• Journal of Preventive Medicine and Public Health
• /
• v.45 no.5
• /
• pp.291-300
• /
• 2012

Objectives: We aimed to estimate the annual socioeconomic burden of coronary heart disease (CHD) in Korea in 2005, using the National Health Insurance (NHI) claims data. Methods: A prevalence-based, top-down, cost-of-treatment method was used to assess the direct and indirect costs of CHD (International Classification of Diseases, 10th revision codes of I20-I25), angina pectoris (I20), and myocardial infarction (MI, I21-I23) from a societal perspective. Results: Estimated national spending on CHD in 2005 was $2.52 billion. The majority of the spending was attributable to medical costs (53.3%), followed by productivity loss due to morbidity and premature death (33.6%), transportation (8.1%), and informal caregiver costs (4.9%). While medical cost was the predominant cost attribute in treating angina (74.3% of the total cost), premature death was the largest cost attribute for patients with MI (66.9%). Annual per-capita cost of treating MI, excluding premature death cost, was $3183, which is about 2 times higher than the cost for angina ($1556). Conclusions: The total insurance-covered medical cost ($1.13 billion) of CHD accounted for approximately 6.02% of the total annual NHI expenditure. These findings suggest that the current burden of CHD on society is tremendous and that more effective prevention strategies are required in Korea.

• Journal of Sasang Constitutional Medicine
• /
• v.16 no.2
• /
• pp.71-83
• /
• 2004

1. Objectives The purpose of nursing is to promote health and well-being for all persons. It is connected with Sasang Constitution theory have regard for viewpoint by other's a special quality & individual difference. A nursing is helping behavior to recover health, disease protection & self care ability through health education. There is need for Oriental nursing research continually. 2. Methods This study attempted to develop a fundamental nursing theory for Sasang Constitution on the focus "Dongyi Soose Bowon Sasang Chobongyun". Because the book is important to understand Lee Je-ma's early medical mind and thinking. 3. Results and Conclusions The Sasang Constitution theory lay great emphasis upon health caring medicine to promote health according to self Constitution at normal times, preventive medicine to manage byself body and mind in ordinary times. The way of Sasang Constitutional Nursing Theory is expected to set up a landmark stone in Korean nursing. It is also can product a new nursing theory. In view of 'Nature and Order' is explained inborned general human being who were gifted from nature. On the other hand, in view of 'Knowledge and Deed' based on Constitutions are explained autonomical human being. There are depend on independant control and make efforts themselves or not. It have a connected in four paradigm (human- environment-health- nursing) of nursing theory. The history taking stage claim caring of sick-people before. The ways of assesment for sick-people have to know a process of illness.

• Health Policy and Management
• /
• v.1 no.1
• /
• pp.27-41
• /
• 1991

The purpose of this study is to estimate cesarean section rate in Korea and analyze characteristics of health care institution which affect regional variation in the rate. We have searched vaginal and cesarean section deliveries among Diagnosis Related Group dat based upon insurance claim bills which have been submitted to Korean Insurance Corporation for two years since March, 1985. The results are as follows: 1. Out of all delivery cases of 87,500, cesarean section rate was 16.3% (14,299 cases). 2. Cesarean section rate varied according to size and ownership of health care institutions. In above 6- bed sized hospitals, the rate was at about 20% higher than small sized institutions, but rather in hospitals that have more than 500 beds, it was somewhat low. Classified by the hospital ownership, the rate was low at 18.4% in hospitals of religious organization and highest at private or corporate hospitals. 3. This study shows large regional variation in cesarean section rate; there are two times differences between region with the highest and lowest rate. Strongly related factors in that variation was the ownership of health care institution and urbanization variables. Low level of cesarean section rate in a region is explained by high proportion of delivery cases at institutions of religious organization and at insitutions in county level site. This result shows that apart from medical conditions of patients, indications of cesarean section differs from health care providers, and especially ownership of institution strongly affect them. Cesarean section rate in Korea is supposed to be at high level and development of utilization review programs to keep appropriate cesarean section rate is needed.

