• Title/Summary/Keyword: 의료보험

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A Study on the Development of Readmission Predictive Model (재입원 예측 모형 개발에 관한 연구)

  • Cho, Yun-Jung;Kim, Yoo-Mi;Han, Seung-Woo;Choe, Jun-Yeong;Baek, Seol-Gyeong;Kang, Sung-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.4
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    • pp.435-447
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    • 2019
  • In order to prevent unnecessary re-admission, it is necessary to intensively manage the groups with high probability of re-admission. For this, it is necessary to develop a re-admission prediction model. Two - year discharge summary data of one university hospital were collected from 2016 to 2017 to develop a predictive model of re-admission. In this case, the re-admitted patients were defined as those who were discharged more than once during the study period. We conducted descriptive statistics and crosstab analysis to identify the characteristics of rehospitalized patients. The re-admission prediction model was developed using logistic regression, neural network, and decision tree. AUC (Area Under Curve) was used for model evaluation. The logistic regression model was selected as the final re-admission predictive model because the AUC was the best at 0.81. The main variables affecting the selected rehospitalization in the logistic regression model were Residental regions, Age, CCS, Charlson Index Score, Discharge Dept., Via ER, LOS, Operation, Sex, Total payment, and Insurance. The model developed in this study was limited to generalization because it was two years data of one hospital. It is necessary to develop a model that can collect and generalize long-term data from various hospitals in the future. Furthermore, it is necessary to develop a model that can predict the re-admission that was not planned.

A Retrospective Study on the Effect of Herbal Extracts Combined with Conventional Therapy on Blood Glucose in Type 2 Diabetes Mellitus (제2형 당뇨병 환자에게 한방의료보험용 혼합엑기스산제와 경구혈당강하제 병용요법이 혈당 변화에 미치는 영향)

  • Jeong, Su-min;Noh, Ji-won;Lee, Min-seung;Yang, Hee-gwon;Ahn, Young-min;Ahn, Se-young;Lee, Byeong-chul
    • The Journal of Internal Korean Medicine
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    • v.41 no.6
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    • pp.1231-1244
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    • 2020
  • Objective: This study was conducted to report the glucose-lowering effect and safety of herbal extracts in patients with type 2 diabetes mellitus. Methods: We investigated 21 patients with type 2 diabetes mellitus who were administered Daeshiho-tang, Bojungikgi-tang, Jowiseunggi-tang, and Hoechunyanggyeok-san at Kyung-Hee University Korean Medical Hospital from 2014 to 2019. The hypoglycemic effect of the herbal extracts was assessed by comparing blood glucose levels, including fasting blood sugar (FBS) and 2-hour postprandial glucose (PP2) levels. For safety assessment, the effects of herbal extracts on liver and kidney function were analyzed by liver function tests, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyltransferase (GGT), and kidney function tests, including blood urea nitrogen (BUN) and creatinine (Cr). Patients were stratified according to their glycated hemoglobin (<6.5 or >6.5) levels and the kind of herbal extract used for treatment. Results: After administration of herbal extracts, FBS and PP2 significantly decreased to 20.24 mg/dL and 35.0 mg/dL respectively. Subgroup analysis revealed that, regardless of the glycated hemoglobin level, FBS and PP2 were significantly reduced in both groups. The safety profile showed no significant difference before and after taking herbal extracts. Conclusions: Daeshigo-tang, Bojungikgi-tang, Jowiseunggi-tang, and Hoechunyanggyeok-san may show the further glucose-lowering effects on patients with type 2 diabetes mellitus who have already treated with anti-hyperglycemic agents.

Impact of COVID-19 on Dental Trauma in Korea (국내에서 발생한 치과적 외상에 대한 코로나 바이러스 감염증-19의 영향)

  • Son, Donghyun;Lee, Yoon;Kim, Jihun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.49 no.1
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    • pp.76-84
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    • 2022
  • The study was conducted to analyze the impacts of COVID-19 on the number of dental trauma patients. Based on the data provided by the Health Insurance Review and Assessment Service's Healthcare Bigdata Hub, dental trauma which occurred from 2010 to 2020 was analyzed. Since the outbreak of COVID-19, the incidence of dental trauma per 100,000 decreased compared to the average Incidence between 2017 to 2019. By age, it decreased by 5.4% (p = 0.017) for 0 - 4 years old, 30.3% (p < 0.001) for 5 - 9 years old, 39.5% (p < 0.001) for 10 - 14 years old, 14.5% (p = 0.002) for 15 - 19 years old, 1.3% for 20 - 29 years old, 0.2% for 40 - 49 years old, 2.7% for 50 - 59 years old, 1.2% for 60 years old or older, but it increased by 2.5% for 30 - 39 years old. Compared monthly, before and after the outbreak of COVID-19 confirmed patients, the number of dental trauma patients dropped sharply. After the outbreak of COVID-19, the incidence of dental trauma decreased significantly for under 20 years old, but the decrease was not significant for 20 years old or older.

