• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.20 no.2 s.33
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• pp.230-239
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• 2007

Introduction : Atopic dermatitis is very epidermic disease in these days. Atopic dermatitis is difficult for patient to be treated because there is no specific treatment. The oriental method of atopic dermatitis is varied as patient situation and doctor's view point. The Treatise on Febrile Diseases(傷寒論) may be a hint for atopy disease. Object: Although we use various method such as acupucture, aroma therapy, a medicine for external use, we use the two decoctions in the Treatise on Febrile Diseases according to differentiation of syndromes and abdominal diagnosis. Result : After inpatient treatment in 21 days, the itching, redness, exudation, crust, lichen get better and insomnia and constipation was removed quickly. The SCORAD index is decreased from 84.2 to 25.9. Conclusion : These decoction can treat the atopic dermatitis although there is no symptom in atopy because we cure the all situation of the patient. We can cure the atopic dermatitis not only by routine remedy for various symptoms but also by diagnosis and treatment based on overall analysis of symptoms and signs.

• Korea Journal of Hospital Management
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• v.12 no.4
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• pp.1-21
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• 2007

The relaxation of the regulation in selection of medical institution allows patients to use their own judgement in choosing proper institution for their diseases. Since the change of the regulation, there should have been many changes in medical institution selection behavior. The analysis of the change in disease specific selection pattern is critical because there be an optimal selection criteria that ensure the efficient and effective utilization of medical resources. This study analysis the institution selection factors by comparing the choice among the cases of acute diseases, the cases of chronic diseases, inpatient services, outpatient services, and emergency medical service. The comparisons performed in terms of size, class and other characteristics of medical institutions. For the study the nationally surveyed database was used and the data were analyzed using logistic regression procedure. The results indicates that the primary care facilities were not properly utilized. This study speculates that the reason for the undesirable pattern of utilization is that the roles of primary care facilities in the healthcare delivery system was not clearly defined. Based on the results, the medical policy implications are discussed.

• Korea Journal of Hospital Management
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• v.26 no.4
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• pp.29-37
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• 2021

Purpose: The purpose of this study is to identify the characteristics and factors affecting falls among elderly inpatients with chronic diseases based on the data from the discharge damage depth survey of the Korea Disease Control and Prevention Agency(KDCA) from 2014 to 2018. Method: The study selected elderly inpatients aged over 65 who were hospitalized(n=1,173). Their data were analyzed after being assigned to either a fall group(KSCD, W00-W19) or a non-fall group. Frequency analysis, cross-tabulation analysis, and binary logistic regression analysis were conducted, using SPSS 28. Results: According to the analysis on category of fall and non-fall group were statistically significant difference in age and having chronic diseases. Based on the binary logistic regression analysis of factors affecting falls, The risk of falls was 1.058 times higher with age, and E11-E14 and I63 as main diagnostic codes, the risk of falls was 2.049 times and 2.437 times higher. Conclusion: It is necessary to develop customized educational manuals and muscle exercise programs considering the characteristics of chronic diseases and to create a safe hospital room environment, and this result is expected to be used as basic data for fall prevention education and manual development for elderly inpatients with chronic diseases.

• Quality Improvement in Health Care
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• v.8 no.2
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• pp.186-207
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• 2001

Background : This study presented an analysis of healthcare quality indicators using data mining and a development of decision support system for quality improvement. Method : Specifically, important factors influencing the key quality indicators were identified using a decision tree method for data mining based on 8,405 patients who discharged from a medical center during the period between December 1, 2000 and January 31, 2001. In addition, a decision support system was developed to analyze and monitor trends of these quality indicators using a Visual Basic 6.0. Guidelines and tutorial for quality improvement activities were also included in the system. Result : Among 12 selected quality indicators, decision tree analysis was performed for 3 indicators ; unscheduled readmission due to the same or related condition, unscheduled return to intensive care unit, and inpatient mortality which have a volume bigger than 100 cases during the period. The optimum range of target group in healthcare quality indicators were identified from the gain chart. Important influencing factors for these 3 indicators were: diagnosis, attribute of the disease, and age of the patient in unscheduled returns to ICU group ; and length of stay, diagnosis, and belonging department in inpatient mortality group. Conclusion : We developed a decision support system through analysis of healthcare quality indicators and data mining technique which can be effectively implemented for utilization review and quality management in a healthcare organization. In the future, further number of quality indicators should be developed to effectively support a hospital-wide Continuous Quality Improvement activity. Through these endevours, a decision support system can be developed and the newly developed decision support system should be well integrated with the hospital Order Communication System to support concurrent review, utilization review, quality and risk management.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.24 no.3
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• pp.141-150
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• 2013

