• 한국임상약학회지
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• 제29권4호
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• pp.278-285
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• 2019

Background: Rheumatoid arthritis is highly prevalent in overweight patients with type 2 diabetes mellitus and can be reduced by physical activity via altered proinflammatory parameters. However, the association between the frequency of physical activity and the prevalence of rheumatoid arthritis in prediabetic patients remains unclear and was evaluated in this study. Methods: Utilizing the Korean National Health Insurance Sharing Service database, 58,391 adults, who met the research criteria and underwent a general medical check-up between 2009 and 2013, were selected for this study. To analyze the data, a logistic regression with a proc survey logistic procedure was used. Results: The study revealed that the cumulative rheumatoid arthritis prevalence was lower in prediabetic patients compared to that in the control group (OR, 0.64; 95% CI, 0.483-0.840; p=0.001). More frequent physical activity (≥3 days/week) was significantly associated with a reduced rheumatoid arthritis prevalence in both groups (OR, 0.28; 95% CI, 0.039-0.521; p=0.044 vs. OR, 0.15; 95% CI, 0.063-0.237; p=0.007). Additionally, a 3.8-fold higher risk of rheumatoid arthritis development was observed in prediabetic adults with less frequent baseline physical activity (≤2 days/week). Overall, in prediabetes, the prevalence of rheumatoid arthritis was associated with the frequency of physical activity and not with the fasting plasma glucose levels. Conclusion: More frequent physical activity is associated with a low risk of developing rheumatoid arthritis in prediabetic patients. Thus, further studies are needed to confirm the clinical outcomes of frequent physical activity in rheumatoid arthritis prevention and control.

• 한방재활의학과학회지
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• 제27권2호
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• pp.67-75
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• 2017

Objectives The study of the clinical effects of traditional east asian medicine (TEAM) using Taiwan national health insurance claim dataset (NHIRD) is useful in Korean Medicine research. We reviewed the clinical studies of TEAM using NHIRD as a whole through this study. Methods We comprehensively searched PUBMED and NHIRD DB for clinical effects of TEAM study using NHIRD from inception to 17, January 2017. As a result, 40 studies investigating the contribution of TEAM intervention to health benefit have been confirmed. We analyzed publication time, target disease, sample size, outcome measurement and main result of 40 searched studies. Results The number of TEAM studies using NHIRD grdually increasing. The topics of the team study using NHIRD covered a wide range of subjects including cardiovascular disease, tumor, gynecological disease, diabetes and kidney disease. The studies have shown large samples and reported significant effects on severe diseases. Conclusions The results of this study suggest that the study of Korean Medicine using Big data will be useful for decision making related to health care in Korea. However, considering the limited domestic Korean health insurance data, it will be necessary to activate the big data research of Korean Medicine through the establishment of a separate cohort in Korea.

• Journal of Preventive Medicine and Public Health
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• 제33권4호
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• pp.383-392
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• 2000

Objective : We have reviewed the potential cancer preventive and other relevant properties of Panax ginseng C. A. Meyer, which has been traditionally used as a natural tonic in oriental countries. Data identification and study selection: Publications on Panax ginseng and its relation to cancer were obtained from the Medline database (1983-2000) and by checking reference lists to find earlier reports. The reports cover experimental models and human studies on cancer-preventive activity, carcinogenicity and other beneficial or adverse effects. In addition, possible mechanisms of chemoprevention by ginseng were also considered. Results : Published results from a cohort and two case-control studies in Korea suggest that the intake of ginseng may reduce the risk of several types of cancer. When ginseng was tested in animal models, a reduction in cancer incidence and multiplicity at various sites was noted. Panax ginseng and its chemical constituents have been tested for their inhibiting effect on putative carcinogenesis mechanisms (e.g., cell proliferation and apoptosis, immunosurveillance, angiogenesis); in most experiments inhibitory effects were found. Conclusion : While Panax ginseng C. A. Meyer has shown cancer preventive effects both in experimental models and in epidemiological studies, the evidence is currently not conclusive as to its cancer-preventive activity in humans. The available evidence warrants further research into the possible role of ginseng in the prevention of human cancer and carcinogenesis.

