• Title/Summary/Keyword: Decrease in visit

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Variables Affecting Long-Term Compliance of Oral Appliance for Snoring (코골이 치료용 구강장치의 지속적 사용에 영향을 주는 요인의 분석)

  • Lee, Jun-Youp;Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.305-316
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    • 2008
  • The mandibular advancement device(MAD) has been used to help manage snoring and obstructive sleep apnea. The aims of this study were to specify the demographic and clinical characteristics of the patients receiving long-term treatment with MAD and to quantify the compliance with and side effects of the use of the device. Of 103 patients who were treated with MAD for at least one full year after delivery date, 49 were able to be contacted with telephone and complete follow-up questionnaires were obtainable. They were telephoned to determine whether they were still using the device. If not, they were asked when and why they stopped using it. Patients were also asked how much effectiveness of the MAD in decreasing snoring and how much they and their bed-partners were satisfied with the MAD therapy. The initial respiratory disturbance indices and pre-treatment snoring frequency and intensity were obtained from the medical records of initial visit. All the data were compared between users and nonusers. The results were as follows: 1. Of 49 patients 25 are still using the device, but 24 stopped using it. Among nonusers nobody stopped wearing the device within first 1 month, but 37.5% of nonusers stopped wearing it in the following 6 months, and another 4.2% before the end of the first year. 2. The one-year compliance of the MAD therapy was 79.59%. 3. There were no significant differences in mean age, mean body mass index, and gender distribution between users group and nonusers group. 4. There was no significant difference in mean respiratory disturbance index at initial visit between users group and nonusers group. 5. There was no significant difference in pre-treatment snoring frequency and intensity between users group and nonusers group. 6. The degree of decrease in snoring with use of MAD was significantly higher in the users when compared to nonusers. 7. Patient's overall satisfaction with treatment outcome was significantly higher in the users when compared to nonusers. 8. Bed partner's satisfaction with treatment outcome tended to be higher in the users when compared to nonusers. 9. The most frequent reasons why patients discontinued wearing the MAD were: jaw pain(25%), dental pain(20.83%), broken appliance(20.83%), hassle using(16.67%), lost weight(8.3%), dental work(8.3%), no or little effect(4.17%), sleep disturbance(4.27).

A Study on Profitability of the Allianced Discount Program with Credit Cards and Loyalty Cards in Food & Beverage Industry (제휴카드 할인프로그램이 외식업의 수익성에 미치는 영향)

  • Shin, Young Sik;Cha, Kyoung Cheon
    • Asia Marketing Journal
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    • v.12 no.4
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    • pp.55-78
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    • 2011
  • Recently strategic alliance between business firms has become prevalent to overcome increasing competitive threats and to supplement resource limitation of individual firms. As one of allianced sales promotion activities, a new type of discount program, so called "Alliance Card Discount", is introduced with the partnership of credit cards and loyalty cards. The program mainly pursues short-term sales growth by larger discount scheme while spends less through cost share among alliance partners. Thus this program can be regarded as cost efficient discount promotion. But because there is no solid evidence that it can really deliver profitable sales growth, an empirical study for its effects on sales and profit should be conducted. This study has two basic research questions concerning the effects of allianced discount program ; 1)the possibility of sales increase 2) the profitability of the discount driven sales. In F&B industry, sales increase mainly comes from increased guest count. Especially in family restaurants, to increase the number of guests we need to enlarge the size of visitor group (number of visitors for one group) because customers visit by group in a special occasion. And because they pay the bill by group(table), the increase of sales per table is a key measure for sales improvement. The past researches for price & discount sensitivity and reference discount rate explain that price sensitive consumers have narrow reference discount zone and make rational purchase decision. Differently from all time discount scheme of regular sales promotions, the alliance card discount program only provides the right to get discount like discount coupon. And because it is usually once a month opportunity given by the past month usage level, customers tend to perceive alliance card discount as a rare chance to get. So that we can expect customers try to maximize the discount effect when they use the limited discount opportunity. Considering group visiting practice and low visit frequency of family restaurants, the way to maximize discount effect should be the increase the size of visit group. And their sensitivity to discount and rational consumption behavior defer the additional spending for ordering high price menu, even though they get considerable amount of savings from the discount. From the analysis of sales data paid by alliance discount cards for four months, we found the below. 1) The relation between discount rate and number of guest per table is positive : 25% discount results one additional guest 2) The relation between discount rate and the spending per guest is negative. 3) However, total profit amount per table is increased when discount rate is increased. 4) Reward point accumulation & redemption did not show any significant relationship with the increase of number of guests. These results suggest that the allianced discount program substantially contributes to sales increase and profit improvement by increasing the number of guests per table. Though the spending per guest is decreased by discount rate increase, the total amount of profit per table is improved. It seems the incremental profit by increased guest count offsets the profit decrease. Additional intriguing finding is the point reward system does not have any significant impact on the increase of number of guest, even if the point accumulation & redemption of loyalty program are usually regarded as another saving offers by customers. In sum, because it is proved that allianced discount program with credit cards and loyalty cards is effective to both sales drive and profit increase, the alliance card program could be recommended as strategically buyable program.

