• Journal of Korea Society of Industrial Information Systems
• /
• v.14 no.2
• /
• pp.32-50
• /
• 2009

Since 1990 when order communication system(OCS) was first introduced, the use of information technology in medical service has been widely accepted in order to enhance quality and customer relationship as well as to increase managerial efficiency. Medical information system is rapidly increasing and is trying to make ubiquitous healthcare environment through telemedicine system. Especially, medical profession and government have taken interest in electronic medical record (EMR) system which can digitalize and manage all medical records in hospitals. By recording patient's medical information in real time, EMR system can improve service efficiency and customer service quality including short waiting time, various utilization of clinic information, and reduced cost.

• Korean Journal of Acupuncture
• /
• v.40 no.4
• /
• pp.194-205
• /
• 2023

Objectives : This study investigated the current utilization status of thermotherapy devices in Korean medicine (KM) institutions and identified areas for improvement and further development, as perceived by KM doctors (KMDs). Methods : An online survey was conducted, targeting KMDs primarily engaged in clinical patient care. The questionnaire included items about respondents' clinical practices, the extent of thermotherapy device usage, their opinions on these devices, and perceived improvement needs. The collected data underwent quantitative analysis. Results : From the 1,025 respondents, data from 862 respondents who provided complete responses were analyzed. On average, respondents utilized thermotherapy treatments for 80% of their patients. Infrared (IR) phototherapy unit, electrical moxibustion apparatus, and heater-based thermotherapy devices were predominantly owned by respondents, with IR being the most frequently used. The average satisfaction score for current thermotherapy devices was 79. A significant concern raised was the necessity for improved health insurance coverage and efficacy evaluation. Conclusions : This research has confirmed that the extensive use of thermotherapy devices by KMDs in treating primarily musculoskeletal and gastrointestinal ailments - common conditions among patients in KM institutions. The main areas identified for improvement encompass safety, cost-effectiveness, and device efficacy. Future enhancements in thermotherapy devices should address these crucial aspects.

• Annals of Hepato-Biliary-Pancreatic Surgery
• /
• v.27 no.1
• /
• pp.56-62
• /
• 2023

Backgrounds/Aims: Endoscopic retrograde cholangiopancreatography-guided gallbladder drainage (ERGD) is an alternative to percutaneous cholecystostomy (PTC) for hospitalized acute cholecystitis (AC) patients. Methods: We retrospectively analyzed propensity score matched (PSM) AC hospitalizations using the National Inpatient Sample database between 2016 and 2019 to compare the outcomes of ERGD and PTC. Results: After PSM, there were 3,360 AC hospitalizations, with 48.8% undergoing PTC and 51.2% undergoing ERGD. There was no difference in median length of stay between the PTC and ERGD cohorts (p = 0.110). There was a higher median hospitalization cost in the ERGD cohort, $62,562 (interquartile range [IQR] $40,707-97,978) compared to PTC, $40,413 (IQR $25,244-65,608; p < 0.001). The 30-day inpatient mortality was significantly lower in hospitalizations with ERGD compared to PTC (adjusted hazard ratio 0.16, 95% confidence interval [CI]: 0.1-0.41; p < 0.001). There was no difference in association with blood transfusions, acute renal failure, ileus, small bowel obstruction, and open cholecystectomy conversion (p > 0.05) between hospitalizations with ERGD and PTC. There was lower association of acute hypoxic respiratory failure (adjusted ratio [AOR] 0.46, 95% CI: 0.29-0.72; p = 0.001), hypovolemia (AOR 0.66, 95% CI: 0.49-0.82; p = 0.009) and higher association of lower gastrointestinal bleed (AOR 1.94, 95% CI: 1.48-2.54; p < 0.001) with ERGD compared to PTC. Conclusions: ERGD is a safer alternative to PTC in patients with AC. The risk complications are lower in ERGD compared to PTC but no difference exists based on mortality or conversion to open cholecystectomy.

• Journal of Nutrition and Health
• /
• v.46 no.2
• /
• pp.137-146
• /
• 2013

The purpose of this study was to evaluate diet-related Quality of Life (QOL) and to analyze the relationship among diet-related QOL, dietary regimen practice, health-related QOL, and gastrointestinal symptoms in hemodialysis patients. Subjects were recruited from an artificial kidney center in Seoul. The self-report questionnaire consisted of socio-demographic characteristics, diet-related QOL, compliance with dietary regimen practice, health-related QOL, and gastrointestinal symptoms was distributed. Diet-related QOL includes a 'Quality of Life and Related to Dietary Change Questionnaire', 'Satisfaction Survey', and 'Dietary Impact Survey'. According to their responses, participants had experienced the greatest difficulty with 'Dietary Impact'. In particular, the mean score for general health was low. Association of dietary regimen practice showed a positive association with 'Cost' and 'Self-care' score. In addition, diet-related QOL showed positive correlation with health-related QOL, particularly in 'taste'. Scores for 'Taste', 'Convenience', and 'Dietary Impact' were lower for subjects with constipation compared to those of subjects without constipation. Scores for 'Taste' and 'Dietary Impact' were lower in subjects with irritable bowel syndrome compared to those of subjects without the syndrome (p < 0.05). Diet-related QOL showed a positive association with health-related QOL (p < 0.05), whereas it showed a negative association with constipation (p < 0.01). In conclusion, hemodialysis patients in Korea suffer from burden of dietary regimen practice and most scores for diet-related QOL and health-related QOL from patients with gastrointestinal symptoms were low. Therefore, appropriate nutrition education considering gastrointestinal symptoms is necessary for improvement of patients' QOL during dietary regimen practice.

