• International Journal of Advanced Culture Technology
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• v.10 no.3
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• pp.164-173
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• 2022

This study aimed to explore the themes and parameters of environmental health behaviors based on Rogers' protection motivation theory through a systematic mapping review. Using a systematic approach, a literature review was conducted of articles that adopted Rogers' protection motivation theory. A total of 11 articles on protection motivation theory using participants and environmental health as outcomes were identified in a search of CINAHL, Cochrane Library, EMBASE, Eric, PsycARTICLES, PubMed, and RISS between September 1 and September 8, 2021. Themes related to the environment and personal behaviors between 2002 and 2021 were extracted. The parameters based on protection motivation theory were identified through systematic mapping as fear appraisal, rewards of maladaptive response, severity, vulnerability, costs of adaptive response, response efficacy, self-efficacy, and intention. Self-efficacy and response efficacy considerably affected environmental health behaviors. Emotional fear appeal related to environmental hazards motivates an internal process that alters the threat appraisal and their coping appraisal. Environmental behavior perception and intention influenced on environmental health behaviors with small effect sizes. Therefore, a deeper understanding of the severity of environmental health issues could lead to the development of helpful, effective, and intensive interventions to promote healthcare among the vulnerable population.

• The Korean Journal of Pain
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• v.36 no.2
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• pp.149-162
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• 2023

Chronic postsurgical pain (CPSP) is a multifactorial condition that affects a significant proportion of patients undergoing surgery. The prevention and management of CPSP require the identification of preoperative risk factors to screen high-risk patients and establish appropriate perioperative pain management plans to prevent its development. Active postoperative pain management should be provided to prevent CPSP in patients with severe pain following surgery. These tasks have become important for perioperative team members in the management of CPSP. This review article provides a comprehensive overview of the latest research on the role of perioperative team members in preventing and managing CPSP. Additionally, it highlights practical strategies that can be employed in clinical practice, covering the definition and risk factors for CPSP, including preoperative, intraoperative, and postoperative factors, as well as a risk prediction model. The article also explores various treatments for CPSP, as well as preventive measures, including preemptive analgesia, regional anesthesia, pharmacological interventions, psychoeducational support, and surgical technique modification. This article emphasizes the importance of a comprehensive perioperative pain management plan that includes multidisciplinary interventions, using the transitional pain service as an example. By adopting a multidisciplinary and collaborative approach, perioperative team members can improve patient outcomes, enhance patient satisfaction, and reduce healthcare costs. However, further research is necessary to establish targeted interventions to effectively prevent and manage CPSP.

• Health Policy and Management
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• v.33 no.3
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• pp.363-369
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• 2023

The term "catastrophic health expenditure" means assessing the extent to which medical costs cause financial hardship for households. The aim of this research is to analyze the percentage of households that faced severe financial strain due to medical expenses from 2006 to 2021. This was achieved by utilizing data obtained from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). A trend analysis was conducted to examine the percentage of households that experienced catastrophic healthcare expenses. The households that experienced the catastrophic health expenditure was 2.49% in 2021 using the NaSTaB data. The trend analysis yielded a statistically significant result, indicating a decreasing trend (annual percent change [APC], -4.79; p<0.0001) in the proportion of households facing catastrophic health expenditures. Also, the results of the 2019 KHP and the 2021 HIES showed 1.09% and 2.44% for the households that experienced catastrophic health expenditure. The trend was increased according to the KHP (APC, 0.55; p=0.0004) and the HIES (APC, 7.04; p<0.0001). As a result, this study proposes that sustained attention and further interventions are necessary to ease the economic pressure caused by catastrophic health expenses, particularly for low-income households.

• Journal of Preventive Medicine and Public Health
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• v.56 no.5
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• pp.407-412
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• 2023

Objectives: Work stress is associated with non-communicable diseases, increased healthcare costs, and decreased work productivity among employees in the information technology sector. There is a need for regular work-stress screening among employees using valid and reliable tools. The Tool to Assess and Classify Work Stress (TAWS-16) was developed to overcome limitations in existing stress assessment tools in India. This study aimed to test the reliability of TAWS-16 in a sample of managerial-supervisory employees. Methods: This observational reliability study included data from 62 employees. Test-retest and inter-method reliability were investigated using a TAWS-16 web application and interview by telephone, respectively. Kappa values and intra-class correlation coefficients were calculated. Internal consistency was assessed through Cronbach's alpha. Results: For both test-retest and inter-method reliability, the agreement for both work-related factors and symptoms suggestive of work stress exceeded 80%, and all kappa values were 0.40 or higher. Cronbach's alpha for test-retest and inter-method reliability was 0.983 and 0.941, respectively. Conclusions: TAWS-16 demonstrated acceptable reliability. It measured stressors, coping abilities, and psychosomatic symptoms associated with work stress. We recommend using TAWS-16 to holistically identify work stress among employees during periodical health check-ups in India.

