• Korean Journal of Clinical Pharmacy
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• v.32 no.1
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• pp.13-19
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• 2022

Background: The use of combination therapy and fixed-dose combination therapy is increasing for the treatment of type 2 diabetes. Sodium glucose cotransporter-2 inhibitor (SGLT2i) is a drug class used in combination with metformin. Methods: Type 2 diabetes patients on SGLT2i/metformin combination therapy were extracted from the 2019 Health Insurance Review & Assessment Service-National Patients Sample. On July 1, 2019, SGLT2i and metformin fixed-dose combination (SGLT2i/metformin FDC) and two-pill combination (TPC) groups were identified, and a chi-square test and multiple logistic regression were performed. Results: Of total 2,992 patients, 1,077 (36%) were prescribed SGLT2i/metformin FDC and 1,915 (64%) were prescribed TPC. We found that the most common comorbidities were in the order of dyslipidemia, gastrointestinal disease, and hypertension. Multiple logistic regression analysis showed that the use of SGLT2i/metformin FDC was lower than TPC in patients with diabetic neuropathy (OR=0.76, p=0.008). Clinic (OR=2.09, p<0.001) and general hospital (OR=1.40, p=0.019) showed higher tendency to prescribe SGLT2i/metformin FDC compared to tertiary hospital. The tendency of prescribing SGLT2i/metformin FDC was lower in Kyeonggi (OR=0.79, p=0.037), Gyeongsang (OR=0.77, p=0.025) and Chungcheong (OR=0.68, p=0.007) than Seoul. Conclusion: Factors related to the use of SGLT2i/metformin FDC in patients with type 2 diabetes were complication, medical institution and region. The tendency to prescribe SGLT2i/metformin FDC was relatively higher in clinics than in tertiary general hospitals and in Seoul than in other regions.

• Journal of Hospice and Palliative Care
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• v.25 no.2
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• pp.76-84
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• 2022

Purpose: We compared cost-effectiveness parameters between inpatient and home-based hospice-palliative care services for terminal cancer patients in Korea. Methods: A decision-analytic Markov model was used to compare the cost-effectiveness of hospice-palliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW). Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results. Results: Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled. Conclusion: Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.

• Korean Journal of Clinical Pharmacy
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• v.33 no.2
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• pp.113-121
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• 2023

Background: Globally, the number of patients with aspergillosis is increasing, and the mortality rate remains high. This study aimed to investigate prescribing patterns of antifungal drugs for patients with aspergillosis in South Korea using real-world data. Methods: This retrospective cross-sectional study was performed using National Patient Sample (NPS) data collected by the Health Insurance Review and Assessment Service (HIRA) during 2011-2020. The use of antifungal drugs in patients with aspergillosis was investigated. Results:A total of 1374 patients were identified: 333 patients with invasive pulmonary aspergillosis (IPA) (24.2%), 436 patients with other PA (31.7%), 73 patients with other forms of aspergillosis (5.3%), and 532 patients with unspecified aspergillosis (38.7%). The odds of receiving an antifungal prescription were higher for IPA than for other PA (aOR, 0.233; p<0.001), and higher for hematologic malignancies than for respiratory disorders other than cancer or infections (aOR, 10.018; p<0.001). During each hospitalization period, 56.1% (97/173) and 6.4% (11/173) of IPA hospitalizations received voriconazole and itraconazole monotherapy, respectively, whereas 44.3% (27/61) and 27.9% (17/61) of other PA hospitalizations received itraconazole and voriconazole monotherapy, respectively. Among outpatients with IPA, 67.5% (85/126) and 26.2% (33/126) received voriconazole and itraconazole alone, respectively, whereas among outpatients with other PA, 86.1% (68/79) and 12.7% (10/79) received itraconazole and voriconazole alone, respectively, during the year. Conclusion: In Korea, voriconazole monotherapy was preferred in IPA inpatients, and itraconazole monotherapy was preferred in other PA inpatients. In the ambulatory care settings for IPA and other PA, itraconazole monotherapy was preferred.

