• Journal of Korea Entertainment Industry Association
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• v.13 no.8
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• pp.661-670
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• 2019

The purpose of this study was to analyze influential factors for blood transfusion for patients undergoing total knee arthroplasty and total hip arthroplasty, which are chronic degenerative arthritis, using the 2017 sample data of Health Insurance Review & Assessment Service, to research the impact of blood transfusion on the usage of medical services among arthroplasty patients, and ultimately to provide some information on how to offer quality medical services. The findings of the study were as follows: First, whether there were any significant differences in the use or nonuse of transfusion during total knee arthroplasty according to hospital characteristics and patient characteristics was compared. As for significant variables, the type of health care institution, the level of sickbed, gender and anemia were found to have been statistically significantly related. Second. whether there were any significant differences in the use or nonuse of transfusion during total hip arthroplasty according to hospital characteristics and patient characteristics was compared. As for significant variables, the type of health care institution and the level of sickbed were found to have been statistically significantly related. Third, whether there were any significant differences in the presence or absence of diabetes among the total knee arthroplasty patients according to hospital characteristics and patient characteristics was compared. As for significant variables, the type of health care institution, the number of sickbed and anemia were found to have been statistically significantly related. In the case of the total hip arthroplasty patients, there were no variables that were significantly related.

• The Korean Society of Law and Medicine
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• v.9 no.1
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• pp.385-411
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• 2008

The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

• Journal of Cadastre & Land InformatiX
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• v.47 no.1
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• pp.267-276
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• 2017

Damages have occurred in various fields such as agriculture, industry, and citizen's health due to the yellow dust. Therefore, it is urgent to take measures against it. In this regard, this study collected data of yellow dust over 11 days on a basis of Feb. 23. 2015 when yellow dust was the greatest after 2009, issue words analysis and recomposed health related tweet data. After testing the significance of yellow dust related diseases by association rule analysis with diseases, it obtained the study results as follows: As a result of significance test for the patients with rhinitis, asthma and conjunctivitis by acquiring the condition data of patients from the Health Insurance Review & Assessment Service, conjunctivitis appeared to be significant in 13 cities for 16 cities at 5% significance probability, while asthma and rhinitis showed a significance in 3 and 6 areas. As described above, it is possible to obtain information about citizens' health from SNS data, such as Tweet data and it is judged that these data will provide useful information for establishing measures of citizens' health care.

• Journal of Korean Foot and Ankle Society
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• v.23 no.3
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• pp.121-130
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• 2019

Purpose: To investigate the spatial distribution of diabetes-related lower limb amputations and analyze the relationship between the spatial distribution of diabetes-related lower limb amputations and regional factors. Materials and Methods: This study was performed based on the data from the Korean Health Insurance Review and Assessment Service, in 2016. The unit of analysis was the administrative districts of city·gun·gu. The dependent variable was the age- and sex-adjusted incidence of diabetes-related lower limb amputations and the regional variables were selected to represent two aspects: socioeconomic factors, and health and medical factors. Along with traditional ordinary least square (OLS) regression analysis, geographically weighted regression (GWR) was applied for spatial analysis. Results: The age- and sex-adjusted incidence of diabetes-related lower limb amputation varied according to region. OLS regression showed that the incidence of diabetes-related lower limb amputation had significant relationships with the health and medical factors (number of healthcare institution and doctors per 100,000 population). In GWR, the effects of regional factors were not consistent. Conclusion: The spatial distribution of the incidence of diabetes-related lower limb amputations and the effects of regional factors varied according to the regions. The regional characteristics should be considered when establishing health policy related to diabetic foot care.

• 한국노년학
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• v.29 no.1
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• pp.37-50
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• 2009

The purpose of the present study was to develop a community-based intensive health care program for the community dwelling elderly to strength their functional status and to verify the effect on their geriatric syndrome. A one-group pretest-posttest design was used for the study. A total of 69 frail elderly, who lived in the area within 20 minutes by car, were committed themselves to the day care center(Sangikjae), and had the ability of verbal communication were selected from G city in Kyunggi province. The participants completed a set of questionnaires to measure the sub-score of frailty, fall, urinary incontinence, malnutrition, and mild cognitive disorder domain, using the Otasha-Kensin through the physical examinations and interviews. After 4 weeks of intervention, the outcome was measured to evaluate the effects of the program, and the data obtained were analyzed using descriptive statistics, paired t-test and McNemar test. The results showed that the sub-score of frailty, fall, urinary incontinence, and malnutrition domain were statistically significantly decreased after intervention except those of urinary incontinence and mild cognitive disorder domain, implying that the risk of frailty, fall, and malnutrition was decreased. These findings indicated that community-based the intensive health care program is effective for relieving geriatric syndrome of the community dwelling elderly.

