• Korean Journal of Clinical Pharmacy
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• v.9 no.2
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• pp.109-118
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• 1999

The need for and components of a contemporary community pharmacy externship for pharmacy students have not been clearly identified in Korea. Mail survey was performed among 20 college of pharmacy deans and 800 community pharmacists to analyze the current status and develop a consensus regarding major focus area and criteria of community pharmacy externship to be implemented under the separation of dispensary from medical practice in year 2000. Mail survey yielded $80\%\;and\;23.5\%$ response rate for pharmacy school deans and community pharmacists, respectively. Of the 16 pharmacy schools that responded 14 said they have externship program in hospital pharmacy, and only 8 pharmacy schools responded of having externship program for community pharmacy. However, these community pharmacy programs lacked criteria and standard guideline for the externship. The results of survey revealed that community pharmacy externship program for students should be organized and directed toward developing expert knowledge and skills in pharmacy practice activities, clinical services, communications, pharmacy management, and professionalism. Pharmacy practice components should include competencies and skills in computer application, prescription processing, dispensing, pharmaceutical compounding, Narcotics Control Law application, maintenance and provision of drug information, and laws and regulations. Clinical service components should include the ability to identify patient's drug-related problems, provide long-term patient care and appreciate drug therapy services. Communication skills should be taught to effectively express his/her professional opinion, deduce the needs of others, utilize appropriate techniques and media to communicate ideas and conduct a patient interview and to obtain patient drug history. Pharmacy management skills should be taught to be efficient in medical insurance and drug control process. It was found that professionalism, morality, pharmacy practice experience, ability to provide clinical services, collect and provide drug information and regality are important criteria of preceptors. Externship sites should possess the ability to stock various drugs, access and provide diverse pharmacy services and should have private patient counseling area. Most pharmacists agreed that top 200 drugs' generic and brand name, indications, dosage, side effects, and contraindication should be instructed during the externship. It was also found that student and preceptor should be evaluated for their performances during the externship. This information will be incorporated into teaming objectives for students and to develop Academic Extemship Program Guidelines.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.326-335
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• 2015

Background: Asian dust is known to have harmful effects on the respiratory system. Respiratory conditions are also influenced by environmental conditions regardless of the presence of pollutants. The same pollutant can have different effects on the airway when the air is dry compared with when it is humid. We investigated hospital visits for chronic obstructive pulmonary disease (COPD) and asthma in relation to the environmental conditions. Methods: We conducted a retrospective study using the Korean National Health Insurance Service claims database of patients who visited hospitals in Chuncheon between January 2006 and April 2012. Asian dust, haze, mist, and fog days were determined using reports from the Korea Meteorological Administration. Hospital visits for asthma or COPD on the index days were compared with the comparison days. We used two-way case-crossover techniques with one to two matching. Results: The mean hospital visits for asthma and COPD were $59.37{\pm}34.01$ and $10.04{\pm}6.18$ per day, respectively. Hospital visits for asthma significantly increased at lag0 and lag1 for Asian dust (relative risk [RR], 1.10; 95% confidence interval [CI], 1.01-1.19; p<0.05) and haze (RR, 1.13; 95% CI, 1.06-1.22; p<0.05), but were significantly lower on misty (RR, 0.89; 95% CI, 0.80-0.99; p<0.05) and foggy (RR, 0.89; 95% CI, 0.84-0.93; p<0.05) days than on control days. The hospital visits for COPD also significantly increased on days with Asian dust (RR, 1.29; 95% CI, 1.05-1.59; p<0.05), and were significantly lower at lag4 for foggy days, compared with days without fog (RR, 0.85; 95% CI, 0.75-0.97; p<0.05). Conclusion: Asian dust showed an association with airway diseases and had effects for several days after the exposure. In contrast to Asian dust, mist and fog, which occur in humid air conditions, showed the opposite effects on airway diseases, after adjusting to the pollutants. It would require more research to investigate the effects of various air conditions on airway diseases.

