• Journal of Technologic Dentistry
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• v.16 no.1
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• pp.78-104
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• 1994

Under the fee for service schedule of Korean health insurance system, rational fee for dental laboratory products based on the cost is required to be formulated. The purpose of this study was to find actual cost of dental laboratory products in case of a University Hospital. Materials of this study were used as follows : 1. Balance sheet at Dec. 31, 1992 and profit and loss report of the year 1992 of the sample hospital 2. Performance report of dental laboratory department. 3. Purchasing and other accounting bills of dental laboratory materials. The following methods were used. 1. Actual cost finding of dental laboratory department was performed. 2. Work sampling methods were used for measuring standard working time by the process of working. 3. To porcelain fused to metal crown(non-precious), Relative value of the cost of dental laboratory products was calculated as 1.00. 4. Fee and cost of those products were compared on the basis of Relative values. The results of the study can be summarized as follow : 1. Overall, it took longs time than other items. to product denture-related items. 2. When several teeth are made in a time, average production time is much sorter than when one tooth is made in a time. 3. The relative price cost of Dicor cast crown and denture related items are higher than the criterion items. 4. The material cost occupies average 11% out of the total price cost, proportion of personnel expenses is average as 60.0%. 5. Some of the components consisting of the price cost are not reflected adequately in setting the level of the reimbursement price. 6. Relative values of dental laboratory products price cost are varied in the range from 0.05 to 2.83, overall, the reimbursement price of dental products appears not to reflect adequately the price cost. On the basis of this study results, the following ideas would be suggested : 1. Fee Schedule of dental laboratory products should be renovated in order to reflect their costs. 2. Dental laboratory product manufacturers should be enlarged for the economy of scale which may be useful for cost- containment. 3. Dental laboratory producters themselves are required to be standardiqed according to the categories of skill.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.577-583
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• 2018

Background/Aims Potassium-competitive acid blockers are expected to be the next generation of drugs for the treatment of diseases caused by gastric acid. In 2015, vonoprazan fumarate, a novel potassium-competitive acid blocker, was approved by the Japanese health insurance system. Since its approval, patients refractory to vonoprazan can be encountered in clinical settings. We designed this study to clarify the pathophysiology of gastroesophageal reflux disease refractory to vonoprazan. Methods In this retrospective study, we involved patients who had refractory symptoms after administration of standard-dose proton pump inhibitors or vonoprazan and underwent diagnostic testing with esophageal high-resolution manometry and 24-hour multichannel intraluminal impedance and pH monitoring while using proton pump inhibitors or vonoprazan. Patients were diagnosed based on the Rome IV criteria for functional gastrointestinal disorders and diagnostic test results. Results Twenty-seven patients were analyzed during this study. Gastric pH ${\geq}4$ was sustained for a longer period of time, and the esophageal acid exposure time and number of acid reflux events were shorter in the vonoprazan group than in the proton pump inhibitor group. The percentage of patients diagnosed with acidic gastroesophageal reflux disease in the vonoprazan group was lower than that in the proton pump inhibitor group. Conclusions Intra-gastric pH and acid reflux were strongly suppressed by 20-mg vonoprazan. When patients with gastroesophageal reflux disease present symptoms after administration of 20-mg vonoprazan, the possibility of pathophysiologies other than acid reflux should be considered.

• Journal of Hospice and Palliative Care
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• v.22 no.1
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• pp.1-7
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• 2019

The first hospice care center in Korea dates back to the East West Infirmaries (Dongseodaebiwon in the Korean language) of the Goryeo period in the early 11th century. It has been 50 years since hospice care was introduced in Korea. Initially hospice care was provided in the private sector, including those with a religious background, and its development was slow. In the 1990s, related religious organizations and academic associations were established, and then, a full-swing growth phase was ushered in as the Korean government institutionalized hospice care in the early 2000s. As a result, enhanced quality of hospice care service could be provided, which meant better pain management and higher quality of life for late stage cancer patients and their families. Still, the nation lacked a realistic reimbursement system which was needed to for financial stability of the affected patients. However, the national health insurance scheme began to cover hospice palliative expenses in 2015. In 2016, the Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life was legislated, allowing terminally-ill patients to refuse meaningless life-sustaining treatments. As the range of diseases subject to hospice palliative care was expanded, more challenges and issues need to be addressed by the service providers.