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Caries Management of High-Risk Children by Caries Risk Assessment (우식위험평가에 의한 우식 고위험 유아의 치아우식 관리)

  • Koo, Seo-Yeon;Lee, Su-Young
    • Journal of dental hygiene science
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    • v.18 no.2
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    • pp.97-104
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    • 2018
  • The purpose of this study was to classify risk groups according to Caries Risk Assessment (CRA) and to investigate the effect of caries prevention program after 1 year of caries prevention intervention program in 6-year-old infants with high caries risk. The subjects were selected based on responses to CRA questionnaires. At the first visit, oral examination, Cariview, bacteria and saliva flow test were performed. The caries risk group was classified accordingly. The subjects were given fluoride application and oral health education every four months and evaluated the same as the first visit after 1 year. As a result of classifying the risk level according to CRA, more than 80% of the subjects were in the high or extreme high risk. The dft index was increased in all risk groups after the intervention. There was a significant difference between the before and after intervention (p<0.05). The Cariview score showed a slight decrease after the intervention in the moderate and high risk groups. As a result of the evaluation of bacteria test, Streptococcus mutans were decreased to ${\geq}10^5CFU/ml$ saliva after intervention in all groups. Lactobacilli were decreased after intervention in high risk and extreme high risk groups. As a result of saliva flow, there was significant difference between caries risk groups before and after intervention (p<0.05). In conclusion, regular caries management has been shown to influence caries risk factors in high-caries risk children. Also, it is necessary to find out periodical dental risk management system which is suitable for domestic situation through the related studies.

The Distribution and Patient Care in Radiography for Emergency Outpatients (응급환자의 방사선영상검사 분포 및 Patient Care)

  • Lee, Hwan-Hyung;Kang, Won-Han
    • Journal of radiological science and technology
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    • v.19 no.1
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    • pp.55-74
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    • 1996
  • This study was carried out to improve service efficiency and to cope with a emergency situation in emergency radiography, through analysis of the radiographic distribution and literature cited about emergency care. Data collection of radiographic distribution was surveyed for 761 emergency outpatients who visit during JAN, 1994 at ER of the general hospital in Pusan city. The results is as follows: Emergency radiography rate of simple radiography was 61.1 %, special radiography 2.5 %, CT 12.6 %, and ultrasonography 6.7 %. In simple radiography rate, a high rate was distributed on male(63.6 %), thoracicsurgery part(90.0%), admission patient(74.9 %), and long stayed patient at ER. In special raiography rate, a high rate was observed in urologic part(28.6%), and in CT rate, observed neurosurgery part(49.2 %) and neurologic part(36.7%). Ultrasonography rate was high for female(8.8 %) and internal medicine part(15.9 %). There are distributed regional radiography rate in radiographic type that chest(55.3 %) is high in the simple radiography, urinary system(1.2%) in the special study, and brain(40.0 %) in the CT. Regional radiography rate according to diagnostic department also was showed highly for head(64.6%) in neurosurgery, chest(90.0%) in thoracic-surgery, abdomen(58.0%) in general-surgery, spine (40.0% ) in neuro-surgery, and pelvis(15.9%), upper extrimity(20.5%), and lower extrimity(31.8%) in orthopedic-surgery each. Mean radiographic case number per patient of simple radiography was sinificant on sex, age, transfer relation in both total and radiographic patients(p<0.05). Mean radiographic case number was highly distributed on male(2.2 case number) in sex, on thirties(2.7) in age, transfered patient(2.7) in patient type, and on neurosurgery(3.4) in diagnostic charged part. Total radiographic case number in regional part was highly distributed on chest(499 case number). Considering the above results, emergency radiographer should take care of the elder patient in emergency radiography and get hold of injury mechanism to decrease possible secondary injury during radiography. Because of high radiography rate of urinary system in special study, radiographer should know well about dealing with contrastmedia administration and related instrument. All radiographer who take charge emergency patient should cope with a emergency situation during radiography, Because head trauma patients is very important in patient care, especilly in CT at night, charged doctor should be always silted with CT room and monitoring-patient. Radiography was reqested by many diagnostic department in ER. Considering that rate of simple radiography is high, special room for emergency radiography should be established in ER area, and the radiographer of this room should be stationed radiologic technician who is career and can implement emergency patient care.

