a Novel Generic Health-related Quality of Life Instrument With 20 Items (HINT-20)
Min-Woo Jo, Hyeon-Jeong Lee, Soo Young Kim, Seon-Ha Kim, Hyejung Chang, Jeonghoon Ahn, Minsu Ock
J Prev Med Public Health. 2017;50(1):38-59.   Published online January 10, 2017
DOI: https://doi.org/10.3961/jpmph.16.081
  • 12,997 View
  • 248 Download
  • 10 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Few attempts have been made to develop a generic health-related quality of life (HRQoL) instrument and to examine its validity and reliability in Korea. We aimed to do this in our present study.
Methods
After a literature review of existing generic HRQoL instruments, a focus group discussion, in-depth interviews, and expert consultations, we selected 30 tentative items for a new HRQoL measure. These items were evaluated by assessing their ceiling effects, difficulty, and redundancy in the first survey. To validate the HRQoL instrument that was developed, known-groups validity and convergent/discriminant validity were evaluated and its test-retest reliability was examined in the second survey.
Results
Of the 30 items originally assessed for the HRQoL instrument, four were excluded due to high ceiling effects and six were removed due to redundancy. We ultimately developed a HRQoL instrument with a reduced number of 20 items, known as the Health-related Quality of Life Instrument with 20 items (HINT-20), incorporating physical, mental, social, and positive health dimensions. The results of the HINT-20 for known-groups validity were poorer in women, the elderly, and those with a low income. For convergent/discriminant validity, the correlation coefficients of items (except vitality) in the physical health dimension with the physical component summary of the Short Form 36 version 2 (SF-36v2) were generally higher than the correlations of those items with the mental component summary of the SF-36v2, and vice versa. Regarding test-retest reliability, the intraclass correlation coefficient of the total HINT-20 score was 0.813 (p<0.001).
Conclusions
A novel generic HRQoL instrument, the HINT-20, was developed for the Korean general population and showed acceptable validity and reliability.
Summary

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    J. Verstraete, E. Bidgood, K. Dalziel, N. Devlin, B. M. Morrow, J. Jelsma, S. Schieskow, M. Herdman
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Meeting Recommended Levels of Physical Activity in Relation to Preventive Health Behavior and Health Status Among Adults
Peter D. Hart, Gabriel Benavidez, James Erickson
J Prev Med Public Health. 2017;50(1):10-17.   Published online December 19, 2016
DOI: https://doi.org/10.3961/jpmph.16.080
  • 14,108 View
  • 313 Download
  • 24 Crossref
AbstractAbstract PDF
Objectives
The purpose of this study was to examine the relationship of meeting the recommended levels of physical activity (PA) with health status and preventive health behavior in adults.
Methods
A total of 5630 adults 18 years of age or older were included in this study. PA was assessed using a series of questions that categorized activities based on their metabolic equivalent values and then categorized individuals based on the reported frequency and duration of such activities. Participants reporting 150 minutes or more of moderate-intensity PA per week were considered to have met the PA guidelines. Multiple logistic regression was used to model the relationships between meeting PA guidelines and health status and preventive health behavior, while controlling for confounding variables.
Results
Overall, 53.9% (95% confidence interval [CI], 51.9 to 55.9%) of adults reported meeting the recommended levels of PA. Among adults with good general health, 56.9% (95% CI, 54.7 to 59.1%) reported meeting the recommended levels of PA versus 43.1% (95% CI, 40.9 to 45.3%) who did not. Adults who met the PA guidelines were significantly more likely not to report high cholesterol, diabetes, chronic obstructive pulmonary disease, arthritis, asthma, depression, or overweight. Furthermore, adults meeting the PA guidelines were significantly more likely to report having health insurance, consuming fruits daily, consuming vegetables daily, and not being a current cigarette smoker.
Conclusions
In this study, we found meeting the current guidelines for PA to have a protective relationship with both health status and health behavior in adults. Health promotion programs should focus on strategies that help individuals meet the current guidelines of at least 150 minutes per week of moderate-intensity PA.
Summary

