• Health Policy and Management
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• v.21 no.1
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• pp.44-60
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• 2011

Background : Surgical site infection(SSI) is one of the important nosocomial infections with pneumonia, urinary tract infection. SSI increases mortality, morbidity, length of stay, and costs for postoperative patients. The purpose of this study was to estimate length of stay(LOS) and health care costs from SSI using the large observational data. The ultimate objective was to show the effect of prevention of SSI. Method : This study used antibiotic prophylaxis evaluation data and claims data of the HIRA(Health Insurance Review and Assessment Service). The study population included 18,361 patients who underwent gastric surgery, endoscopic cholecystectomy, colon surgery, hysterectomy, cesarean section in nationwide hospitals from August to October 2007. SSI group and non-SSI group were matched according to propensity score resulted from logistic regression. The paired t-test was used to compare the difference of the LOS and health care costs between SSI group and non-SSI group. Results : The 598 cases of SSI were detected of total subjects, and the crude SSI rate was 3.3%. For each surgery, SSI rates were 5.5% for gastric surgery, 4.7% for cholecystectomy, 6.6% for colon surgery, 2.6% for hysterectomy, and 1.6% for cesarean section. The 596 cases of SSI and the 596 cases of non-SSI were matched by propensity score. The LOS of SSI group was longer than that of non-SSI group, and the difference was statistically significant. Health care costs of SSI group was more than that of non-SSI group which was significant. Conclusions : SSI increased apparently the LOS and healthcare costs. The economic loss might affect the cost of national healthcare as well as patients and hospitals. This study provided the evidence that the healthcare expenditure could be reduced by preventing SSI.

• Journal of Environmental Impact Assessment
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• v.4 no.1
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• pp.59-64
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• 1995

Environmental Impact Assesment(EIA) is composed of various procedures, such as screening, scoping, inventory survey, prediction, assessment, mitigation measure, alternative assessment, and post management. Remote sensing introduced lately begins to be applied ecosystem and land use in inventory survey and assessment of EIA. This study explains on land use classification, buffering analysis of residential area, and overlaying analysis of odor predictive data with residential area for application to EIA with remote sensing data. Residential area extracted from land use classification of remote sensing provides effectively buffering analysis of residential area in selection of landfill site with GIS. It could assess also residential effect to an offensive odor by overlaying analysis. Application methods in EIA should be enlarged to assess effectively.

• Journal of Korean Academy of Nursing
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• v.35 no.5
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• pp.810-816
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• 2005

Purpose: This study was to test the effectiveness of Web-based multimedia contents for Physical Examination and Health Assessment on learning achievement. Method: Multimedia contents based on Jung's teaching and learning structure model were used to enhance learning achievement. Learning achievement was measured by the knowledge of Physical Examination and Health Assessment. The participants of this study were students in a BSN and RN-BSN program in a university located in Seoul. 59 students in the experimental group received lectures using web-based multimedia contents and 75 students in the control group received regular lectures. Results: The mean score of the degree of educational achievement in the experimental group(mean=31.09) was significantly higher than in the control group(mean=25.55)(t=-3.883, p=.000). Conclusion: These web-based multimedia contents were found to maximizethe effectiveness of the teaching process when used as a teaching aid, and yet kept the strength of a face to face teaching learning method. This program is recommended as part of a main text, vital teaching aid or cyber lecture materials in nursing schools and in health care educational institutions.

• Journal of Soil and Groundwater Environment
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• v.16 no.4
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• pp.10-22
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• 2011

Human health risk assessment for petroleum, oil and lubricant (POL) contaminated sites is challenging as total petroleum hydrocarbon (TPH) is not a single compound but rather a mixture of numerous substances. To address this concern, several TPH fractionation approaches have been proposed and used as an effective management tool for the POL-contaminated sites in many countries. In Korea, there are also recognized needs to establish a reliable and cost-effective human health risk assessment strategy based on the TPH fractionation method. In order to satisfy the social and institutional demand, this study suggested that the comprehensive risk assessment strategy based on a newly modified TPH fractionation method with 10 fractions, the Korean Standard Test Method (KSTM)-based analytical protocol and a stepwise risk assessment framework should be introduced into the domestic contaminated land management system. Under the proposed strategy, POL-contaminated sites can be effectively managed in terms of human health protection, and remedial cost and time can be determined reasonably. In addition, more researches required to increase our understanding of environmental risks and improve the domestic management system were proposed.