• Korean Journal of Clinical Pharmacy
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• v.33 no.4
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• pp.261-269
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• 2023

Background: Acute rhinosinusitis (ARS) is a common condition encountered in ambulatory practice and is one of the most common reasons for antibiotic prescriptions. This study aimed to evaluate the potentially inappropriate antibiotic prescribing for ARS in South Korea and identify influencing factors. Methods: We analyzed Health Insurance Review and Assessment Service-National Patient Samples data. We selected outpatients aged 20 to 64 with ARS, prescribed antibiotics between February and November 2020. Potentially inappropriate antibiotic prescribing was categorized as: 1) inappropriate antibiotic selection and 2) inappropriate antibiotic dosage or duration. Multiple logistic regression was conducted to estimate the impact of various factors on inappropriate antibiotic prescribing. Results: Of 1,210 patients, 80.83% received potentially inappropriate ARS antibiotic prescriptions. Inappropriate antibiotic selection accounted for 43.55%, and inappropriate antibiotic dosage and duration contributed to 37.28%. Otolaryngologists had higher odds ratio (OR) of potentially inappropriate antibiotic prescribing compared to internal medicine practitioners, while dentists had lower OR. Patients aged 20 to 29 years had a higher OR than other age groups, and those who visited primary care clinics had a higher OR than those who visited hospitals. Conclusion: Potentially inappropriate antibiotic prescribing for ARS is prevalent in South Korea. This study identified physician specialty, patient age group, and the level of healthcare facility as factors influencing potentially inappropriate antibiotic prescriptions. Addressing this issue through targeted interventions, such as improved guidelines adherence and patient education, is imperative to mitigate the risks associated with antibiotic misuse and antibiotic resistance.

• Journal of Radiation Protection and Research
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• v.49 no.3
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• pp.141-150
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• 2024

Background: Computed tomography (CT) scans in the Republic of Korea have spiked, reaching approximately 9 million examinations annually in 2017. CT provides significant medical benefits, but radiation exposure remains a concern. This study aims to analyze CT scans in Korea, as a basis study for radiation safety management. Materials and Methods: The raw data of total CT scans was obtained from the Health Insurance Review & Assessment Service and analyzed by CT scan type, patients' age and sex, and medical facility type. CT scans trends were analyzed considering the disease incidence. Results and Discussion: In 2017, CT scans accounted for 8,977,300. Usage per capita was 0.18 in males and 0.17 in females. CT scans increased with age until the 50- to 59-year-old groups, then decreased. CT scans were high in abdominal/pelvic (35%), chest (26%), and head (22%) regions due to higher disease rates. Head CT was most frequently used for infants and children. Abdominal/pelvic, chest, and spine CT were more frequent for older groups. The CT scans in the upper and lower extremities was high in child and juvenile groups. Chest and abdominal/pelvic CTs were higher in males, whereas spine, whole spine, and CT densitometry were higher in females. The proportion of CT scans of tertiary and general hospitals, hospitals, and clinics accounted for ≥80%, 13%, and 5%, respectively. Abdomen/pelvis, chest, and head/neck CTs were mostly conducted in tertiary and general hospitals, spine CT in hospitals and clinics, extremity CT in hospitals, and CT densitometry in clinics. Conclusion: The trend of CT scans varied based on the incidence rate for each patient's sex and age, and serious illness diagnosis by medical facility type. The results of this study provide data and guidance for evaluating the radiation exposure of the Korean population by CT and developing management policies for medical radiation safety.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.8
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• pp.407-414
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• 2016

This study was conducted to provide basic data to evaluate the appropriateness of convalescent hospitalization treatment by investigating the number of hospitalization days and the total treatment expenses of a total of 44,037 monthly billing statements requested from the Health Insurance Review and Assessment Service. Evaluated data consisted of medical care expenses of patients of the diem payment system hospitalized at convalescent hospitals in Daejeon, Chungnam, Chungbuk and Sejong from January through December of 2014. According to the analysis result of the general characteristics of the study objects and the canonical correlation analysis of the top 15 main diagnosis names, 7 canonical functions have been deducted. Among them, six canonical functions were shown to be statistically significant (p<0.001), and canonical function 1 had a chi-squared value of 5955.49 and 98 degrees of freedom at p<0.001 level. Overall, the results indicated that if health and welfare service in the regional society is magnified, social hospitalization can be reduced.

• Clinical and Experimental Pediatrics
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• v.51 no.9
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• pp.977-986
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• 2008

Purpose : This study aims to estimate the financial cost of rotavirus infection in Korea in the year of 2005. Methods : The incidence rates used were from the epidemiological profile at Jeoungeub District (5.8 cases/1,000 children <5 years old for inpatients, and 22.65 cases/1,000 children <5 years old for outpatients, per year). The health care cost per capita of rotavirus infection (ICD code: A08.0) was extracted from the Health Insurance Review and Assessment Service database in Korea. The patient survey was conducted to capture information about non-medical costs and associated productivity loss incurred by adult caregivers. Results : The number of annual national cases among children <5 years old with rotavirus infection was estimated to be 69,122 (i.e., 55,030 outpatients and 14,092 inpatients). The total cost of rotavirus infection was estimated at 13.3 billion Korean won, comprising 11 billion Korean won (82.7%) of direct medical costs, 1.6 billion Korean won (12.0%) of direct non-medical costs (e.g., transportation and supplies), and 0.68 billion Korean won (5.1%) of productivity lost by adult caregivers. Conclusion : Rotavirus infection carries not only medical costs but also non-medical and indirect costs; together, these costs incur a significant burden on South Korean society. The impact of rotavirus on quality of life and health among patient caregivers was not considered in this study, but it does merit further research.

