• Korea Journal of Hospital Management
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• v.21 no.1
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• pp.51-61
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• 2016

This study attempted to investigate how mass media marketing of a hospital influences patient volume. Additionally, the association of patient volume with exposure time and the type of mass media was examined. Data from a university hospital in Bundang (from January 2014 to November 2014) were used. Degree of physicians' mass media marketing was measured by the number of media exposure. Linear mixed model for repeated measures data was run to identify the associations between the number of media exposure and patient volume. First, the number of hospital physician's mass media exposure and new patients and the first visit patients were positively associated. Second, broadcasting media which has relatively significant in patient volume is TV programs such as cultural programs and news. Third, hospital physicians with higher ranks who were exposed to press media receive more patient appointment. Also, nonsurgical hospital physicians who were exposed to press media receive more patients. Fourth, medical treatment activities for hospital staff who hold the rank of Professor in case of making an appearance at press media have relatively increased. Hospital physician's media exposure, particularly TV programs, was significantly related to patient volume for outpatients.

• YAKHAK HOEJI
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• v.51 no.5
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• pp.327-335
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• 2007

This study was to evaluate economic impact of a comprehensive pharmaceutical care intervention provided by community pharmacists on drug-related morbidity and mortality in the elderly population, in a societal perspective. Clinical outcomes of pharmaceutical care included compliance increase, inappropriate medication discontinuation, and subsequent drug-related morbidity and mortality reduction. Economic outcomes included cost savings from direct medical costs reduction such as medication and healthcare resource utilization. Input costs for pharmaceutical care included pharmacist time and computerized prescription review supporting program costs. Model parameters of outcomes were derived from published literatures, and costs were from literatures and health insurance statistical data in Korea. Annual costs and benefits were estimated in the year 2005. Current usual care and standardized pharmaceutical care required 0.3 and 2.0 hours per year respectively, for elderly outpatient using average 4.4 prescription drugs per visit and average annual frequency of 17.8 pharmacy visits. Comprehensive pharmaceutical care provided to overall elderly outpatients at community pharmacies would have cost of \74,994 mil. and benefit of \357,002 mil. per year. Benefit:cost ratio was 4.8:1 and net benefit was \282,008 mil/year. It was corresponded to net benefit of \73,816/year for individual elderly patient. In addition, pharmaceutical care was estimated to reduce 1,531 drug-related deaths/year. Conclusively this study, a first attempt in Korea to evaluate an economic value of pharmaceutical care at community pharmacies, proved that it was a cost-effective intervention having significant economic benefit.

• Journal of Oral Medicine and Pain
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• v.38 no.2
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• pp.137-142
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• 2013

Oral Medicine includes temporomandibular disorder, orofacial pains such as neuropathic pain, soft tissue diseases, halitosis, laser treatment, snoring, sleep apnea and identification through forensic dentistry etc. Such diseases are relatively common and cause great inconvenience and pain to the patients, as well as incur fatal health scare at times. In terms of oral medicine, the number of orofacial patients is growing due to a change in the life style and an increased stress as time goes in contemporary society and the demand of areas requiring oral medical professionalism, such as soft tissue lesions, snoring and sleep apnea, forensic dentistry evaluation and others are rapidly ascending. Consequently, among the areas in dental science, the calls for the expertism in oral medicine and its role are mounting. Analyzing the distribution according to disease entity, symptoms, duration of disease, and the prehistory courses of new patients visiting the department of oral medicine in a year provides information of the role and the relative importance of oral medicine in prospect and enables effective diagnosis and treatments for the patients. Therefore, in the present study, by analyzing new patients visiting the oral medicine clinic in our dental hospital for a year and by evaluating the role and the professionalism in future oral medicine, the authors concluded the followings: 1. It was founded that new patients to oral medicine mainly had temporomandibular disorders, soft tissue diseases, and neuropathic pains. 2. The number of patients with temporomandibular disorder appeared to be the highest percentage and the order within this was the patients with combined disorders, muscle disorder, and internal derangement of joint disc. 3. The number of patients with xerostomia appeared to be the highest percentage within soft tissue disease, followed by lichen planus and recurrent apthous ulcers. 4. The number of patients with burning mouth syndrome appeared to be the highest percentage within neuropathic pain.

