• Health Policy and Management
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• v.25 no.1
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• pp.3-10
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• 2015

Background: Previous studies showed differences in healthcare utilization among insurance types. This study aimed to analyze the difference in healthcare utilization for percutaneous transluminal coronary angioplasty inpatients by insurance types after controlling factors affecting healthcare utilization using propensity score matching (PSM). Methods: The 2011 national inpatient sample based on health insurance claims data was used for analysis. PSM was used to control factors influencing healthcare utilization except insurance types. Length of stay and total charges were used as healthcare utilization variables. Patients were divided into National Health Insurance (NHI) and Medical Aid (MA) patients. Factors representing inpatients (gender, age, admission sources, and Elixhauser comorbidity index) and hospitals (number of doctors, number of beds, and location of hospitals) were used as covariates in PSM. Results: Tertiary hospitals didn't show significant difference in length of stay and total charges after PSM between two insurance types. However, MA patients showed significantly longer length of stay than that of NHI patients after PSM in general hospitals. Multivariate regression analysis provided that admission sources, Elixhauser comorbidity index, insurance types, number of doctors, and location of hospitals (province) had significant influences on the length of stay in general hospitals. Conclusion: Study results provided evidences that healthcare utilization was differed by insurance types in general hospitals. Health policy makers will need to prepare interventions to influence the healthcare utilization differences between insurance types.

• The Journal of Korean Institute of Communications and Information Sciences
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• v.31 no.4B
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• pp.270-277
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• 2006

In the wireless adaptive modulation and coding(AMC) systems, the modulation type of user's connection can be changed dynamically. and the ongoing connection might fail due to the change of modulation. In this paper, we approach the AMC-induced CAC problem by focusing on the guaranteed connection. Three kinds of calls, new, handoff, and modulation-changed calls, are considered. We propose a modified guard channel CAC scheme that allows the modulation-changed and handoff calls to use the guard channel. Then we analyze a Markov model for the CAC scheme with long-term AMC in mind. According to the simulation results, the proposed approach reduces the call dropping probability for modulation-changed calls, which suggests the threshold of guard channels can be determined based on the proposed approach.

• Journal of Communications and Networks
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• v.10 no.3
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• pp.287-296
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• 2008

The IEEE 802.11 wireless standard uses the carrier sense multiple access with collision avoidance (CSMA/CA) as its MAC protocol (during the distributed coordination function period). This protocol is an adaptation of the CSMA/CD of the wired networks. CSMA/CA mechanism cannot guarantee quality of service (QoS) required by the application because orits random access method. In this study, we propose a new MAC protocol that considers different types of traffic (e.g., voice and data) and for each traffic type different priority levels are assigned. To improve the QoS of IEEE 802.11 MAC protocols over a multi-channel CSMA/CA, we have developed a new admission policy for both voice and data traffics. This protocol can be performed in direct sequence spread spectrum (DSSS) or frequency hopping spread spectrum (FHSS). For voice traffic we reserve a channel, while for data traffic the access is random using a CSMA/CA mechanism, and in this case a selective reject and push-out mechanism is added to meet the quality of service required by data traffic. To study the performance of the proposed protocol and to show the benefits of our design, a mathematical model is built based on Markov chains. The system could be represented by a Markov chain which is difficult to solve as the state-space is too large. This is due to the resource management and user mobility. Thus, we propose to build an aggregated Markov chain with a smaller state-space that allows performance measures to be computed easily. We have used stochastic comparisons of Markov chains to prove that the proposed access protocol (with selective reject and push-out mechanisms) gives less loss rates of high priority connections (data and voices) than the traditional one (without admission policy and selective reject and push-out mechanisms). We give numerical results to confirm mathematical proofs.

