• Quality Improvement in Health Care
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• v.28 no.1
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• pp.45-54
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• 2022

Purpose: The study aims to identify the theme list and priority criteria of patient safety theme reports in South Korea. Methods: The survey was conducted twice, and the importance of each criterion and theme was measured on a nine-point scale using the Delphi technique by a panel of 19 patient safety experts. The criteria included severity, universality, preventability, and organizational-social impact. Descriptive statistics such as frequency, percentage, mean, standard deviation, median, and interval quartile range were used to analyze the data. Results: The parameters were assigned a weighted average of 35% for severity, 20% for universality, 30% for preventability, and 15% for organizational-social impact, respectively. The final top three rankings were surgery safety, blood transfusion safety, and medication safety. In addition to expert opinion, for the theme that is selected based on the priority ranking, one to five sub-topics can be derived from the theme based on the priority ranking, societal demands, or the yearly priority list of patient safety incidents. Conclusion: It is recommended that the official patient safety center distribute the report in the form of a summary that can be utilized nationwide at medical institutions, government institutions, and other places. Updates, as well as accumulated theme reports, will serve as the baseline data for the proposal of the system and for the policy designed to implement and improve institutions' safety practices as a standard of domestic patient safety practice guidelines.

• Health Policy and Management
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• v.23 no.2
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• pp.112-123
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• 2013

Background: Under the risk of financial sustainability of National Health Insurance, Korean government attempted a series of regulations over pharmaceutical prices. The first price-cut was implemented to the hyperlipidemial treatments, and the prices of statins were reduced on 15th, April in 2009. The purposes of this study are 1) to investigate the impact of this price-cut on pharmaceutical expenditure, and 2) to identify the factors associated with drug-switch among statins. Methods: Using the national patients sample data, this study conducted time series analysis on the expenditures, prices, and volumes of statin drugs. To understand the factors associated with drug-switch, the multinomial logit model was analyzed at the patients level. Results: The results of time series analysis demonstrated that the price-cut of hyperlipidemic medicines did not lead to the reduced expenditure, suggesting the increased volume was the major cause. The multinomial logit analysis identified the switch of healthcare provider as the significant factor that was highly associated with drug-switch, implying the physicians' preference was the major motivation of drug-switch. Conclusion: Without control of utilization, price regulation itself could not reduce pharmaceutical expenditure. This suggests that the pharmaceutical regulations should be implemented on the basis of understanding of provider behaviors. The findings of this study will form the first step for further empirical studies.

• Journal of Oriental Neuropsychiatry
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• v.29 no.3
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• pp.135-144
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• 2018

Objectives: The purpose of this study was to analyze the medical cost for patients with vertigo and to examine associations between chronic vertigo and mental disorder using 2014 Health Insurance Review & Assessment Service-National Patients Sample (HIRA-NPS). Methods: We analyzed sociodemographic characteristics, medical cost and medical care use pattern for vertigo patients. We used hierarchical multiple logistic regression analysis to examine odds ratio between chronic vertigo and mental disorder. Results: A total of 46,502 people and 118,504 claims data were identified for vertigo cases. Characteristics of vertigo patients have significant differences on proportion of female patients (68.36%), patients' average age (54.98) and proportion of medical assistance (5.76%) compared with non-vertigo patients. Results revealed that Korean medicine are one of frequent methods among total treatments for vertigo patients. Total days of medical care and total costs are 2.78 days and 111,362 won, respectively, and days for outpatients in Korean medical care (mean: 2.26 days) are more than those (mean: 5.05 days) in Western medical care. There is significant difference relative to sex between acute vertigo and chronic vertigo. The odds ratio between chronic vertigo and mental disorder is estimated as 1.34, that means risk of becoming chronic is 34% higher for vertigo patients with mental disorder. Conclusions: This study assessed socio-demographic characteristics, medical care use and expenses related to vertigo, and estimated associations between chronic vertigo and mental disorder. Findings provide a basis for economic evaluation studies on vertigo patients and development of clinical practice guidelines for vertigo patients with mental disorder.