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Variations in the Hospital Standardized Mortality Ratios in Korea
Eun-Jung Lee, Soo-Hee Hwang, Jung-A Lee, Yoon Kim
J Prev Med Public Health. 2014;47(4):206-215.   Published online July 31, 2014
DOI: https://doi.org/10.3961/jpmph.2014.47.4.206
  • 13,222 View
  • 114 Download
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AbstractAbstract PDF
Objectives
The hospital standardized mortality ratio (HSMR) has been widely used because it allows for robust risk adjustment using administrative data and is important for improving the quality of patient care.
Methods
All inpatients discharged from hospitals with more than 700 beds (66 hospitals) in 2008 were eligible for inclusion. Using the claims data, 29 most responsible diagnosis (MRDx), accounting for 80% of all inpatient deaths among these hospitals, were identified, and inpatients with those MRDx were selected. The final study population included 703 571 inpatients including 27 718 (3.9% of all inpatients) in-hospital deaths. Using logistic regression, risk-adjusted models for predicting in-hospital mortality were created for each MRDx. The HSMR of individual hospitals was calculated for each MRDx using the model coefficients. The models included age, gender, income level, urgency of admission, diagnosis codes, disease-specific risk factors, and comorbidities. The Elixhauser comorbidity index was used to adjust for comorbidities.
Results
For 26 out of 29 MRDx, the c-statistics of these mortality prediction models were higher than 0.8 indicating excellent discriminative power. The HSMR greatly varied across hospitals and disease groups. The academic status of the hospital was the only factor significantly associated with the HSMR.
Conclusions
We found a large variation in HSMR among hospitals; therefore, efforts to reduce these variations including continuous monitoring and regular disclosure of the HSMR are required.
Summary

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    Hyeki Park, Ji-Sook Choi, Min Sun Shin, Soomin Kim, Hyekyoung Kim, Nahyeong Im, Soon Joo Park, Donggyo Shin, Youngmi Song, Yunjung Cho, Hyunmi Joo, Hyeryeon Hong, Yong-Hwa Hwang, Choon-Seon Park
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Improving the Performance of Risk-adjusted Mortality Modeling for Colorectal Cancer Surgery by Combining Claims Data and Clinical Data
Won Mo Jang, Jae-Hyun Park, Jong-Hyock Park, Jae Hwan Oh, Yoon Kim
J Prev Med Public Health. 2013;46(2):74-81.   Published online March 28, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.2.74
  • 12,397 View
  • 75 Download
  • 6 Crossref
AbstractAbstract PDF
Objectives

The objective of this study was to evaluate the performance of risk-adjusted mortality models for colorectal cancer surgery.

Methods

We investigated patients (n=652) who had undergone colorectal cancer surgery (colectomy, colectomy of the rectum and sigmoid colon, total colectomy, total proctectomy) at five teaching hospitals during 2008. Mortality was defined as 30-day or in-hospital surgical mortality. Risk-adjusted mortality models were constructed using claims data (basic model) with the addition of TNM staging (TNM model), physiological data (physiological model), surgical data (surgical model), or all clinical data (composite model). Multiple logistic regression analysis was performed to develop the risk-adjustment models. To compare the performance of the models, both c-statistics using Hanley-McNeil pair-wise testing and the ratio of the observed to the expected mortality within quartiles of mortality risk were evaluated to assess the abilities of discrimination and calibration.

Results

The physiological model (c=0.92), surgical model (c=0.92), and composite model (c=0.93) displayed a similar improvement in discrimination, whereas the TNM model (c=0.87) displayed little improvement over the basic model (c=0.86). The discriminatory power of the models did not differ by the Hanley-McNeil test (p>0.05). Within each quartile of mortality, the composite and surgical models displayed an expected mortality ratio close to 1.

Conclusions

The addition of clinical data to claims data efficiently enhances the performance of the risk-adjusted postoperative mortality models in colorectal cancer surgery. We recommended that the performance of models should be evaluated through both discrimination and calibration.

