• Journal of Preventive Medicine and Public Health
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• 제39권1호
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• pp.13-20
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• 2006

Objectives: To propose a risk-adjustment model with using insurance claims data and to analyze whether or not the outcomes of non-emergent and isolated coronary artery bypass graft surgery (CABG) differed between the low- and high-volume hospitals for the patients who are at different levels of surgical risk. Methods: This is a cross-sectional study that used the 2002 data of the national health insurance claims. The study data set included the patient level data as well as all the ICD-10 diagnosis and procedure codes that were recorded in the claims. The patient's biological, admission and comorbidity information were used in the risk-adjustment model. The risk factors were adjusted with the logistic regression model. The subjects were classified into five groups based on the predicted surgical risk: minimal (<0.5%), low (0.5% to 2%), moderate (2% to 5%), high (5% to 20%), and severe (=20%). The differences between the low- and high-volume hospitals were assessed in each of the five risk groups. Results: The final risk-adjustment model consisted of ten risk factors and these factors were found to have statistically significant effects on patient mortality. The C-statistic (0.83) and Hosmer-Lemeshow test ($x^2=6.92$, p=0.55) showed that the model's performance was good. A total of 30 low-volume hospitals (971 patients) and 4 high-volume hospitals (1,087 patients) were identified. Significant differences for the in-hospital mortality were found between the low- and high-volume hospitals for the high (21.6% vs. 7.2%, p=0.00) and severe (44.4% vs. 11.8%, p=0.00) risk patient groups. Conclusions: Good model performance showed that insurance claims data can be used for comparing hospital mortality after adjusting for the patients' risk. Negative correlation was existed between surgery volume and in-hospital mortality. However, only patients in high and severe risk groups had such a relationship.

• 보건행정학회지
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• 제7권2호
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• pp.46-64
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• 1997

Background & Objectives : Korea is face with the social need for health care technology assessment so that it is urgently needed to found principles and methodology in technology assessment in health care. As a groundwork for health care technology assessment, we tried to prioritize medical technology for assessment. Among medical technologies, procedure is somewhat difficult to assess, compared to drug or equipment. In this study, we aimed at the prioritisation of medical procedure to be assessed, in terms of efficay, safety, and adequacy. Method : For the standardized classification of medical procedure, ICD-9-CM(International Classification of Diseases 9th edition - Clinical Modification) was used. Among the list the procedures coming under otorhinolaringjology and thoracic surgery were selected by three family physicians. The list of procedure was mailed to the board certified surgeons of both disciplines, with the question asking about the necessity for assessment in terms of efficay, safety, and adequacy. Replied questionnaires were analyzed in each procedure. Results : Of 560 otorhinolaryngologist and 480 thoracic surgeon, 114 surgeons replied. Of otorhinolaryngological procedure, incision, excision, and destruction of inner ear : fenestration of inner ear : stapedectomy and its revision were the most urgent technology to assess in the aspect of safety. For adequacy, operations on Eustachian tube: fenestration of inner ear: incision, excision, and destruction of inner ear were highly ranked in necessity, and for efficary, operations on Eustachian tube; external maxillary antrotomy; fenestration of inner ear. Thoracic surgeons replied thoracic procedures, lung transplantation; heart transplantation; implantation of heart assist system [pump] are most important for evaluation in terms of safety; and heart transplantation; Lung transplantation; Implantation of heart assist system [pump] in terms of adequacy, and surgical collapse of lung [Artificia니 pnemothorax or pnuexoperitoeum]; lung transplantation; periarterial sympathectomy in terms of efficacy. As a whole, surgeons regard safety evaluation is more urgent than adequacy or efficary. In addition, otorhinolaryngological surgeons regard evaluation of their procedures more urgent than thoracic surgeons regard theirs. Conclusion : By the questionnaire to board certified physicians, we get some preliminary data for prioritisation of technologies to assess. Through the questionnaire like this, much information would be gathered for technology assessment, especially for medical procedure, if not enough. In the near future, well structured expert opinion gathering research, such as modified Delphi or nominal group technique, should be done succeedingly.

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.2841-2846
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• 2016

Background: Tobacco use is the single most important preventable risk factor for cancer. Surveillance of tobacco-related cancers (TRC) is critical for monitoring trends and evaluating tobacco control programmes. We analysed the trends of TRC and evaluated the population-based cancer registry (PBCR) in Delhi for simplicity, comparability, validity, timeliness and representativeness. Materials and Methods: We interviewed key informants, observed registry processes and analysed the PBCR dataset for the period 1988-2009 using the 2009 TRC definition of the International Agency for Research on Cancer. We calculated the percentages of morphologically verified cancers, death certificate-only (DCO) cases, missing values of key variables and the time between cancer diagnosis and registration or publication for the year 2009. Results: The number of new cancer cases increased from 5,854 to 15,244 (160%) during 1988-2009. TRC constituted 58% of all cancers among men and 47% among women in 2009. The age-adjusted incidence rates of TRC per 100,000 population increased from 64.2 to 97.3 among men, and from 66.2 to 69.2 among women during 1988-2009. Data on all cancer cases presenting at all major government and private health facilities are actively collected by the PBCR staff using standard paper-based forms. Data abstraction and coding is conducted manually following ICD-10 classifications. Eighty per cent of cases were morphologically verified and 1% were identified by death certificate only. Less than 1% of key variables had missing values. The median time to registration and publishing was 13 and 32 months, respectively. Conclusions: The burden of TRC in Delhi is high and increasing. The Delhi PBCR is well organized and generates high-quality, representative data. However, data could be published earlier if paper-based data are replaced by electronic data abstraction.

