• Title/Summary/Keyword: Comparative study Primary care

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Dental trauma trends in emergency care: a comparative analysis before, during, and after COVID-19

  • Woo-Jung Yang;Ji-Young Yoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.6
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    • pp.339-346
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    • 2023
  • Objectives: This analysis details the characteristics of dental trauma in South Korea during the coronavirus disease 2019 (COVID-19) (DC) pandemic and compares them in patients before and after COVID-19 (BC and AC, respectively). Materials and Methods: Data were collected from medical records of patients who visited Seoul National University Bundang Hospital's Emergency Dental Care Center during three 12-month periods: BC, DC, and AC (BC from March 1, 2019 to February 29, 2020; DC from March 1, 2020 to February 28, 2021; AC from March 1, 2022 to February 28, 2023). A retrospective review was conducted to investigate patient age, sex, time of visit, cause, and diagnosis. The study included 1,544 patients: 660 BC, 374 DC, and 510 AC. Results: Significant difference in age and sex was not observed among the three periods; 1-9 years of age was the largest group (38.3% in BC, 29.6% in DC, and 27.8% in AC), and the percentage of male patients was greater than of female patients (male proportion as 63.5% in BC, 67.4% in DC, and 64.9% in AC). The number of patients generally peaked at a Saturday night in spring (for BC: May, Saturday, 18:00-19:59; for DC: March, Saturday, 18:00-19:59; for AC: April as the second most (October as the most peaked), Saturday, 20:00-21:59). The primary etiology of the dental trauma was identical in the three periods: falls, followed by sports. The most frequent diagnosis was laceration, followed by tooth avulsion and jaw fracture. Conclusion: Significant differences were not found between the characteristics and patterns of dental trauma in the BC, DC, and AC periods. However, due to the pandemic and social distancing, activities decreased and associated dental trauma-related incidents declined.

A Comparative Study on Medical Utilization between Urban and Rural Korea (도시 농촌간 의료이용 수준의 비교분석)

  • Joo, Kyung-Shik;Kim, Han-Joong;Lee, Sun-Hee;Min, Hye-Young
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.2 s.53
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    • pp.311-329
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    • 1996
  • This study was designed to compare the level of medical utilization between the urban and rural areas of Korea and to explain the differences between the two regions. Data from the National Health Interview Survey performed by the Korean Institute of Health & Social Affairs in 1992 were used for this study utilizing a sample size of 21,841 people. The level of medical utilization such as the number of physician visits and the number of hospital admissions was compared between the regions with ANOVA. Various determinants for medical use were also compared by univariate analysis. Statistical models which included enabling factors, predisposing factors, need factors and region were constructed for bivariate analysis in order to further elucidate the level of medical utilization. The results were as follows: 1. There was greater medical use, both in terms of physician visits and inpatient care in the rural areas in spite of insufficient health resources. The particular reasons for higher medical utilization in rural areas were attributed to a higher number of initial physician visits as well as a longer the length of stay per hospital admission. Therefore, indicators representing the degree of met need (utilization/need) showed no significant difference between rural and urban areas in spite of the fact that the medical need is larger in rural areas. 2. Use of public health facilities received a significant portion of physician visits in the rural area. The government's effort to enhance primary health care through health centers, health subcenters and the nurse practitioner's post in rural areas has contributed to the increase of access to medical care in the rural areas. 3. There were some differences in the socio-demographic characteristics between two regions ; There were more elderly people over the age of 65: unstable marital status, less education and lower incomes also characterized the rural areas. Therefore, among rural people, there were more predisposing factors for medical use. Additionaly, need factors such as poor self-reported health status and high morbidity level were also high in the rural area. 4. In contrast it was learned that, the supply of health resources was mostly concentrated in the urban areas except for public health facilities. Therefore, geographical access to medical care was lower in the rural area both in terms travel time and travel cost. 5. The coefficient of the region variable was insignificant in the regression model which controlled the supply factor only. However, utilization was significantly higher in urban areas if the model included predisposing factors and need factors in addition to the supply factor. The results were interpreted as rural people have greater medical needs.

