• Research in Community and Public Health Nursing
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• v.27 no.4
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• pp.358-369
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• 2016

Purpose: This study was to identify health-related quality of life of Korean young adults and elderly with multimorbidity and to examine factors influencing their health-related quality of life. Methods: Health-related quality of life was measured by the Korean version of the EQ-5D. Using a descriptive study, the study incorporated a secondary analysis of the Korean version of the EQ-5D data from the 8th wave of the Korea Health Panel Survey in 2013. Selected demographic data and the Korean version of the EQ-5D were analyzed using ${\chi}^2$-test, t-test, ANOVA and multiple regression analysis. Results: Education, drinking, type of health insurance, and number of chronic disease significantly affected the health-related quality of life in the young adults with multimorbidity. Educational level, occupational type, drinking, physical activity, number of chronic disease, unmet healthcare need and the type of multimorbidity significantly affected the health-related quality of life in the elderly with multimorbidity. Conclusion: The factors influencing health-related quality of life were different for young adults versus elderly with multimorbidity. Therefore, there is a need for age-specific health care programs that may improve health-related quality of life of adults with multimorbidity.

• Journal of the Korea Convergence Society
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• v.9 no.1
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• pp.151-159
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• 2018

This study analyzes the impact of competitions clinics on the total treatment cost and anti-biotics prescription rate. The result of implementing the basic statistics, correlations, and regression analysis by facilitating the evaluation data by Health Insurance Review & Assessment Service in 2015 for acute otitis media in children is shown as follows. First, there is a significant difference for each si-gun-gu for the competition index between total treatment cost and clinics, but there is almost no significant difference for the anti-biotics prescription rate. Second, competition in clinics has statistically important impact on the total examination cost And, third, competition in clinics has no statistically important impact on the anti-biotics prescription rate. There is a need for additional studies on re-examination rate, treatment cost per visit and so forth in order to clarify other factors of competition for medical institutions impacting on the physician behavior in the future studies.

• Journal of Technologic Dentistry
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• v.33 no.3
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• pp.237-246
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• 2011

Purpose: This study investigates dental health and chewing ability of patients hospitalized in geriatric hospital, and compares the chewing ability for each factor that can be used as data for dental healthcare of senior citizens and basic data for denture insurance for the elderly. Methods: The 101 subjects of this study were selected from 178 patients hospitalized in a geriatric hospital located in Daegu Metropolitan City, excluding 77 patients who were being treated in the intensive care unit and who were unable to communicate. The chewing ability of the patients were measured using an evaluation scale based on foods consisting of 10 different hardnesses. Results: Patients with less than 21 teeth, those with dentures and patients who were less than satisfied with their dental conditions had difficulties in chewing hard food such as dried squid and radish kimchi, and the Chewing ability increased proportionally to the number of remaining teeth(p<0.001), appropriateness of the maxillary and mandibular dentures(p<0.005) and the level of dental satisfaction(p<0.001). Conclusion: This study is limited as the subjects were selected from a single hospital and the authors estimate that various studies will be necessary to investigate the Chewing ability of patients hospitalized in long-term hospitals. The subjects of this study did not receive any dental treatment while staying in the hospital and many of the subjects had bad fit denture or didn't have dentures or did not use dentures, although they have dentures, which calls for denture construction and prosthetics through dental treatment.

• The Journal of the Korea Contents Association
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• v.11 no.9
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• pp.372-383
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• 2011

Our study was carried out to develop the severity-adjustment model for length of stay in hospital for percutaneous coronary interventions so that we would analysis the factors on the variation in length of stay(LOS). The subjects were 1,011 percutaneous coronary interventions inpatients of the Korean National Hospital Discharge In-depth Injury Survey 2004-2006 data. The data were analyzed using t-test and ANOVA and the severity-adjustment model was developed using data mining technique. After yielding the standardized value of the difference between crude and expected length of stay, we analysed the variation of length of stay for percutaneous coronary interventions. There was variation of LOS in regional differences, size of sickbed and insurance type. The variation of length of stay controlling the case mix or severity of illness can be explained the factors of provider. This supply factors in LOS variations should be more studied for individual practice style or patient management practices and healthcare resources or environment. We expect that the severity-adjustment model using administrative databases should be more adapted in other diseases in practical.

