• Clinical and Experimental Pediatrics
• /
• v.51 no.9
• /
• pp.977-986
• /
• 2008

Purpose : This study aims to estimate the financial cost of rotavirus infection in Korea in the year of 2005. Methods : The incidence rates used were from the epidemiological profile at Jeoungeub District (5.8 cases/1,000 children <5 years old for inpatients, and 22.65 cases/1,000 children <5 years old for outpatients, per year). The health care cost per capita of rotavirus infection (ICD code: A08.0) was extracted from the Health Insurance Review and Assessment Service database in Korea. The patient survey was conducted to capture information about non-medical costs and associated productivity loss incurred by adult caregivers. Results : The number of annual national cases among children <5 years old with rotavirus infection was estimated to be 69,122 (i.e., 55,030 outpatients and 14,092 inpatients). The total cost of rotavirus infection was estimated at 13.3 billion Korean won, comprising 11 billion Korean won (82.7%) of direct medical costs, 1.6 billion Korean won (12.0%) of direct non-medical costs (e.g., transportation and supplies), and 0.68 billion Korean won (5.1%) of productivity lost by adult caregivers. Conclusion : Rotavirus infection carries not only medical costs but also non-medical and indirect costs; together, these costs incur a significant burden on South Korean society. The impact of rotavirus on quality of life and health among patient caregivers was not considered in this study, but it does merit further research.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.50 no.3
• /
• pp.360-372
• /
• 2023

The aim of this study was to identify the current state of pediatric dentists, evaluate the adequacy of pediatric dentist supply and demand, and find out the perception of all pediatric dentists on the current state of pediatric dentists and policy establishment. An Online survey was conducted among pediatric dentists. The questionnaire was subdivided into 'general characteristics', 'number of dental treatments and working days per year', 'proportion of covered services', 'perceptions of supply and demand of pediatric dentists'. Through the Korean Academy of Pediatric Dentistry, the Health Insurance Review and Assessment Services, the National Health Insurance Service (NHIS), and the Korean Statistical Information Service, the current state of pediatric dentists, the number of claims for covered services, and the decrease in births per year were investigated. Dental clinics claiming to be pediatric dentistry reached half of all medical institutions, but only 3.78% of pediatric dentists actually worked. 61.36% of all pediatric dentists were concentrated in the metropolitan area, showing a national imbalance. Although the population of children and adolescents have continuously decreased over the past 20 years, the number of NHIS-covered services has shown a continuous increase. Over the past 10 years, the optimal supply of pediatric dentists has been maintained at around 4,000. According to the analysis, 92.15% of pediatric dentists thought that it was necessary to prepare policies and support measures at the government level. This study is expected to be used as basic data for establishing a demand estimation method for pediatric dentistry specialists in the future.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.19 no.9
• /
• pp.146-155
• /
• 2018

This study was conducted to evaluate the clinical outcomes of coronary artery bypass surgery for ischemic heart disease according to use of a cardiopulmonary bypass machine. The subjects were 10,981 patients who underwent coronary artery bypass grafting for ischemic heart disease from July 2008 to June 2012. Analysis data were retrospectively collected using health insurance claims data. The results of the study showed that mean time to surgery (280 min vs 357 min, p<0.0001) and intubation time (about 24 hours vs 40 hours, p<0.0001) were significantly shorter in the Off-Pump CABG (OPCAB) group than in the On-Pump CABG (ONCAB) group. The rate of reoperation because of postoperative bleeding and hematoma was lower in the OPCAB group (2.7% vs 8.3%, p<.0001). The odds ratio of risk adjusted 30 days mortality rate was 0.339 (0.266-0.434) and the postoperative length of stay was decreased in the OPCAB (p<0.0001). Overall, the 30 days mortality and reoperation rates were lower in the OPCAB, as was the resources use.