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Comparative analysis of RN-BSN Program in Korea and U. S. A. (간호학사 편입학제도의 교과과정 비교분석)

  • Lee Ok-Ja;Kim Hyun-Sil
    • The Journal of Korean Academic Society of Nursing Education
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    • v.3
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    • pp.99-116
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    • 1997
  • In response of the increasing demand for professional degree in nursing, some university in Korea offers RN-BSN program for R. N. from diploma in nursing. However, RN-BSN program in Korea is in formative period. Therefore, the purpose of this survey study is for the comparative analysis of RN-BSN curriculum in Korea and U.S.A. In this study, subjects consisted of 18 department of nursing in university and 5 RN-BSN programs in Korea and 18 department of nursing in university and 12 RN-BSN programs in U.S.A. For earn the degree of Bachelor of Science in Nursing, the student earns 134 of mean credits in U.S.A., whereas 150.3 of mean credits in Korea. The mean credit for clinical pratice is 30.1 in U.S.A., whereas 23.9 in Korea. Students are assigned to individually planned clinical experiences under the direction of a preceptor in U.S.A. In RN-BSN program, total mean credits through lecture and clinical practice for earn the degree of BSN is 35.5(lecture : 27.7, practice ; 7.8)in U.S.A., whereas,48.1 (lecture;42.1, practice;6.0) in Korea. RN-BSN program can be taken on a full-or-part time basis in U.S.A., whereas didn't in Korea. Especially, emphasis is place on the advanced nursing practicum that focus on the role of the professional nurse in providing health care to individuals, families, and groups in community setting in U.S.A. 27.7 of mean credits was earned through lecture in U.S.A., whereas 42.1 of mean credits in Korea. It means that RN-BSN program in Korea is the lesser development in teaching method and appraisal method than in U.S.A. Students of RN-BSN program in U.S.A. can earns credit through CLEP, NLN achievement test, portfolio review session etc as well as lecture. Therefore, the authors suggests some recommendations for the development of curriculum of RN-BSN program in Korea based on comparative analysis of RN-BSN curricula in U.S.A. and Korea. 1. The curriculum of RN-BSN Program in nursing was required to do some alterations. Nursing care, today, is complex and ever changing. According to change of public need, RN-BSN curriculum intensified primary care program in community setting, geriatric nursing, marketing skill, computer language. 2. The various and new methods of earning credit should be developed. That is, the students will earn credits through the transfer of previous nursing college credits, accredited examination of university, advanced placement examination, portfolio review session, case study, report, self-directed learning and so on. Flexible teaching place should ile offered. 3. Flexible teaching place should be offered. The RN-BSN curriculum should accommodate each RN student's geographical needs and school/work schedule. Therefore, the university should search a variety of teaching places and the RN students can obtain their degrees comfortably throughout the teaching place such as lecture room inside the health care agency and establishment of the branch school in each student's residence area. 4. The RN-BSN program should offer a long distance education to place-bound RN student in many parts of Korea. That is, from the main office of university, the RN-BSN courses are delivered to many areas by Internet, EdNet (satellite telecommunication) and other non-traditional methods. 5. For allowing RN student to take nursing courses, program length should be various, depending upon the student's study/work schedule. That is, the various term systems such as semester, three terms, quarter systems and the student's status like full time or part time should be considered. Therefore, the student can take advantage of the many other educational and professional opportunities, making them available during the school year.

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A Study on Efficiency of Case Management Practical Model for Industrial Injury Inpatients (산업재해 입원환자를 위한 사례관리실천모형의 효과성에 관한 연구)

