Munjae Lee - Academia.edu (original) (raw)

Papers by Munjae Lee

Background The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incid... more Background The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. Interpretation The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively.

Sustainability, Jan 10, 2020

The Healthy City program is a comprehensive health promotion program implemented by local governm... more The Healthy City program is a comprehensive health promotion program implemented by local governments to improve citizens' health. The Healthy City program aims to improve citizens' quality of life through health promotion activities in daily life. It also improves health by eliminating health risk factors and increasing citizens' happiness. Therefore, this study investigated the effects of the Healthy City program on the happiness index of local residents and the correlation between the Healthy City program and the happiness index using quality of life as a parameter. We conducted a questionnaire survey of residents of Seoul, where Healthy City networks are actively promoted. A total of 392 responses were obtained. Structural equations were used to analyze the collected data. The Healthy City program had positive effects on the happiness index. In other words, it increased the happiness index by improving the health of the local residents. Relevant policy efforts are also being made to advance health services through Healthy City programs. For an effective Healthy City program, it is necessary to implement policies regarding health equity, to expand Healthy City programs based on a settings approach, and to implement a sustainable Healthy City program through the establishment of Healthy City governance.

International Journal of Environmental Research and Public Health, Feb 14, 2019

Healthy cities continuously attempt to improve residents' health. Health is affected by psycholog... more Healthy cities continuously attempt to improve residents' health. Health is affected by psychological factors, such as happiness and emotions. Therefore, this study investigates the effects of healthy city program performance on individuals' emotions, as well as the correlation between healthy city program performance and emotions using personal happiness index as a parameter. We conducted a questionnaire survey of residents in areas implementing healthy city projects. A total of 596 responses were obtained. We used structural equations to analyze the relationship of structural influences. Results showed that healthy city program performance had significant static effects on emotion. This observation shows that healthy city programs decrease local residents' negative emotions, such as stress and depression. Therefore, healthy city programs stabilize residents' emotions by increasing health friendliness. To improve the performance of healthy city programs, it is necessary to mitigate health risk factors and positively affect individuals' emotions.

European Journal of Cancer Care, Jun 11, 2018

Cancer is a disease that poses a great burden not only on the patients and their families but als... more Cancer is a disease that poses a great burden not only on the patients and their families but also in terms of socioeconomic aspects. As of 2013, the incidence of cancer in Korea was 445.7 per 100,000 persons, and if Koreans live to the average lifespan, they appear to have a 36.6% chance of getting cancer. Mortality due to cancer is 150.8 per 100,000 persons as of 2015, which takes up the biggest portion (27.9%) of the cause of death. In addition, health insurance medical expenditure for cancer in 2015 was 4.9 trillion KRW, which is 8.5% of total health insurance medical expenditures. The government consistently implemented the insurance guarantee reinforcement policy to protect patients with cancer financially and focused on increasing coverage by switching nonpayment items to payment items. However, the health insurance coverage for beneficiaries of the special benefit system for patients with cancer is 72.6%, which indicates that patients cover at least 1/4 of the total health expenditures through out-of-pocket payments, and nonpayment out-ofpocket fees is approximately 20% of total health expenditures. As such, cancers result in a great burden of health expenditures and have a significant impact on household income (Berkowitz & Johnson, 1974). The concept of catastrophic health expenditure (CHE) is a typical indicator that measures households' economic burden. CHE occurs if the household's health expenditure compared to its economic capacity (ability to pay) exceeds a certain threshold (Wyszewianski, 1986; Xu et al., 2003). This concept measures the economic burden and loss due to health expenditures, and researchers use it to indirectly evaluate the health security system in terms of its

