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Promotion of participation in religious organizations, friendship organizations, and family/school reunions (only for older persons) may help preserve cognitive function in individuals aged 45 years or older in Korea. Copyright © 2016 John Wiley & Sons, Ltd.

Study Objectives: Sleep duration is recognized as one of the most common issues in modern society. Self-rated health is a commonly used subjective health measure based on a single question asking individuals to rate their general health on a four-or fi ve-point scale. However, few studies have examined the relationship between sleep duration and self-rated health. Here, we examined the association between sleep duration and poor self-rated health, using a large representative sample of the general Korean adult population. Design: We conducted a cross-sectional study of 15,252 participants in the Korea National Health and Nutrition Examination Survey IV (2007)(2008)(2009)) who were aged 19 years and older. Sleep duration was categorized as ≤ 5, 6, 7, 8, or ≥ 9 hours. The main outcome of interest was poor self-rated health (n = 3,705, 19.7%). Multiple logistic regression analysis was performed to examine the association between sleep duration and self-rated health. Results: We found both short (≤ 5 h) and long (≥ 9 h) sleep duration to be associated with poor self-rated health independent of sociodemographic, health risk, and health status variables. Compared with 7-h sleep duration, the multivariate odds of poor self-rated health were 1.358 times higher (95% CI 1.167-1.580) with short sleep duration and 1.322 times higher (95% CI 1.091-1.601) with long sleep duration. This association persisted in subgroup analyses of gender, body mass index, and age by gender. Conclusions:In a large representative sample of the Korean general adult population, compared with sleep duration of 7 hours, we found a positive association between short and long sleep duration and poor self-rated health in Korean adults. Furthermore, the association between sleep duration and poor self-rated health was consistently present in subgroups divided by gender, age, and BMI. Keywords: Sleep, sleep duration, self-rated health, gender, age, body mass index (BMI), KNHANES Citation: Kim JH; Kim KR; Cho KH; Yoo KB; Kwon JA; Park EC. The association between sleep duration and self-rated health in the Korean general population.

BackgroundA system for managing chronic disease including diabetes mellitus based on primary care clinics has been used in Korea since April 2012. This system can reduce copayments for patients that are managed by a single primary-care provider and lead to improve continuity of care. The aim of this study is to determine whether there is an association between continuity of care for outpatients and hospital admission and identify the continuity index that best explains hospital admissions for patients with type 2 diabetes.MethodsWe performed a cross-sectional study using 2009 National Health Insurance Sample (NHIS) from the Health Insurance Review & Assessment Services (HIRA) of Korea. The dependent variable was hospital admission due to type 2 diabetes mellitus. Continuity of care was measured using the Usual Provider Care index (UPC), Continuity of Care index (COC), Sequential Continuity of Care index (SECON), and Integrated Continuity of Care index (ICOC).ResultsPatients with low COC scores (<0.75) were more likely to be hospitalized [odds ratio, 2.44; 95% CI, 2.17–2.75] compared with the reference group (COC ≥0.75), after adjusting for all covariates. we calculated the area under the receiver operating characteristic (AUROC) curve for each index to find which index had the greatest explanatory ability for hospital admission. The AUROC of the COC was the greatest (0.598), but the AUROC curves for the UPC (0.597), SECON (0.593), and ICOC (0.597) were similar.ConclusionsHigh continuity of care may reduce the likelihood for hospital admission. The COC had marginally more explanatory power.