• Journal of Preventive Medicine and Public Health
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• v.51 no.1
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• pp.15-22
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• 2018

Objectives: The use of administrative data is an affordable alternative to conducting a difficult large-scale medical-record review to estimate the scale of adverse events. We identified adverse events from 2002 to 2013 on the national level in Korea, using International Classification of Diseases, tenth revision (ICD-10) Y codes. Methods: We used data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC). We relied on medical treatment databases to extract information on ICD-10 Y codes from each participant in the NHIS-NSC. We classified adverse events in the ICD-10 Y codes into 6 types: those related to drugs, transfusions, and fluids; those related to vaccines and immunoglobulin; those related to surgery and procedures; those related to infections; those related to devices; and others. Results: Over 12 years, a total of 20 817 adverse events were identified using ICD-10 Y codes, and the estimated total adverse event rate was 0.20%. Between 2002 and 2013, the total number of such events increased by 131.3%, from 1366 in 2002 to 3159 in 2013. The total rate increased by 103.9%, from 0.17% in 2002 to 0.35% in 2013. Events related to drugs, transfusions, and fluids were the most common (19 446, 93.4%), followed by those related to surgery and procedures (1209, 5.8%) and those related to vaccines and immunoglobulin (72, 0.3%). Conclusions: Based on a comparison with the results of other studies, the total adverse event rate in this study was significantly underestimated. Improving coding practices for ICD-10 Y codes is necessary to precisely monitor the scale of adverse events in Korea.

• Journal of Preventive Medicine and Public Health
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• v.51 no.5
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• pp.257-262
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• 2018

Objectives: Smoking cessation decreases morbidity and mortality due to chronic obstructive pulmonary disease (COPD). Pharmacotherapy for smoking cessation is highly effective. However, the optimal prescription rate of smoking cessation medications among smokers with COPD has not been systemically studied. The purpose of this study was to estimate the national prescription rates of smoking cessation medications among smokers with COPD and to examine any disparities therein. Methods: We conducted a retrospective study using National Ambulatory Medical Care Survey data from 2007 to 2012. We estimated the national prescription rate for any smoking cessation medication (varenicline, bupropion, and nicotine replacement therapy) each year. Multiple survey logistic regression was performed to characterize the effects of demographic variables and comorbidities on prescriptions. Results: The average prescription rate of any smoking cessation medication over 5 years was 3.64%. The prescription rate declined each year, except for a slight increase in 2012: 9.91% in 2007, 4.47% in 2008, 2.42% in 2009, 1.88% in 2010, 1.46% in 2011, and 3.67% in 2012. Hispanic race and depression were associated with higher prescription rates (odds ratio [OR], 5.15; 95% confidence interval [CI], 1.59 to 16.67 and OR, 2.64; 95% CI, 1.26 to 5.51, respectively). There were no significant differences according to insurance, location of the physician, or other comorbidities. The high OR among Hispanic population and those with depression was driven by the high prescription rate of bupropion. Conclusions: The prescription rate of smoking cessation medications among smokers with COPD remained low throughout the study period. Further studies are necessary to identify barriers and to develop strategies to overcome them.

• YAKHAK HOEJI
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• v.51 no.5
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• pp.327-335
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• 2007

This study was to evaluate economic impact of a comprehensive pharmaceutical care intervention provided by community pharmacists on drug-related morbidity and mortality in the elderly population, in a societal perspective. Clinical outcomes of pharmaceutical care included compliance increase, inappropriate medication discontinuation, and subsequent drug-related morbidity and mortality reduction. Economic outcomes included cost savings from direct medical costs reduction such as medication and healthcare resource utilization. Input costs for pharmaceutical care included pharmacist time and computerized prescription review supporting program costs. Model parameters of outcomes were derived from published literatures, and costs were from literatures and health insurance statistical data in Korea. Annual costs and benefits were estimated in the year 2005. Current usual care and standardized pharmaceutical care required 0.3 and 2.0 hours per year respectively, for elderly outpatient using average 4.4 prescription drugs per visit and average annual frequency of 17.8 pharmacy visits. Comprehensive pharmaceutical care provided to overall elderly outpatients at community pharmacies would have cost of \74,994 mil. and benefit of \357,002 mil. per year. Benefit:cost ratio was 4.8:1 and net benefit was \282,008 mil/year. It was corresponded to net benefit of \73,816/year for individual elderly patient. In addition, pharmaceutical care was estimated to reduce 1,531 drug-related deaths/year. Conclusively this study, a first attempt in Korea to evaluate an economic value of pharmaceutical care at community pharmacies, proved that it was a cost-effective intervention having significant economic benefit.

