• Health Policy and Management
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• v.30 no.4
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• pp.479-492
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• 2020

Background: As the prevalence of hypertension is increasing in Korea, the government is seeking policy actions to manage patients with hypertension more efficiently. In this paper, we aimed to identify factors associated with the use of medical care at hospitals among outpatients with hypertension. Methods: We analyzed a total of 15,040 cases of 3,877 outpatients with hypertension obtained from the Korea Medical Panel database from 2010 to 2016. The dependent variable was whether a patient with hypertension visited a hospital or not; and independent variables were the patient's various socio-demographic, health-related, and heath-status characteristics. We conducted a generalized linear mixed model analysis with logit link for all the cases and then conducted it stratified by gender. Results: As a result of a multivariable analysis, women were less likely than to visit at a hospital (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.32-0.61) and people aged 65 years and older than those aged less than 65 years (OR, 0.71; 95% CI, 0.57-0.89). Residents in Busan, Ulsan, and Gyeongnam were more likely than those in than Seoul, Gyeonggi, Incheon, and Jeju to visit a hospital (OR, 1.40; 95% CI, 1.05-1.86). The likelihood of visiting a hospital was high in people belonging to a group of: the highest level of annual household income (OR, 1.73; 95% CI, 1.30-2.29); Medical care aid recipients (OR, 1.94; 95% CI, 1.34-2.83); people having three or more complex chronic diseases (OR, 1.59; 95% CI, 1.19-2.11); people having diabetes (OR, 1.81; 95% CI, 1.41-2.32); or people having ischemic heart disease or cerebrovascular disease (OR, 6.80; 95% CI, 5.28-8.76). Also, we found that factors associated with the use of medical care at hospitals among outpatients with hypertension differed between genders. Conclusion: A variety of factors seem to be associated with the use of medical care at hospitals among outpatients with hypertension. Future research needs to find a way to help patients with hypertension visit an appropriate medical institution between clinics and hospitals.

• Journal of Chest Surgery
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• v.51 no.1
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• pp.22-28
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• 2018

Background: Lung transplantation is a life-saving procedure in patients with end-stage lung disease, and is increasingly performed in Korea. Methods: We retrospectively evaluated the outcomes of patients who received a lung transplant at Asan Medical Center between January 2008 and December 2016. Thirteen of 54 patients experienced multiorgan transplantation; the remaining 41 who received only lung grafts were included. Results: The mean age of the lung transplant recipients was 44.6 years; 27 were men and 14 were women. The most frequent reasons were idiopathic interstitial pneumonia (21 of 41 patients, 51.2%), interstitial lung disease (9 of 41, 22.0%), and bronchiolitis obliterans after bone marrow transplantation (7 of 41, 17.1%). The median waiting time was 47 days, and many patients received preoperative intensive care (27 of 41, 65.9%), ventilator support (26 of 41, 63.4%), or extracorporeal life support (19 of 41, 46.3%). All 41 patients received bilateral lung grafts. Ten deaths occurred (24.3%), including 5 cases of early mortality (12.2%) and 5 cases of late mortality (12.2%). The 1-, 3-, and 5-year survival rates were 78.9%, 74.2%, and 69.3%, respectively. Conclusion: Despite a high percentage of patients who required preoperative intensive care, the transplantation outcomes were acceptable.

• Journal of Korean society of Dental Hygiene
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• v.13 no.6
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• pp.995-1004
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• 2013

Objectives : The purpose of the study is to provide basic data for oral health promotion in national basic livelihood security. Methods : The data were extracted from the 4th National Health and Nutrition Survey (2007-2009) in Korea. The data were analyzed using SPSS 18.0. to $x^2$-test and CSGLM. Results : 1. The subjects were not able to receive dental treatment because of the financial difficulty. 2. The infuencing factors of DMFT include gender (p<0.05), type of health insurance (p<0.05), membership for private health insurance (p<0.05), frequency of toothbrushing (p<0.05), use of oral hygiene products (p<0.01), smoking (p<0.05), drinking (p<0.05). The influencing factors of CPI include gender (p<0.01) and smoking (p<0.05). The influencing factors of fixed bridge include age (p<0.05), income (p<0.05) and use of accessory oral hygiene products (p<0.05). The influencing factors of fixed bridge include age (p<0.001), income (p<0.01), education (p<0.001), type of health insurance (p<0.001), membership for private health insurance (p<0.001), frequency of toothbrushing (p<0.01), use of oral hygiene products (p<0.01), and drinking (p<0.05). Conclusions : It is necessary to provide oral health care and health promotion to the recipients of National basic livelihood security. The government must give them better quality of dental health care in the near future.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.8
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• pp.5430-5441
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• 2015

The purpose of this study is to investigate the effect of Medicaid case management (CM) performed by Medicaid case managers on health management and to examine the overall health care utilization with high risk Medicaid beneficiaries. The subjects involved in this research were 113 Medicaid beneficiaries who were recipients CM in Y-gu between October 1st, 2012 and March 31th, 2013. The results show that there were significant differences in 'recognition of own disease', 'understanding of Medicaid policy', 'medication' and 'healthy lifestyle'. Also there were significant differences in 'appropriateness of health utilization', 'number of medical institutions', 'level of social isolation' and 'general health status'. In addition, significant differences were found in Medicaid days, outpatient days, medication days and Medicaid costs. It was found that the Medicaid CM had a positive effect on health care utilization. The study suggests the need of strengthening and diversifying Medicaid CM as well as supporting the management and monitoring after the termination of Medicaid CM.