• 동의신경정신과학회지
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• 제32권3호
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• pp.207-217
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• 2021

Objectives: The objective of this study was to perform a scoping review to describe clinical study trends on Qigong in order to identify further directions of Qigong in Korean medicine. Methods: Under the Arksey and O'Malley methodological framework, PubMed was searched to identify articles published from January 1, 2019 to June 28, 2021. A total of 224 articles were retrieved. Results were systematically filtered by two independent reviewers based on inclusion/exclusion criteria. Publication information, disease, intervention and research results of a total of 153 articles were extracted and analyzed. Results: Asia had the largest number of Qigong studies (82 studies, 65%). Most research studies were conducted in the academic field of Medicine (n=109, 86.5%), including Complementary and Alternative Medicine (n=35), Medicine (miscellaneous) (n=15), and Oncology (n=15). Based on ICD-10 classification, Mental and Behavioral Disorder (n=25, 19.8%) was the most frequently analyzed decease, followed by Neoplasm (n=24) and Disease of the Nervous system (n=12). Almost half of all studies were Systematic Reviews. RCTs only accounted for 25.4%. Interventions were very diverse and inconsistent. Sixty (47.6%) studies analyzed Qigong as a single intervention. In 66 cases, Qigong was analyzed as part of a large category such as Mind-Body intervention. Most studies designed a Donggong (動功) program. The age of the population was relatively high as 47.1% of all studies were conducted on middle aged or older adults. Conclusions: These findings suggest that further standardized research on Qigong, especially Junggong (靜功), needs to be conducted by developing research protocols and practice programs to verify effects of Qigong and utilize Qigong as a medical intervention in Korean Medicine.

• 해운물류연구
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• 제34권4호
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• pp.637-656
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• 2018

본 연구는 강원영동남부권 내륙물류기지 필요성 및 입지 경쟁력 분석을 위해, 강원권 물동량 추정 및 내륙물류기지 입지 경쟁 요인분석을 수행하였다. 분석결과, 강원권 산업단지 산출 가능 물동량은 775만 톤이며, 내륙물류기지의 조성지역은 기종점 분석 결과 가장 적합한 지역은 원주시로 나타났다. 내륙물류기지 경쟁 요인을 도출하기 위해서 선행연구를 통해 28개 변수를 도출하였으며, 해당 요인에 대해 탐색적 요인분석을 수행한 결과 16개의 요소가 4개의 요인으로 분류 되었다. AHP 분석결과 요인별 중요도는 '접근성 요인'(0.374)이 가장 높은 수치를 보였으며, '연계성 요인'(0.358), '운영성 요인'(0.166), '정부정책 요인'(0.102)의 순으로 나타났다. 전체 항목에서의 중요도는 '내륙물류기지에서 수요지까지의 수배송'(0.160)이 가장 큰 요인으로 분석되었다.

• 한국임상약학회지
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• 제30권4호
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• pp.250-258
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• 2020

Background: Dopamine receptor agonists (DRAs) have been associated with impulse control disorders (ICDs) in Parkinson's disease (PD) in preliminary studies. Whether the association holds true when DRAs are used to treat non-PD, such as restless legs syndrome, prolactinoma, and several mood disorders is uncertain. Objective: The present study aimed to understand the research gaps related to the risk of ICDs associated with pramipexole or ropinirole (PRX/ROP) use as a treatment for specific underlying diseases, excluding Parkinson's disorders. Methods: We conducted a scoping review, systematically searching databases to identify literature on the types, prevalence, and factors associated with ICD in non-PD patients receiving PRX/ROP. All relevant information that helped understand the epidemiology of ICDs among non-PD patients taking PRX/ROP were extracted and analyzed. We also evaluated the potential associations between PRX/ROP and ICDs, utilizing the Naranjo scale or statistical analysis, depending on the type of literature. Results: We included 24 articles (19 case reports or case series and 5 population-based studies) in this scoping review. Evaluating the 19 case reports or case series using Naranjo scores led to the discovery of a possible link between PRX/ROP exposure and ICDs. However, important information to assess causality is frequently missing. Moreover, the population-based studies lack diversity in the study populations and enough study samples to draw conclusive results. Conclusion: Our scoping review suggests that the currently available literature requires more details in future case reports and for well-powered studies in various disease conditions where PRX/ROP is frequently used.