• Journal of Hospice and Palliative Care
• /
• v.13 no.2
• /
• pp.81-88
• /
• 2010

Purpose: This study was conducted to study the attitude of Korean lawyers toward withdrawal of life sustaining treatment, and compare and analyze different types of their attitudes. Methods: Research design of this project was Q methodology approach. The study population was 24 lawyers, aged from 32 to 69 years. Q sample to investigate the attitude of the lawyers toward withdrawal of life sustaining treatment included 34 statements obtained from literatures, TV debate, and depth interviews of 5 lawyers among the lawyers included. After listening to the purpose and method of the study, the 24 lawyers agreed to fill out a survey asking sociodemographic information, and the information was distributed in 9 scale Q-sample. Results: The collected data were processed through QUANL PC program and sorted into 5 types as follows: The first type was 'Choosing to withdraw life sustaining treatment', the second 'Withholding life sustaining treatment' regardless of the cost, the third is neutral type that claims that humans have the right to decide the death and life, and demands the proper legalization to protect such rights, the fourth type agrees to withdrawal of life sustaining treatment, nevertheless, admits that one has a rigt to withhold one's own life treatment, categorized as self contradiction type. The fifth type believed that 'Life and death are providential' with the faith, therefore, such authority to decide life and death belongs to God, but not human beings. Conclusion: In conclusion, the lawyer's attitudes toward withdrawal of life sustaining treatment were grouped into five different types as follows: 'Choosing to withdraw life sustaining treatment', 'Withholding life sustaining treatment', 'Demanding legalization', 'Self contradiction type', and 'Life and death are providential'.

• Journal of The Korean Ophthalmological Society
• /
• v.59 no.11
• /
• pp.1039-1048
• /
• 2018

Purpose: To evaluate the effects of anti-vascular endothelial growth factor (VEGF) treatment on the healthcare-related finances of patients with age-related macular degeneration. Methods: Changes in health care financing due to newly introduced benefit standards were predicted over the coming 5-year period (2018-2022). We also analyzed the financial impact of scenarios in which agents similar to anti-VEGF, such as the over-licensed drug bevacizumab, were introduced. For this purpose, the future number of patients receiving anti-VEGF treatments was estimated for various scenarios based on National Health Insurance Corporation claims data followed by an estimate of the financial burden. Results: In the case of age-related macular degeneration, the current standard of care (14 times in a lifetime) was maintained in scenario 1. In 2018, the insurance budget for the coming 5-year period was estimated at approximately 440.3 billion won. The insurance cost for that period was estimated at approximately 560.1 billion won under the revised standard of December 2017 (scenario 2). For scenarios wherein, after 2020, similar treatments (scenario 3) and bevacizumab (scenario 4) were introduced, the estimated health insurance costs were 521 billion won and 419.7 billion won, respectively. Conclusions: Health insurance costs are projected to increase substantially due to the elimination of the 14 time pay standard; however, the actual budget will only moderately increase, due to new limitations of visual acuity ${\leq}0.1$ or in case of scarring/atrophic lesions. Clinically similar agents and bevacizumab could be considered as alternatives to anti-VEGF treatment for age-related macular degeneration.

• Korea Journal of Hospital Management
• /
• v.6 no.1
• /
• pp.120-146
• /
• 2001

This study was carried out to provide the essential information in improving the graduate medical education in Korea. For the study, a survey targeting the directors of GME of nationwide teaching hospitals was performed with a questionnaire asking the questions such as the director's perception on the quality of GME, trainees' salary level, trainees' specialty selection tendency, training system and its duration. The collected data were analyzed using t-test, ANOVA, and $x^2$-test. The results were as follows: 1. The survey were executed on 240 teaching hospitals in Korea and the response rate was 66.2% (159 hospitals replied). 2. The bigger a hospitals is the better in Quality of education. Larger hospitals tend to have better status in all items including medical specialists' experience, contents of medical curriculum, general environment for medical education and medical trainees's salary level. The result supported the general perception on the positive relationship between hospital size and Quality of GMA. 3. Providing convenience for medical trainees who prepares for the medical specialist Qualifying examination didn't affect the results of the examination. 4. The directions of GME have a perception that the trainees give positive impact on financial performance of their hospitals. This seems to be one of the reasons that hospitals try to retain as many trainees as possible. 5. The directors of GME considered medical trainees as an educate, and most of them responded positively on the need of governmental supports for the education cost and the trainee's salary. Considering above results, it seems that GME would get more social attention and the trainees' impact on hospitals operation would be increased more than before. In response to these trends, hospitals would find out the ways to lower dependency on trainees, and this change of attitude of hospitals on the GME would cause problems in operation of hospitals and GME itself. In order to prevent these problems the policy on GME should be directed in following ways. 1. The contents of Qualifying examination for specialist should be improved. 2. The curriculum of GME should be strictly followed. 3. The status of trainee in a hospital has to be defined as eductee. 4. Government has to support a half of the education cost and salary of trainee. 5. The distribution of the trainee among the hospital group have to be based on total available. 6. The financial support and welfare of trainee should be improved gradually and systematically.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.4
• /
• pp.614-623
• /
• 2017