• Clinical and Experimental Reproductive Medicine
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• v.25 no.3
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• pp.239-244
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• 1998

The purpose of this study is compare IVF cycle outcome in poor responders between clomiphene citrate (CC) stimulated and controlled ovarian hyperstimulation (COH) protocol. A total of 94 patients responding poorly in previous IVF cycles (estradiol<600 pg/ml or less than 3 oocytes retrieved) subsequently underwent either COH (COH group: 122 cycles, 68 patients) or CC-stimulated cycles (CC group: 43 cycles, 26 patients). CC was administered for five consecutive days starting on cycle day 3 at a dose of 100 mg daily. Serial transvaginal ultrasound examination was done from cycle day 8. Urine was collected $3\sim4$ times before hCG injection for the detection of LH surge. The hCG was administered when serum estradiol reached greater than 150 pg/ml and mean follicle diameter>16 mm. In COH group, ovarian stimulation was done using short protocol (GnRH-a/FSH/HMG/hCG). No difference in age or number of transferred embryos was found between CC group and COH group. COH group had significantly (p<0.05) higher mean peak level of $E_2$ ($810{\pm}112$ vs $412{\pm}55$ pg/ml) and greater number of retrieved oocytes ($3.0{\pm}0.2$ vs $2.0{\pm}0.2$) than CC group. CC group had transferred embryos $(1.8{\pm}0.2)$ compared with $(2.1{\pm}0.2)$ in COH group. However, CC group had higher pregnancy rate than COH group per retrieval [26.9% (7/26) vs 6.2% (6/97)], or per transfer [31.8% (7/22) vs 7% (6/86)]. Although cycle cancellation rate in CC group (48.8%) was higher than that of COH group (21.3%), the pregnancy rate per cycle in CC group was still higher (16.3%) than COH group (4.9%). In addition, implantation rate in CC group was 17.5% (7/40), which was significantly (p<0.01) higher than 3.9% (7/180) in COH group. These data suggest that oocyte and embryo quality are lower in COH cycles of poor responders than CC cycles. We suggest that clomiphene citrate stimulated IVF cycle may be more efficient than COH IVF cycle in poor responders in terms of lower costs and higher pregnancy performance.

• Journal of Digital Convergence
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• v.17 no.12
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• pp.427-434
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• 2019

The Medical Residents Act was enacted in December 2016 to protect the rights of residents, and to ensuring the safety of patients, and nurturing good medical human resources. This study analyzed the changes of training conditions according to the enforcement of The Medical Residents Act by comparing the results of two surveys conducted in 2015(1,793 Residents) and 2017(1,768 Residents). As a result, Residents worked over 80 hours per week on average('15=92.4h, '17=87.3h) and they worked twice as many times as 36 hours('15=89.4h, '17=70.1h). Female residents' leave before and after childbirth('15=78.5day, '17=82.2day), Preparation of Standard training contract('15=19.3%, '17=40.8%), Delivery of training contract('15=12.4%, '17=36.1%) did not comply with the regulations. The training conditions of the residents is directly related to the safety of patients and the public's health. National support is needed for the support of substitute workforces, fair training evaluation conditions and incentives based on the evaluation results, labor costs for residents and supervising medical specialists, and the cost of making training programs.

• Korea Journal of Hospital Management
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• v.19 no.1
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• pp.32-42
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• 2014

It is necessary to calculate prime cost of medical services accurately in order to evaluate the adequacy of medical fee. This paper aims to identify cost analysts' perception on prime cost of medical services and needs in establishing a cost accounting system in hospitals, proposing future directions and guidelines for the calculation of medical fee. A self-administered questionnaire and telephone survey on operation of a hospital cost-accounting system was conducted in November, 2012, among cost analysts currently working in the hospitals and hospital administrators planning to implement the hospital cost-accounting system. Our study shows that most of the cost analysts were aware of the importance of calculating prime cost and responded that collection of the prime cost data from government is necessary although they are less likely to provide the data in the future concerning the risk of data misuse and data security. They also responded that lack of budget allocation and excessive workload were the main reasons for not estimating the prime cost and operating cost management information system. Results show that hospital cost analysts considered the data accuracy is the most critical factor in calculating prime costs of medical services. However, there was no investment budget allocated in some hospitals or limited to less than 100 million, indicating that hospitals are reluctant to invest on implementing the cost accounting system. Respondents stated the organization that collects the prime cost of medical services among hospitals should display strong analytical capabilities, ensure data security, and maintain independence, which is most demanded. There are 57 hospitals that calculated the prime cost of medical services for 2012 by each medical department and 20 hospitals that calculated the prime cost by fee-for-services, aiming to establish a cost accounting system. Our results indicate that hospitals should voluntarily provide the accurate prime cost for medical services in order to properly evaluate the adequacy of medical fee. Consequently, it is critical to establish an independent organization to collect and appraise the data. It is also recommended that government should implement various policies to encourage hospitals to participate in the data collection to achieve the data accuracy and representativeness.

