The divorce rate has been increasing rapidly in Korea; the single rate and trends in divorce are also changing rapidly. This study aimed to examine the relationship between marital status and quality of life (QOL) in an attempt to understand these changes. We also investigated the relationship between QOL and marital status by age group. We used data from the Community Health Survey (2008: n = 200,800; 2009: n = 227,700; 2010: n = 229,229) administered by the Korean Centers for Disease Control and Prevention. After excluding 63,527 participants with incomplete information on QOL and/or marital status, the final analysis involved 594,202 participants. The analysis used t-tests and Chi-square tests to compare demographic variables between men and women, and ANOVA to compare QOL scores among comparison groups. We also performed a multilevel analysis on the relationship between QOL and marital status while accounting for the provincial differences. The multilevel analysis by marital status showed that single men had significantly worse QOL (both EQ-VAS and EQ-5D) than married men. On the other hand, the QOL measured by EQ-VAS was better in single women than in married, and separated or divorced women. When QOL was assessed using EQ-5D, single and separated or divorced women had worse scores than married women. In the analysis by age group, the QOL of married men under the age of 30 years was lower than that of single men or men with marriage problems as measured by EQ-VAS. However, among 40–69-year-old men, married men had the highest QOL values. Similarly, for women in their 30s, single women had the highest EQ-VAS values, but for 40–69-year-old women, single women had lower EQ-VAS scores than married women. There was significant relationship between marital status and QOL, and this relationship appeared to differ by gender and age.

Objectives This study investigated the association between employment status and depression. Methods Data from the Korea Welfare Panel Study (KOWEPS) collected from 2008 to 2011 were used. A total of 7368 subjects were included in this study after exclusion of subjects with missing data and those who were self-employed or could not work. Depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Employment status, age, sex, region, education, marital status, income, head of household, self-rated health, smoking status, drinking habits, and the current year's and the previous year's CES-D scores were included in the model as independent variables. A generalised linear mixed-effects model for longitudinal binary data was used. Results Compared with those who were permanently employed, individuals who moved from permanent to precarious employment (OR 1.45, 95% CI 1.23 to 1.70) or to unemployment (OR 1.78, 95% CI 1.30 to 2.43) and from precarious employment to unemployment (OR 1.65, 95% CI 1.32 to 2.06) showed a significantly increased the odds of having depression. Continuing precarious employment (OR 1.54, 95% CI 1.30 to 1.83) or unemployment (OR 1.45, 95% CI 1.23 to 1.70) also significantly increased the odds of having depression. These results were particularly identified in men and head of household women. The effects were not significant among non-head of household women. Conclusions Precarious employment and unemployment were clearly associated with having depression. In addition, in view of our findings, policy makers should consider sex and head of household status when developing welfare policies. The inequity between precarious jobs and permanent jobs should be tackled.

The aim of this study was to examine the relationship between types and amount of social activity and health-related quality of life according to gender and age group. This study used data from the Community Health Survey (CHS), which was collected in 2011 and consisted of 229,226 participants aged 19 or older. A linear mixed effects model was used to evaluate the factors influencing health-related quality of life among individuals tracked in the CHS and, in particular, to analyze the associations between the amount and types of social activities participated in and the EuroQol EQ-5D assessment. We found that the average quality of life increased according to the amount of social activities individuals participated in (zero = 89.30, one = 93.28, two = 95.25, three = 96.27, four = 96.85). When people participated in one social activity, social activity was more strongly associated with EQ-5D in the elderly age group (males: 19–34 years = 0.195, 35–49 years = 0.642, 50–64 years = 1.716, ≥65 years = 4.408; females: 19–34 years = 0.170, 35–49 years = 0.502, 50–64 years = 1.411, ≥65 years = 4.180). More participation was positively associated with higher EQ-5D (one = 1.939, two = 2.377, three = 2.439, four = 2.515, p for trend < 0.0001). In females, those who participated in relationship organizations had a higher EQ-5D than those who participated in other types of social activities (Females ≥65 age group; Relationship = 4.373, Leisure = 2.620, Religion = 1.842, Charity = 1.544). There was a positive association between the increase in the number of social activities and increase in health-related quality of life, especially when evaluated in terms of type of social activities and health-related quality of life according to gender and age group.