• Health Policy and Management
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• v.26 no.2
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• pp.107-114
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• 2016

Background: Over the last few decades, because hospitals in South Korea also have undergone dramatic changes, Korean hospitals traditionally have provided specialized health care services in the health care market. Inner Herfindahl-Hirschman Index (IHI) measures hospital caseloads based on patient proportions, independent of patient volumes. However, IHI that rely solely on patient proportions might be problematic for larger hospitals that provide a high number of diagnosis categories, as the patient proportions in each category are naturally relatively smaller in such hospitals. Therefore, recently developed novel measure, category medical specialization (CMS) is based on patient volumes as well as patient proportions. Methods: We examine the distribution of hospital specialization score by hospital size and investigate association between each hospital specialization and length of stay per case and hospital cost per case using Korean National Health Insurance Service-cohort sample data from 2002 to 2013. Results: Our results show that IHI show a decreasing trend according to the number of beds and hospital type but CMS show an increasing trend according to the number of beds and hospital type. Further, inpatients admitted at hospitals with higher IHI and CMS had a shorter length of stay per case (IHI: B=-0.104, p<0.0001; CMS: B=-0.044, p=0.001) and inpatients admitted at hospitals with higher IHI and CMS had a shorter hospital cost per case (IHI: B=-0.110, p=0.002; CMS: B=-0.118, p=<0.0001). Conclusion: This study may help hospital policymakers and hospital administrators to understand the effects of hospital specialization strategy on hospital performance under recent changes in the Korean health care environment.

• Health Policy and Management
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• v.26 no.2
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• pp.95-106
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• 2016

A new manual of System of Health Accounts (SHA) 2011, was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. This offers more complete coverage than the previous version, SHA 1.0, within the functional classification in areas such as prevention and a precise approach for tracking financing in the health care sector using the new classification of financing schemes. This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 1970-2014 constructed according to the SHA2011. Data sources for public financing include budget and settlement documents of the government, various statistics from the National Health Insurance, and others. In the case of private financing, an estimation of total revenue by provider groups is made from the Economic Census data and the household income and expenditure survey, Korean healthcare panel study, etc. are used to allocate those totals into functional classifications. CHE was 105 trillion won in 2014, which accounts for 7.1% of Korea's gross domestic product. It was a big increase of 7.7 trillion won, 7.9%, from the previous year. Public share (government and compulsory schemes) accounting for 56.5% of the CHE in 2014 was still much lower than the OECD average of about 73%. With these estimates, it is possible to compare health expenditures of Korea and other countries better. Awareness and appreciation of the need and gains from applying SHA2011 for the health expenditure classification are expected to increase as OECD health expenditure figures get more frequently quoted among health policy makers.

• Journal of Advanced Navigation Technology
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• v.15 no.4
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• pp.585-590
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• 2011

In the past few years, M2M (Machine-to-Machine) applications have become a hot topic in the wireless industry. While M2M applications can be used for many purposes (smart homes, smart metering/electricity meter reading, fleet management, mobile workforce, automobile insurance, vending machines, etc), and in many sectors (healthcare, agriculture, commercial, industrial, retail, utility, etc.), smart metering applications or smart grids present the biggest growth potential in the M2M market today. M2M platform is the future ubiquitous network technologies which provide the integrated service with the networks and devices. The promising technologies to tackle these problems are the Semantic technologies, for interoperability, and the Agent technologies for management of complex systems. In this paper the information communication technique based on the disaster prevention system's for the M2M, concepts and its requirement technology and application are studied.