Summary

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The Relationship Between the Social Network of Community-living Elders and Their Health-related Quality of Life in Korean Province
Jun Tae Lim, Jong-Heon Park, Jin-Seok Lee, Juhwan Oh, Yoon Kim
J Prev Med Public Health. 2013;46(1):28-38.   Published online January 31, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.1.28
  • 14,855 View
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AbstractAbstract PDF
Objectives

This study aimed to collect information that will help enhance the social networks and improve the quality of life among elderly people by observing the relationship between their social network and health-related quality of life (HRQoL) and by analyzing social network factors affecting HRQoL.

Methods

This study was based on the 2008 Community Health Survey in Yeoncheon County. Three hundred elders were included in the study population. We compared the revised Lubben Social Network Scale (LSNS-R) score and Euro quality of life-5 dimensions health status index by demographic characteristics and chronic disease prevalence. We analyzed the data using multiple regression and tobit regression by setting the HRQoL as the dependent variable and social network and other characteristics as the independent variables. We analyzed social network factors by using factor analysis.

Results

The LSNS-R score differed significantly according to age and existence of a spouse. According to the results from the hierarchical multiple regression analysis, the LSNS-R explained 0.10 of the variance and LSNS-R friends factor explained 0.10 of the variance. The tobit regression indicated that the contribution of the LSNS-R family size factor to the regression coefficient of the independent variable that affected the HRQoL was BT=2.96, that of the LSNS-R family frequency factor was BT=3.60, and that of LSNS-R friends factor was BT=5.41.

Conclusions

Social networks among elderly people had a significant effect on HRQoL and their networks of friends had a relatively higher effect than those of family members.

Summary

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Prevalence of Musculoskeletal Symptoms Related With Activities of Daily Living and Contributing Factors in Korean Adults
Kyusik Choi, Jae-Hyun Park, Hae-Kwan Cheong
J Prev Med Public Health. 2013;46(1):39-49.   Published online January 31, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.1.39
  • 14,195 View
  • 107 Download
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AbstractAbstract PDF
Objectives

This study aims to investigate the prevalence of musculoskeletal symptoms and factors related to daily activities in a representative Korean population.

Methods

This study was based on the questions about musculoskeletal symptoms in the Korean General Social Survey 2010. The questionnaire about musculoskeletal symptoms was adopted from Korean Occupational Safety and Health Agency guide, and it includes general characteristics, characteristics of pain, work type, work intensity and a 12-item Short Form Health Survey (SF-12). We utilized the criteria of the National Institute for Occupational Safety and Health to define the prevalence of musculoskeletal symptoms. Demographic, behavioral and socioeconomic factors were analyzed using logistic regression.

Results

The prevalence of musculoskeletal symptoms was 38.3%. The prevalence was higher in females, the elderly, those without health insurance, and those with a low income, low education, and occupations with a heavy workload. The prevalence by body part was highest in the back, shoulder, and knee, in that order. The physical component summary and mental component summary of the SF-12 decreased with increasing musculoskeletal symptoms.

Conclusions

Musculoskeletal symptoms are very common in the general population, and related to various socio-demographic factors. These results suggest that active prevention and management of musculoskeletal symptoms is needed at a national level.

Summary

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Special Article
Physical Activity and Quality of Life
Diane L. Gill, Cara C. Hammond, Erin J. Reifsteck, Christine M. Jehu, Rennae A. Williams, Melanie M. Adams, Elizabeth H. Lange, Katie Becofsky, Enid Rodriguez, Ya-Ting Shang
J Prev Med Public Health. 2013;46(Suppl 1):S28-S34.   Published online January 30, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.S.S28
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AbstractAbstract PDF