Objectives : The objective of this report is to identify the utilization of hospital school service during hospitalization among patients in their childhood and adolescence with psychiatric disorders. Methods : We retrospectively reviewed the medical record of child and adolescent psychiatric who were hospitalized during March 2009 through October 2012. We compared the one-year successful schooling and outpatient follow up rate between users and nonusers of the inpatient hospital school service. The hospital schooling experiences of the users were investigated upon follow-up visits to the outpatient clinic. Results : Sixty-three students received hospital school service during hospitalization among total 122 child and adolescent inpatients. Hospital school participants showed a significantly higher school reentry rate (61.9%) than non-participants (40.7%). However, there was no difference on follow up rate between the two groups. More than 60% of the 22 interviewed participants expressed an above-average level of satisfaction about hospital school service. Conclusion : Many patients with mental illness experience difficulty in receiving school education during treatment. That induces deterioration in disease, academic failure, poor social skills, low self-esteem, economic difficulties, and future job opportunities. The results of this study emphasize the importance of hospital school service and offer useful guidance for hospital school operation.

• The Journal of Korean Medicine
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• v.36 no.3
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• pp.98-110
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• 2015

Objectives: The purpose of this study was to analyze the medical cost of facial paralysis in payer perspective and to estimate the practice pattern of patient using 2011 Health Insurance Review & Assessment Service-National Patients Sample(HIRA-NPS). Methods: Basic statistical system was used for descriptive analysis of NPS dataset. A table for general information (table20) was extracted by disease code, and social demographic characteristics, distribution of the use among inpatients and outpatients, utilization of each kind of medical care institutions, medical cost were analyzed. Subgroup analysis was conducted for assuming the practice pattern of korean medicine and western medicine. Results: A total of 8,219 people and 64,345 claims data were identified as having facial paralysis. Proportion of outpatient was 95.23%, inpatient 0.84% and patient using both services 3.93%. Mean patient charges was 44,229 won per outpatient, 178,886 won per inpatient and 523,542 won per patient using both services. Utilization of korean medical care institutions was 68.81%(claims), 40.46%(patients), utilization of western medical care institutions was 31.19%(claims), 59.54%(patients). The amount charged by korean medical care institutions was 52.61% and western medical care institutions was 47.39%. Cost per claim was higher than those of the korean treatment and cost per patient of western treatment was lower than those of the korean treatment. Conclusions: The research assessed the medical cost and practice pattern associated with facial paralysis. These findings could be used in health care policy and subsequent studies.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.21 no.1
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• pp.121-132
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• 2008

Objective : This study was performed to examine the patterns of inpatients that had visited Dept. of Dermatology Hospital of Oriental Medicine, Dongguk University. Methods : We analysed statistic study in 106 patients, who had admitted to the Dept. of Dermatology, Ophthalmology & Otorhinolaryngology Hospital of Oriental Medicine, Dongguk University from July, 2005 to January, 2008. Results : The results were as follows; 1. Males were 50.94% and females were 49.06%. 2. Distribution of aging was 18.87% in twenties and 17.92% in fifties. 3. Common disease group were Facial palsy(33.96%); Atopic dermatitis(21.7%); Tinnitus(7.55%); Sudden Sensorineural Hearing loss(4.72%); Sore throat(5.66%). 4. Average age of Facial palsy patients was 50.9 years old, average hospitalized period were 10.47days and subjective satisfaction rate was 2.56 points on the basis of 4 points. 5. Average age of Atopic dermatitis patient's average age was 22.22 years old, average hospitalized period were 8.35days and subjective satisfaction rate was 3.44 points on the basis of 4 points. 6. 47.2% of all patient were admitted into the hospital on 1st or 2nd outpatient service and 44% of Facial palsy patient were admitted into the hospital via emergency room. 7. All patient's average hospitalized period were 7.5 days. 8. All patient's subjective satisfaction rate were 2.97 points on the basis of 4 points. Conclusion : This study suggests that oriental medical treatments is especially popular in facial palsy and atopic dermatitis. We have to take steps for effective management and treatment for special diseases and ages.