• 보건행정학회지
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• 제28권1호
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• pp.53-69
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• 2018

Background: This study investigates association modified category medical specialization (CMS) and hospital charge, length of stay (LOS), and mortality among lumbar spine disease inpatients. Methods: This study used National Health Insurance Service-cohort sample database from 2002 to 2013, using stratified representative sampling released by the National Health Insurance Service. A total of 56,622 samples were analyzed. The primary analysis was based on generalized estimating equation model accounting for correlation among individuals within each hospital. Results: Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had a shorter LOS (estimate, -1.700; 95% confidence interval [CI], -1.886 to -1.514; p<0.0001). Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had a lower mortality rate (odds ratio, 0.635; 95% CI, 0.521 to 0.775; p<0.0001). Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had higher hospital cost per case (estimate, 192,658 Korean won; 95% CI, 125,701 to 259,614; p<0.0001). However, inpatients admitted with lumbar spine surgery patients at hospitals with higher modified CMS had lower hospital cost per case (estimate, -152,060 Korean won; 95% CI, -287,236 to -16,884; p=0.028). Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had higher hospital cost per diem (estimate, 55,694 Korean won; 95% CI, 46,205 to 65,183; p<0.0001). Conclusion: Our results showed that increase in hospital specialization had a substantial effect on decrease in hospital cost per case, LOS, and mortality, and on increase in hospital cost per diem among lumbar spine disease surgery patients.

• 대한두경부종양학회지
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• 제37권1호
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• pp.11-16
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• 2021

Background/Objectives: To analyze changes in the incidence of thyroid cancer for Korean population using big data from the National Health Insurance Service. Materials & Methods: Sample cohort database between January 2004 and December 2013 with 1,000,000 cases for each year was enrolled in this study. Thyroid cancer incidence was analyzed by sex, age and by region. Public health insurance payment was used to reflect socioeconomic status. Results: The incidence of thyroid cancer in Korea increased for 10 years annually. There are 3 times increasing in the incidence rate of thyroid cancer from 2004, 0.03% to 2013, 0.09%. The sex ratio in the incidence rate of thyroid cancer was male : female = 1:7.2 in 2004 and male : female = 1:3.6 in 2013 that suggest decreased gap between the sex ratio. Between 2004 and 2010, the incidence rates of those in their 40s were found to be the highest, whereas the incidence rates for those in their 50s were found to be highest from 2011 and thereafter. Every year the high socioeconomic status group showed a higher incidence of thyroid cancer than low socioeconomic status group. Some specific region showed continuous high incidence of thyroid cancer, not all city and state. Conclusion: The incidence rate of thyroid cancer for 10 years had special feature by sex, age, socioeconomic status and especially by region. This results will be a barometer for further epidemiologic study about the incidence of thyroid cancer for Korean population

• Journal of Korean Neurosurgical Society
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• 제62권2호
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• pp.217-224
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• 2019

Objective : We attempted to discover that Ankylosing spondylitis (AS) has a comprehensive relationship with congestive heart failure and death. Methods : We used a nationwide database managed by the Korean National Health Insurance Service from 2010 to 2014. Twelve thousand nine hundred eighty-eight patients with a diagnosis of AS and 64940 age- and sex- stratified matching subjects without AS were enrolled in the AS and control groups. Incidence probabilities of 6 years congestive heart failure and death in each group were calculated. The Cox proportional hazard regression analysis was used to estimate the hazard ratio. We divided the AS and control groups into subgroups according to sex, age, income, and comorbidities. Results : During the follow-up period, 102 patients (0.79%) in the AS group and 201 patients (0.32%) in the control group developed congestive heart failure (p<0.0001). In addition, 211 (1.62%) subjects in the AS group died during the follow-up period compared to 639 (0.98%) subjects in the control group (p<0.0001). The adjusted hazard ratio of congestive heart failure and death in the AS group was 2.28 (95% confidence interval [CI], 1.80-2.89) and 1.66 (95% CI, 1.42-1.95), respectively. The hazard ratios of congestive heart failure and death were significantly increased in all of the subgroups. Conclusion : The incidence rates of congestive heart failure and death were increased in AS patients.

• International Journal of Computer Science & Network Security
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• 제21권2호
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• pp.171-180
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• 2021