• The Korean Journal of Applied Statistics
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• v.33 no.5
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• pp.627-637
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• 2020

In this paper, the 1.24 million elderly patient medical data (HIRA-APS-2014-0053) provided by the Health Insurance Review and Assessment Service and weather data are analyzed with generalized estimating equation (GEE) model and long short term memory (LSTM) based recurrent neural network (RNN) model to predict the number of disease occurrence. To this end, we estimate the patient's residence as the area of the served medical institution, and the local weather data and medical data were merged. The status of disease occurrence is divided into three categories(occurrence of disease of interest, occurrence of other disease, no occurrence) during a week. The probabilities of categories are estimated by the GEE model and the RNN model. The number of cases of categories are predicted by adding the probabilities of categories. The comparison result shows that predictions of RNN model are more accurate than that of GEE model.

• Journal of Korean Foot and Ankle Society
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• v.21 no.2
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• pp.66-69
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• 2017

Purpose: This study reports on limb amputations in diabetic patients according to gender, age, and region based on the data from the Korean Health Insurance Review & Assessment Service. Materials and Methods: The number of amputations was compared by region, age, gender, and year, as well as by femoral region, lower leg, foot, and toe in diabetic patients who received limb amputation. This analysis was performed based on the data from the Korean Health Insurance Review & Assessment Service, between January 2009 and December 2014. Results: The total number of amputations between the study period was 9,155. The number of patients who were treated at hospitals for diabetes in 2009 was 1.9 million, among which, 1,214 patients underwent amputation. In 2014, the incidence of diabetes was 1,747 in 2.58 million individuals. With this rising incidence of diabetes, the amputation of limbs due to diabetes is increasing every year. In particular, the following regions were amputated more often: femoral region, 2.3%; lower legs, 19.6%; feet, 18.1%; and toes 60.0%. Regarding gender differences, males showed a higher amputation rate than females for all body parts. With respect to region, Seoul was the highest with 30.2%, followed by Gyeonggi with 19.9%, and Busan with 8.8%. According to age, older age showed greater diabetic amputation rate. Conclusion: In accordance with the rising incidence of diabetes, the diabetic amputation is also increasing. Here, we showed that toes were amputated with the highest percentage and males had greater amputation rate than females for all body parts. Moreover, amputation rate was highest in older diabetic patients, especially for those in their seventies. Additionally, Seoul was the region with highest amputation rate.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.4
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• pp.89-100
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• 2019

Objectives We are going to analyze patient's medical and Korean medicine use trends after lumbar surgery, and examine the percentage of use of Korean medicine after surgery and its relevance to the medical care outcome after lumbar surgery. Methods Using 3% patients' sample data of the Health Insurance Review and Assessment Service, two groups were compared the treatment progress of the Korean Medicine treatment group and the untreated group after lumbar surgery by hierarchical logistic regression analysis. After hierarchical logistic regression analysis(including propensity scores), two groups were compared after lumbar surgery, the Korean Medicine treatment group within 50days and untreated group within 50days. Results Lumbar surgery was performed in 2750 patients in 2015. It was 3.72 that the risk(odds ratio) of finished treatment of patients treated without Korean Medicine, compared to patients with Korean Medicine. It was 0.12 that the risk of continuing treatment(odds ratio) of patients treated with Korean Medicine within 50 days, compared to patients treatment more than 50 days. Conclusions The ratio of Korean Medicine treatment after lumbar surgery was 14.8%. The group that did not have Korean Medicine showed a higher possibility of treatment termination than the group who did not. Among the groups treated with Korean Medicine, the early treatment group was more likely to end treatment than the late treatment group. Considering various situations in the medical environment, further studies such as prospective studies and long-term data analysis are considered to be necessary.

