• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.12
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• pp.384-389
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• 2017

This study was conducted to investigate the patient and hospital characteristics that affect receiving and non-receiving blood transfusion for hepatoma embolization. We analyzed data describing 757 patients of the Health Insurance Review and Assessment Service's 2011 claims sample data. Chi-squared and logistic regression analysis was performed using STATA 12.0. Logistic regression analysis revealed that anemia (Odds ratio (OR)=9.544, 95% confidence interval (CI)=3.362-27.097), female (OR=2.186, Cl=l.240-3.854), age 65-74 (OR=0.506, CI=0.269-0.952), 1000 over bed (OR=0.053, CI=0.018-0.151), out-department (OR=0.211, CI=0.081-0.551), and 700-999 bed (OR=0.105, CI=0.036-0.304) were significant predictors of blood transfusion in tertiary hospitals. Additionally, anemia (OR=69.681, CI=8.545-568.246) and aged 75 or over (OR=0.112, CI=0.025-0.506) were significant predictors of blood transfusion in general hospitals. This research would expected to cost effective and preliminary data of blood transfusion quality.

• Food Science and Industry
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• v.55 no.2
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• pp.154-165
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• 2022

Humans have been breeding the mulberry silkworm for the long period of time to obtain silk fabric and nutrient-rich pupae. Currently, silkworm larvae, pupae, and silk-Fibroin hydrolysates are registered as food raw materials, while silkworm feces and Bombyx batryticatus are registered as Korean traditional medicines. Among sericulture products, individually recognized health functional food ingredients include silk-protein acid-hydrolysates for immunity enhancement, Fibroin-hydrolysates for memory improvement, and freeze-dried 5^th instar and 3^rd-day-silkworm powder for lowering-blood sugar. Recently, HongJam produced by steaming and freeze-drying mature silkworms were reported to have various health-promoting effects such as preventing the onset of Alzheimer's disease and Parkinson's disease, enhancing gastro-intestinal functions, improving skin-whitening and hair growth, and extending healthspan. By consuming silkworm products with various health-promoting effects, it is possible to increase the healthspan of human beings, thereby reducing personal and national medical expenses, resulting in increasing the individual's happiness.

• Journal of Oral Medicine and Pain
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• v.34 no.1
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• pp.63-79
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• 2009

While previous epidemiological studies on temporomandibular disorders (TMD) have been based on a given health center or population sample, no study has been performed on general population of Korea, especially concerning about treatment pattern such as clinician’s specialty involved in TMD treatment, types and amount of prescription medication and cost. This study aimed to investigate magnitude of health visits and treatment patterns for Korean patients with TMD through the computerized database of Health Insurance Review and Assessment Service (HIRAS). Inclusion criteria were all patients registered on the HIRAS database over 3 years' period from 2003 to 2005 and the medical records of patients with TMD as a main diagnosis were extracted. Information collected was as follows; distribution related to gender, age and region and type of hospital the patients visited, treatment duration, clinicians' specialty involved in treatment, cost, types of prescription medication and surgical treatment. The results of this study indicated that 0.15% of the population yearly sought TMD treatment, presenting with increase of incidence over the three years. Most of TMD patients were women (99.8%) and the biggest age group was second and third decades and decreased with age. Seoul and Kyeonggi province presented with higher incidence of TMD compared to the other regions of Korea, which seems to be related with magnitude of population. 56% of TMD patients visited primary care sector and the numbers of treatment visits was the highest in dental clinic (38.4%), followed by orthopedics (28%) and ENT (13.6%) clinics in order. Duration of prescription medication was the longest for anti-inflammatory analgesics, followed by antipsychotic drugs and muscle relaxants. Inpatient care related to TMD was primarily performed in dental hospital compared to medical hospital. Medical database of HIRAS provided comprehensive and vast information on epidemiologic characteristics and treatment patterns for patients seeking TMD treatment, which can be more reliable data to expect medical demand for TMD in condition that accurate diagnosis and standardized treatment is delivered in clinical settings.