• Health Policy and Management
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• v.34 no.1
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• pp.17-25
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• 2024

Background: This study aimed to assess the appropriate allocation of emergency medical beds across 17 provinces and presume the economic benefits associated with such allocation. Methods: To estimate the optimal allocation of emergency medical beds by province, data from the Statistics Korea's "cause of death statistics (2014-2021)," regional statistics on "area, population, gender, age," and "population projections" were utilized. The "number of emergency beds by city and district" provided by the Health Insurance Review and Assessment Service was also used. In estimating the economic benefits of preventing avoidable emergency deaths due to the expansion of emergency medical facilities, guidelines from the Korea Development Institute and the Korea Transport Institute were referenced to calculate the wage loss costs associated with emergency deaths and estimate the economic benefits. Results: The optimal ratio of emergency medical beds allocation by region was highest in Gyeonggi, Seoul, Gyeongnam, Gyeongbuk, and Busan, while Daejeon, Jeju, and Sejong showed lower ratios. Additionally, the prevention of avoidable deaths and economic benefits resulting from the increase in emergency medical facilities were highest in Gyeonggi, Seoul, Gyeongbuk, Gyeongnam, and Busan. However, when standardized by population, the prevention of avoidable deaths and economic benefits were analyzed to be highest in Gyeongbuk, Chungnam, Jeonnam, Gyeongnam, and Busan. Conclusion: The results of this study can serve as foundational data for future policy measures aimed at addressing the imbalance in the supply of emergency medical facilities across regions. Considering regional characteristics in the distribution of emergency medical facilities is expected to ultimately increase the efficiency of national finances and yield economic benefits.

• Therapeutic Science for Rehabilitation
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• v.5 no.2
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• pp.23-33
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• 2016

Objectives: The aim of this study was to investigate the association between cognitive function and upper extremity function in the elderly. The articles were analyzed based on patient, intervention, comparison, and outcome using the P.I.C.O. principle. Methods: We systematically examined papers from January, 2000 to November, 2015 published papers through the foreign journals which were Medline & Pubmed for three months. mainly used key words were elderly, dementia, Alzheimer's disease, Mild cognitive impairment, age-related, aging, cognitive, upper extremity function, hand function, hand-grip strength, grip force, complex motor function, bimanual, dexterity, UE performance, and coordination. Results: The number of discovered outcomes for association between cognitive function and upper extremity function in the elderly was 7; grip strength & sex are impact on manipulation object, 1. The results show that cognitive function is associated with upper extremity function in the elderly. Conclusion: This study is expected to help selecting intervention, assessment tools according to the individual's degree of cognitive level and upper extremity function. In future domestic research, variety assessment tools need to be used and more qualitative level experiment will be carried out.

• Child Health Nursing Research
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• v.21 no.1
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• pp.37-45
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• 2015

Purpose: In this study, a comparison was done of the extent of health-related quality of life (HRQoL) for preterm and fullterm children during early childhood, and factors affecting HRQoL in the early childhood of premature children were analyzed. Methods: Eighty mothers of children born prematurely and 83 mothers of children born at fullterm listed on two Internet cafes were sampled for this study. The major instrument used for the study was the TNO-AZL Preschool Quality Of Life (TAPQOL) questionnaire. Results: Total score for HRQoL in the premature group was 80.5 (${\pm}9.9$) and for the full term group, 85.0 (${\pm}8.3$), on a 100-point scale. A comparison of the premature group and full term group showed that the domains which scored relatively lower with respect to HRQoL included the stomach, motor function, anxiety, liveliness and communication. Among the factors that have an impact on HRQoL were 'length of stay in neonatal intensive care unit (${\geq}7$ days)' and 'birth weight (<1,000 gm)'. The explanation power of the model was 17%, which was statistically significant. Conclusion: These findings indicate that a differentiated premature infant follow-up program for children who are hospitalized over 7 days in NICU or weighed under 1,000g at birth is urgently needed.