Healthcare, Jun 4, 2020

The purpose of this study is to identify factors that affect health-related quality of life (HRQO... more The purpose of this study is to identify factors that affect health-related quality of life (HRQOL) of older patients with Benign Prostatic Hyperplasia (BPH) and suggest ways to improve the same. Through this, we will improve the self-management practice of patients and promote the treatment of BPH in older patients. The 2015 Korea Health Panel Survey data were used in this study. A total of 422 BPH patients aged 65 or older were included. Logistic regression analysis was conducted to identify factors affecting the HRQOL of older patients with BPH. General characteristics of factors affecting older patients with BPH included income level and type of insurance. In addition, among medical-related characteristics and health behavior factors, subjective health status, unmet medical care needs, moderate physical activity, sitting time, and drinking influenced the HRQOL. Therefore, in order to improve the HRQOL of adult patients with BPH, it is necessary to improve medical accessibility by strengthening primary care. In addition, it is necessary to increase the amount of activity in daily life through healthcare medical devices.

Osong public health and research perspectives, Aug 1, 2015

The aim of this study is to analyze the influence of the research and development (R&D) investmen... more The aim of this study is to analyze the influence of the research and development (R&D) investment of pharmaceutical companies on enterprise value. Methods: The period of the empirical analysis is from 2000 to 2012, considering the period after the influence of the financial crisis. Financial statements and comments in general and internal transactions were extracted from TS-2000 of the Korea Listed Company Association, and data related to stock price were extracted from KISVALUE-III of National Information and Credit Evaluation Information Service Co., Ltd. STATA 12.0 was used as the statistical package for panel analysis. Results: In the pharmaceutical firms, the influence of the R&D intensity with regard to Tobin's q was found to be positive. However, only the R&D expenditure intensities of previous years 2 and 5 (te2 and te5, respectively) were statistically significant (p < 0.1), whereas those of previous years 1, 3, and 4 years (te1, te3, and te4, respectively) were not statistically significant. Conclusion: R&D investment not only affects the enterprise value but is also evaluated as an investment activity that raises the long-term enterprise value. The research findings will serve as valuable data to understand the enterprise value of the Korea pharmaceutical industry and to strengthen reform measures. Not only should new drug development be made, but also investment and support should be provided according to the specific factors suitable to improve the competitiveness of each company, such as generic, incrementally modified drugs, and biosimilar products.

Osong public health and research perspectives, Oct 1, 2015

Objectives: This study analyzes the influence of the financial structure of pharmaceutical compan... more Objectives: This study analyzes the influence of the financial structure of pharmaceutical companies on R&D investment to create a next-generation profit source or develop relatively cost-effective drugs to maximize enterprise value. Methods: The period of the empirical analysis is from 2000 to 2012. Financial statements and comments in general and internal transactions were extracted from TS-2000 of the Korea Listed Company Association (KLCA), and data related to stock price is extracted from KISVALUE-Ⅲ of NICE Information Service Co., Ltd. Stata 12.0 was used as the statistical package for panel analysis. Results: The current ratio had a positive influence on R&D investment, the debt ratio had a negative influence on R&D investment, and return on investment and net sales growth rate did not have a significant influence on R&D investment. Conclusion: It was found in this study that the higher liquidity ratio, the greater the R&D investment. The stability of pharmaceutical companies has a negative influence on R&D investment. This finding is consistent with the prediction that if a company faces a financial risk, it will be passive in R&D investment due to its financial difficulties.

한국콘텐츠학회논문지, Aug 1, 2015

The purpose of this study is to analyze the influence of the cash flow of pharmaceutical companie... more The purpose of this study is to analyze the influence of the cash flow of pharmaceutical companies on R&D investment. 143 pharmaceutical companies listed in the KOSDAQ market from 2009 to 2013. Financial statements and comments in general and internal transactions were extracted from TS-2000 of the Korea Listed Company Association (KLCA), and data related to stock price was extracted from KISVALUE-Ⅲ of NICE Information Service Co., Ltd. STATA 12.0 was used as the statistical package for panel analysis. The summary of the findings and the interpretation of the significance of this are as follows: First, the current ratio (internal finance) had a positive influence on R&D investment. Second, the debt ratio (external finance) had a negative influence on R&D investment. The pharmaceutical company prefers internal funds to external funds due to the asymmetry of information in the loan markets. In other words, this shows why internal finances have a significant influence on R&D investment at pharmaceutical companies.