• Korean Journal of Psychosomatic Medicine
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• v.6 no.2
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• pp.104-119
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• 1998

This study was conducted to determine the important factors in the illness behavior of panic disorder patients. And then, find the best ways to lead the patients who have recurrent panic attacks to the adequate therapeutic situations. We studied 53 patients diagnosed as panic disorder according to DSM-IV among the outpatients who had been followed up at Bong Seng Memorial Hospital for 6 Ms, from May 1997 to October 1997. To evaluate the illness behaviors, we designed a checklist including socio-demographic data, degree of subjective distress from medical and psychiatric treatment, panic symptoms, life events, places of help-seeking, Anxiety Sensitivity Index. Using the checklist, we had semistructured interviews with the panic disorder patients to elucidate their help-seeking behaviors from first panic attack to diagnosing as panic disorder. The results were as follows ; 1) After first panic attack, the patients initially sought help at 1) Emergency room 40%, 2) Rest &/or Personal emergency care 35%, 3) Pharmacy 10%, 4) Outpatient care at hospital 10%, 5) Oriental medicine 5%. 2) Considering the panic symptoms, derealization, paresthesia and the severity of panic symptoms were the most important factors affecting the patient's help-seeking behaviors who had experienced the first panic attack. 3) Most of all the patients (80%) were apt to visit the hospitals within 15 days after experiencing about 3 panic attacks. 4) Before diagnosed as panic disorder, the patients had visited 3-5 health care centers during about 1 year. 5) Primary care physicaians(for example, emergency care physicians, family doctors and internists) had the most important roles in treating or guiding the patients to the adequate therapeutic situations. From the above results, the authors propose that non-psychiatric physicians have to know the panic disorder or attacks exactly. When patients complaint sudden onset physical symptoms e.g. palpitation, dyspnea, dizziness or the cognitive symptoms like the fear of death or insanity, physicians should consider the possibility of panic attack and encourage the patients to be evaluated for psychiatric illness.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.77-84
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• 2019

Objectives : The Illness Intrusiveness Rating Scale (IIRS) is a well-validated self-report instrument for assessing negative impact of chronic illness and/or adverse effects of its treatment on everyday life domains. Although extensive literature probed its psychometric properties in medical illness, little attention was paid for its validity for psychiatric population. This study aimed to test factorial structure of the Korean Version of the IIRS (IIRS-K) in a consecutive sample of psychiatric outpatients. Methods : Data set of 307 first-visit patients of psychiatric clinic at Guri Hanyang univ. Hospital were used. Exploratory and confirmatory factor analysis, internal consistency were tested in IIRS-K. We also checked Spearman's correlation analysis between IIRS-K, Zung's self-report anxiety scale and Zung's self-report depression scale. Results : 76.9% of the patients were with anxiety disorder and depressive disorder. The principal component factor analysis of the IIRS-K extracted three-factor structure accounted for 63.2% of total variance that was contextually similar to the original English version. This three-factor solution showed the best fit when tested confirmatory factor analysis compared to the original IIRS, two-factor model of IIRS-K suggested from medical outpatients, and one-factor solution. The IIRS-K also showed good internal consistency (Cronbach's α=0.90) and good convergent validity with anxiety and depression scales. Conclusions : The IIRS-K showed the three-factor structure that was similar but not identical to original version. Overall, this study proved factorial validity of the IIRS-K and it can be used for Korean clinical population.