• Journal of the Architectural Institute of Korea Planning & Design
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• v.34 no.11
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• pp.3-12
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• 2018

Hospice is the wholistic caring service for terminally ill patient and his family so that he can live in dignity and maintain the quality of life until he passes away peacefully. The purpose of this study is to compare the development of hospice movement in UK, USA, Japan and Korea, to analyze space configuration characteristics of facilities built between 1980-2009 through case study. The result is as follows. First, The modern hospice started in England and it has spread around the world rapidly. In Korea, hospice service was introduced even prior to US and Japan and developed in spite of poor medical environment. The application of health insurance subsidies were late compared to other countries, but the hospice and palliative care system was quickly set on the basis of precedent cases. Second, the number of hospital beds per facility is decreasing, and it has been divided into smaller clusters for the residential atmosphere. The controversy between private rooms and multi-patient room is still ongoing, and increasing facilities without in-patient service. Rather than establishing uniform and absolute regulations, it is necessary to design a flexible space which can cope with various situations such as patients' needs, service changes, and manpower status. Third, the spaces for family members and friends to stay in both private rooms and communal spaces are increasing. Forth, Facilities for patients with different needs, such as children and adolescents and AIDS patients, have been developed in UK and USA. Further research on of patients' diverse needs and customized environmental support is necessary.

• The korean journal of orthodontics
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• v.51 no.1
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• pp.3-14
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• 2021

Objective: This study aimed to identify the perceptions of orthodontic treatment among Korean adults and determine the factors that drive them to seek orthodontic treatment. Methods: A total of 2,321 adults aged 19-64 years were surveyed using an internet research system from a specialized research company. The participants were divided into the following groups based on their experience of and willingness to undergo orthodontic treatment: experience, acceptance, and non-acceptance groups. The characteristics of the participants were compared using analysis of variance with post-hoc analysis. Multinomial logistic regression analysis was performed in all three models with the non-acceptance group as a reference. Results: In terms of demographic characteristics, age, gender, marital status, and education had significant influences on orthodontic treatment decisions in adults in the experience and acceptance groups (p < 0.001). When all the factors were analyzed, age, marital status, past dental treatment experience, regular oral examinations, demand for orthodontic treatment, optimal treatment period, health insurance coverage, information on orthodontic treatments, perceptions regarding orthodontic treatment, and psychosocial impact of dental esthetics significantly influenced orthodontic treatment decisions in adults in the experience and acceptance groups (p < 0.001). Conclusions: These findings suggest that various factors influence orthodontic treatment decisions in adults. Individuals who seek orthodontic treatment were found to undergo more regular dental treatment and oral examination than those who did not. They also had a better perception of orthodontic treatment and more negative values for the psychosocial impact of dental esthetics.

• Journal of Society of Preventive Korean Medicine
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• v.26 no.2
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• pp.1-9
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• 2022

Objectives : The purpose of this study is to identify priorities for the 4th Comprehensive Plan for Korean Medicine Development using Delphi and AHP techniques. Methods : This study uses Delphi-AHP method to first, select the target priority policy based on the policy content of the 4th Comprehensive Plan. In addition, two surveys on the priorities were conducted to reach consensus between experts. The main results of the first survey were also provided to experts participating in the second survey to help form expert consensus. Finally, the final policy priority was chosen based on the second survey result. Results : Survey results showed that of the 39 policies in the 4th Comprehensive Plan, "improve the accessibility of Korean medicines," was the most important goal. This was followed by "support for Korean medicine R&D from clinical research to industrialization," "provide foundation for a pilot project that provides customized medical services" and "strengthen the public medicine function of Korean medicine by expanding the its infrastructure in national and public hospitals." Conclusion : The results showed that capacity building of Korean medicine in primary care, improvement of the health insurance system, and research centered on industrialization are relatively more important goals, while the need to enhance global competitiveness was much less important. These key points can serve as a reference when formulating the 5th Comprehensive Plan for Korean Medicine Development in the future.