• Journal of Acupuncture Research
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• v.20 no.3
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• pp.75-85
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• 2003

Objective : The main purpose of this research is to make a survey of the effective way of the Korean traditional medical care about Industrial accidental patients. Methods : In following research, 40 cases of industrial accidental patients who hospitalized in the Dong-Shin Korean Traditional Medicine Hospital from January 1, 1996 to October 21, 2002 were surveyed. Results : 1. The highest incidence was shown in the age of twenties to fifties as much as 92.5% and the ratio of malr to female was 35:5. 2. The highest type in the industrial is professional negligences. 3. The number of patients via other hospital(82.5%) was much than that of the first visitor to our hospital(17.5%) 4. In admission motives, the patients who had been treated by western medical treatment expressed the dissatisfaction of that treatment, so hoped to be treated by oriental medical styles. 5. CVA was 47.5%, disease of sinews and bones system was 52.5%. 6. Hemiplegia(47.5%) was the most frequent out of all CVA patients symptoms, back pain(32.5%) was the commonest pain region of all the condition of sinews and bones system. 7. At first stage of admission period, Acupunture and Herb-medication was frequently prescribed for hwalhyultonglakgige, but as going to end stage was frequently used for bogi, bohyul, gudam and ansingige. 8. The treatment methods which was used for treating industrial accident was acupunture, cupping therapy, physical therapy.

• Clinical and Experimental Pediatrics
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• v.54 no.1
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• pp.11-16
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• 2011

Purpose: Enterovirus 71, one of the enteroviruses that are responsible for both hand-foot-and-mouth disease and herpangina, can cause neural injury. During periods of endemic spread of hand-foot-andmouth disease caused by enterovirus 71, CNS infections are also frequently diagnosed and may lead to increased complications from neural injury, as well as death. We present the results of our epidemiologic research on the clinical manifestations of children with CNS infections caused by enterovirus 71. Methods: The study group consisted of 42 patients admitted for CNS infection by enterovirus 71 between April 2009 and October 2009 at the Department of Pediatrics of 5 major hospitals affiliated with the Catholic University of Korea. We retrospectively reviewed initial symptoms and laboratory findings on admission, the specimen from which enterovirus 71 was isolated, fever duration, admission period, treatment and progress, and complications. We compared aseptic meningitis patients with encephalitis patients. Results: Of the 42 patients (23 men, 19 women), hand-foot-and-mouth disease was most prevalent (n=39), followed by herpangina (n=3), upon initial clinical diagnosis. Among the 42 patients, 15 (35.7%) were classified as severe, while 27 (64.3%) were classified as mild. Factors such as age, fever duration, presence of seizure, and use of intravenous immunoglobulin (IVIG) were statistically different between the 2 groups. Conclusion: Our results indicate that patients with severe infection caused by enterovirus 71 tended to be less than 3 years old, presented with at least 3 days of fever as well as seizure activity, and received IVIG treatment.

• Health Policy and Management
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• v.21 no.4
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• pp.617-642
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• 2011

The purpose of our study is to analyze the determinants of the benefits of the long-term care insurance in Korea using 2008 and 2009 cross-sectional data. Per capita long-term care insurance benefits can be divided into home care services utilization rate, institutional care services utilization rate, per capita home care services benefits, and per capita institutional care services benefits, which are used as the dependent variables in our regression analysis. Admission rate and the ratio of the admitted to the applicant also used as the dependent variables. The results of our analysis show that the explanatory variables such as income level, needs for care, family type, access to the services, and regional characteristics are statistically significant to explain the dependent variables, the long-term care insurance benefits. The higher is the regional income and the more of the female residents, the more are the long-term care insurance benefits. The easier is the access to the services, the more are the insurance benefits. In the rural area, the level of the insurance benefits is relatively high. We propose that copayment rates of the long-term care insurance should be examined and monitoring on the over-use of the services should be done. Also preventive services and care by the family member should be expanded.

• Journal of the Korean Society for Aeronautical & Space Sciences
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• v.39 no.8
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• pp.735-743
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• 2011

In this study, the distribution of surface pressure was measured in a steady state on a turbine blade which was moved the injected region and receded the stagnation region using a linear cascade apparatus. Axial-type blades were used and the blade chord was 200mm. The rectangular nozzle was applied and its size was $200mm{\times}200mm$. The experiment was done at $3{\times}10^5$ of Reynolds number based on the chord. The surface pressures on the blade were measured at three different nozzle angles of $58^{\circ}$, $65^{\circ}$ and $72^{\circ}$ for off-design performance test. In addition, three different solidities of 1.25, 1.38 and 1.67 were applied. From the results, the low solidity caused the low pressure on the blade suction surface at entering region and the reverse rotating force was generated at the low nozzle angle. The positive incidence also made the pressure lower on the suction surface at entering region.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.18 no.1
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• pp.32-39
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• 2011