• Journal of Preventive Medicine and Public Health
• /
• v.56 no.2
• /
• pp.180-189
• /
• 2023

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has led to a global shortage of medical resources; therefore, we investigated whether COVID-19 impacted the quality of non-COVID-19 hospital care in Korea by comparing hospital standardized mortality rates (HSMRs) before and during the pandemic. Methods: This retrospective cohort study analyzed Korean National Health Insurance discharge claim data obtained from January to June in 2017, 2018, 2019, and 2020. Patients' in-hospital deaths were classified according to the most responsible diagnosis categories. The HSMR is calculated as the ratio of expected deaths to actual deaths. The time trend in the overall HSMR was analyzed by region and hospital type. Results: The final analysis included 2 252 824 patients. In 2020, the HSMR increased nationwide (HSMR, 99.3; 95% confidence interval [CI], 97.7 to 101.0) in comparison to 2019 (HSMR, 97.3; 95% CI, 95.8 to 98.8). In the COVID-19 pandemic zone, the HSMR increased significantly in 2020 (HSMR, 112.7; 95% CI, 107.0 to 118.7) compared to 2019 (HSMR, 101.7; 95% CI, 96.9 to 106.6). The HSMR in all general hospitals increased significantly in 2020 (HSMR, 106.4; 95% CI, 104.3 to 108.5) compared to 2019 (HSMR, 100.3; 95% CI, 98.4 to 102.2). Hospitals participating in the COVID-19 response had a lower HSMR (HSMR, 95.6; 95% CI, 93.9 to 97.4) than hospitals not participating in the COVID-19 response (HSMR, 124.3; 95% CI, 119.3 to 129.4). Conclusions: This study suggests that the COVID-19 pandemic may have negatively impacted the quality of care in hospitals, especially general hospitals with relatively few beds. In light of the COVID-19 pandemic, it is necessary to prevent excessive workloads in hospitals and to properly employ and coordinate the workforce.

• International Journal of Contents
• /
• v.13 no.2
• /
• pp.14-20
• /
• 2017

The purpose of this study was to investigate the association of obesity with medical care use and costs according to overall diseases, cerebrovascular diseases (CVD), ischemic heart disease (IHD), hypertension (HTN) and diabetes mellitus (DM). The final sample was a group of persons who were free of diseases mentioned above and were not underweight. Their baseline screening program data and health insurance contribution data were connected with a 7-year medical claim database. The participants were classified according to their baseline BMI into normal, overweight, obese, and severely obese groups. Given the disease type, the total costs of DM showed the largest difference in each obesity group in both males and females. Also, the pharmacy costs for DM were more relevant than any other type of service to the obesity level. Considering the high prevalence of obesity and the relevantly increased medical care use and costs, there is a need for reduction in medical costs through obesity prevention efforts.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.10
• /
• pp.5891-5893
• /
• 2013

Incidence/mortality of liver cancer follow logistic curves because there is a limit reflecting the prevalence of hepatitis virus carriers in the cohort. The author fitted logistic curves to incidence/mortality data covering the nine five-year cohorts born in 1911-1955 of both sexes. Goodness-of-fit of logistic curves was sufficiently precise to be used for future predictions. Younger cohorts born in 1936 or later were predicted to show constant decline in incidence/mortality in the future. The male cohort born in 1931-35 showed an elevated incidence/mortality of liver cancer early in their lives supporting the previous claim that this particular cohort had suffered massive HCV infection due to nation-wide drug abuse in the 1950s. Declining case-fatality observed in younger cohorts suggested improved treatment of liver cancer. This study demonstrated that incidence/mortality of liver cancer follow logistic curves and fitted logistic formulae can be used for future prediction. Given the predicted decline of incidence/mortality in younger cohorts, liver cancer is likely to be lost to history in the not-so-distant future.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.8
• /
• pp.3587-3590
• /
• 2015

In spite of limited data regarding the safety or effectiveness of electronic cigarette introduced into the market as a healthier alternative to tobacco smoking, its popularity has increased enormously. E-cigarettes have penetrated the market rapidly owing to the elaborate marketing network and attractive marketing strategies. Stated advantages include the claim that they help quit smoking and produce less exposure than conventional smoking. The list of disadvantages is even more elaborate. While the majority of the studies supporting health claims and efficacy for quitting smoking are not scientifically sound, they are also challenged by studies providing contradictory results. Owing to the limited evidence on the potential advantages and disadvantages of e-cigarettes, the debate on their safety continues.