• International journal of advanced smart convergence
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• v.11 no.1
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• pp.111-116
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• 2022

After COVID-19, the number of people with sleep disorders around the world is increasing. In particular, in the flow of the 4th industrial revolution, the differentiation of types and characteristics of the sleep industry is accelerating. Therefore, in this study, the characteristics of each type of sleep-related industry were reclassified from an industrial point of view, and based on this, an attempt was made to review the classification system that can help companies develop sleep products and improve related national systems. Based on the 10th standard industry classification, we compared input cost, value, and usability and analyzed common characteristics, treatments, and preventive effects based on this. A comprehensive taxonomy using matrix analysis was reviewed. As a result, in terms of cost (A), the most common sleeping products are general mattresses and general bedding. It is an IOT device (auxiliary device), and the value aspect (B, B/D) included sleep cafe, bedding rental and management service, and sleep consulting. In terms of utility (A/B), a total of 6 product groups including sleep aids (health functional foods) belong to this category, and in terms of treatment (A/C), a total of 3 product groups including sleep clinics (medical services) belong to this category. As for the product group (A/D) with both properties, it was found that non-insurance sleep treatment medical devices, sleep-related over-the-counter drugs, and some sleep monitoring applications belong to this category. Ultimately, it was found that the sleep industry classification enables the most active product development and composition according to the relative relationship between cost and utility, and treatment and utility. appeared to be necessary.

• 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 Radiology
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• v.22 no.4
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• pp.596-603
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• 2021

Objective: To evaluate the feasibility and diagnostic performance of ultrasound (US)-guided fine-needle aspiration cytology and core-needle biopsy (US-FNAC/CNB) for the diagnosis of laryngo-hypopharyngeal masses. Materials and Methods: This was a single-center prospective case series. From January 2018 to June 2019, we initially enrolled 40 patients with highly suspicious laryngo-hypopharyngeal masses on laryngoscopic examinations. Of these, 28 patients with the mass involving or abutting the pre-epiglottic, paraglottic, pyriform sinus, and/or subglottic regions were finally included. These patients underwent US examinations with/without subsequent US-FNAC/CNB under local anesthesia for evaluation of the laryngo-hypopharyngeal mass. Results: Of the 28 patients who underwent US examinations, a laryngo-hypopharyngeal mass was identified in 26 patients (92.9%). US-FNAC/CNB was performed successfully in 25 of these patients (96.2%), while the procedure failed to target the mass in 1 patient (3.8%). The performance of US caused minor subclinical hematoma in 2 patients (7.7%), but no major complications occurred. US-FNAC/CNB yielded conclusive results in 24 (96.0%) out of the 25 patients with a successful procedure, including 23 patients with squamous cell carcinoma (SCC) and 1 patient with a benign mass. In one patient with atypical cells in US-FNAC, additional direct laryngoscopic biopsy (DLB) was required to confirm SCC. Among the 26 patients who received US-FNAC/CNB, the time from first visit to pathological diagnosis was 7.8 days. For 24 patients finally diagnosed with SCC, the time from first visit to the initiation of treatment was 25.2 days. The mean costs associated with US-FNAC/CNB was $272 under the Korean National Health Insurance Service System. Conclusion: US-FNAC/CNB for a laryngo-hypopharyngeal mass is technically feasible in selected patients, providing good diagnostic performance. This technique could be used as a first-line diagnostic modality by adopting appropriate indications to avoid general anesthesia and DLB-related complications.

• Annals of Occupational and Environmental Medicine
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• v.34
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• pp.17.1-17.10
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• 2022

Background: This study aimed to investigate the decline in quality of life (QOL) by examining changes in the employment status of workers who had completed medical treatment after an industrial accident. Methods: This study utilized the Panel Study of Worker's Compensation Insurance cohort (published in October 2020) containing a sample survey of 3,294 occupationally injured workers who completed medical care in 2017. We divided this population into four groups according to changes in working status. A multivariate logistic regression model was utilized for evaluating QOL decline by adjusting for the basic characteristics and working environment at the time of accident. Subgroup analysis evaluated whether QOL decline differed according to disability grade and industry group. Results: The QOL decline in the "maintained employment," "employed to unemployed," "remained unemployed," and "unemployed to employed" groups were 15.3%, 28.1%, 20.2%, and 11.9%, respectively. The "maintained employment" group provided a reference. As a result of adjusting for the socioeconomic status and working environment, the odds ratios (ORs) of QOL decline for the "employed to unemployed" group and the "remained unemployed" group were 2.13 (95% confidence interval [CI], 1.51-3.01) and 1.47 (95% CI, 1.13-1.90), respectively. The "unemployed to employed" group had a non-significant OR of 0.76 (95% CI, 0.54-1.07). Conclusions: This study revealed that continuous unemployment or unstable employment negatively affected industrially injured workers' QOL. Policy researchers and relevant ministries should further develop and improve "return to work" programs that could maintain decent employment avenues within the workers' compensation system.