• Journal of Preventive Medicine and Public Health
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• v.35 no.2
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• pp.99-106
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• 2002

Objective : Until now, there have been no evidence-based guidelines produced for the mass screening of hyperlipidemia cases in Korea. This study was done to find the most efficient strategy for a hyperlipidemia-screening program among Korean adults, Method : Seven alternative strategies for hyperlipidemia screening were formulated and compared ir terms of cost-effectiveness. Cost and effectiveness were estimated from social perspectives and using a two-stage screening process (initial testing and additional testing for positives from the first test). A computerized database (based on persons who had visited a health promotion center in one teaching hospital for a routine health check-up) was used to determine the cost and the outcome of various strategies. Official data was used in calculating direct and indirect costs. Effectiveness was measured according to the number of persons who needed clinical intervention for hyperlipidemia. A stratified analysis, considering age group and sex, was then done. Sensitivity analyses, focusing on several uncertain parameters, were also done. Results : Of the seven test alternatives available, the most cost-effective strategy was a screening program, which consisted of an initial test of total cholesterol, high-density lipoprotein cholesterol and triglyceride. There was some variation in the rank of the cost-effectiveness ratios for the seven alternatives dependent on age group or gender. Conclusions : Current hyperlipidemia screening practice, for National Health Insurance beneficiaries, tests only the total cholesterol level with a cut-off value of 260mg/dl as an initial screening test. It is not the best strategy for cost-effectiveness, and should be modified. Different screening strategies taking age group and sex into account should be developed and used for the efficient mass screening of hyperlipidemia cases among Korean adults.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.23 no.1
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• pp.199-214
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• 2010

Objective : Atopic dermatitis (AD) may profoundly affect patient's quality of life (QOL), and also cause economic impact. The aim of our study was to evaluate the quality of life and the economic impact of adult atopic dermatitis patient in Seoul. We also evaluate the relationship of QOL and economic impact with severity of AD. Methods : 30 adult atopic dermatitis patient were included and evaluated by using the SCORAD Index and EASI. Patients were asked to fill in the questionnaires about their quality of life and financial costs during the past year by AD. Data about sleep disturbance and pruritus were also obtained. Pearson's correlation were used for statistical analysis. Results : 1. Among 30 patients, women were 19(63.3%), men were 11(36.7%). The mean age of the patients were 27.3 years old, patients between the ages of 17 and 30 years were 23, over 30 were seven. 2. The mean score of Objective SCORAD was $32.89{\pm}7.30$, Subjective SCORAD was $8.13{\pm}3.53$ and EASI was $9.15{\pm}6.90$이었다. 3. The mean score of Skindex-29 was $28.26{\pm}7.58$, DLQI was $10.17{\pm}5.55$. 4. By analyzing the questionnaire, a monthly average cost of 583,200 won for each patient was determined. Direct cost was 236,800 won and indirect cost was 346,300 won. 5. By analyzing the correlation between the severity of AD and QOL, Objective SCORAD and EASI were positively correlated with QOL(Skindex-29, DLQI) but not significant, meanwhile subjective SCORAD were significantly and positively correlated with QOL(Skindex-29, DLQI). 6. By analyzing the correlation between the severity of AD and economic impact, Objective SCORAD were significantly and positively correlated with direct cost and indirect cost. Also, EASI were significantly and positively correlated with direct cost and oriental medical hospital visits. Conclusions : The above results show that the QOL of the patients with atopic dermatitis is significantly related to their disease severity. Atopic dermatitis patients pay 583,200 won a month, and the economic impact of the patients is significantly related to their disease severity.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.11
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• pp.370-379
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• 2018

