• The Journal of Korean Medicine
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• v.40 no.3
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• pp.59-75
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• 2019

Objectives: The purpose of this study is to examine the current status of Korean medicine health technology assessment and explore realistic plans to activate it. Methods: We investigated all the applications for new health technology assessment related to Korean medicine from 2007 to 2016. The several expert meetings were held to draw out the barriers and improvement strategies of the new health technology assessment of Korean medicine field. Results: There were 31 cases in total except for duplications or reapplies falling into 3 main types. First, 19 of them were to try to enter a medical market and be covered by National Health Insurance. Eight cases were to apply western medicine technology as new health technology in Korean medicine area. The rest was 4 cases, which were totally not appropriate for the purpose of new health technology assessment system. According to the expert opinion, the obstacles of activation in new health technology assessment of Korean medicine were application of unstandardized technology, lack of understanding and experience, lack of clinical trial supporting system for Korean medicine, lack of committee members within the nHTA(new Health Technology Assessment) review board, ambiguous definition of medical practice and sharp conflict between western medicine and Korean medicine. Conclusions: Several suggestions were derived. First of all, to activate Korean medicine in the nHTA system, the existing system should be used sufficiently, and multifaceted efforts are needed to upgrade the system, if necessary. Also, self-help efforts, Korean medicine clinical trial supporting system and increasing R&D investment, establishing extra-committee for Korean medicine in nHTA could be needed. Finally, long-term strategy for improving collaboration between Korean medicine and western medicine should be considered.

• Journal of The Korea Institute of Healthcare Architecture
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• v.23 no.1
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• pp.15-24
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• 2017

Purpose: Korea is expected to enter an aged society in 2018 and then a super-aged society in early 2025. The country's aging is progressing faster than any other country in the world. However, the foundation of the elderly friendly industry is weak, and measures at the government level are urgently needed. Especially, housing problems of the elderly are one of the most urgent measures to be taken. Korea does not have the minimum residential area standard for the elderly, and the current general minimum residential area standard is based on the survey of the housing situation without scientific evidence. Therefore, both standards need to be revised as soon as possible based on scientific evidence. Methods: The minimum residential area standard has been calculated following Karl H. E. Kroemer's Min or Max design also being called as-single cut and dual cut theory- as the maximum population value and minimum population value theory of Ernest J. McCormick. Therefore there is a need for a formula made using a few key factors, such as corresponding dimension, practical dimension, clearance, spare dimension, integrated dimension. These elements can be defined and used as formulas to calculate minimum residential area standards. Results: Assuming the results of the spatial variability in this study showed that it is possible to raise the standard of living in a terms of sustainable minimum size for the young, old and all residents. Implications: The government should set a minimum residential area standard with scientific grounds and set up a policy improving the life of people who live in an needy residential environment.

• Health Policy and Management
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• v.30 no.3
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• pp.376-385
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• 2020

Background: The purpose of this study is to investigate the factors affecting the healthy living practice rate such as non-smoking, moderate drinking, walking, and low-salt diet by elementary municipality (so called, 'si-gun-hu'). Methods: The 2016 Korean Community Health Survey was used for the analysis. The theoretical model is founded upon the Anderson model, and both the multiple linear regression analysis and the beta regression analysis was performed for estimation. Results: As a result of the beta regression analysis, healthy living practice rate was found to be significantly higher in the areas with a less number of cigarette retailers, participating in healthy city projects, a low proportion of people who perceive their body type as obesity, a higher proportion of women, and a lower proportion of spouses. Conclusion: In order to improve healthy living practices, the regulations on health risk businesses, the spread of Healthy City project, and policy efforts awaring obesity are recommended.

• Journal of Digital Convergence
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• v.13 no.10
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• pp.549-559
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• 2015

This study aimed to find the problems of evidence-based complementary and alternative medicine and seek the future development direction by evaluating the quality of oriental medicine related systematic review(SR) studies using AMSTAR tool. The 26 SR studies related to oriental medicine were searched from the database of DBPIA, OASIS, and KISS, and they were evaluated on the basis of AMSTAR. The average of AMSTAR for the quality assessment of SR studies was 6.0 point, and the 26 studies included 2 high quality studies (7.7 %), 21 normal quality studies (80.8 %), and 3 low quality studies (11.5 %). The quality of studies was not correlated with the publication years. The quality of oriental medicine related SR studies need to be improved steadily. Furthermore, continued efforts to promote the evidence-based practice in the field of Oriental Medicine will help to establish foundation for the convergence approach in the healthcare sector.

• Journal of Home Health Care Nursing
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• v.20 no.2
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• pp.141-151
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• 2013

Purpose: The purpose of this study was to examine the economic effectiveness of by conducting a literature review of published articles, masters theses, and doctoral dissertations. Method: Prior to the literature review, inclusion-exclusion criteria were established. We then reviewed 1,029 CINAHL, MEDLINE, and Cochrane DB papers, and 153 RISS papers collected between Results: A total of 12 studies met the inclusion-exclusion criteria.-effectiveness: 6 cost-effectiveness studies, 1 cost-utility studies, and 5 cost-benefit studies. Each of the 12 reviewed studies concluded that home care nursing had greater economic benefits than other compared healthcare services. Conclusion: Home care nursing has significant economic benefits in multi health care service settings and for various patient groups. Therefore these results will be used a critical evidence for the development of economically effective home based health care systems for future policy making.