Currently, hospitals and medical practices have a large amount of unstructured information, gathered in time at each ward or practice by physicians in a wide range of medical branches. The data requires processing in order to be able to extract relevant information, which can be used to improve the medical system. It is useful for a physician to have access to a patient's entire medical history when he or she is in an emergency situation, as relevant information can be found about the patient's problems such as: allergies to various medications, personal history, or hereditary collateral conditions etc. If the information exists in a structured form, the detection of diseases based on specific symptoms is much easier, faster and with a higher degree of accuracy. Thus, physicians may investigate certain pathological profiles and conduct cohort clinical trials, including comparing the profile of a particular patient with other similar profiles that already have a confirmed diagnosis. Involving information technology in this field will change so the time which the physicians should spend in front of the computer into a much more beneficial one, providing them with the possibility for more interaction with the patient while listening to the patient's needs. The expert system, described in the paper, is an application for medical diagnostic of the most frequently met conditions, based on logical programming and on the theory of probabilities. The system rationale is a search item in the field basic knowledge on the condition. The web application described in the paper is implemented for the ward of pathological anatomy of a hospital in Romania. It aims to ease the healthcare staff's work, to create a connection of communication at one click between the necessary wards and to reduce the time lost with bureaucratic proceedings. The software (made in PHP programming language, by writing directly in the source code) is developed in order to ease the healthcare staff's activity, being created in a simpler and as elegant way as possible.

• 근관절건강학회지
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• 제29권1호
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• pp.41-49
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• 2022

Purpose: The purpose of this study was to assess the influence of nurses staffing level on patient health outcomes in intensive care units (ICUs) in Korea. Methods: The study was retrospective in nature. Information on patients and their outcomes, as well as nurse cohort data, were obtained from Korea's National Health Insurance Service Database. The observation period was from January 1, 2008 to December 31, 2018, and data for 2,964,991 patients were analyzed. Independent variables included patient' age and sex and hospital type, intensivist, and nurses staffing level. Results: The mortality rate in ICUs was significantly higher at tertiary hospitals with a level 3~4 (HR, 1.21; 95% confidence interval, 1.19~1.22) or level 5~9 nurse staffing (HR, 1.31; 95% confidence interval, 1.27~1.34) compare to that of tertiary hospitals with a 1~2 level. 28-day mortality rate was also higher at general hospitals with a level 3~4 (HR, 1.13; 95% confidence interval, 1.12~1.14), level 5~6 (HR. 1.34; 95% confidence interval, 1.32~1.36), level 7~9 nurse staffing (HR, 1.38; 95% confidence interval, 1.38~1.42), using level 1~2 as reference. Conclusion: Nurses staffing level is a key determinant of healthcare-associated mortality in critically ICUs patients. Policies to achieve adequate nurse staffing levels are therefore required to enhance patient outcomes.

• 대한한방소아과학회지
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• 제36권2호
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• pp.1-12
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• 2022

Objectives We analyzed visiting patterns to medical institutions and cost per visit according to the common cold patients aged 0-19 years. We analyzed Korean medical treatment for common cold. Methods Using the Pediatric Patient Sample data of the Health Insurance Review and Assessment Service (HIRA-PPS), we analyzed the data on health insurance claims of approximately 1 million people from 2017 to 2019. The data included the number of patients who visited the hospital due to common cold for the first and second time, the ratio of second visits by type of medical institution, and the status of prescriptions in Korean medical institutions. Results The number of patients visiting healthcare providers for common cold was higher in Western medical institutions than in Korean medical institutions. However, the number of second visits was higher in Korean medical institutions. Acupuncture is the most commonly used medical treatment in Korean medical institutions for common cold. Herbal medicine for common cold was usually prescribed for 2-3 days for children and adolescents. Conclusions Although the average medical cost of Korean medical institutions was higher than that of Western medical institutions, the rate of second visits to Korean medical institutions was higher because of the demand for Korean medical treatment

• 보건행정학회지
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• 제32권2호
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• pp.205-215
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• 2022

Background: The purpose of this study is to identify the factors infecting the medical care utilization from a new perspective by newly classifying the categories of administrative districts using the urban decline index and medical vulnerability index as indicators. Methods: This study targeted 150,940 people who used medical services using the 2015 cohort database (DB), 2010-2015 urban regeneration analysis index DB, and 2014-2015 public health and medical statistics DB. The decline of the region was classified using the urban decline index typed using k-means clustering and the medical vulnerability index typed using the quantile score calculation. Regression analysis was performed 3 times with medical expenditure, length of stay, and the number of outpatient visits as dependent variables. Results: There were 37 stable region (47.4%), 29 health vulnerable region (37.2%), and 12 decline region (15.4%). The health vulnerable region had lower medical expenditure, fewer outpatient visits, and a higher length of stay than the stable region. The decline region was all higher than the stable region but had no significant effect. Conclusion: The factors that cause the health disparity between regions are not only factors related to individual health behavior but also environmental factors of the local community. Therefore, there is a need for a systematic alternative that properly considers the resources within the community and reflects the characteristics of the population.