Physical activity (PA) professionals and participants recognize enhanced quality of life (QoL) as a benefit of and motivator for PA. However, QoL measures are often problematic and rarely consider the participants'perspective. This paper focuses on recent findings from a larger project on the role of QoL in PA and health promotion. More specifically, we focus on the views of participants and potential participants to better understand the relationship of PA and QoL. In earlier stages of the project we began with a conceptual model of QoL and developed a survey. We now focus on participants' views and ask two questions: 1) what is QoL? and 2) how does PA relate to QoL? We first asked those questions of a large sample of university students and community participants as open-ended survey items, and then asked focus groups of community participants. Overall, participants' responses reflected the multidimensional, integrative QoL model, but the responses and patterns provided information that may not be picked up with typical survey measures. Findings suggest that PA contributes to multiple aspects of QoL, that social and emotional benefits are primary motivators and outcomes for participants, and that the meaning of QoL and PA benefits is subjective and contextualized, varying across individuals and settings. Programs that directly target and highlight the multiple dimensions and integrative QoL, while considering the individual participants and contexts, may enhance both PA motivation and participants' health and QoL.

Summary

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Original Article
Selecting the Best Prediction Model for Readmission
Eun Whan Lee
J Prev Med Public Health. 2012;45(4):259-266.   Published online July 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.4.259
  • 15,697 View
  • 109 Download
  • 38 Crossref
AbstractAbstract PDF
Objectives

This study aims to determine the risk factors predicting rehospitalization by comparing three models and selecting the most successful model.

Methods

In order to predict the risk of rehospitalization within 28 days after discharge, 11 951 inpatients were recruited into this study between January and December 2009. Predictive models were constructed with three methods, logistic regression analysis, a decision tree, and a neural network, and the models were compared and evaluated in light of their misclassification rate, root asymptotic standard error, lift chart, and receiver operating characteristic curve.

Results

The decision tree was selected as the final model. The risk of rehospitalization was higher when the length of stay (LOS) was less than 2 days, route of admission was through the out-patient department (OPD), medical department was in internal medicine, 10th revision of the International Classification of Diseases code was neoplasm, LOS was relatively shorter, and the frequency of OPD visit was greater.

Conclusions

When a patient is to be discharged within 2 days, the appropriateness of discharge should be considered, with special concern of undiscovered complications and co-morbidities. In particular, if the patient is admitted through the OPD, any suspected disease should be appropriately examined and prompt outcomes of tests should be secured. Moreover, for patients of internal medicine practitioners, co-morbidity and complications caused by chronic illness should be given greater attention.

Summary

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Special Articles
Korean National Health Insurance Value Incentive Program: Achievements and Future Directions
Sun Min Kim, Won Mo Jang, Hyun Ah Ahn, Hyang Jeong Park, Hye Sook Ahn
J Prev Med Public Health. 2012;45(3):148-155.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.148
  • 13,786 View
  • 108 Download
  • 27 Crossref
AbstractAbstract PDF

Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poor-quality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.

Summary

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Lessons From Healthcare Providers' Attitudes Toward Pay-for-performance: What Should Purchasers Consider in Designing and Implementing a Successful Program?
Jin Yong Lee, Sang-Il Lee, Min-Woo Jo
J Prev Med Public Health. 2012;45(3):137-147.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.137
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AbstractAbstract PDF

We conducted a systematic review to summarize providers' attitudes toward pay-for-performance (P4P), focusing on their general attitudes, the effects of P4P, their favorable design and implementation methods, and concerns. An electronic search was performed in PubMed and Scopus using selected keywords including P4P. Two reviewers screened target articles using titles and abstract review and then read the full version of the screened articles for the final selections. In addition, one reference of screened articles and one unpublished report were also included. Therefore, 14 articles were included in this study. Healthcare providers' attitudes on P4P were summarized in two ways. First, we gathered their general attitudes and opinions regarding the effects of P4P. Second, we rearranged their opinions regarding desirable P4P design and implementation methods, as well as their concerns. This study showed the possibility that some healthcare providers still have a low level of awareness about P4P and might prefer voluntary participation in P4P. In addition, they felt that adequate quality indicators and additional support for implementation of P4P would be needed. Most healthcare providers also had serious concerns that P4P would induce unintended consequences. In order to conduct successful implementation of P4P, purchaser should make more efforts such as increasing providers' level of awareness about P4P, providing technical and educational support, reducing their burden, developing a cooperative relationship with providers, developing more accurate quality measures, and minimizing the unintended consequences.

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