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The Effect of Nutrition Education and Excercise Program on Body Composition and Dietary Intakes, Blood Lipid and Physical Fitness in Obese Women (2) - Relationship between Participation Rates and Effectiveness of Obesity Management Program - (영양교육과 운동중재 프로그램이 성인비만여성의 신체성분과 식이섭취, 혈중지질 및 기초체력에 미치는 효과 (2) - 비만관리 프로그램의 참여율과 프로그램 효과와의 상관성 -)

  • Lee, Hee-Seung;Lee, Ji-Won;Kim, Ji-Myung;Chang, Nam-Soo
    • Journal of Nutrition and Health
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    • v.43 no.3
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    • pp.260-272
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    • 2010
  • This study examined how the participation rates contribute to subjects' outcomes after a nutrition education (once/week) and exercise (3 times/week) intervention program for 12 weeks in 44 obese female subjects. The subjects were divided into two groups: high-participator (HP) or low-participator (LP) groups according to their participation levels based on the median visit value (30 visits out of a total of 48 visits). Daily nutrient intakes assessed by a 24-hour recall, body composition, blood lipid profiles and physical fitness were measured at baseline and after 12 weeks. After the intervention, weight, BMI, percent body fat, and the waist-hip ratio were significantly decreased in the HP group. In addition, the HP group had a greater rates of changes in weight (HP group: -6.6% and LP group: -3.1%, p < 0.01), BMI (-7.0% and -3.2%, p < 0.01), percent body fat (-7.8% and -4.2%, p < 0.05), and waist-hip ratio (-3.1% and -0.4%, p < 0.01) compared to the LP group. Energy-adjusted protein, fiber, potassium, vitamin $B_1$, vitamin $B_6$, and vitamin C were significantly increased in the HP group. The HP group showed a significant increase in HDLcholesterol and a decrease in blood pressure, total cholesterol, LDL-cholesterol, triglycerides, and atherogenic index (AI). While the muscle endurance, muscle strength, power, agility and flexibility were significantly increased in the HP group, agility and balance were improved in the LP group. In addition, dietary behavior score was significantly increased and stress score decreased in the HP group compared to the LP group. High participation rates were correlated with the improvement of the nutrient density (protein, fiber, potassium, Vitamin $B_1$, Vitamin $B_2$, Vitamin $B_6$ and folate), anthropometric parameters (body weight, BMI and percent body fat), serum lipid profiles (HDL-cholesterol, Triglyceride, and AI) and physical fitness (muscle endurance) adjusted for age, menopausal status, alcohol drinking, nutritional supplement use and baseline BMI. Our results suggest that high participation in nutrition education and exercise program was effective not only for weight reduction but also for the improvement of physical fitness in obese women.

Efficacy and Safety of Sublingual Immunotherapy in Elderly Rhinitis Patients Sensitized to House Dust Mites

  • Kim, Ji Hye;Lee, Ji Ho;Ye, Young-Min;Lee, Jae-Hyun;Park, Jung Won;Hur, Gyu-Young;Kim, Joo-Hee;Lee, Hyn-Young;Shin, Yoo Seob;Yang, Eun-Mi;Park, Hae-Sim
    • Allergy, Asthma & Immunology Research
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    • v.10 no.6
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    • pp.675-685
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    • 2018
  • Purpose: This study aims to determine the efficacy and safety of house dust mite (HDM)-sublingual immunotherapy (SLIT) in elderly patients with AR. Methods: A total of 45 patients aged ${\geq}60years$ with HDM-induced AR who had ${\geq}3$ A/H ratio on skin prick test and/or ${\geq}0.35IU/L$ to both Dermatophagoides farinae and Dermatophagoides pteronyssinus by ImmunoCAP were enrolled in 4 university hospitals. To evaluate additional effects of HDM-SLIT, they were randomized to the SLIT-treated group (n = 30) or control group (n = 15). Rhinoconjunctivitis total symptom score (RTSS), rhinoscopy score, Korean rhinoconjunctivitis quality of life questionnaire, rhinitis control assessment test, asthma control test scores, and adverse reactions, were assessed at the first visit (V1) and after 1 year of treatment (V5); for immunological evaluation, serum levels of HDM-specific immunoglobulin A/IgE/IgG1/IgG4 antibodies and basophil response to HDMs were compared between V1 and V5 in both groups. Results: There were no significant differences in demographics, RTSS, skin reactivity to HDMs, or serum total/specific IgE levels to HDMs (P > 0.05, respectively) between the 2 groups. Nasal symptom score and RTSS decreased significantly at year 1 in the 2 groups (P < 0.05). There were no significant differences in percent decrease in nasal symptom score and RTSS at year 1 between the 2 groups (P > 0.05); however, rhinoscopic nasal symptom score decreased significantly in the SLIT-treated group (P < 0.05). Immunological studies showed that serum specific IgA levels (not specific IgE/IgG) and CD203c expression on basophils decreased significantly at V5 in the SLIT-treated group (P = 0.011 and P = 0.001, respectively), not in the control group. The control group required more medications compared to the treatment group, but there were no differences in adverse reactions. Conclusions: It is suggested that HDM-SLIT for 1 year could induce symptom improvement and may induce immunomodulation in elderly rhinitis patients.

