코호트 관찰을 통한 한국인 의사의 질병력(疾病力)에 관한 연구

Abstract

[한글]

[영문]

To quantita the magnitude of the occurrence of diseases and to measure the dynamic morbidity patterns in Korea during the lest 70 years, 22 diseases among Korean physicians, as an indirect index population, were studied. Data were collected applying the postal survey method from the 9.036 Korean physicians registered to the Korean Medical Association in 1972. Data were analyzed by age, sex, year of birth and by calendar year arid various rates such as experience rates, prevalence rates, incidence rates were competed adopting cohort concept.

Followings are brief summary of the study :

Malaria

The total experience rates for malaria were 35.8% in male and 27.5% in female. The older the age the higher was the experience rates in both sexes. The incidence distribution by age shows unimodal curve with the sharp peak at the age of 10-14. The birth-cohort shows the sharpest drop in the incidence rates between those born in 1935-1939 and in 1940-1944. Secular trend shows marked gradual decrease in incidence rates from 1910 to 1949, however during the Korean War the incidence rates increased markedly up to 8.4% and then from 1960 the sharp downward trend was observed

Typhoid Fever

16.2% of Korean Physicians have experienced the typhoid fever. The experience rate for male(17.0%) was higher than that of female (10.3%). The older the age the higher was the experience rates. The incidence curve shows unimodal distribution with the peak at the ages of 10-14.Thereafter, the incidence rates decrease very slowly by the progress of age. the birth-cohort shows, in general the younger the age the lower the incidence rated, however. the distribution of incidence rates by age fluctuate. The secular trend by calendar year shows show decrease in incidence rates from 1920 to 1930 and then increase to 1950, thereafter the incidence rates decreased very rapidly. However, far the recent 10 years, the degree of decrease was slowing down until the time of the survey. The annual incidence rates for

typhoid fever in recent years are 0.2%.

Infectious Hepatitis

The experience rates of the disease among mate and female were 4.6% and 2.7% respectively. The very sharp peak of incidence distribution was observed at the ages of 25-29, but another small peek was also shown in ages of 10-14 with the lower rate for male than female. A slight increasing tendency was observed in recent years.

Serum Hepatitis

The experience rates were higher among female (1.8%) than male (0.7%) The incidence rates were equally distributed among ages over 20, however no secular trend was able to be observed. There was no case reported before 1945.

Pulmonary Tuberculosis

13.7% of Korean physicians have experienced pulmonary tuberculosis in the past. Both sexes have similar experience rates. The prevalence rates for both sexes were 1.2% with no sex difference. The incidence rates show the highest peak at the age

of 25-29 and decrease both sides slowly. The birth-cohort show that the highest incidence rates were seen among those who were born in 1930-34. Before and after those years, both incidence rates and experience rates were low. Real reduction of incidence rates for tuberculosis among Korean physicians started from 1965, even though it was very slow. The annual incidence rates in early 1970 were 0.2%.

Tinea Pedis

It had the highest prevalence and experience rates among the diseases surveyed Female (27.5%)had lower experience rates than male (47.7%). The prevalence rates disclosed 31.3% in male and19.3% in female. The incidence rates for male show the highest peak at the ages of 25-29 and then decrease rapidly by the progress of age, however the incidence curve of female shows no peak of any age. It rather distributes evenly through whole ages from 25 to 50. The birth-cohort shows rapid increase among the later-born groups, particularly among the younger ages. Those

who were born before 1930 showed no particular age preferences in incidence rates, however, those who were born after 1930 showed peak at the ages of 25-29 and getting sharper in the later-born groups. The secular trend shows glow increase up to 1955 and then exponential increase up to 1970. This trend maintains the plateau

after 1970.

Peptic Ulcer

The total experience rates for the peptic ulcer were 14.2% in male and 8.7% in female. The prevalence rates were 5.7% in male an? 5.2% in female. The incidence curve shows bimodal distribution. The Peak of higher mode is seen at the age of

25-29 and the smaller peak at the ages of 40-44 which suggest the different age distributions of the duodenal ulcer and gastric user. Birth-cohort $hows the later-born groups had a higher incidence rates particularly among the younger (25-29) ages. The secular trend shows the incidence rates increased from 1910 to

1970, however the degree of increase route faster from 1950. The incidence rates in early 1970 were approximately 0.8%.

Diabetes Mellitus

The prevalence rates were 4.2% in male and 1.6% in female. The incidence rates by age show slow increase from the age 20. however from the age 45, it rises sharply. The birth-cohort of incidence rates show rapid, marked increase in later-born

groups. The prevalence rates for age over 50 ranged 7-8% and the incidence rates for age above 45 were about 4.0%. The secular trend shows rapid increase from 1950, however the increase was accelerated from 1965 until the year of survey.

Hypertension

The prevalence rates for self-reported hypertension were 12.4% in mate arid 8.2% in female. The prevalence rates were particularly higher among age over 50. The incidence rates of age over 50 ware about 17.0%. The birth-cohort shows the later-born groups had higher incidence rates in general, however, the increase started earlier age in later-born groups. The secular trend shows general increase in incidence rates since early years, however, rapid increase started from 1955.

Heart Diseases

Arteriosclerotic heart disease, hypertensive heart disease, valvular heart disease and angina pectoris were studied separaely. In general, incidence rates for heart diseases were too low to see a tread except valvular heart disease of which rates recently were reducing. Only 1.8% reported that they had hypertensive heart disease and 7.75% arteriosclerotic heart disease.

Hemorrhoid

The prevalence rates for hemorrhoid were 18.9% in male and 15.4% in female. The Peak of incidence distribution by age was in 15-19 in both sexes. and then the incidence rates decrease rather rapidly by the progress of age. The birth-cohort shows the groups born later than 1930 have higher incidence rates particularly

among the younger ages, however, those who were born later than 1940 have also low incidence rates. The secular trend shows rapid increase in incidence rates from 1940 until 1955 and therm very sharp group until 1972.