Current Status of the Reimbursement for Pharmacist-provided Health Care Services in Japan, the United States, and the United Kingdom (국외 약사서비스 지불보상체계 현황 : 일본, 미국, 영국을 중심으로)

  • Park, Ji Hyun
    • The Journal of the Korea Contents Association
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    • v.22 no.6
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    • pp.712-728
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    • 2022
  • World-widely, there has never been a greater need for people to access high-quality expertise about the effective and safe use of medications. Therefore, the profession of pharmacy should meet these needs of the times, as the demographic shifts have led to a situation where older adults now outnumber children, and polypharmacy is also a commonplace. However, the reimbursement system covered by the National Health Insurance (NHI) in Korea is still limited to the traditional dispensing and compounding role of pharmacist. To provide a take-home message to Korean pharmacy reimbursement system, we aimed to review and analyze the international trends in pharmacy remuneration systems. This is a comparative study between Korea, Japan, the United Kingdom, and the United States. Comparison was conducted by reviewing each country's policy and enforcement programs, as well as the related literature. Japan, the UK and the US systems remunerate diverse patient-centered pharmaceutical care services. The Korean pharmacy service fee is, however, narrowly focused on the traditional product-oriented pharmacy services. This study discussed the future direction of improving pharmacist reimbursement systems in Korea, by expanding professional pharmacy service coverage and diversifying fee schedule.

The Developing Trend of Cardiovacular Drug Coated Balloon Catheter (심장혈관용 약물코팅풍선카테터의 개발 동향)

  • Park, Junghun;Jo, Won-Il;Byeon, Dae-Heung;Kang, So Young;Nam, Choong-hyun;Seo, Kyoung-Woo;Park, Jun-Kyu
    • Applied Chemistry for Engineering
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    • v.33 no.5
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    • pp.545-550
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    • 2022
  • As a result of the rapid entry into an aging society and westernized eating habits, the number of heart disease patients caused by angina pectoris, myocardial infarction, and high blood pressure has increased by more than 100,000 over five years. Heart disease has consistently ranked second in the cause of death in Korea over the past eight years, and medical expenses consumed annually reach 6 trillion won. While various treatments are being proposed for more patients, drug-coated balloon catheters have been developed and gradually commercialized to solve the disadvantages of stent implantation such as restenosis and increased risk of bleeding due to long-term double antiplatelet medication. In Korea, it began to use a drug-coated balloon catheter with the first release of it called "SeQuent Please (Bibrown Korea)" in 2010. Its demand increased gradually as insurance benefits were applied in 2012. Drug-coated balloon angioplasty is increasing in use not only in Korea but also around the world, especially in the Asia-Pacific region, including Japan. Until now, the demand for domestic products is increasing, and if the efficiency in vivo and clinical trials is proven in the future, it is expected to be an effective procedure compared to high-risk stent implantation.

A Suggestions of Future Direction of the Integrated Community Care Business for Improvement of the Elderly's Life Care (노인의 라이프케어 향상을 위한 지역사회 통합돌봄사업 미래 방향에 대한 제시)

  • Yang, Seung-Hoon
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.8
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    • pp.423-432
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    • 2021
  • In this study, we investigated and the following conclusions are presented by identifying the current status and problems in order to expand the future's value of the community care project introduced and implemented to improve the quality and care for the elderly's life. First, the needs analysis of the elderly receiving services is composed of patient-centered rather than investigator-centered, and in particular, medical management through medical staff visits should be strengthened, and specialized service items according to gender, age, disability type, and personal preference should be strengthened. This will have to be gradually strengthened. Second, by analyzing the satisfaction, redundancy, and effectiveness of service items, we save money, and consider the consumer-oriented service item composition and application of items necessary for new services. Third, through the introduction of an integrated schedule management system, it is necessary to specialize in pre-booking and visit schedule management between the elderly and the direct service organizations that provide services. Fourth, as an effort to solve the financial problem, it is necessary to prepare a rational resource sharing system with health and medical finance, long-term care insurance system, and social welfare financial project. and it may consider that putting the medical personnel who are from local public medical college input. Through these proposals, the community care business will be able to complete and have future value as a universal aged care system.

Trends in Ankyloglossia and Surgical Treatment among Pediatric Patients in South Korea (국내 소아청소년 환자에서의 혀유착증 진단과 설소대 수술 시행의 최근 경향)