• Child Health Nursing Research
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• v.21 no.1
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• pp.37-45
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• 2015

Purpose: In this study, a comparison was done of the extent of health-related quality of life (HRQoL) for preterm and fullterm children during early childhood, and factors affecting HRQoL in the early childhood of premature children were analyzed. Methods: Eighty mothers of children born prematurely and 83 mothers of children born at fullterm listed on two Internet cafes were sampled for this study. The major instrument used for the study was the TNO-AZL Preschool Quality Of Life (TAPQOL) questionnaire. Results: Total score for HRQoL in the premature group was 80.5 (${\pm}9.9$) and for the full term group, 85.0 (${\pm}8.3$), on a 100-point scale. A comparison of the premature group and full term group showed that the domains which scored relatively lower with respect to HRQoL included the stomach, motor function, anxiety, liveliness and communication. Among the factors that have an impact on HRQoL were 'length of stay in neonatal intensive care unit (${\geq}7$ days)' and 'birth weight (<1,000 gm)'. The explanation power of the model was 17%, which was statistically significant. Conclusion: These findings indicate that a differentiated premature infant follow-up program for children who are hospitalized over 7 days in NICU or weighed under 1,000g at birth is urgently needed.

• Korea Journal of Hospital Management
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• v.22 no.4
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• pp.33-49
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• 2017

Background: Health care utilizations and costs of the patients with degenerative lumbar spine disease in Korea increased dramatically. We analyzed whether hospital market competition is associated with charges and length of stay for patients with degenerative lumbar spine disease. Methods: We used Medical claims data of 2002 and 2010 from the nationwide representative sample of National Health Insurance Service of Korea. The study subjects were inpatients with degenerative lumbar spine disease (N=24,768) in 2002 and 2010. We employed a multilevel linear mixed model that included patient- and hospital-level variables in hierarchical data. Results: Higher hospital competition was associated with lower charges (${\beta}=57.5$, p<.0001 in 2002; ${\beta}=353.7$, p<.0001 in 2010) and shorter length of stay (${\beta}=0.3$, p<.0001 in 2002; ${\beta}=0.9$, p<.0001 in 2010) in both 2002 and 2010. Compared to 2002, the magnitude of such association became greater in 2010. However, subgroup analyses show that the influence of competition on charges and length of stay differed by hospital size. Conclusions: This study showed that hospital market structure (e.g., hospital competition) affects hospital efficiency (i.e., hospital charges and length of stay). It is necessary to continue to monitor how changing market structure influences hospital outcomes, including more detailed outcomes such as patient satisfaction.

• Clinical Psychopharmacology and Neuroscience
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• v.16 no.4
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• pp.398-406
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• 2018

Objective: Hospitalization of patients with delirium after visiting the emergency department (ED) is often required. However, the readmission risk after discharge from the ED should also be considered. This study aimed to explore whether (i) immediate hospitalization influences the readmission risk of patients with delirium; (ii) the readmission risk is affected by various risk factors; and (iii) the healthcare cost differs between groups within 28 days of the first ED visit. Methods: Using the National Health Insurance Research Database, the data of 2,780 subjects presenting with delirium at an ED visit from 2000 to 2008 were examined. The readmission risks of the groups of patients (i.e., patients who were and were not admitted within 24 hours of an ED visit) within 28 days were compared, and the effects of the severities of different comorbidities (using Charlson's comorbidity index, CCI), age, gender, diagnosis and differences in medical healthcare cost were analyzed. Results: Patients without immediate hospitalization had a higher risk of readmission within 3, 7, 14, or 28 days of discharge from the ED, especially subjects with more severe comorbidities ($CCI{\geq}3$) or older patients (${\geq}65years$). Subjects with more severe comorbidities or older subjects who were not admitted immediately also incurred a greater healthcare cost for re-hospitalization within the 28-day follow-up period. Conclusion: Patients with delirium with a higher CCI or of a greater age should be carefully considered for immediate hospitalization from ED for further examination in order to reduce the risk of re-hospitalization and cost of healthcare.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.34 no.1
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• pp.112-135
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• 2021