• Journal of Oral Medicine and Pain
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• v.31 no.2
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• pp.185-197
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• 2006

The aim of this study was to investigate the beneficial effect of a daily dose of 300 mg of ASU taken for more than 3 months on the subjects diagnosed as osteoarthritis of temporomandibular joint by RDC/TMD. Total 68 outpatients(15-54y) of female except menopause in Orofacial Pain Clinics of the Pusan National University Hospital were randomly assigned to either an ASU group(n=36) or a placebo group(n=32). The pain, noise and limited mouth opening(LOM) were evaluated by numerical analogue scale(NAS, range 0-10) and maximum comfortable opening(MCO) were measured by milimeter scale. The difference of simple uptake rate(SUR) on bone scan, hot spot(HS) on coronal SPECT, condylar bony changes on CT between the ASU and placebo groups were compared to investigate the objective effect. The obtained results were as follows. 1. Comparison of the NAS of pain, noise, LOM and MCO before treatment and 3, 6 and 9 months after treatment showed no significant difference between the ASU and placebo groups. 2. Comparison of the NAS of pain, noise, LOM and MCO before treatment and 3, 6 and 9 months after treatment showed no significant difference between the ASU and placebo groups without splint treatment, but showed more increased MCO in the ASU group than the placebo group with splint treatment at 6, 9 months after treatment. 3. Comparison of the NAS of pain before treatment and 3, 6 and 9 months after treatment that the NAS of pain at first visit divided into two groups(above or below 6) showed more decreased the NAS of pain in the ASU group than the placebo group that the NAS of pain at first visit was above 6. 4. Comparison of the NAS of pain, noise, LOM and MCO during 6 months period showed improvement of clinical symptoms within group, but no significant difference between subjects. 5. The simple uptake ratio(SUR) on bone scan and hot spot(HS) on coronal SPECT showed more increased SUR and HS in affected side than non-affected side of the ASU and placebo groups. 6. Comparing of condylar bony changes, osseous remodeling were observed highest, osteophyte lowest in the affected and non-affected side of the two groups. After treatment, comparison of condylar bony changes were observed more decreased erosive features in the ASU group than the placebo group.

• Journal of Acupuncture Research
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• v.26 no.6
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• pp.121-132
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• 2009

Objectives : To evaluate the current status of East-West combination treatment in joint disorders. Methods : The medical records of patients who visited the Joints & Rheumatism Center at the Kyung Hee East-West Neo Medical Center from April 2006 to June 2009 were evaluated. The general characteristics of patients who underwent combination treatment, trend in number of cross-system referrals, and disorders and involved body regions of patients referred to the Eastern medical hospital from the Western medical hospital were initially assessed. 6 major disorders were found from the initial scanning. The trend in number of cross-hospital referrals, number of visits to the Eastern medical hospital, current status of combination treatment, treatment modality, and reason for cross-system referral was evaluated. Results : 1. 1510 patients were referred from the Eastern medical hospital to the Western medical hospital, and 1065 patients were referred from the Western medical hospital to the Eastern medical hospital. First visit patients reached a peak at the second quarter of 2007 and fourth quarter of 2006 respectively, and have steadily decreased from then on. Referrals of female patients were twice as common as male patient referrals. Patients in their sixth or seventh decade of life were most commonly referred, and more outpatients were referred compared to inpatients. 2. Patients with knee joint disorders were most commonly referred from the Western medical hospital to the Eastern medical hospital, followed by hip, shoulder, ankle, wrist, and elbow joint disorders. The most common disorders for each of the above regions in referred patients were knee osteoarthritis, avascular necrosis of the hip, adhesive capsulitis, and ankle strain and sprain. The generalized disorders rheumatoid arthritis and ankylosing spondylitis followed. 3. Patients referred to the Eastern hospital received approximately 3 to 10 Eastern medical treatment sessions. 45 percent remained on constant combination treatment, and 98 percent of referred patients received acupuncture treatment. Conclusions : In regard to the number of patients and duration of combination treatment, combination treatment was successfully performed for knee osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, while it was not so for avascular necrosis of the hip, adhesive capsulitis, and ankle strain and sprain. Further research on this subject is required.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.11 no.1
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• pp.11-23
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• 2016