• Journal of Food Hygiene and Safety
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• v.39 no.2
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• pp.171-179
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• 2024

In previous Cost-of-Illness (COI) studies, the economic impact of lost leisure time of patients has been mostly underexplored. Furthermore, few studies have focused on chronic or severe diseases, thereby inadequately addressing the segment of self-care patients who do not fall into the categories of inpatients or outpatients. In the present study, we used a comprehensive approach to calculate the annual cost of leisure loss, incorporating factors such as employment status, self-care options, and total period of leisure activity disruption. This required analyzing data from various sources, including health and labor statistics, and applying methods to accurately assess the leisure time lost due to food poisoning. The findings showed that the annual cost of leisure loss for South Korean patients with food poisoning is significant, amounting to approximately 784.5 billion KRW (702.8 million USD, USD/KRW : 1128.34). This study revealed that overlooking self-care patients and not accounting for the affected time in addition to treatment time and employment status significantly underestimated these costs. This study highlights the importance of considering a wider range of factors, including self-care, employment status, as well as the entire affected period, in assessing the societal impact of diseases such as food poisoning. These findings provide valuable insights for policymakers and healthcare professionals to understand the broader economic implications of illness and allocate healthcare resources more effectively.

• International Journal of Heart Failure
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• v.6 no.2
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• pp.56-69
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• 2024

Background and Objectives: The number of people with heart failure (HF) is increasing worldwide, and the social burden is increasing as HF has high mortality and morbidity. We aimed to provide updated trends on the epidemiology of HF in Korea to shape future social measures against HF. Methods: We used the National Health Information Database of the National Health Insurance Service to determine the prevalence, incidence, hospitalization rate, mortality rate, comorbidities, in-hospital mortality, and healthcare cost of patients with HF from 2002 to 2020 in Korea. Results: The prevalence of HF in the total Korean population rose from 0.77% in 2002 to 2.58% (1,326,886 people) in 2020. Although the age-standardized incidence of HF decreased over the past 18 years, the age-standardized prevalence increased. In 2020, the hospitalization rate for any cause in patients with HF was 1,166 per 100,000 persons, with a steady increase from 2002. In 2002, the HF mortality was 3.0 per 100,000 persons, which rose to 15.6 per 100,000 persons in 2020. While hospitalization rates and in-hospital mortality for patients with HF increased, the mortality rate for patients with HF did not (5.8% in 2020), and the one-year survival rate from the first diagnosis of HF improved. The total healthcare costs for patients with HF were approximately $2.4 billion in 2020, a 16-fold increase over the $0.15 billion in 2002. Conclusions: The study's results underscore the growing socioeconomic burden of HF in Korea, driven by an aging population and increasing HF prevalence.

• The Journal of the Convergence on Culture Technology
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• v.3 no.2
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• pp.21-30
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• 2017

This study investigated the total annual direct cost of cerebrovascular disease patients. For this study, 265 respondents who answered that they used more than one emergency, inpatient, and outpatient services for cerebrovascular disease during the year of 2012 among Korean medical panel investigators in 2012 were included. In general, patients with cerebrovascular disease responded to cerebrovascular disease among Korean medical panel respondents in 2012. Percentage of respondents using inpatient and outpatient services. Total direct cost was calculated. According to the results of the study, the per capita annual medical expenditure per person is about 561,934 won, 669,557 won for men and 448,696 won for women. In the case of health insurance subscribers, the per capita self burden due to cerebrovascular disease averaged 634,459 won and the medical benefit recipients 160,236 won. The average total direct cost of 265 people with cerebrovascular disease is about 162,165,690, 193,223,955 won for men and 129,486,685 for women. The total direct cost per person due to cerebrovascular disease was 183,095,125 won and the medical benefit recipient was 46,241,705 won. According to household income, the highest rate of 672,268 won in the third income group of the household income, and 108,970,650 won in the fifth income group, the lowest total direct cost of the patients with cerebrovascular disease.