The Clinical Effect of Tetracycline Fiber used in conjuction with Root Planing (치근활택술과 Tetracycline fiber적용의 임상적 효과)

  • Cho, Kyoo-Sung;Ryoo, Dong-Hyun;Suh, Jong-Jin;Choi, Seong-Ho;Chai, Jung-Kiu;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.28 no.3
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    • pp.389-401
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    • 1998
  • In this study, 21 patients diagnosed as adult periodontitis were divided into 4 groups. One quadrant with an average of 6mm deep pocket depth was chosen from each individual - Group A inserted tetra-cycline fiber after removing supragingival calculus while group RP had calculus removal and root planning alone. Group RP+A received combination of these treatments while group C received none. Plaque index, bleeding on probing, pocket depth, attachment level, and distribution of subgingival plaque were compared and evaluated among these groups at periods of first visit, 4th week and 8th week. The results were as follows ; 1. Plaque index and bleeding on probing improved after treatment and no significant difference was found between the groups. 2. When comparing the change in pocket depth between the groups, the use of tetracycline fiber showed significant reducton in pocket depth comparable to root planing. Combined therapy of tetracycline fiber and root planing showed synergistic effect in pocket depth reduction. 3. When comparing the change in attachment level between the groups, the use of tetracycline fiber showed significant increase in clinical attachment level comparable to root planing, but no synergistic effect was found in the combined therapy. 4. When comparing the change in the motile bacteria ratio between the groups, group RP and group RP+A showed significant decrease compared with control group. 5. There were no severe adverse effects from using tetracycline fiber, except for a few patient who experienced mild discomfort. In summary, the use of local adminstration of tetracycline fiber in adjunction to mechenical treatment can be effective for adult periodontitis.

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Association between Cigarette Smoking History and Mortality in 36,446 Health Examinees in Korea

  • Kim, Kyoungwoo;Yoo, Taiwoo;Kim, Yeonju;Choi, Ji-Ho;Myung, Seung-Kwon;Park, Sang-Min;Hong, Yun-Chul;Cho, Belong;Park, Sue K.;Yoo, Keun-Young
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5685-5689
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    • 2014
  • Background: It is well known that smoking is a preventable factor for all-cause mortality; however, it is still questionable how many years after smoking cessation that people will have reduced risk for mortality, in particular in those with a high interest in their own health. We aimed to examine the association between time since quitting smoking and total mortality among past-smokers relative to current smokers. Materials and Methods: We enrolled 36,446 health examinees that voluntarily taken with diverse health check-up packages of high cost burden in 1995-2003 and followed them till death by 2004. The history of cigarette smoking consumption was collected using a self-administrative questionnaire at the first visit time. Mortality risk by smoking cessation years was analyzed using Cox's proportional hazard model. Results: Compared to non-smokers, male smokers over 15 pack-years had higher risk for total mortality (HR=1.60, 95%CI 1.23-2.14). The mortality risk in female smokers with same pack-years was more pronounced than that in male smokers (HR=2.83, 95%CI 1.17-7.04) despite a small number of cases. Compared to current smokers, a decrease of total mortality was observed among those who ceased smoking, and inverse dose-response was found with years after cessation: RR 0.98 (95%CI, 0.64-1.41) (<2 yrs), 0.60 (95%CI, 0.43-0.83) (3-9 yrs), and 0.58 (95%CI, 0.43-0.79) (${\geq}10$ yrs). Conclusions: A reduced risk of total mortality was observed after 3 years of smoking cessation. Our findings suggest that at least 3 years of smoking cessation may contribute to reduce premature mortality among Asian men.