Objectives : The purpose of this study was to investigate the characteristics and visiting patterns of traffic accident outpatients Methods : In this study, we reviewed the medical charts of 2,048 traffic accident patients who visited Jaseng Hospital of Korean Medicine from January 1st, 2012 to December 31st, 2012. Results : In the distribution of gender and of age patients, the male percentage was 52.3% and the majority of patients were in their thirties(47.2%). In the distribution of the patient's initial visit, most patients visited our clinic from Monday to Wednesday. By monthly distribution, the more patients visited the clinic at the latter half of the year. In the duration of treatment, 1,389 patients(67.8%) finished treatment within four weeks. The most frequently cited sites of pain were neck(82.0%), followed closely by low back(74.0%). In the access route, 746 patients(36.4%) visited our traffic accident clinic as a first choice for primary treatment. We referred patients for radiologic examination in 159 patients(7.9%), of which the exams were mainly lumbar spine MRIs(3.6%) and cervical spine MRIs(2.8%). The most frequent diagnosis were herniated nucleus pulposus. Conclusions : This study shows that most of the patients who visited the traffic accident clinic of a Korean Medical Hospital presented neck and low back pain, and the majority showed improvement without surgical treatment. Following the increasing minor injury rate caused by traffic accidents, we expect the role of Korean Medicine Hospital to become more prominent.

• Journal of Acupuncture Research
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• v.18 no.6
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• pp.1-13
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• 2001

Objective : To broaden understanding about relationship between Meridian Tendino-musculature and muscles in a lumbar area and to evaluate the effect of Meridian Tendino-musculature acupuncture and release therapy on acute lumbar sprain. Materials and Methods : From Oct. 1st, 2000 to Mar. 31th, 2001, 692 outpatient's chart of Kyung Won University Hospital were reviewed. Out of them, 39 outpatients were selected. they had low back pain, were diagnosed with acute lumbar sprain, showed only straightened curvature on lateral view of lumbar spine X-ray and get the Tendino-musculature acupuncture and release therapy. Results : 1. On patients' first visit, 72% had GrIII and Gr.IV predominantly. 2. Major muscles related with low back pain were divided into two groups. One was Quadratus lumborum group and the other was Rectus abdominis group. In the correlation with Meridian Tendino-musculature, the former was mainly related with Chok-taeyang(B) and slightly related with Chok-soyang(G), Chok-taeum(SP), the latter was mainly related with Chok-taeyum(SP), Chok-yangmyong(S) and slightly related with Chok-taeyang(B), Chok-soyang(G). 3. In the evaluation of treatment effect, Exellent was 27(69%), Good was 10(6%), Fair was 2(5%) and Bad was 0(0%). Fair rate reached 100% eventually. 4. Most of Gr.Ⅲ, Gr.Ⅳ patients who had severe conditions that almost every R.O.M. was limited and Milgram test positive was shown on the physical examination, were fully recovered and lived normal daily life without admission by Meridian Tendino-musculature acupuncture and release therapy within 3 to 5, 4 to 7 days, respectively, since they had started to get their outpatient treatment. 5. Two patients was troubled with pain induced, by twitching response and acupuncure stimuli, which lasted around acupunctured muscle for about a day after treatment, so they coudn't endure the pain and quitted treatment in spite of Fair condition. conclusion : Meridian Tendino-musculature acupuncture and release therapy was found to be helpful to patients who wish to recover from their back pain induced by acute lumbar sprain as soon as possible, but the treatment actually had some problems to be overcome such as pain during or after the treatment. therefor, in order to make this treatment method more available, we should pay more attention to improving treatment appliance and acupuncture technique.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.99-128
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• 2008

Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.