Objectives : To report a case of drug-induced xerostomia treated with Integrative Korean Medicine Visiting Care Service of a Public Health Center. Methods : Home visit treatment and telemedicine were provided by public health doctor(Korean medicine doctor) for person with physical disability who were diagnosed with Behcet's Disease. Palmul-tang(PMT) soft extract was provided steadily 3 times a day for 6 months, and acupuncture, electro-acupuncture, and electro-moxibustion were provided irregularly 6 times for 6 months. Yin-deficiency questionnaire(YDQ), oral health impact profile-14(OHIP-14), oral pain visual analogue scale(VAS), and xerostomia inventory(XI) were used 3 times(baseline, intermediate and termination) to evaluate the changes. Results : YDQ decreased from 620 to 375, OHIP-14 decreased from 34 to 6, VAS decreased from 70 to 40, and XI decreased from 44 to 34. Four scales all gradually decreased. Conclusions : Integrative Korean Medicine Treatments in health insurance including PMT soft extract through home visit treatment can improve drug-induced xerostomia and Quality of life(QoL) of person with disabilities.

• The Journal of the Korea Contents Association
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• v.22 no.3
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• pp.354-360
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• 2022

Metabolic disease is a disease with a prevalence of 26% in Korean, and has three of the five states of abdominal obesity, hypertension, hunger glycemic disorder, high neutral fat, and low HDL cholesterol at the same time. This paper links the consumer panel data of the Rural Development Agency(RDA) and the medical care data of the National Health Insurance Service(NHIS) to generate a classification model that can be divided into a metabolic disease group and a control group through food consumption characteristics, and attempts to compare the differences. Many existing domestic and foreign studies related to metabolic diseases and food consumption characteristics are disease correlation studies of specific food groups and specific ingredients, and this paper is logistic considering all food groups included in the general diet. We created a classification model using regression, a decision tree-based classification model, and a classification model using XGBoost. Of the three models, the high-precision model is the XGBoost classification model, but the accuracy was not high at less than 0.7. As a future study, it is necessary to extend the observation period for food consumption in the patient group to more than 5 years and to study the metabolic disease classification model after converting the food consumed into nutritional characteristics.

• Therapeutic Science for Rehabilitation
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• v.12 no.1
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• pp.65-78
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• 2023

Objective : The typical decline in function due to aging includes limitations in vision, hearing, cognitive function, and activities of daily living. Therefore, this study evaluated the mediating effect of cognitive function on the relationship between vision and hearing and activities of daily living. Methods : The participants in this study were 36,767 persons from the long-term care database on older adults provided by the National Health Insurance Sharing Service. The extracted variables were: (i) independent variables: visual and hearing; (ii) dependent variables: basic and instrumental daily living activities; and (iii) mediator variables: cognitive function. Regression analysis was performed evaluate the mediating effects of the extracted variables. Results : Cognitive function showed a mediating effect of 30% on the relationship between vision and basic daily life activities and 42% in the relationship with instrumental daily life activities. The mediating effect was 50% in the relationship between hearing and basic activities of daily living, and 53% in the relationship with instrumental activities of daily living. Conclusion : Prevention programs for functional decline due to aging are in progress in Korea. Based on the results of this study, establishing a prevention program would help promote successful aging.

• The Journal of the Convergence on Culture Technology
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• v.9 no.5
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• pp.669-674
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• 2023

This study examined the specific contents of social welfare policies of the Joseon Dynasty through the analysis of Mokminsimseo, Aemin Sixjo and Jinhwang Yukjo, and identified the connection between them and today's social welfare policies. As a result, In the Care of the People, it contained the basic contents of the Elderly Welfare Act and welfare services for the elderly, and in the Freedom, it included welfare policy services related to infants and children, and the value system of welfare for the disabled through government affairs. The policy direction was confirmed, and it was found that disaster relief calls for social integration in response to social crises and disasters. This also confirmed that major areas of social welfare policy such as family safety, income security, health policy, and social integration have been emphasized through social welfare policy indicators. In addition, through the analysis of Qinhwangyukjo, it was found that it contains not only the basic ideology and values of the social security system and social insurance system in terms of visa, scale, and power, but also the details of specific policy implementation. Today's social welfare policies and social service policies, which are equipped with social welfare facilities and are implementing systematic social welfare services for each target, were able to confirm their foundation through the Qinhwangyukjo. This confirms that the emphasis on social integration and income security is prominent in the Qinhwangyukjo through the social welfare policy indicators of the current policy system.

• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.70-79
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• 1999

This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.