• Journal of Korean Clinical Nursing Research
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• v.17 no.2
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• pp.123-137
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• 2011

Purpose: This study was conducted to develop standards ensuring nursing process-based care of patient admission and discharge, to develop a performance measurement tool evaluating the care applied according to the standards, and finally to determine validity of the standards and the tool. Methods: The standards and the tool were reviewed by a panel of experts and refined based on the panel's suggestions. Validity of the standards and the tool were examined through surveying a total of 302 hospital nurses. Results: The mean validity scores of the performance measurement standards and the tool were 4.11 and 4.09, respectively, out of 5.00. So the performance measurement standards and the tool in this study were found to be acceptable in evaluating quality of nursing care provided at patient admission and discharge. Conclusion: This result indicates that the performance measurement standards and the tool developed in this study are valid instruments to monitor and improve quality of nursing care for patient admission and discharge.

• Journal of Korean Clinical Nursing Research
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• v.16 no.3
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• pp.5-23
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• 2010

Purpose: This study was conducted to determine the validity and reliability of performance measurement tools based on the nursing process for prevention and management of pressure ulcers, falls and pain. Methods: The performance measurement tools were reviewed by a panel of experts and refined on the basis of the panel's suggestions. The validity of the performance measurement tools was measured by surveying hospital nurses. The reliability of these tools was tested by having nursing experts use the tools in five nursing units to assess nursing performance in prevention and management of pressure ulcers, falls and pain. Results: The performance measurement tools in this study were found to be acceptable as tools to evaluate quality of nursing care in pressure ulcers, falls and pain. The reliability of the performance measurement tools was acceptable. Conclusion: These results indicate that the performance measurement tools developed in this study are valid and reliable instruments to monitor and improve quality of nursing care in prevention and management of pressure ulcers, falls and pain.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.195-218
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• 2017

The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system.

• Korean Journal of Clinical Pharmacy
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• v.22 no.1
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• pp.13-20
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• 2012

서론: 주사제 사용을 줄이기 위한 정책의 일환으로 건강보험심사평가원은 의료기관별 주사제 처방률을 통보하고 있으나, 여전히 주사제 처방은 높은 실정이다. 따라서 본 연구에서는 주사제에 대한 환자의 인식수준을 살펴보고, 환자의 주사제 요청에 영향을 미치는 요인을 파악하고자 하였다. 연구방법: 본 연구는 최근 6개월 이내에 병의원을 방문한 전국의 20세 이상의 남녀를 대상으로 전화조사한 단면설계 연구다. 환자의 일반적 특성과 주사제에 대한 태도, 인식을 조사하였고, 환자가 주사제를 요청하는데 영향을 미치는 특성을 규명하기 위해 일반적 특성(성, 연령, 결혼여부, 보험형태, 지역규모, 질환, 교육, 소득 등), 주사제에 대한 인식, 태도를 독립변수로 하고, 주사제 처방 요청여부를 종속변수로 하며, 16개 행정지역을 무작위 효과로 층화한 다수 준 분석을 실시하였다.결과: 연구대상에 포함된 응답자는 997명이었고(응답률 82.2%), 응답자 중 24%가 병의원 방문 당시 주사제를 요구했다고 응답했고, 58%가 한번 이상 주사제를 맞은 경험이 있다고 보고했다. 92%가 주사제에 대해 잘못된 인식을 갖고 있었고, 15%는 의사가 부적절하게 주사제를 처방한다고 응답했다. 다수준 로지스틱 회귀분석 결과, 남성의 경우(Odds ratio(OR) 0.71, 95% confidence interval(CI) 0.52-0.99), 고졸이상자(OR 0.63, 95% CI 0.41-0.96), 기혼자(OR 1.72, 95% CI 1.01-2.92)가 주사제를 더 요구하는 것으로 나타났고, 대도시에 비해 농촌지역 환자가(OR 2.12, 95% CI 1.24-3.63), 호흡기계 질환으로 방문한 경우(OR 1.48, 95% CI 1.03-2.12), 주사제를 처방하면 경구제에 비해 신뢰감이 생긴다는 응답자의 경우(OR 1.91, 95% CI 1.33-2.73) 주사제를 더 요구하는 것으로 나타났다. 결론: 본 연구결과 여성, 기혼자, 농촌 거주자, 호흡기계 질환으로 방문한 환자의 경우와 주사를 맞으면 신뢰감이 생긴다는 잘못된 태도를 가진 환자가 주사제를 요구하는 것으로 나타났고, 이러한 환자특성을 고려하여 주사제 사용을 감소시키기 위한 정책을 실시하는 것이 필요하겠다.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.1
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• pp.26-34
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• 2018