• The Korean Journal of Health Service Management
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• v.12 no.2
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• pp.125-134
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• 2018

Objectives : The purpose of this study was to analyze factors related to the functional state of stroke patients after discharge from hospital. Methods : The data was provided from a hospital in Wonju, Gangwon-do. The subjects of the analysis were those who were admitted to the emergency room due to stroke from July to December 2016. The dependent variable was the patient's functional status as measured by the modified Rankin Scale(mRS). Independent variables were demographic factors (age, sex, and marriage status), transportation and distance factors (transportation, travel distance), inpatient factors (lengths of stay, Charlson Comorbidity Index (CCI), Tissue plasminogen activator, National Institute of Health Stroke Scale (NIHSS). Hierarchial regression analysis was applied for the analysis. Results : In the hierarchical regression analysis, Model 3, including socio-demographic factors, transportation, distance factors, and inpatient factors, was the best fitted model. It showed that functional status of stroke patients was positively associated with age, length of stay, CCI, NIHSS, and negatively associated with unmarried status. Conclusions : Results indicated that management of stroke requires care from the pre-disease stage, and a customized education program policy is needed for high-risk stroke patients who are older and have comorbid illness.

• Korean Journal of Clinical Pharmacy
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• v.31 no.2
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• pp.153-159
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• 2021

Background: With increasing economic evaluation studies on the treatment of or screening tools for liver diseases that cause hepatocellular carcinoma (HCC), interest in the analysis of the medical utilization and costs of HCC treatment is increasing. Therefore, we aimed to estimate the medical utilization and costs of HCC patients, and calculate the cost of main procedures for HCC treatment, including liver transplant (LT), hepatic resection (HR), radiofrequency ablation (RFA), and transarterial chemoembolization (TACE). Methods: We analyzed claim data from January to December 2018 from the Health Insurance and Review and Assessment Service-National Patient Sample (HIRA-NPS-2018) dataset, including data of patients diagnosed with HCC (Korean Standard Classification of Diseases code C22.0) who had at least one inpatient claim for HCC. Results: A total of 715 HCC patients were identified. In 2018, the yearly average medical cost per HCC patient was ₩18,460K (thousand), of which ₩14,870K was attributed to HCC. Among the total medical costs of HCC patients, the inpatient cost accounted for the largest portion of both the total medical and HCC-related costs. The major procedures of HCC treatment occurred most frequently in the order of TACE, RFA, HR, and LT. The average medical cost per treatment episode was the highest for LT (₩87,280K), followed by HR (₩10,026K), TACE (₩4,047K), and RFA (₩2,927K). Conclusion: By identifying the medical costs of HCC patients and the costs of the main procedures of HCC treatment, our results provide basic information that could be utilized for cost estimation in liver disease-related economic evaluation studies.

• 한국노년학
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• v.31 no.1
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• pp.171-188
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• 2011

The purpose of this study is to examine the factors associated with the probability and levels of the health service utilization among the disabled elderly in Korea. The sample includes 2,111 people older than 65 who are extracted from the 2008 National Survey on People with Disabilities. More than half (54.3%) of the sample experienced at least 1 outpatient physician visit within two weeks and 26.7% were hospitalized within a year. The key factors associated with the outpatient visits were health insurance status, the existence of chronic disease, self-rated health, the Activities of Daily Living (ADLs), as well as renal impairment. Similarly, the utilization of inpatient care was related to health insurance status along with the existence of the internal organ disabilities such as cardiac or respiratory disorders. The study implies the need for the health care policies regarding the prevention of chronic diseases, dependency for daily activities of the elderly, and a management system that specifically targets those with internal organ disabilities. Moreover, the study suggests that financial supports for the low-income group would be helpful to increase their access to health service utilization.