The purpose of this study is to analyze the impact of the financial performance of regional public hospitals on their efficiency. In addition, the analysis of their efficiency using environmental factors, such as the market share, operating mode, and size of the regional public hospitals, as well as the factors influencing their efficiency, are selected by selecting the input and output factors of the hospitals and some differences were found between them. The DEA index and financial performance of the 31 regional public hospitals were calculated for the three years from 2012 to 2014. ANOVA and hierarchical regression analysis were used. As a result, there was a significant difference in their efficiency according to the environmental factors, such as the city scale of the regional public hospital, the number of hospital beds, and their business performance, productivity, and publicness. The medical profit margin (p<0.05), labor cost investment efficiency (p<0.05) and HHI (p<0.05) were found to affect the efficiency. In order to identify the inefficiencies of the regional public hospitals and increase their efficiency, it is necessary to measure the efficiency of the input resources and to reduce their cost. In addition, if the regional public hospitals were to provide specialized services, such as specialized functions of medical care that would give them a competitive advantage over private hospitals, their operational efficiency would be enhanced and they would be able to fulfill their role as public medical institutions.

• Journal of agricultural medicine and community health
• /
• v.27 no.2
• /
• pp.17-26
• /
• 2002

Reducing the level of stress and insomnia by aromatherapy is proposed as a method of self-care and health promotion in the future. Of the people who received aromatherapy from July, 1999 to February, 2000 at the Complementary and Alternative Medicine Center at the Gyeongu City Health Center, 48 people agreed to participate in a questionnaire survey, presented before and after their aromatherapy, and the data were analyzed. When the people received aromatherapy at the Complementary and Alternative Medicine Center, they inhaled the aroma from a vaporizer and when at home, they inhaled from a tissue, gauze or washbowl. Two sessions per week (2 hrs./session) were provided at the Center in the total 1-month duration of the therapy. The oil made from a blend of clarysage, geranium, rose at a ratio of 3:2:1 was used for relieving stress, and the oil made from a blend of clarysage, lavender, and lemon at 2:2:1 ratio was used for relieving insomnia. The scores of stress of 92.5 17.5 points before aromatherapy significantly reduced to $87.4{\pm}4.2$ points after therapy(p<0.01), and the scores of insomnia of $2.5{\pm}1.2$ points before aromatherapy significantly reduced to $1.0{\pm}1.1$ points after therapy(p<0.01). The reduction in stress and insomnia from aromatherapy was more significant in those who were experiencing high levels of stress and insomnia. Therefore, stress and its related insomnia can be effectively relieved with proper application of aromatherapy. With benefits such as little side-effects, convenient and simple education, low cost, and the do-it-yourself feature. aromatherapy can be expanded into a self-management program for promoting health of the community people.

• Health Policy and Management
• /
• v.34 no.2
• /
• pp.196-210
• /
• 2024

Background: In January 2018, revised elderly fixed outpatient copayment for the elderly were implemented. When people ages 65 years and older receive outpatient treatment at clinic-level medical institutions (clinic, dental clinic, Korean medicine clinic), with medical expenses exceeding 15,000 won but not exceeding 25,000 won, their copayment rates have decreased differentially from 30%. This study aimed to examine the changes of health utilization of elderly after revised elderly fixed outpatient copayment. Methods: We used Korea health panel data from 2016 to 2018. The time period is divided into before and after the revised elderly fixed outpatient copayment. We conducted Poisson segmented regression to estimate the changes in outpatient utilization and inpatient utilization and conducted segmented regression to estimate the changes in medical expenses. Results: Immediately after the revised policy, the number of clinic and Korean medicine outpatient visits of medical expenses under 15,000 won decreased. But the number of clinic outpatient visits in the range of 15,000 to 20,000 won and Korean medicine clinic in the range of 20,000 to 25,000 won increased. Copayment in outpatient temporarily decreased. The inpatient admission rates and total medical expenses temporarily decreased but increased again. Conclusion: We confirmed the temporary increase in outpatient utilization in the medical expense segment with reduced copayment rates. And a temporary decrease in medical expenses followed by an increase again. To reduce the burden of medical expense among elderly in the long run, efforts to establish chronic disease management policies aimed at preventing disease occurrence and deterioration in advance need to continue.