Objectives : This study tried to explore the prevalence of chronic physical diseases in patients with schizophrenia and its effects on total medical costs. Methods : The Health Insurance Review and Assessment Service data in 2014-2015 was employed. Only the injuries and diseases, identically diagnosed 3 times or more as a major or minor injury and disease, were classified into chronic physical diseases to improve data accuracy. Total medical costs included out-of-pocket and insurer's costs from health care system perspective. Results : It was shown that 24.5%, 17.3% and 23.4% of schizophrenia patients had one, two and three or more chronic physical diseases, respectively. There was a high prevalence of not only metabolic, but also musculoskeletal, diseases in those patients. The amount of 2015 total medical costs of patients with schizophrenia in 2014 was about 1.08 trillion won. The factors affecting the costs included sex, age, number of chronic physical diseases, and health insurance status. Conclusions : It is considered that clinical practice guidelines based on personal diseases may not sufficiently solve the problems for comorbidities in schizophrenia patients. Accordingly, it should be required to develop models for new types of medical systems capable of treating and caring varied illnesses at the same time.

• Research in Community and Public Health Nursing
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• v.32 no.3
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• pp.356-367
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• 2021

Purpose: This study conducted an economic evaluation of hospital-based home care services for the patients who had undergone breast cancer surgery. Methods: A total of 12,483 patients over 18 years of age who had received breast cancer surgery in 26 tertiary hospitals in 2018 were analyzed with the claim data from the Health Insurance Review & Assessment Service using cost-minimization analysis and societal perspectives. Results: There were 156 patients who utilized hospital-based home care services within 30 days after breast cancer surgery, and they received 2.17 (SD=1.17) hospital-based home care service on average. The average total cost was 5,250,028 KRW (SD=1,905,428) for the group receiving continuous hospital-based home care and 6,113,402 KRW (SD=2,033,739) for the group not receiving continuous hospital-based home care (p<.001). The results of the economic evaluation of continuous hospital-based home care services in patients who had undergone breast cancer surgery indicated a total benefit of 953,691,000 KRW, a total cost of 819,004,000 KRW, and a benefit-cost ratio of 1.16 in 2018. Conclusion: Continuous hospital-based home care was considered economically feasible as the total costs for the group receiving continuous hospital-based home care were lower than those of the group not receiving continuous hospital-based home care. Therefore, policy modification and financial incentives are recommended to increase the utilization of hospital-based home care services for patients who had undergone breast cancer surgery.

• The Journal of Health Technology Assessment
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• v.6 no.2
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• pp.100-105
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• 2018

Objectives: The purpose of this research is to investigate regional variations of mastication difficulty rates in the elderly over 65 in 229 primary autonomous districts in Korea and explore relevant characteristics. For the research data, local community health survey conducted in 2015 and data from Ministry of the Interior and Safety, Ministry of Health & Welfare, National Health Insurance Service and Statistics Korea were used. Methods: Frequency analysis was conducted for general characteristics and mastication difficulty rates of each region, and distribution of mastication difficulty rates was displayed for each town, city and province by mapping them. Extremal quotient (EQ), coefficient of variation (CV) values were calculated for regional variations, and logistic regression analysis was performed to reveal the relationship between each independent variable and mastication difficulty rates. Results: The average of standardized mastication difficulty rate was 46.78%, and regional variations were significant with EQ 3.46, CV 0.18. Characteristic factors that have significant effects on mastication difficulty rate included sex ratio, elderly population and the number of dentists per 10000 people. Conclusion: As a result, there were variations among mastication difficulty rates in 229 primary local governments across the country, and the distribution of health care resources by the characteristics of the local environment by region affected mastication difficulty rates. Accordingly, it is required to provide political supports to overcome regional inequality of oral health levels and develop cooperative system between local governments and local dentists.