• Health Policy and Management
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• v.23 no.2
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• pp.132-144
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• 2013

Background: The purpose of this study was to analyze the medical expense change and influencing factors after introducing longterm care insurance system. The study period was 2 years before and after introduction of the system. Methods: We analyzed data collected from two divided group lived in Incheon. Four hundred and eighty-five elderly who received long-term care wage for one year were selected for experimental group. For control group, 1,940 elderly were selected by gender and age stratified random sampling. Difference-In-difference analyses was used for evaluating policy effectiveness. Also multiple regression analyses were conducted to identify the factors associated with total medical expenditures. The control variables were demographic variables, economic status, diseases, and medical examination variables. Results: Difference-in-difference analyses showed that total average medical expenses among long-term patients has decreased by 61.85%. Of these, the hospitalization expenses have decreased by 91.63% and the drug expenses have increased by 31.85%. Multiple regression analyses results showed that total average medical expenses among long-term patients have significantly decreased by 46.5% after introducing the long-term care insurance. The hospitalization expenses have significantly decreased by 148.5%, whereas the drug expenses have increased by 53.6%. And outpatient expenses have increased by 10.4%, but the differences were not statistically significant. Conclusion: The results showed that total medical expenses and hospitalization expenses have decreased after introducing the long-term care insurance. These results could support the opinion that the health insurance spending among long-term patients will be reduced gradually by long-term care insurance through changing medical demand.

• Korea Journal of Hospital Management
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• v.21 no.1
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• pp.14-31
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• 2016

Obesity of adolescents causes mental and physical problems as well as social problems, which need prevention and management. Although a number of systematic reviews and meta-analyses on obesity programs for adolescents were conducted, there is no study evaluating the programs based on CCM(Chronic Care Model), an organizing framework for improving chronic illness care. This study was conducted to review the features of studies in obesity management programs and interventions of the selected studies were evaluated in terms of inclusion of components of the Chronic Care Model. 4 databases were searched for relevant studies in obesity management programs, which were published from 1994 to 2014 in Korea. Results were analyzed in a qualitative way. 14 studies were satisfied inclusion criteria. The interventions most frequently utilized the elements of self-management support(66.7%) and only 1 of the studies included more than three components of CCM. This study presents the direction of health policies about managements of metabolic syndrome, which means that we identified effective process of the obesity management programs for adolescents in Korea and also this study will be used as a basic information for the development of obesity management program.

• The Journal of Korean Medicine
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• v.43 no.4
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• pp.102-130
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• 2022

Objectives: The persistence and unpredictability of coronavirus disease (COVID-19) and new measures to prevent direct medical intervention (e.g., social distancing and quarantine) have induced various psychological symptoms and disorders that require self-treatment approaches and integrative treatment interventions. To address these issues, the Korean Medicine Mental Health (KMMH) center developed a field manual by reviewing previous literature and preexisting manuals. Methods: The working group of the KMMH center conducted a keyword search in PubMed in June 2021 using "COVID-19" and "SARS-CoV-2". Review articles were examined using the following filters: "review," "systematic review," and "meta-analysis." We conducted a narrative review of the retrieved articles and extracted content relevant to previous manuals. We then created a treatment algorithm and recommendations by referring to the results of the review. Results: During the initial assessment, subjective symptom severity was measured using a numerical rating scale, and patients were classified as low- or moderate-high risk. Moderate-high-risk patients should be classified as having either a psychiatric emergency or significant psychiatric condition. The developed manual presents appropriate psychological support for each group based on the following dominant symptoms: tension, anxiety-dominant, anger-dominant, depression-dominant, and somatization. Conclusions: We identified the characteristics of mental health problems during the COVID-19 pandemic and developed a clinical mental health support manual in the field of Korean medicine. When symptoms meet the diagnostic criteria for a mental disorder, doctors of Korean medicine can treat the patients according to the manual for the corresponding disorder.

• Clinical Endoscopy
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• v.55 no.2
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• pp.167-182
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• 2022

Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Cardiopulmonary complications are usually temporary. Most patients recover without sequelae. However, they may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.4
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• pp.423-432
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• 2014

Purpose: This study was done to evaluate effectiveness of deep breathing exercise as a postoperative intervention to prevent pulmonary complications. Methods: A search of databases from 1990 to 2012 was done including MEDLINE, EMBASE, CINAHL, Cochrane Library and eight Korean databases. Ten studies met eligibility criteria. Researchers trained in systematic review, independently assessed the methodological quality of selected studies using the Cochrane's risk of bias tool. Data were analyzed using RevMan 5.2 program. Results: Among ten RCTs in four studies, deep breathing exercise was compared with an instrument using interventions such as incentive spirometry, in the other four studies deep breathing exercise was compared with non-intervention, and in last two studies bundles of interventions including coughing and early ambulation were assessed. A significant difference was found between deep breathing exercise group and non-intervention group. The odds ratio (OR) of occurrence of pulmonary complications for deep breathing exercise versus non-intervention was 0.30. However, there was no significant difference between deep breathing exercise group and incentive spirometry group (OR=1.22). Conclusion: Deep breathing exercise is vital to improving cost-effectiveness and efficiency of patient care in preventing postoperative pulmonary complications. For evidence-based nursing, standardized guidelines for deep breathing in postoperative care should be further studied.