• Health Policy and Management
• /
• v.7 no.1
• /
• pp.125-154
• /
• 1997

The hospital, clinical department and the physician factor in explaining variations of hospital resource use in surgically admitted patients was compared. This analysis was based on 6, 361 discharges in 28 hospitals for three surgical conditions - lens procedures anal and stomal procedures, uterine and ovarian procedures using medical insurnce claim data. The results were as follows: 1. Regression analysis indicated that the hospital and clinical department characteristics, such as hospital ownership and size, were more significant predictors of the resource use indicators than the physician and patients' social characteristics. 2. Regarding to the physician factors, the hospital where the physician received the residency training and the medical shool where he/she graduated had less effect compared to the hospitals where he/she currently works. Between the residency trained hospital and medical school, the is more important than the latter. 3. When the hospital charges were divided into type of service provided i. e. room, drug, laboratory & radiologic, procedure & operation, and anesthesic charges, variance due to the hospital factor was larger than that due to the physician factor in each item. In summary, the hospital and clinical departmental factor played an important role than physician factor ; indicating to reduce the variation in hospital resource use, the policy that affects hospital behavior would be more effective than that targets individual physician behavior.

• Korean Journal of Clinical Pharmacy
• /
• v.22 no.1
• /
• pp.73-80
• /
• 2012

This study was to determine the inappropriate drug use in pediatric outpatients who received 2 or more prescriptions on the same day. Retrospective drug utilization reviews (DURs) were implemented to samples obtained from national health insurance claims data during December 2008 to February 2009, using 5 DUR criteria (duplication, drug-drug interaction, drug-disease interaction, drug-age contraindication, incorrect dosage) established in the Drug Information Framework (DIF)-$Korea^{TM}$, DUR program. Among 38,451 claims analyzed in the study, 74.7% had more than one conflicts in the 5 DUR modules. Among 16,472 patients analyzed, 49.6% had conflicts with duplication criteria composing of ingredient duplication (23.3%) and therapeutic class duplication (39.6%). Incorrect dosages were found in 73.6% of patients and under-dosage conflicts accounted for 59.9%, which was higher than over-dosage conflicts (38.3%). In this study, inappropriate drug prescriptions such as under-dose, pediatric contraindication and therapeutic duplication were prevalent in pediatric outpatient settings, suggesting much more awareness to the society, to prevent drug related problems in a vulnerable pediatric group.

• Korean Journal of Clinical Pharmacy
• /
• v.25 no.3
• /
• pp.159-165
• /
• 2015

Objective: Polypharmacy is one of the main causes of inappropriate medication use, adverse drug-related events and cost. It aimed to investigate the status of polypharmacy and potentially inappropriate medication (PIM), the factors affecting polypharmacy and cost in elderly outpatients. Method: A pharmacy claim data were retrospectively analyzed with elderly patients prescriptions at a pharmacy located near a top tier general hospital. The numbers of medications per person, prevalence of polypharmacy and PIM according to the 2012 Beers criteria and Korea PIM list, medication cost and the factors affecting polypharmacy were investigated. Results: Forty-six percentages of the elderly outpatients received polypharmacy and over 21% of them had medications listed in Beers or Korean PIM. In multiregressional analysis, we found that age, gender and insurance types were affective factors of polypharmacy. (p < 0.001, 0.047, 0.009, respectively). The cost of polypharmacy with PIM in elderly outpatients was increased with age. Various approaches of interventions would be further required.