  • Baek, Eun-Joo
    • Korean Journal of Occupational Health Nursing
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    • v.10 no.1
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    • pp.24-40
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    • 2001
  • This study is to observe the effectiveness of the applied model and to present the improvement plan and directions for development for the case management practical model suitable for the actual condition of Korea Labor Welfare Co. and needs of the industrial injury patients. The concrete purpose of this study is: First, observe the difference of stressor experience and experience degree between the experimental group and the comparative group. Second, observe the difference of stress of the experimental group and the comparative group. Third, find out how the stress affects the support degree and satisfaction degree. Fourth, present the improvement plan of case management model, which can promote the psychosocial rehabilitation of the industrial injury patient based on the research results. The outline of the main research results identified in this study is as follows. The stressors the industrial injury patients perceived are health problems, family matters, the problems concerning hospital recuperation (hospital staff and environmental problems), economical problems, problems of coming back to society, problems with companies, problems with Korea labour Welfare Co. and other problems. And the experience of stressor was prominently lower in experimental group than comparative group in the whole problem, health problem, problems with Korea Labour-Welfare Co. and other problems. The stressor experience degree was conspicuously lower in experimental group in the whole problem experience degree, health problem experience degree, problem with Korea Labour Co. experience degree and other problem experience degree. Besides whether or not the case management is applied is having a prominent affect on the primary factor affecting the stressor experience degree, therefore the patients applied with case management has less stressor than the patient who didn't. The difference of degree of tension experienced by the stressor in both groups, the degree of stress, was not conspicuous in statistics so it shows that the application of case management in this research has not affected the degree of tension. The field which had been the most help was emotional support in help level the experimental group perceived through applying case management about industrial accident patients and recuperation, compensation problem, medical treatment problem, family matters has been helpful in this order. The help level of the whole problem was in higher level than the middle value. The stress factor which affects the case management problem settlement is the whole body of stress. The satisfaction level of help through applying case management was highest in emotional support and family matters, recuperation problem, company problem, compensation problem, and medical treatment problem was the next highest. The satisfaction level of the whole problem was higher than the middle value. The stress factor affecting the satisfaction level of help is the whole body of stress. Therefore to reduce the stress level of industrial accident patients and for them to come back to local societies, we need to reinforce the continuance and responsibility of case management model, increase staff, reinforce the role of counsel and medical treatment, intervene in the patient's plan of leaving the hospital, develop social support system and the need to establish After Care Center.

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A Study on the Effect of Basic Life Support Training on the First Responsive Police Officers

  • Jo, Byung-Tae;Kim, Seon-Rye
    • Journal of the Korea Society of Computer and Information
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    • v.24 no.10
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    • pp.175-182
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    • 2019
  • The study was conducted to verify the effect of basic life support training on the skill ability of police officers. The subjects of this study were 10 experimental group and 10 comparative group with voluntary consent after explaining the theory and significance of the training experiment at the police station located in K. The education program used in this study consists of theoretical education and practical training, and the theoretical education is 60 minutes and the practical training is 30 minutes. The measurement tool for basic resuscitation performance was measured based on the 'CPR and ECG Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care' presented by the American Heart Association. The results are as follows. The experimental group showed higher performance skills than the traditional control group in field confirmation performance skills, primary evaluation performance skills (A, B, C, medical evaluation), and BLS performance skills (heart compression, artificial respiration, medical evaluation) which are the basic resuscitation performance skills. In conclusion, this study confirmed that the theory and practice education program is more effective in improving the clinical performance of police officers than the traditional lectures and practice education, so it is possible to apply this simulation education program to the cardiac arrest patient emergency treatment.

A comparative study on analgesic and non-analgesic outcomes of inter pleural analgesia compared to thoracic epidural analgesia in open pancreatico-duodenectomy

  • Lu Yao;Niroshini Rajaretnam;Natalie Smith;Lisa Massey;Somaiah Aroori
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.3
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    • pp.270-276
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    • 2022
  • Backgrounds/Aims: Thoracic epidural analgesia (TEA) is an established analgesic method in open Kausch-Whipple pancreaticoduodenectomy (KWPD). Although, it can cause hemodynamic instability and neurological complications. Inter pleural analgesia (IPA) is an alternative option. We aim to evaluate the effectiveness of IPA versus TEA after KWPD. Methods: We retrospectively studied the efficacy of IPA against TEA in patients, operated by a single surgeon. The primary outcome was the analgesic efficacy and secondary outcomes were analgesia-related complications, inotrope use, and duration. Results: Forty patients (TEA, 22; IPA, 18) were included. Both groups were well matched for patient characteristics, type, and duration of surgery. TEA was associated with higher analgesia-related complications (n = 8, 36.4% vs. n = 1, 5.6%; p = 0.027). TEA complications included analgesia not working (n = 4), leakage (n = 2), refractory hemodynamic instability (n = 1), and lower limb anaesthesia (n = 1). One patient in the IPA group encountered leakage. TEA was associated with longer inotrope requirement (35 vs. 18 hours; p = 0.047). There was no significant difference in intensive care unit (ITU) admission rate (81.8% vs. 77.8%; p > 0.999), median ITU stay (3 vs. 2 days, p = 0.385), or hospital stay (11 days in both groups). Conclusions: In open KWPD, IPA is not inferior to TEA in its efficacy of pain control. IPA was associated with less analgesia-related complications and shorter inotrope requirements. However, this was a small retrospective study. Larger randomized controlled trials are needed to study the effectiveness of IPA.

