• Title/Summary/Keyword: KCD-7

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Usage Report of Chuna Manual Therapy in Patients Visiting Korean Medical Institutions -Using Electronic Medical Records(EMR) of 21 Korean Medicine Hospitals and Clinics - (한방의료기관 이용환자의 추나 이용실태 - 21개 한방병의원 전자의무기록 자료를 이용하여 -)

  • Kim, Min-Young;Ha, In-Hyuk;Lee, Jin-Ho;Kim, Jong-Ho;Jung, Boyoung
    • The Journal of Korean Medicine
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    • v.40 no.1
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    • pp.86-98
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    • 2019
  • Objectives: This study analyzes the electronic medical record (EMR) data of the spine specialist oriental hospital and clinic in various regions, and reports the actual number and used cases of Chuna therapy. Methods: 2,470,772 data was extracted retrospectively from electronic medical records of all inpatients and outpatients who were treated chuna therapy at 21 Korean medicine hospitals and clinics from January 1, 2018 to December 31, 2018. The characteristics of medical treatment using chuna therapy reflect the minimum, maximum and average values of the number of hospitalized patients, length of hospitalization, frequency of hospitalization, number of outpatients, frequency of treatment and frequency of visit. Diseases were classified in the proportion of Chuna treatment according to the KCD, 7th edition. The chuna and blindness charts were derived accordingly from illness and disease of each part of the body. Results: During the study period, a total 1,342,022 inpatients and outpatients visited the study sites. The male proportion was a little higher than the females' (male: 53.7%, female: 46.3%). According to age, the 30s and 40s were more than half the total(30s: 33.0% and 40s: 20.1%). Chuna therapy was treated to more outpatients than hospitalized patients (outpatient: 83.6%, hospitalization: 16.4%), and most treatments were related to musculoskeletal illness(99.06%). Conclusions: As a result of this study, 1,342,389 chuna therapy was performed in 21 hospitals for one year. As highly demanded by the public, we look forward to ensuring national health care options and medical access when health insurance for chuna therapy is applied beginning March 2019.

Drug Utilization in Korean Children with Kawasaki Disease (국내 가와사키병 환아의 약물사용)

  • Cha, SungHee;Je, Nam Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.3
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    • pp.127-135
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    • 2017
  • Background: Kawasaki disease (KD) is an acute febrile, systemic vasculitis as a leading cause of acquired heart disease in children. Intravenous immunoglobulin G (IVIG) and aspirin are the standard initial therapy in the treatment of acute KD. The purpose of this study was to investigate drug utilization in children with KD, and to compare "IVIG + high-dose aspirin" and "IVIG + moderate-dose aspirin" in preventing cardiac complications. Methods: We analyzed pediatric patient sample data compiled by the Health Insurance Review & Assessment Service from 2010 to 2015. We identified patients with KD using the KCD-6 code of M30.3. We excluded patients in chronic phase or ${\geq}1$0 years. We also excluded patients who were diagnosed KD in November or December. Drug utilization pattern were assessed in acute KD patients and 30-day and 60-day cardiac complications were investigated between "IVIG + high-dose aspirin" group and "IVIG + moderate-dose aspirin" group. Results: In acute phase, IVIG was administered to 95.8% patients, and 57.1% patients were prescribed moderate-dose aspirin and 25% patients were with high-dose aspirin. Steroid use was rapidly increased from 4.0% in 2010 to 11.3% in 2015. Both 30-day and 60-day cardiac complications occurred less in "IVIG + high-dose aspirin" group compared to "IVIG + moderate-dose aspirin" group, but not statistically significant (0.9% vs 1.8%, p=0.252 for 30-day complication rate; 1.5% vs 2.7%. p=0.073 for 60-day complication rate). Conclusion: We were not able to demonstrate which aspirin therapy is superior for preventing cardiac complications in acute KD patients and further research is warranted.

A Study of the Co-Administration of Herbal and Western Medicines to Hospitalized Patients with Osteoarthritis (골관절염 환자의 한약 양약 투여 현황 및 안전성 연구)

  • Kim, Dong-hyun;Lee, Da-eun;Noh, Ji-won;Ahn, Young-min;Ahn, Se-young;Lee, Byung-cheol
    • The Journal of Internal Korean Medicine
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    • v.39 no.2
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    • pp.97-106
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    • 2018
  • Objectives: The combined use of herbal and Western medicine is increasing. However, herbal medicine is highly likely to interact with Western medicine making it important to understand the effects of co-administration. This study investigates the ratio of patients who take Western medicine with herbal medicine, the types of medicines commonly prescribed together, and the results of hospital examinations. Methods: We investigated patients who were hospitalized at Kyung Hee University Korean Medical Hospital for at least one day from January 1, 2010 to December 31, 2017. There were some inclusion criteria. First, we chose patients aged 19 and over. Second, we chose patients who were diagnosed with osteoarthritis (OA) with diagnosis codes M13, M15, M17 according to KCD-7. Third, patients had liver function tests, renal function tests, and general hematology tests performed at least two times during hospitalization. Results: Among a total of 131 OA patients, 32 (24.4%) patients were treated with herbal-Western medicine combination therapy. The most commonly prescribed herbal medicine was Daegalwhal-tang, and the most commonly prescribed Western medicine was celecoxib. In the laboratory findings, all liver function tests, renal function tests, and general hematology tests showed no difference compared to admission day. There were also no differences between herbal medicine single treatment and herbal-Western medicine combination treatment. Conclusions: From these results, we suggest that herbal medicine single treatment and herbal-Western medicine combination treatment for OA patients does not cause adverse effects.