Influence of review system using computerized program for Acute Respiratory Infection upon practicing doctors' behaviour (전산프로그램을 이용한 급성호흡기감염증 청구자료 심사 시행 후 개원의의 진료 및 청구 행태 변화)

  • Chung Seol-Hee;Park Eun-Chul;Jeong Hyoung-Sun
    • Health Policy and Management
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    • v.16 no.2
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    • pp.49-76
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    • 2006
  • The aim of this study was to explore the effects of a computerized review program which was introduced in August 1, 2003, using claims data for acute respiratory infection related diseases. National Health Insurance (NHI) claims data on respiratory infection related diseases before and after the introduction, with six month intervals respectively, were used for the analysis. Clinic was the unit of observation, and clinics with only one physician whose specialty was internal medicine, pediatrics, otorhinolaryngology and family medicine and clinics with a general practitioner were selected. The final sample had 7,637 clinics in total. Indices used to measure practice pattern was prescription rates of antibiotics, prescription rates of injection drug per visit, treatment costs per claim, and total costs per claim. Changes in the number of claims for major disease categories and upcoding index for disease categories were used to measure claiming behavior. Data were analysed using descriptive analysis, t-test for indices changes before and after the introduction, analysis of variance (ANOVA) for practice pattern change for major disease categories, and multiple regression analysis to identify whether new system influenced on provider' practice patterns or not. Prescription of antibiotics, prescription rates of injection drug, treatment costs per claim, and total costs per claim decreased significantly. Results from multiple regression analysis showed that a computerized review system had effects on all the indices measuring behavior. Introduction of the new system had the spillover effects on the provider's behavior in the related disease categories in addition to the effects in the target diseases, but the magnitude of the effects were bigger among the target diseases. Rates of claims for computerized review over total claims for respiratory diseases significantly decreased after the introduction of a computerized review system and rates of claims for non target diseases increased, which was also statistically significant. Distribution of the number of claims by disease categories after the introduction of a computerized review system changed so as to increase the costs per claims. Analysis of upcoding index showed index for 'other acute lower respiratory infection (J20-22)', which was included in the review target, decreased and 'otitis media (H65, H66)', which was not included in the review target, increase. Factors affecting provider's practice patterns should be taken into consideration when policies on claims review method and behavior changes. It is critical to include strategies to decrease the variations among providers.

Clinical Outcomes of Ultrasound-Guided Transmeniscal Injection in Medial Compartment Knee Osteoarthritis (무릎 내측 구획 골관절염에서 초음파 유도하 경 반월상 연골 주사의 임상적 효과)

  • Jung, Eui Yub;Wang, Joon Ho;Lee, Eui-Sub;Lee, Sung-Sahn;So, Sang-Yeon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.418-425
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    • 2020
  • Purpose: The purpose of this study was to introduce the ultrasound-guided transmeniscal injection in medial compartment knee osteoarthritis and analyze the clinical outcomes. Materials and Methods: The electronic medical records of 36 patients with medial compartment knee osteoarthritis who were treated with an ultrasound-guided transmeniscal injection from March 2019 to July 2019 were accessed for this retrospective review. Using an ultrasound guided spinal needle, the patients received an intra-articular steroid injection at the medial compartment of the knee. A physical examination was conducted at the initial visit (pre-injection), and at one week, four weeks, and eight weeks after the injection. The numeric pain rating scale (NRS), Lequesne index, and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score were measured at each visit and analyzed over time. The percentage change of the patients who revealed substantial improvement was analyzed. The NRS, Lequesne index, and percentage of patients, who revealed substantial improvement over time classified by osteoarthritis grade, were analyzed. Results: The NRS and Lequesne index decreased at one week, four weeks, and eight weeks after the injection compared to the initial baseline, and the pain-relief effect continued without change until eight weeks. The percentage of patients who showed substantial improvement at one, four, and eight weeks was 50.0%, 47.2%, and 52.8%, respectively. The WOMAC scores decreased at one, four, and eight weeks compared to the initial baseline, and the decrease was continued without any difference until eight weeks. The percentage of patients with osteoarthritis stage 1 or 2 who revealed more than substantial improvement was significantly higher at one, four, and eight weeks than those with osteoarthritis stages 3 or 4 (p<0.05). Conclusion: In patients with medial compartment knee osteoarthritis, the pain reduction and functional improvement persisted for at least eight weeks after the ultrasound-guided transmeniscal injection at the medial compartment. In particular, patients with medial compartment osteoarthritis stage 1 or 2 showed more effective pain reduction.