Journal of Clinical Medicine, Mar 25, 2020

This study aimed to analyze the factors affecting the unmet medical needs of patients with benign... more This study aimed to analyze the factors affecting the unmet medical needs of patients with benign prostate enlargement (BPE) based on Andersen's behavioral model. The data were taken from the 2009-2016 Korea Health Panel Study and 3003 participants were used for analysis. "Unmet medical needs" was used as a dependent variable. Independent variables were predisposing variables: age, educational attainment, and marital status; enabling factors: income, job type, and insurance type; and need factors: lying in a sickbed, activity limitation, subjective health status, and having chronic diseases. Results showed that younger patients experienced a higher probability of unmet medical needs. Those with higher educational attainment had a lower chance of experiencing unmet medical needs. Patients with national health insurance were less likely to experience unmet medical needs. In addition, patients who experienced lying in a sickbed had a higher probability of experiencing unmet medical needs. Therefore, in order to reduce the unmet medical needs of patients with BPE, it is necessary to allow patients to be treated early and give them accurate information about the disease. In addition, access to medical care should be strengthened through continuous care focused on primary care.

Research Square (Research Square), Feb 28, 2020

Background Aging societies are increasing the need for care services. In order to solve the probl... more Background Aging societies are increasing the need for care services. In order to solve the problem of care, we suggest community care, and through this, we will provide medical services that meet individual needs. Korea provides care services in advance of the community care project and implements quality control to improve the quality of these social services. Therefore, this study aims is to intend to compare and analyze the factors affecting user satisfaction in care services in both 2013 and 2016. Methods We used quantified secondary data based on social services performed analysis reports. Based on the evaluation indexes for care service in 2013 and 2016, we used commonly used indexes for analysis. Results As a result, there was a difference between care services quality evaluation (QE) indexes by profit type, and care services evaluation indexes had an effect on user satisfaction. In addition, the change rate in the care service evaluation scores affects the change rate in user satisfaction Conclusions Therefore, in order to increase satisfaction with care service, evaluation indexes by service type should be diversified and differentiated. In addition, it should be composed of field evaluations related to user satisfaction to provide care services appropriate for local characteristics.

Sustainability, Mar 12, 2020

Through an active administration approach, the Local Living Security Commission (LLSC) has provid... more Through an active administration approach, the Local Living Security Commission (LLSC) has provided relief to protect the poor strata and reinforce the distribution of entitlements. However, the absence of a system to monitor operational performance makes it difficult to manage it efficiently. The purpose of this study is to find ways to strengthen and efficiently operate the functions of the LLSC through priority analysis of its operation. To this end, the analytic hierarchy process (AHP) was conducted based on the results of the focus group interview to derive priorities for the operation of the LLSC. The variables used in the AHP analysis included regional conditions, operational performance, organizational method, and network. The result of the analysis revealed, first, that the performance of the committee has increased due to a joint evaluation or verification survey conducted at the end of each year, second, that the creation of a budget for the organization and the operation of an independent LLSC is necessary, and third, that operational performance is the most important, followed by organizational method, network, and regional conditions. Therefore, a system for monitoring performance should be established to improve the operation performance of the LLSC. Additionally, it is necessary to establish an independent LLSC and secure the budget for each city and county. It should be possible to provide feedback on operations through regular priority analysis.