• Health Policy and Management
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• v.26 no.1
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• pp.63-70
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• 2016

Background: Selective health benefit was introduced for decreasing economic burden of patients. Medical devices with economic uncertainty have been covered as selective health benefit by National Health Insurance since December 2013. We aimed to analyze impact of selective health benefit to medical expenditure and provider behavior focused on electrosurgery (ultrasonic shears, electrothermal bipolar vessel sealers) for gastric cancer patients covered since December 2014. Methods: We used the National Health Insurance claims data of 2,698 patients underwent gastric cancer surgery between August 2014 and March 2015. Medical cost and patient sharing per inpatient day were analyzed to verify that covering electrosurgery increased medical expenditure and changed provider behavior from open surgery to endoscopic or laparoscopic surgery. Additionally, we analyzed the claim rate of medical device or goods relating gastric endoscopic and laparoscopic surgery. Results: Medical cost and patient sharing per inpatient day were increased after covering electosurgery as selective health benefit (39,724/1,421 won). However, there were no medical expenditure increases after adjusting claim of electosurgery and patient sharing was decreased 1,057 won especially. The coverage of selective health benefit did not increase the claim rate of medical device or goods related endoscopic or laparoscopic surgery, either. Conclusion: Covering electosurgery decreased patient economic burden and did not change of provider behavior. Expanding selective health benefit is needed to decrease economic burden of severe patients. Further study should evaluate the long term effect with accumulated data.

• Journal of Environmental Health Sciences
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• v.46 no.6
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• pp.667-675
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• 2020

Objectives: Exposure to fine dust (PM10) could contribute to the occurrence of cardiovascular disease or respiratory abnormalities. Since garlic is known to possess an anti-oxidative stress effect, the present study was performed to evaluate the effect of garlic intake on fine dust-mediated pulmonary toxicity. Methods: Rats were intratracheally instilled with fine dust at 15 mg/kg body weight (BW)/day for five days following five-day intragastric intubation of garlic at 0.7 or 1.4 g/kgBW/day, or 13.1 mg/kgBW/day S-allyl-cysteine (SAC) as a reference component in garlic. Blood and bronchoalveolar lavage fluid (BALF) were collected. Results: Deposit of fine dust was visually and histopathologically observed in the lungs. Body weight gain during the instillation period was significantly lowered in all the groups instilled with fine dust. Neutrophil numbers in blood were significantly elevated in the fine dust alone group, but this alteration was diminished in the groups administered with garlic. Levels of serum glutathione were lower in the rats instilled with fine dust alone, and this decrease in the glutathione level seems dose-dependently compensated among the groups administered with garlic. Similar findings were observed in the BALF with statistical significance. Typical pulmonary histopathological observation related with inflammation was demonstrated in the lungs of the rats exposed to fine dust alone, whereas such histopathologic findings were not improved in the groups administered with garlic. Conclusion: The present study suggests that garlic intake could alleviate fine dust-mediated pulmonary or systemic toxicities. Further investigation is necessary to delineate the mechanism of garlic-mediated effects on pulmonary function.

• Journal of Environmental Impact Assessment
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• v.19 no.3
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• pp.259-270
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• 2010

We conducted human risk assessment for exposure to inhalation of chemical substances emitted from the storage tanks of petroleum refineries. To assess human risk, this study calculated chemical emissions from the external floating roofs on storage tank at petroleum refineries, as well as concentrations thereof in the ambient air using the K-SCREEN model, and then determined risk in accordance with the Reference Concentration (RfC) values and Inhalation Unit Risk criteria developed by the US Environmental Protection Agency. The results indicated that non-carcinogenic chemicals have a hazard quotient of less than 1, meaning they have an insignificant effect on human health for residential areas near the storage tanks. Among the known carcinogens, the hazard risk for benzene slightly exceeded $10^{-6}$, indicating the need for corrective reduction measures. The methodology for health impact assessment devised herein provides findings useful in decision making for policy makers and the general public with respect to construction of industrial complexes. However, the methodology proposed herein does have limitations, including discrepancy in results induced by use of U.S. data (due to the lack of usable domestic data). More systematic studies from related researchers will be needed to address these issues and produce more reliable outcomes.