Convergence Comparative Analysis of Young-Old and Old-Old Patients Hospitalized Owing to Injury (손상으로 입원한 전·후기 노인의 융복합 비교분석)

  • Suhn, Mi-Ohk
    • Journal of the Korea Convergence Society
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    • v.11 no.2
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    • pp.75-83
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    • 2020
  • This study aimed to understand the differences in general characteristics, principal diagnosis, injury-related characteristics, and types of transportation accidents between young-old and old-old patients who were hospitalized owing to injury based on data from the Korean National Hospital Discharge In-Depth Injury Surveys. We used a complex sample cross tabulation analysis (chi-square test) and complex sample generalized linear model (t-test). Therefore, the primary focus of healthcare professionals working with the old-old should prevent falls in the home and increase the available medical care, financial aid plans, and psychosocial support for aging. Additionally education on traffic accident prevention and road safety is particularly important for old-old patients.

Resistance to local anesthesia in people with the Ehlers-Danlos Syndromes presenting for dental surgery

  • Schubart, Jane R.;Schaefer, Eric;Janicki, Piotr;Adhikary, Sanjib D.;Schilling, Amber;Hakim, Alan J.;Bascom, Rebecca;Francomano, Clair A.;Raj, Satish R.
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.5
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    • pp.261-270
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    • 2019
  • Background: People with the Ehlers-Danlos Syndromes (EDS), a group of heritable disorders of connective tissue, often report experiencing dental procedure pain despite local anesthetic (LA) use. Clinicians have been uncertain how to interpret this apparent LA resistance, as comparison of EDS and non-EDS patient experience is limited to anecdotal evidence and small case series. The primary goal of this hypothesis-generating study was to investigate the recalled adequacy of pain prevention with LA administered during dental procedures in a large cohort of people with and without EDS. A secondary exploratory aim asked people with EDS to recall comparative LA experiences. Methods: We administered an online survey through various social media platforms to people with EDS and their friends without EDS, asking about past dental procedures, LA exposures, and the adequacy of procedure pain prevention. Among EDS respondents who both received LA and recalled the specific LA used, we compared agent-specific pain prevention for lidocaine, procaine, bupivacaine, mepivacaine, and articaine. Results: Among the 980 EDS respondents who had undergone a dental procedure LA, 88% (n = 860) recalled inadequate pain prevention. Among 249 non EDS respondents only 33% (n = 83) recalled inadequate pain prevention (P < 0.001 compared to EDS respondents). The agent with the highest EDS-respondent reported success rate was articaine (30%), followed by bupivacaine (25%), and mepivacaine (22%). Conclusions: EDS survey respondents reported nearly three times the rate of LA non-response compared to non-EDS respondents, suggesting that LAs were less effective in preventing their pain associated with routine office dental procedures.