Urology, Feb 1, 2019

the penile cuff test predict the outcome of Holmium laser enucleation of the prostate for benign ... more the penile cuff test predict the outcome of Holmium laser enucleation of the prostate for benign prostatic obstruction?, Urology (2018), doi:

BMC Primary Care, Jan 21, 2023

Background As the health paradigm shifts toward patient-centeredness, patients can actively parti... more Background As the health paradigm shifts toward patient-centeredness, patients can actively participate in their own treatment. However, there is still a unilateral aspect of doctor-patient communication, so it is necessary to specify obstacles between doctors and patients. Therefore, this study attempted to extract obstacles that block doctorpatient communication and to analyze differences in perception of doctor-patient communication. Methods A total of 35 questionnaires composed of brainstorming for the study were distributed, and a total of 21 questionnaires were used for analysis. The collected data was analyzed by AHP using dress ver 17.0. Results As a result of the study, doctors ranked the priority of health communication in the order of professionalism, reliability, fairness, communication, and psychologically. On the other hand, for patients, the priority factors of health communication were communication, fairness, professionalism, reliability, and psychologically. Conclusion In order to improve the quality of health communication between doctors and patients, doctors will be able to communicate from the patient's point of view and strengthen communication with patients by providing consistent medical services and patients need to trust the doctor and patients need to trust their doctors and participate in the medical process faithfully.

PLOS ONE, May 4, 2021

Recent changes in the medical paradigm highlight the importance of patient-centered communication... more Recent changes in the medical paradigm highlight the importance of patient-centered communication. However, because of the lack of awareness of dental clinics and competency of medical personnel, the quality of medical services in terms of the communication between doctors and patients has not improved. This study analyzed the impact of health communication and medical service quality, service value, and patient satisfaction on the intention to revisit dental clinics. The study participants were outpatients treated at 10 dental clinics in Seoul. The research data were collected using a questionnaire during visits to these dental clinics from December 1 to December 30, 2016. A total of 600 questionnaires were distributed (60 copies to each clinics) and 570 valid questionnaires were used for the analysis. The influence of the factors was determined using structural equation modeling. The factors influencing service value were reliability (β = 0.364, p < 0.001), expertise (β = 0.319, p < 0.001), communication by doctors (β = 0.224, p < 0.001), and tangibility (β = 0.136, p < 0.05). In addition, the factors influencing patient satisfaction were reliability (β = 0.258, p < 0.001), tangibility (β = 0.192, p < 0.001), communication by doctors (β = 0.163, p < 0.001), and expertise (β = 0.122, p < 0.01). Further, service value (β = 0.438, p < 0.001) raised patient satisfaction, which was found to influence the intention to revisit dental clinics (β = 0.383, p < 0.001). Providing accurate medical services to inpatients based on smooth communication between doctors and patients improves patient satisfaction. In addition, doctors can build long-term relations with patients by increasing patients' intention to revisit through patient-oriented communication.

International Journal for Equity in Health, Nov 12, 2018

Background: This study aimed to verify the mediating effect of using assistive devices as a facto... more Background: This study aimed to verify the mediating effect of using assistive devices as a factor that alleviates the relationship between multimorbidity and subjective health status. Methods: This study used three-year data (2011-2013) from the Korea Health Panel (KHP). The data were jointly collected by the consortium of the

eClinicalMedicine

Journal of Medical Economics

Frontiers in Public Health

IntroductionIn this study, we investigated the health satisfaction levels of users of regional he... more IntroductionIn this study, we investigated the health satisfaction levels of users of regional health and medical institutions in South Korea and the influencing factors.MethodsWe included randomly selected 300 people with experience in using health and medical institutions from panel data targeting the entire nation. We used questionnaire (EQ-5D-5L) and sociodemographic characteristics to analyze the health satisfaction. EQ-5D-5L was used to measure health-related quality of life in five areas: mobility, self-management, daily activities, pain/discomfort, and anxiety/depression. Hierarchical linear regression analysis was performed in three steps to examine the factors influencing health satisfaction.ResultsThe analysis showed that the health satisfaction was positively (+) correlated with monthly income, mobility, self-management, daily life, pain/discomfort, and anxiety/depression, and negatively (−) correlated with the number of chronic diseases and type of health insurance. The...