• Journal of Korean society of Dental Hygiene
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• v.11 no.2
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• pp.293-301
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• 2011

Objectives : The aim of the trial was to study the effect of plaque control(tooth brushing instruction) for oral health improvement on periodontitis patients. Methods : 30 patients(35~65 years) with advanced periodontal disease were subjected to a baseline examination including assessment of oral hygiene status(O'leary index), gingival condition(bleeding). the assessment were repeated after 2, 4, 6 weeks. cognitive, behavioral and clinical outcomes were assessed in the primary care setting by questionnaire and clinical oral examination. Results : The oral hygiene status expressed as the individual mean percentage of tooth surfaces with plaque 59.3% at baseline and 21.2% after 6 weeks(p<0.001). The gingival bleeding status expressed as the individual mean point of interdental papilla 3.8 at baseline and 1.9 after 6 weeks(p<0.001). Also, the patients self-assessment about correct tooth brushing behavior was 3.9(5-point likert scales), satisfaction of plan practices 4.1(5-point likert scales), efficacy of tooth brushing instruction 8.7(10-point likert scales). Patients wanted to continuous participation. Conclusions : A verification of effect after individualized oral health instruction and repeated dental plaque control represented to significance on plaque control score, oral care practice and oral health recognition. The important oral care step against periodontal disease is to establish good oral health habits. Also, oral health behavior recognition is more important for the practice of oral health. Therefore professional plaque control and tooth brushing instruction absolutely need in improving oral health.

• Environmental Analysis Health and Toxicology
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• v.25 no.3
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• pp.207-214
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• 2010

Toxicity identification and quantification are important factors to evaluate the effect of industrial effluent on the aquatic environment. In order to measure the potential and real toxicity of mixed chemicals in the effluents, the biological method (i.e., WET test) should be used as well as chemical analysis method. In this study, we conducted WET test for various kinds of industrial effluents using aquatic organisms such as water flea (Daphnia magna), algae (Pseudokirchneriella subcapitata), fish (Oryzias latipes, Danio rerio), and microorganism (Vibrio fisheri). In addition, we carried out chemical analysis and TIE (Toxicity Identification Evaluation) for effluents in order to identify the substances causing toxicity. Among the 30 kinds of wastewater, S13 showed the highest eco-toxicity and $Ca^{2+}$ and $Cl^-$ ion were suspected as major compounds causing toxicity for aquatic organisms. In order to confirm these suspected compounds, various confirmation procedures need to be carried out.

• Journal of Environmental Health Sciences
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• v.49 no.6
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• pp.334-343
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• 2023

Background: South Korea's Act on Registration and Evaluation, etc. of Chemicals (known as K-REACH) was established to protect public health and the environment from hazardous chemicals. 4,4'-Methylenedianiline (MDA), which is used as a major intermediate in industrial polymer production and as a vulcanizing agent in South Korea, is classified as a toxic substance under the K-REACH act. Although MDA poses potential ecological risks due to industrial emissions and hazards to aquatic ecosystems, no ecological risk assessment has been conducted. Objectives: The aim of this study is to assess the ecological risk of MDA by identifying the actual exposure status based on the K-REACH act. Methods: Various toxicity data were collected to establish predicted no effect concentrations (PNECs) for water, sediment, and soil. Using the SimpleBox Korea v2.0 model with domestic release statistical data and EU emission factors, predicted environmental concentrations (PECs) were derived for ten sites, each referring to an MDA-using company. Hazard quotient (HQ) was calculated by ratio of the PECs and PNECs to characterize the ecological risk posed by MDA. To validate the results of modeling-based assessment, concentration of MDA was measured using in-site freshwater samples (two to three samples per site). Results: PNECs for water, sediment, and soil were 0.000525 mg/L, 4.36 mg/kg dw, and 0.1 mg/kg dw, respectively. HQ for surface water and sediment at several company sites exceeded 1 due to modeling data showing markedly high PEC in each environmental compartment. However, in the results of validation using in-site surface water samples, MDA was not detected. Conclusions: Through an ecological risk assessment conducted in accordance with the K-REACH act, the risk level of MDA emitted into the environmental compartments in South Korea was found to be low.