This study was conducted 1) to investigate the effects of treatment and other factors on the quality of life of thyroid cancer surgical patients and 2) to provide fundamental data for development of an intervention and symptom management program to improve the quality of life of those patients. A total of 76 patients who were diagnosed with thyroid cancer and underwent thyroidectomy from July 2013 to December 2014 participated in this study. To investigate the factors affecting quality of life, a t-test and ANOVA analyses were conducted, after which multiple regression analysis was performed. The results were statistically significant between preoperative and one month after surgery of sex, cancer history, fatigue, and quality of life until 3 months after surgery of stage, cancer history, anxiety, and pain. Multiple regression analysis showed that the most influential factors affecting the quality of life were depression and fatigue at one month prior to and after surgery and anxiety at three months after surgery, while no factors were found to be influential at six months after surgery. Overall, the results of this study suggested that it is imperative to manage depression and fatigue one month prior to and after surgery to reduce the physical and psychological pain experienced by thyroid cancer patients. Moreover, three months after the surgery, anxiety should be closely monitored and controlled to improve the quality of life of the patients. This approach is expected to reduce the burden on the health care system and social costs, which will positively affect public health.

• Journal of Convergence for Information Technology
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• v.9 no.3
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• pp.140-145
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• 2019

With the development of IT technology, many changes are taking place in the health service environment over the past. However, even if medical technology is converged with IT technology, the problem of medical costs and management of health services are still one of the things that needs to be addressed. In this paper, we propose a model for hospitals that have established the IoT system to efficiently analyze and manage the personal information of users who receive medical services. The proposed model aims to efficiently check and manage users' medical information through an in-house IoT system. The proposed model can be used in a variety of heterogeneous cloud environments, and users' medical information can be managed efficiently and quickly without additional human and physical resources. In particular, because users' medical information collected in the proposed model is stored on servers through the IoT gateway, medical staff can analyze users' medical information accurately regardless of time and place. As a result of performance evaluation, the proposed model achieved 19.6% improvement in the efficiency of health care services for occupational health care staff over traditional medical system models that did not use the IoT system, and 22.1% improvement in post-health care for users who received medical services. In addition, the burden on medical staff was 17.6 percent lower on average than the existing medical system models.

• 한국사회정책
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• v.25 no.1
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• pp.99-123
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• 2018

Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.

• Journal of the Korean Society of Radiology
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• v.16 no.3
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• pp.211-216
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• 2022

In radiation therapy, accurate Quality Assurance (QA) is required to irradiate tumor tissue while minimizing damage to normal tissue. Therefore, a dosimeter that can accurately measure radiation is needed. The purpose of this study is to develop a highly efficient radiation dosimeter with high sensitivity by applying a particle in binder method that can reduce manufacturing costs and simplify processes to perovskite materials that are cheaper and simpler to manufacture. By evaluating the response characteristics to high-energy photon, the applicability of QA dosimeter to radiation therapy was evaluated. As a result of reproducibility evaluation, RSD at 6 MV energy was presented as 1.178% and 15 MV energy was presented as 1.141%. As a result of linearity evaluation according to linear regression analysis, R² values of 0.9999 were presented under each condition of 6 MV and 15 MV energy. It was found that the CsPbBr₃ dosimeter manufactured based on the results of reproducibility and linearity evaluation is highly applicable as a QA dosimeter in the field of therapeutic radiation. The CsPbBr₃ dosimeter manufactured in this study presented more than the standard performance in the evaluation of reproducibility and linearity, and it can be used as a radiotherapy QA dosimeter through improvement.

• Health Policy and Management
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• v.34 no.1
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• pp.68-77
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• 2024

Background: Depressive disorders can be categorized into daily depression and clinical depression. The experience of depressive disorder can increase health care utilization due to decreased treatment compliance and somatization. On the other hand, the clinical depression group may also experience social prejudice associated with the illness, which can limit their access to health care utilization. In terms of the significance of health care utilization as a factor in individual and social issues, this study aims to compare the health care utilization of the clinical depression group with that of the non-depressed group and the daily depression group. Methods: The analysis utilized the inverse probability of treatment weighting based on the generalized propensity score. Results: As a result of the analysis, clinical depression and daily depression were higher among women, low-income groups, individuals with low education levels, and so forth. The clinical depression group was also higher among individuals who were not economically active, did not have private health insurance, or had multiple chronic diseases. The number of outpatient department visits in the depression group was significantly higher than in the non-depressed group. In addition, the number of outpatient department visits for the clinical depression group was significantly higher than that for the daily depression group. Outpatient medical expenses were higher in the depression group than in the non-depressed group, and there was no significant difference between the clinical depression group and the daily depression group. Conclusion: Health care utilization was higher in the depression group than the non-depressed group, it was also higher in the clinical depression group than the daily depression group.