• Korean Journal of Biological Psychiatry
• /
• v.26 no.2
• /
• pp.39-46
• /
• 2019

Antidepressants are widely used to treat depression in Korea, however, only a few studies have focused on the provider of the treatment. The aim of the study is to compare the differences between patients who were prescribed antidepressants by psychiatrists and those who were prescribed antidepressants by non-psychiatrists in South Korea. Patients with a diagnosis of depressive disorder who had been newly prescribed antidepressants in 2012 were selected from the Health Insurance Review and Assessment Service database. They were classified into two groups depending on whether they received the antidepressant prescription from a psychiatrist or non-psychiatrist. Sociodemographic, clinical, and depression related cost has been investigated. Treatment resistant depression, which is defined as a failure of two antidepressant regimens to alleviate symptoms, was also investigated. Prescription adequacy was assessed based on whether a regimen was maintained for at least 4 weeks. Among the 834694 patients with pharmaceutically treated depression (PTD) examined in this study, 326122 (39.1%) were treated by psychiatrists. Patients who were treated by psychiatrists were younger and had more psychiatric comorbidities than those treated by non-psychiatrists. They had longer PTD duration (229.3 days vs. 103.0 days, p < 0.05) and a larger proportion of treatment resistant depression (9.3% of PTD) when compared to those patients treated by non-psychiatrists. The patients treated by psychiatrists had a smaller proportion of inadequate antidepressant use compared to those patients in the non-psychiatrist group (44.5% vs. 65.1%, p < 0.05). The costs related to depression corrected with PTD duration were higher in the non-psychiatrist group (32214 won vs. 56001 won, p < 0.05). Patients who receive antidepressants from psychiatrists are patients with more severe, treatment-resistant depression. Psychiatrists prescribe antidepressants more adequately and cost- effectively than non-psychiatrists.

• Pediatric Infection and Vaccine
• /
• v.28 no.3
• /
• pp.144-148
• /
• 2021

Purpose: Nonpharmaceutical measures, such as social distancing, have resulted in unintended consequences, including a decrease in the incidence of childhood diseases. This study aimed to estimate the impact of social distancing on the incidence of febrile seizure (FS) in Korea using nationally representative data. Methods: We used claims data from the Health Insurance Review and Assessment Service, a single-payer database capturing >95% of the Korean population. The database included any inpatient encounter with a FS diagnosis from January 2010 to September 2020 for those aged 0-5 years old. We aggregated the monthly number of cases to estimate the incidence per 100,000 patient-years in 2020 (January 1 to September 30) for the same periods in 2010-2019. Results: The incidence of FS in 2020 ranged from 113 per 100,000 (95% confidence interval [CI], 108-118 per 100,000) in January to 27 per 100,000 (95% CI, 25-30 per 100,000) in September, whereas the average FS incidence in 2010-2019 ranged from 116 per 100,000 (95% CI, 112-121 per 100,000) in January to 101 per 100,000 (95% CI, 97-106 per 100,000) in September. Conclusions: The incidence of FS decreased by -38% in 2020, suggesting that social distancing contributed towards decreasing the incidence of FS.

• Pediatric Infection and Vaccine
• /
• v.30 no.3
• /
• pp.139-144
• /
• 2023

Purpose: Children with incomplete Kawasaki disease (KD) and pyuria may be misdiagnosed with urinary tract infection (UTI) during the early phase of the prodrome. We investigated the percentage of UTI diagnoses preceding a KD diagnosis. Methods: Using the National Health Insurance data of South Korea, we assessed differences in UTI diagnoses made during the week preceding a KD diagnosis, according to demographic and geographic factors from November 2007-October 2019. Results: A total of 53,822 KD cases were identified, including 304 patients (0.56%) diagnosed with a UTI during the week preceding a KD diagnosis. The younger age group (0-11 months) showed the highest percentage of preceding UTI diagnoses (0.95%), with higher odds than 4-year-old children (3.12; 95% confidence interval, 2.05-4.77). Conclusions: These findings suggest a potentially misleading presentation of incomplete KD, a clinical conundrum requiring further investigation and validation, particularly in infants.

• The Korean Society of Law and Medicine
• /
• v.17 no.1
• /
• pp.299-346
• /
• 2016

There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.