• Korea Journal of Hospital Management
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• v.21 no.2
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• pp.37-49
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• 2016

The purpose of this study is to investigate the level of competition between Public Health Centers (PHCs) and private clinics (PCs) by examining the number of patients that used PHCs vs. PCs, estimating the total amount of revenue generated from outpatient services at both PHCs and PCs, thereby analyzing the financial impacts on PCs derived from the PHCs. We utilized 2011 National Inpatient Sample data (NIS). Using the 20 table containing general information on each individual claims, we integrate it with the 40 table which contains all the diagnostic codes for each claim. Then, we disaggregate the bundled claims into the original individual claims. Overall, 3.1% of outpatient visits are made at PHCs while the rest was made at the PCs (96.9%). Among the total claim costs of 6.34 billion USD (as of 2011), PHCs occupy 2.0% (124 million USD), and 98.0% are contributed to PCs (6.21 billion USD). The estimated economic losses of PCs due to PHCs are summarized as follow; the maximum potential loss is estimated at 198 million USD in total and 7,099 USD per clinic when we include all patient types; the minimum loss is estimated at 71 million USD in total and 2,540 USD per clinic where Medical Aid recipients and the elderly (aged 65 and over) are excluded. Our results confirm the potential economic effect on PCs due to PHCs providing outpatient services. PCs and PHCs are the most important players providing primary care in Korea. Unnecessary competition between PCs and PHCs is not desirable. Health authorities should carefully examine the healthcare services currently provided by PHCs and their impacts on PCs.

• Perinatology
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• v.28 no.2
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• pp.47-58
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• 2017

Objective: We evaluated the Korean mothers' level of awareness of human milk bank (HMB) in order to find out the issues in establishing HMB in Korea. These mothers had infants younger than 18 months old to find out the issues that would help establishment of HMB in Korea. Methods: The survey questionnaire was developed by a team composed by nurses, neonatologists, obstetricians, nutritionists, health care specialists and faculty members. The internet survey was performed by sending emails to mothers who are registered to M family members and have children younger than 18 months. In total, 864 questionnaire were gathered from 114,469 answers and the results were analyzed. Results: Fifty two point eight percent of the respondents had awareness of HMB. 79.4% of subjects agreed with the necessity of HMB. On the basis of multivariate logistic regression analysis, we found that the numbers of children, awareness of HMB, the concern on the HMB in Korea, and the expected problems in establishing HMB in Korea were significant factors when evaluating the necessity of HMB in Korea. The common factors associated with positive thinking of potential users, donors and recipients were the awareness of HMB, and the experience of feeding own breast milk to other's babies. Conclusion: More than half of Korean women were found to agree with the necessity of HMB in Korea, even though they had concern on infection controls and management of HMB and the purpose and function of HMB was not widely educated. The establishment of HMB in Korea would be effective with public education and considering their demands.

• Korea Journal of Hospital Management
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• v.22 no.3
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• pp.1-17
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• 2017

Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.

• The Korean Journal of Health Service Management
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• v.10 no.2
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• pp.121-131
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• 2016

Objectives : The purpose of this study was to analyze the status of oral health in relation to the acknowledgement of oral health trouble and oral health habits. Methods : This study was conducted after IRB was received, on 273 patients who had received health screenings between October-1, 2014 and January-31, 2015 at a general hospital in Busan. Results : Regarding the status of oral health in relation to the acknowledgement of oral health trouble, the rates of dental caries and periodontal disease were higher when the patients knew the reasons for trouble about the oral hygiene. With regard to oral health habits, our results showed that the more frequently the patients ate sugary snacks per day, the probability of experiencing periodontal disease was higher than for the patients who did not eat sugary snacks. Our results also, showed that the occurrence of dental caries is very much dependent upon whether a patient had experienced education on toothbrushing. Conclusions : Patients need to become more aware of their oral health through education. A program that emphasizes the importance of preventive oral health behaviors and the maintenance of correct oral health behavior should be developed.

• Journal of Korean Academy of Nursing
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• v.44 no.5
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• pp.534-541
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• 2014

Purpose: This study was done to examine the actual state of influenza vaccination among pregnant women and factors affecting vaccination rate. Methods: Data were collected using self-report questionnaires. Participants were pregnant women who participated in a prenatal education program at an acute care hospital in 2013. Data collected from 218 pregnant women were analyzed using the SPSS 18.0 Program. Results: Only 48.6% of the pregnant women had received vaccination when the influenza was prevalent. Statistically significant factors affecting the influenza vaccination rate among pregnant women were vaccination experience in the previous year, knowledge and attitude about vaccination, and gestation period. Conclusion: Results indicate that the influenza vaccination rate among pregnant women is lower than that of elders, healthcare workers, and patients with chronic diseases, who have been considered to be the mandatory vaccination recipients. Therefore, it is necessary to develop programs and policies which provide information including safety of vaccines for pregnant women and to induce positive attitudes towards vaccination for these women, in order to ultimately improve the vaccination rate.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.4
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• pp.43-52
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• 2019

Purpose: This study aimed to analyze the affecting factors related to cancer screening for persons with disabilities. Methods: We examined the factors affecting cancer screening in individual aged older than 20 years who participated in the 2017 National Survey of the Disabled. The subjects were 6031 individuals with disabilities who were aged older than 20 years. Data were analyzed using descriptive statistics, the chi-square test, and multiple logistic regression with the SPSS Win 21.0 software. Results: Cancer screening among persons with disabilities is differentiated based on age, education level, marital status, type of disability, grade of disability, subjective house economic status, health insurance, chronic disease, unmet healthcare needs, suicidal thinking, and health screening. The significant predictors of health screening were age, marital status, chronic disease, and health screening. Conclusion: Based on the results of this study, it is necessary to develop a program for young, medical care recipients to improve the participations of disabled in cancer screening.