• Journal of Korean Foot and Ankle Society
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• v.25 no.3
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• pp.126-132
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• 2021

Purpose: This study examined whether there are seasonal variations in the number of plantar fasciitis cases from the database of the Korean Health Insurance Review & Assessment Service and an internet search of the volume data related to plantar fasciitis and whether there are correlations between variations. Materials and Methods: The number of plantar fasciitis cases per month was acquired from the Korean Health Insurance Review & Assessment Service from January 2016 to December 2019. The monthly internet relative search volumes for the keywords "plantar fasciitis" and "heel pain" were collected during the same period from DataLab, an internet search query trend service provided by the Korean portal website, Naver. Cosinor analysis was performed to confirm the seasonality of the monthly number of cases and relative search volumes, and Pearson and Spearman correlation analysis was conducted to assess the correlation between them. Results: The number of cases with plantar fasciitis and the relative search volume for the keywords "plantar fasciitis" and "heel pain" all showed significant seasonality (p<0.001), with the highest in the summer and the lowest in the winter. The number of cases with plantar fasciitis was correlated significantly with the relative search volumes of the keywords "plantar fasciitis" (r=0.632; p<0.001) and "heel pain" (r=0.791; p<0.001), respectively. Conclusion: Both the number of cases with plantar fasciitis and the internet search data for related keywords showed seasonality, which was the highest in summer. The number of cases showed a significant correlation with the internet search data for the seasonality of plantar fasciitis. Internet big data could be a complementary resource for researching and monitoring plantar fasciitis.

• Journal of the Health Care and Life Science
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• v.9 no.1
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• pp.103-115
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• 2021

The purpose of this study is to understand the annual trend of patients with cervical vertebrae disability and improve their health service utilization in the general description (200 TABLE) of patients with cervical vertebrae disability.The main results of this study are as follows. All patients with cervical vertebrae disability were women aged 50 to 59. Compared to 2010, the proportion of patients with disease increased year by year in all subjects in 2018, with men under 30-39 years of age and women under 19 years of age increasing the highest.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.1
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• pp.31-39
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• 2019

Objectives To obtain future research basis of Korean Medicine for total knee arthroplasty patient by analyzing medical and Korean Medical service utilization and treatment duration. Methods Data sampling was performed on Health Insurance Review and Assessment Service patient data of 2015 (Confidence level of 97%) to analyze patients' medical and Korean Medical service tendency. Sampling groups were divided into two groups; i) Patients who completed their treatment within 5 months of total knee arthroplasty, ii) Patients who continued their treatment after 5 months of total knee arthroplasty, to investigate patients' medical and Korean Medical service tendency and individual characteristics were carefully monitored. Results It was confirmed that total of 1,655 patients had gone through total knee arthroplasty out of 1,453,486 patients who were gathered for sampling. First sampling group (Patients who completed their treatment within 5 months of total knee arthroplasty) was 287 patients and second sampling group (Patients who continued their treatment after 5 months of total knee arthroplasty) was 385 patients. The proportion of patients who visited Korean Medical service in first sampling group was lower than that of second sampling group. Conclusions It was confirmed that medical and Korean Medical service and cost consumed by second group (Patients who continued their treatment after 5 months of total knee arthroplasty) was higher than that of first group (Patients who continued their treatment after 5 months of total knee arthroplasty). It is highly recommended to continue with further study for efficient medical and Korean Medical service and reduced cost.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.34 no.2
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• pp.53-69
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• 2021

Objectives : The purpose of this study is to analyze the effects of treatment between Western medicine and Korean medicine on Allergic rhinitis patients using national population-based claim data from the Health Insurance Review and Assessment Service. Methods : The subjects of the study were 30,024 patients in the Korean medicine group and 30,024 in the Western medicine group who were diagnosed with Allergic rhinitis from September 1, 2018 to December 31, 2018. Propensity score analysis was used for matching age, sex, etc. at a ratio of 1:1. Cox regression and subgroup analysis were used to estimate the adjusted hazard ratio of recurrence, Asthma, and Atopic dermatitis in Korean medicine group and Western medicine group. In addition, the total treatment period, total treatment cost, and average cost per day of visit were compared and analyzed. Results : Compared to Korean medicine, Western medicine had a significantly higher risk of recurrence at 1.701 times, Asthma occurrence risk at 1.609 times and Atopic dermatitis occurrence risk at 1.098 times. Compared to Western medicine, the total treatment period of Korean medicine was 14.27 days longer, the total treatment cost was 53,591 won more, and the average cost per day was 7,539 won more. Conclusions : This study is a retrospective cohort study using the propensity score matching in Korea to compare the outcomes of Allergic rhinitis between Western medicine and Korean medicine. Further research is needed by considering patients characteristics, and linking with additional data.