• Health Policy and Management
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• v.34 no.1
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• pp.1-3
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• 2024

Currently, the issue of poor accessibility to essential medical services has been brought to light as a social discontent. In order to strengthen the essential medical service system, the government has announced the "the policy package related to essential medical service" as a comprehensive solution and has vowed to invest more than 10 trillion won by 2028. As it contains crucial elements for changing the framework of the healthcare system, I would like to present several points to consider in policy implementation. Given that this package contains important elements for changing the framework of the healthcare system, there are a few issues to consider in policy implementation. First, a mechanism to prevent politicization should be established when designing the physician training system. Second, changing from a hospital centered on residents to one centered on specialists means that the society bears the cost of training residents, while paying a high price for specialist services. The willingness of society to pay for the costs incurred by such a change should be carefully considered, and an appropriate budget must be prepared. Third, as the operation of shared human resources and inter-organizational networking, among other detailed policy measures, are still at a level of conceptual discussion, various issues should be solidly reviewed and considered for in the mid to long term to suit the conditions of the domestic healthcare system.

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.23 no.1
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• pp.61-81
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• 2024

eCall system assists traffic accident victims by connecting emergency rescue institutions with accurate accident information, helping them to identify the on-site situation in the event of a traffic accident. The purpose of this paper is to develop a Korean eCall system that reflects the requirements of domestic emergency rescue institutions and to analyze the expected effects through an integrated demonstration. The results of an integrated demonstration indicated that the communication success rate between the eCall IVS and the call center was 99.25%, and the average location information error was 1.2 m. In particular, it has been confirmed that the average location information error is less than 21.6 meters, as assessed by the Korea Communications Commission when evaluating the accuracy of domestic emergency rescue location information. When the eCall system was introduced, it was confirmed that the time from traffic accidents to hospital arrival could be shortened by 3 m 38 s for highways and 1 m 22 s for general roads. By it to traffic deaths from 2005 to 2022, it was analyzed that the number of fatalities decreased by 82,662, resulting in a reduction of approximately social costs.

• Clinical and Experimental Pediatrics
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• v.48 no.4
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• pp.401-405
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• 2005

Purpose : The use of mechanically-assisted ventilators at home reduces morbidity and improves the quality of life in children with chronic respiratory failure. But in Korea there is no clinical data of children with home mechanical ventilation. We investigated ventilator types, duration, the causes of failure or death, and the cost needed for care. Methods : We retrospectively analyzed the medical records of 21 children who were admitted and who applied for home mechanical ventilation at the Pediatric Intensive Care Unit in Asan Medical Center. Phone interviews took place after discharge. and interviewed by phone after discharge. Results : The median age was 31 months; the median duration with ventilator was 25 months. Underlying diseases were 16 neuromuscular diseases, one metabolic disease and four chronic respiratory diseases. The types of ventilator were pressure and volume type(16 and five patients, respectively). The frequency of ventilation failure was once per 19 months. Weaning could be performed in three cases. Frequencies of admission after receiving ventilators were 1.7 times per year; the most common cause was pneumonia. Nine patients(43%) died; four of them died because of endotracheal tube obstruction. The costs for medical care were about 1,110,000 won per month. Conclusion : There is an increment in the numbers of individuals who need mechanical ventilation support. The most common cause of death was endotracheal tube obstruction. The most important problem for the patients was medical cost. There needs to be more interest in patients with ventilator and social welfare systems to support their families need to be prepared.