• The Korean Society of Law and Medicine
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• v.23 no.3
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• pp.47-87
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• 2022

Due to the COVID-19 pandemic, non-face-to-face treatment was temporarily permitted. A lot of consensus has been formed on the need to continuous non-face-to-face treatment. However, the current 「Medical Service Act」 only permits telemedicine between doctors and medical personnel. On the other hand, as a result of legal interpretation, there is an opinion that non-face-to-face treatment is allowed. But considering the overall legal system, non-face-to-face treatment is not allowed. Nevertheless, we have to consider the reality such as the development of science and technology and the outbreak of infectious diseases. Therefore, it is not advisable to allow face-to-face treatment only. Ultimately, it is necessary to find ways to ensure that non-foce-to-face treatment can be performed in a safe and effective manner. And it should be institutionalized. This is strategically necessary and important. Therefore, we must look over ahead legal issues to be discussed. First of all, the scope, the target disease and the subject of implement have to be clear. Also, structurally, the standards of facilities and equipment must be prepared for non-face-to-face treatment to be implemented. Functionally, communication and information exchange between doctors and patients should be well conducted. In addition, the information protection management system that occurs in the process of non-face-to-face treatment should be materialized. Lastly, the issue of responsibility and cost of non-face-to-face treatment should be decided in detail. When these problems materialize, it can be expected that a safe non-face-to-face treatment environment will be established.

• Korea Journal of Hospital Management
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• v.22 no.3
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• pp.1-17
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• 2017

Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.

• Korean Circulation Journal
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• v.52 no.11
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• pp.814-825
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• 2022

Background and Objectives: Real-world trends in the utility and type of gatekeeping studies in invasive coronary angiography (ICA) requires further investigation. Methods: We identified outpatients who underwent noninvasive cardiac tests or directly ICA for suspected coronary artery disease (CAD) from the nationwide Korea Health Insurance Review and Assessment Service-National Patient Sample database between 2012 and 2018. Results: Among 71,401 patients, the percentage of patients who were evaluated for suspected CAD was 34.7% for treadmill test (TMT), 4.2% for single-photon emission computed tomography (SPECT), 24.2% for coronary computed tomography angiography (CCTA), 1.6% for multiple gatekeepers, and 32.3% for directly ICA without noninvasive studies. The proportion of CCTA as a gatekeeper showed linear increase, (18.6% in 2012 and 28.8% in 2018; p<0.001), while those of TMT, SPECT, and direct ICA have decreased (p<0.001, p=0.03, and p<0.001, respectively). The overall incidence of downstream ICA after gatekeeper was 13.8% (6,662/48,346), and SPECT showed higher ICA rate in pairwise comparison with TMT and CCTA (p<0.001). Patients who performed gatekeepers before ICA showed higher rate of subsequent PCI (34.7% vs. 32.3%; p<0.001) and CABG (3.5% vs. 1.0%; p<0.001), compared to those who directly underwent ICA, and CCTA was associated with higher revascularization rate after ICA in pairwise comparison with TMT and SPECT (p<0.001). Conclusions: Nationwide database demonstrated that CCTA is utilized increasingly as a gatekeeper for ICA and is associated with high revascularization rate after ICA in outpatients with suspected CAD.

• Journal of Korean Neurosurgical Society
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• v.65 no.6
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• pp.834-840
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• 2022

Objective : C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count are inflammatory markers used to evaluate postoperative infections. Although these markers are non-specific, understanding their normal kinetics after surgery may be helpful in the early detection of postoperative infections. To compliment the recent trend of reducing the duration of antibiotic use, this retrospective study investigated the inflammatory markers of patients who had received antibiotics within 24 hours after surgery according to the Health Insurance Review & Assessment Service guidelines and compared them with those of patients who had received antibiotics for 5 days, which was proven to be non-infectious. Methods : We enrolled 74 patients, divided into two groups. Patients underwent posterior lumbar interbody fusion (PLIF) at a single institution between 2019 and 2020. Group A included 37 patients who received antibiotics within 24 hours after the PLIF procedure, and group B comprised 37 patients who had used antibiotics for 5 days. A 1 : 1 nearest-neighbor propensity-matched analysis was used. The clinical variables included age, sex, medical history, body mass index, estimated blood loss, and operation time. Laboratory data included CRP, ESR, and WBC, which were measured preoperatively and on postoperative days (POD) 1, 3, 5, and 7. Results : CRP dynamics tended to decrease after peaking on POD 3, with a similar trend in both groups. The average CRP level in group B was slightly higher than that in group A; however, the difference was not statistically significant. Multiple linear regression analysis revealed operation time, number of fused levels, and estimated blood loss as significant predictors of a greater CRP peak value (r²=0.473, p<0.001) in patients. No trend (a tendency to decrease from the peak value) could be determined for ESR and WBC count on POD 7. Conclusion : Although slight differences were observed in numerical values and kinetics, sequential changes in inflammatory markers according to the duration of antibiotic administration showed similar patterns. Knowledge of CRP kinetics allows the assessment of the degree of difference between the clinical and expected values.

• The Korean Society of Law and Medicine
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• v.22 no.3
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• pp.3-30
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• 2021

Reasons for disqualification to restrict a medical person's license should be considered in functional and moral terms. In this sense, the grounds for disqualification of medical personnel should be expanded to include all crimes that have been declared to be "imprisonment without labor or greater punishment" by a court. Because a sentence of "imprisonment without labor or greater punishment" means that it is highly reprehensible and undermines the trust of the state as well as the trust in medical personnel. Therefore, the expansion of the scope of license restrictions for medical personnel cannot be regarded as a violation of "the Less Restrictive Alternative" rule. However, it is necessary to reflect the specificity of medical services in the license restrictions of medical personnel. This is because not all diseases can be treated with current medical services. In addition, unpredictable situations can occur at any time during medical practice. Consequently, the negligence that occurs during medical practice should be carefully examined from a functional perspective of the medical personnel. And it should be treated differently from ordinary crimes. To this end, an independent license review organization should be established to establish expertise in license management.