Purpose: The purpose of this study was to investigate treatment types and the status of referral to home care services for patients with diabetic foot. Methods: A retrospective survey was conducted by reviewing medical records from January to December in 2008 at a university hospital. The subjects were 76 patients at the age of 20 years or older who were admitted, had home care services, or received outpatient care for diabetic foot. The data were analyzed using descriptive statistics. Results: Among the total of 9,317 patients diagnosed with diabetes, 5.03% (n=469) had diabetic foot. Admission (81.6%) was the most frequently used treatment type followed by outpatient care only (7.9%) and hemodialysis only (10.5%). Of the 76 admission cases, 44.9% received post-discharge care at outpatient clinics, 20.5% had both outpatient and home care services, and 16.7% were transferred to other hospitals. Readmission rate after discharge was 15.6% for one year. Conclusion: This study suggests referral to home care services should be encouraged to provide effective follow-up care to patients with diabetic foot after discharge from a hospital.

• Physical Therapy Korea
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• v.14 no.3
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• pp.81-89
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• 2007

The purpose of this study was to utilize the K-MBI (Korean Modified Barthel Index) and subscales of K-MBI in predicting the length of hospital stay (LOS) and the discharge destinations for stroke patients. The study population consisted of 97 stroke patients (57 men and 40 women) admitted to the Seoul National University at the Bundang Hospital. All participants were assessed by K-MBI at admission and discharge after rehabilitation therapy and the information available was investigated at admission. The data were analyzed by using the Mann-Whitney U test, the stepwise multiple regression and the logistic regression. The median LOS was 30 days (mean, 32.8 days; range, 22 to 43 days). The K-MBI score at initiation of rehabilitation therapy (p<.001), the type of stroke and living habits before a stroke were the main explanatory indicators for LOS (p<.05). Within the parameters of K-MBI measured at initiation for rehabilitation, feeding and chair/bed transfer were the explanatory factors for LOS prediction (p<.01). Confidence in the prediction of LOS was 20%. Significant predictors of discharge destination in a logistic regression model were the discharge K-MBI score, sex and hemiplegic side. Dressing in items of discharge K-MBI was the significant predictor of discharge destination. The K-MBI score was the most important factor to predict LOS and discharge destination. Knowledge of these predictors can contribute to more appropriate treatment and discharge planning.

• Journal of Trauma and Injury
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• v.21 no.2
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• pp.78-84
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• 2008

Purpose: Recently, the incidence of blast injury has been on the increase worldwide. The purpose of this study was to evaluate and analyze blast injuries in South Korea. Methods: This was a retrospective multi-center study of blast injuries in three tertiary military centers. The medical records of patients with blast injuries from January 2003 to December 2007 were reviewed. The injury severity was evaluated according to the Injury Severity Score (ISS), the Revised Trauma Score (RTS), and the Trauma Score and the Injury Severity Score (TRISS). Results: This study revealed epidemiological data of blast injury in the three tertiary military hospital. A total of 94 cases of blast injury had occurred. Various body regions were involved. The most frequently injured site was the upper extremity (52.1%). The mechanisms for the blast injuries were primary (41.5%), secondary (74.5%), tertiary (7.4%), and quaternary (29.8%). The mean injury-to-hospital arrival time was $3.2{\pm}1.7hour$. The rate of admission was 88.3%, and the rate of ICU admission was 32.5%. Thirty-six (36) cases required an emergency operation. Most were performed by an Orthopedist (55.6%), an Ophthalmologist (19.4%), or a general surgeon (13.9%). The mortality rate from blast injury was 4.3%. Conclusion: This was the first paper to present data on the type of injury, the site of injury, the cause of death, and the mortality from blast injury in South Korea. Chest injury, brain injury, tertiary injury mechanisms, $ISS{\geq_-}16$, and a Maximal Abbreviated Injury Scale Score $(ABI){\geq_-}4$ were significantly associated with death.