  • Taehyun Kim;Daewoo Lee;Jae-Gon Kim;Yeonmi Yang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.2
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    • pp.229-238
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    • 2023
  • The objective of this study was to investigate trends in ankyloglossia and its surgical treatment among pediatric patients in South Korea from 2011 to 2020. Data from Health Insurance Review and Assessment Service (HIRA)'s Healthcare Bigdata Hub were used for analysis of the ankyloglossia diagnosis rate and frenum surgery rate. Considering annual population change, crude rates per 100,000 were calculated and analyzed. To investigate other factors of frenum surgery incidence besides gender and age, pediatric patient sample data from HIRA were used. The diagnosis rate of ankyloglossia increased from 204.4 in 2011 to 356.6 per 100,000 people in 2020, while the frenum surgery rate increased from 26.8 to 34.3 per 100,000 people. Males were more likely to receive frenum surgery than females. Surgeries were more likely to be done at a hospital instead of a clinic or a general hospital. In the age group of 0 - 4 years, the largest number of frenum surgeries were performed in pediatrics, and in the age group of 5 - 9 years, the largest number of surgeries were conducted in pediatric dentistry. In the older age groups, the largest proportion of frenum surgeries were performed in the departments of conservative dentistry and oral and maxillofacial surgery. The diagnosis of ankyloglossia and the operation of frenum surgery among South Korean children increased during the last decade. Since the function of the tongue can affect maxillofacial development in many aspects, pediatric dentists should pay more attention to the functional management of intraoral soft tissue in growing children.

Blood Collection Workload and Safety of Medical Technologists at Korean Hospitals (한국 의료기관에서 임상병리사의 채혈 업무 현황과 안전 실태 조사)

  • Sung-Bae PARK;Suk JEKAL;Weon Joo HWANG;Do Wang LEE;Choong Won SEO;Sunghyun KIM
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.3
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    • pp.159-166
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    • 2023
  • This study investigates the current situation of medical technologists for blood collection, which is considered the most important step for diagnosis. The survey enrolled 650 medical technologists working in hospitals and medical check centers in Busan, Ulsan, and Gyeongnam. We found that each medical technologist performed blood collection for about 100 patients. There was more than one blood collection failure per day, with more than one case of pain and filing of civil complaints per year. Hence, there was a high work burden on the medical technologists. Cases where a medical technologist was stabbed with a used needle occurred more than once a year, and about 15% of them received infection control and treatment because of stab wounds. Additionally, more than half of the participants suffered from musculoskeletal disorders and mental stress due to blood collection work. Unlike administering intravenous and intramuscular injections using the same needle, no fee is charged for blood collection. Based on the results of this study, it will be possible to improve the safety and rights of medical technologists by calculating the actual fee for blood collection work and assigning a relative value score.

A Study on Satisfaction of Service by the Models of Informal-formal Resources Linkages for Long-term Care Elder (장기요양대상노인의 비공식적·공식적 자원연계 유형에 따른 서비스 만족도 연구)

  • Kim, Geum-Yeol
    • 한국노년학
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    • v.30 no.4
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    • pp.1027-1044
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    • 2010
  • This study is to examine the effective system for providing services for long-term care elders, despite the expansion of formal care, informal care still is needed. Thus, this study's purpose is to classify the informal-formal resources linkages types of long-term care elders and looks into service satisfaction by these types and discover effective informal-formal resources linkages models. For that, this study is to divide informal-formal resources linkages types by the degree of providing services of informal and formal caregivers and discover the informal-formal resources linkages types using cluster analysis and explores the effectiveness of service satisfaction using multiple regression. The study's results is to suggest four models, such as family care, complementary, separation, formal service and complementary type was founded to be the most effective and then based on the result, we discuss as follows. First, we must strive to combine informal resources into formal service systemto the system for providing of service is made up the complementary type. Second, the system for providing services of long-term care elders is required integrated care system to alining of medical and long-term care services. Third, we have to consider a measure to improve of formal service type, for the satisfaction of formal service appears low relatively. Based on research findings, this study propose that the informal-formal resources linkages models are subdivided into the dimension of quantity and quality of care for improving the effectiveness of long-term care services.

The Rehabilitation of Gambling Addiction: Comparison with the other psychiatric disorder (도박중독의 재활: 타 정신장애와의 비교)

  • Heung-Pyo Lee;Tae-Woo Kim
    • Korean Journal of Culture and Social Issue
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    • v.16 no.3
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    • pp.241-265
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    • 2010
  • This study reviewed the present state and differences of rehabilitation programs of the gambling addiction by comparing with other psychiatric disorder(including psychotic disability and alcohol addiction). This study also intended to suggest necessities, meanings and inherent fields of the rehabilitation in gambling addiction. First of all, the government and a few gambling industries run clinic centers for gamblers and their families, but have been lacked rehabilitation services for social comeback and adaptation or devaluated rehabilitation services than therapies. Gambling addict didn't have impairments of the cognitive function and their daily abilities was better than any other psychiatric disorders. But Damage of social role or function of gambling addiction was severe. And it is caused by nonadaptive nature of gambling behavior, personality/emotional change through gambling addiction process, and previous personality problem etc. There are many severe failure of social role and its attendant bankrupcy, family's problems and social poverty in gambling addiction, Therefore, important fields in the rehabilitation of gambling addiction should be services for basic social comeback support service, credit recovery support, monetary management, support of rehabilitation of family and vocational rehabilitation. Finally, the significance and critical points of the current study has been discussed as well.

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