To examine whether hospital-based physical therapy is associated with functional changes and early hospital readmission among hospitalized older adults with community-acquired pneumonia and declining physical function. Study design was a retrospective observation study. Participants were community-dwelling older adults admitted to medicine floor for community-acquired pneumonia (n = 1,058). Their physical function using Katz activities of daily living (ADL) Index declined between hospital admission and 48 hours since hospital admission (Katz ADL Index 6→5). The intervention group was those receiving physical therapy for ≥ 0.5 hour/day. Outcomes were Katz ADL Index at hospital discharge and all-cause 30-day hospital readmission rate. The intervention and control groups did not differ in the Katz ADL Index at hospital discharge (p = 0.11). All-cause 30-day hospital readmission rate was lower in the intervention than in control groups (OR = 0.65, p = 0.02). Hospital-based physical therapy has the benefits toward reducing 30-day hospital readmission rate of acutely ill older adults with community-acquired pneumonia and declining physical function.

Background: In 2002, a voluntary diagnosis-related groups (DRGs) payment system was introduced in South Korea for seven disease groups, and participation in the DRGs was mandated for all hospitals beginning in 2013. The primary aim of this study was to compare results reflective of patient care between voluntary participation hospitals (VPHs) and mandatory participation hospitals (MPHs) governed by either the DRGs or fee-for-service (FFS) payment system. Methods: We collected DRGs and FFS inpatient records (n=3,038,006) from the Health Insurance Review and Assessment for the period of July 2011 to July 2014 and compared length-of-stay, total medical costs, shifting services to an outpatient setting, and readmission rates according to payment system, time of DRGs implementation, and hospital type. We analyzed the effects of mandatory introduction in DRGs payment system on results for patient care and used generalized estimating equations with difference-in-difference methodology. Results: Most notably, patients at MPHs had significantly shorter LOS and lower readmission rates than VPH patients after mandatory introduction of the DRGs. Shifting services to an outpatient setting was similar between the groups. Conclusions: Our findings suggest that the DRGs payment policy in Korea has decreased LOS and readmission rates. These findings support the continued implementation and enlargement of the DRGs payment system for other diseases in South Korea, given its potential for curbing unnecessary resource usage encouraged by FFS. If the Korean government deliberates on expansion of the DRGs to include other diseases with higher rates of complications, policymakers need to monitor deterioration of health care quality caused by fixed pricing.

Suicide is a major health problem in Korea. Extensive media exposure of celebrity suicide may induce imitative suicide, a phenomenon called the Werther effect. We examined the increased suicide risk following the suicides of an entertainer and a politician, and identified the relative suicide risks. News articles about the celebrity suicides were obtained from three major newspapers and analysed for quantitative and qualitative features. Imitative suicide risk was investigated by applying a Poisson time series autoregression model with suicide mortality data from the National Statistics Office for 1.5 years before and 1.5 years after each celebrity’s suicide. The period with a significantly increased number of suicides immediately after the celebrity’s suicide determined the Werther effect band. The relative risk during this period was examined for different ages, genders, and suicide methods. News reports were more numerous and they contained more positive definitions about the entertainer’s suicide. The risk of suicide deaths rose markedly after both celebrity suicides. However, the Werther effect band was longer for the entertainer (6 weeks) than for the politician (4 weeks). The relative suicide risk was significant for almost all ages and both genders during that of both individuals. Use of the same suicide method was a prominent risk factor after both celebrity suicides. Our results confirm the existence of imitative suicide behaviours, suggesting a facilitation effect of media reports. Guidelines for responsible media reporting need to be implemented to enhance public mental health in Korea.