• 한국임상수의학회지
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• 제39권5호
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• pp.217-225
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• 2022

The population of pet cats has increased significantly, from 0.3% in 2002 to 5.6% in 2017. Large-scale feline demographic and disease data from Korea are lacking. The aim of this study was to investigate the demographic data (breed, sex, and age) and disease distribution of cats who visited private veterinary practices in Korea. Data including breed, sex, age, and disease, were compiled from 32,728 electronic medical records from 30 selected private veterinary practices, between January 1, 2016, and December 31, 2017. Diseases were classified based on the International Classification of Diseases 11 by the World Health Organization, and then compared and cross-analyzed according to breed, sex, and age. Korean shorthair was the most common breed. There was a high distribution of young cats, with 77.6% of the cats under 4 years of age, and an average age of 2.5 years. Diagnoses related to preventative medicine were the most frequent and diagnoses common to young cats had higher incidence. This demographic data and information about disease distribution can be used as a basis for future research and may be helpful for determining priorities in the diagnosis of diseases and establishing strategies for health management in cats.

• Safety and Health at Work
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• 제13권3호
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• pp.302-307
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• 2022

Background: In Brazil, asbestos was intensively used from the 1960s until its ban in 2017. Mesothelioma, asbestosis, and pleural plaques are typical asbestos-related diseases (ARD-T). To create an ARD-T national database, death records from 1996-2017 were retrieved from several health information systems (HIS). Methods: All national HIS containing coded diagnoses (ICD-10) and death information were obtained. Linkage was performed to create a single database of ARD-T death records, either as underlying or contributory causes, in adults aged 30 years and older. Results: A total of 3,057 ARD-T death records were found, 2,405 (76.4%) of which being malignant mesotheliomas (MM). Pleural MM (n = 1,006; 41.8%) and unspecified MM (n = 792; 32.9%) prevailed. Male to female MM ratio (M:F) was 1.4:1, and higher ratios were found for non-malignant ARD-T: 3.5:1 for asbestosis and 2.4:1 for pleural plaques. Male crude annual mesothelioma mortality (CM_mm ×1,000,000) was 0.98 in 1996 and 2.26 in 2017, a 131.1% increment, while for females it was 1.04 and 1.25, a 20.2% increase, correspondingly. The small number of deaths with asbestosis and pleural plaques records precluded conclusive interpretations. Conclusions: Even with the linkage of several HIS, ARD-T in death records remained in low numbers. MM mortality in men was higher and showed a rapid increase and, along with non-malignant ARD-T, higher M:F ratios suggested a predominant pattern of work-related exposure. The monitoring of workplace and environmental asbestos exposure needs to be improved, as well as the workers surveillance, following the recent Brazilian ban.

• 한국학교ㆍ지역보건교육학회지
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• 제23권4호
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• pp.29-39
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• 2022

Objectives: The purpose of this study was to assess the incidence of delivery and puerperium complications in South Korea and analyze the correlations between the patient's characteristics and delivery and complications before and after 10 years. Methods: This study used the data from an Korean National Hospital Discharge In-depth Injury Survey. Cases of which the principal diagnosis and second diagnoses were disease classification ICD code O00-O99(Pregnancy, childbirth and the puerperium) were defined as the study subjects, and the first study group was divided as the year of discharge from 2005 to 2007, and the second study group from 2015 to 2017. Results: The number of patients discharged whose principal diagnosis or second diagnoses was O00-O99 was 21,598(Weighted 423,306) from 2005 to 2007 and 19,028(Weighted 364,384) from 2015 to 2017, which decreased by 13.9% compared to 10 years ago. The average age of discharged patients increased by about 2 years and was statistically significant (p<.0001). Factors associating spontaneous delivery, caesarean section and puerperium complication were hospitalization route, bed size, maternal age, length of hospital stay, and the year of discharge. Conclusion: Based on the results of this study, health and education policies and economic support for medical care for high-risk pregnancy and delivery management would be necessary continuously. In addition, policies to strengthen the medical system for high-risk pregnancy management in non-metropolitan areas with high fertility rates would also be needed.

• 한국인터넷방송통신학회논문지
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• 제22권4호
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• pp.35-40
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• 2022

본 논문은 전자제품의 PCB 기판 외곽에 위치시켜 ISM 대역에서 무선통신이 가능하도록 하는 안테나를 제안하였다. PCB에서는 부품의 간섭 또는 디자인에 방해가 되지 않도록 소형화하기 위해 T자형 OPEN - STUB 급전선을 설계하였다. T자형 스터브 급전선과 스파이럴 구조를 이용하여 각각 2.4GHz, 5.8GHz 대역에서 안테나의 특성을 확인하였다. 실험을 위하여 안테나 크기는 가로 5mm × 세로 6.5mm의 크기로 하였으며 PCB두께는 1.2T로 하여 제작하였다. 제작된 안테나의 실험 측정결과 2.4GHz, 5.8GHz에서 -10dB 이상의 반사손실을 얻을 수 있었다. 또한 E-plane에서 이득은 -4.45dBi로 나타났으며, H-plane에서 이득은 -1.05dBi 나타났다. 따라서 여기서 제안된 무선통신용 소형안테나에서 우수한 성능을 나타내었다.