A Comparative Study on the Effect of Gel Pad, Sheepskin and Sponge on Prevention and Treatment of Decubitus Ulcers (양털, Gel Pad 및 Sponge의 욕창예방 및 치료효과에 관한 연구)

  • 이은옥;김매자
    • Journal of Korean Academy of Nursing
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    • v.4 no.3
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    • pp.93-104
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    • 1974
  • Regardless of a patient's diagnosis, the care of his skin has been a primary concern of nurses throughout the years. Nurses has washed, dried, and rubbed the skin and have changed his position so as to keep the patient's skin in good condition and to protect him from pressure sores. However, we still find many-patients suffering from the pressure sores which may take many mothers or years of treatment and cost a lot to be repaired. In view of expensive cost for treatment of the sores and low ratios of nursing staff per patient for intensive nursing care, prophylaxis of the bed sores with sufficient aids is extremely important both for patients and for nurses. Therefore, the unique purpose of this study was to determine whether sponge is good enough to treat and prevent the pressure sore as compared with gel pad and sheepskin. Sixty patients in the age range of 15 through 45 who were in unconscious status or have difficulty of mobility were chosen between January and March of 1974 at Seoul National University Hospital. They were randomly assigned to each treatment and observed on every 4th day with regard to level of consciousness, status of mobility, moisture or dryness of the bed, general skin condition, intake of nutrition, vital signs and intervals of position change in comparison with the changes of skin over the bony prominences. The study results were reviewed in a statistical method analysis of valiance-to obtain the following findings: 1. There was no significantly different changes of skin over the sanctum or the trochanter in each group using get pad, sheepskin or sponge. It means that we may substitute sponge for expensive gel pad or sheepskin. 2. There was no significant difference among mean changes of patient's skin in relation to sheepskin, gel pad and sponge. 3. There was no significant changes of patient's akin in relation to level of consciousness, status of mobility, intake of nutrition, general skin condition, temperature, blood pressure or interval of position change. 4. There were no meaningful interactions between each treatment and level of consciousness, moisture or dryness of the bed, intake of nutrition, general skin condition, temperature or blood pressure. 5. Sheepskin and gel pad had significantly better influence on patients with limited mobility than on patients with immobility, and sponge on patients with immobility on than patients with limited mobility, 6. Sheepskin and sponge had meaningfully totter influence on patients changing position at below 2-hour interval, gel pad at 2-4-hour interval, sheepskin at 4-6-hour interval, and three of them at above 6-hour interval.

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Through analyzing the health insurance data provided by Health Insurance Review & Assessment Service (HIRA) of Korea, understanding the characteristic of patient who were diagnosed somatic dysfunction and analysis of the current local status of the usage of code M99 (건강보험심사평가원 데이터의 분석을 통한 체성기능부전 환자의 특성 및 M99 진단명의 사용현황 분석)

  • Shin, Jae-Kwon;Joo, Han-Soo;Lee, Seong-Yup;Shin, Ye-Sle;Ko, Won-Il;Park, Ki-Byung;Kim, Min-Kyu;Ha, In-Hyuk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.11 no.1
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    • pp.53-64
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    • 2016
  • Objectives : The aim of this study is to assess the usage of diagnosis codes for somatic dysfunctions and the general characteristics of patients diagnosed with the code, by analyzing health insurance data provided by the Health Insurance Review & Assessment Service(HIRA) of Korea. This investigation is intended to outline future and willing to contribute to further use of diagnosis code and the approach of Oriental Medicine to somatic dysfunction. Materials and Methods : By analyzing HIRA data, those diagnosed with M99 codes, a code attributed to somatic dysfunction, were selected for analysis. Patients included were assessed for the relevant general characteristics, and the specific diagnostic criteria. The current usage rates and noteworthy characteristics of diagnostic codes of somatic dysfunctions were assessed. A comparative analysis between clinical departments and subcategories, and a comparative analysis to data of 2014 was conducted. Results : Patients given M99 codes constituted a small minority of all patients diagnosed in 2011 as shown by HIRA data. The codes were more frequently to older patients, females, outpatients, and those who filed for Health Insurance compensation. Medical institutions participating in the diagnosis were mostly primary care facilities, usually specializing in orthopedic(Western medicine sector) and internal medicine (Oriental Medicine sector). The most registered code in 2011 and 2014 was M995. The same trend can be observed in Oriental/Western medicine institutions and Public health center, on the other hand, between them, have some different patterns both 2nd and 3rd. Conclusions : This investigation is that of current usage of diagnostic codes of somatic dysfunction. HIRA insurance claim data was analyzed. Based on the current results, more precise diagnostic standards of somatic dysfunction are warranted. This study will provide a foundation for future Oriental Medicine approach to somatic dysfunctions.

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