Analysis of Clinical Tendency of Spinal Disorder in Primary, Middle and High School Students in Korea (국내 초.중.고등학생들의 척추질환 진료경향 분석)

  • Kim, Min-Jung;Son, Chang-Gue;Heo, Dong-Seok;Hong, Kwon-Eui
    • Journal of Acupuncture Research
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    • v.27 no.2
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    • pp.43-49
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    • 2010
  • Objectives : Among young generation, the prevalence of spinal disorders is known to be increasing. This study aimed to analyze the clinical data of spinal disorder in young ages in Korea. Methods : Number of patient, kinds of disorder, and medical cost were analyzed for patients(7~18 years) underwent spinal disorders using computerized database of Health Insurance Review and Assessment Service(HIRAS) from 2004 to 2008. We included dorsopathies as spinal disorder according to Korean Classification of Diseases(KCD) and excluded spinal disorder caused by trauma. We compared the data of traditional Korean medicine treatment with that of western medical care. Results : 4.8% of the children and adolescents had medical treatment with spinal disorder in 2008. The claim number and medical cost for both traditional Korean medicine and western medicine treatment are increasing 1.8 and 1.3 times respectively over 5 years. Total medical spent of western clinic was 2.1 times than those of traditional Korean clinic. The most common spinal disorder was dorsalgia(31.8%) and scoliosis(13.5%) in western clinics while back pain(29.0%) and neck pain(10.8%) in oriental clinic. Conclusions : We first reported the clinical tendency of spinal disorder in Korean children adolescents from 2004 to 2008. This study will support the development of a strategy for traditional Korean medicine-based prevention or treatment of spinal disorders in young generation.

A study of Utilization behavior in patients receiving Korean Medicine and Western Medicine collaboration (의·한의 협진 의료이용 행태 분석 연구)

  • Kim, Hyun-Min;Kim, Nam-Kwen;Nam, Soon-Hoo;Lee, Hye-Yoon
    • Journal of Society of Preventive Korean Medicine
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    • v.22 no.2
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    • pp.25-32
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    • 2018
  • Objectives : This study was conducted to investigate the frequent diseases among the people who had been treated by collaborative treatment of Korean medicine and Western medicine, and to compare their medical use behaviors before and after the collaborative first-stage pilot project between Korean medicine and Western medicine. Methods : 4,467 patients were identified as the patients who are participated in the collaborative first-stage pilot project between Korean medicine and Western medicine during the period between July 15, 2016 and March 31 2017. We used 28,480 records of Korean national health insurance claim data from January 1 2016 to March 31 2017 to analyzed present condition of cooperative medical usage. Also we conducted a paired t test to compare the percentage of collaborative treatment days before and after the pilot project period. Results : We found that the most frequent diseases treated in the pilot project were the diseases of musculoskeletal and nervous system and then 10 major diseases such as H, K, J, C (D), N, L, E, A, H and F disease codes in order. Also it was confirmed that 14 major and 53 medium diseases are included from more than 90% of total patients. As a result of high frequency of medical treatment in Western medicine or Korean medicine is "administration of Korean medicine", which is same as before and within the pilot project. The ratio of utilizing both Western and Korean medical care for the same disease on the same day by both general patients and patients in KCD-7 disease code group C, G, I, M and S had been increased significantly. Conclusions : The pilot project might change the behavior of utilizing the medical care service by increasing the ratio of collaborative treatment of Western medicine and Korean medicine for the same disease on the same day.

Suggestion of Standard Process in Developing Questionnaire of Pattern Identification (한의 변증 설문지 개발 표준프로세스 제안)

  • Jang, Eunsu;Lee, Eun Jung;Yun, YongGi;Park, Yang Chun;Jung, In Chul
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.30 no.3
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    • pp.190-200
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    • 2016
  • The aim of this study was to suggest the standard process in developing Questionnaire of Pattern Identification (QPI). The process in developing QPI was researched from validated and developed questionnaire and the standard process in developing QPI was suggested through review of the experts in research, statistics and clinics. Check list was also provided. The number of QPI reviewed in this research was 17(4 in disease in Korea Medicine, 5 in Pathological symptoms, 6 in Sasang constitutional Diagnosis, and 2 in etc), The standard process in developing QPI consisted of 11 phage and 33 check lists. 1) Composition of Research Member(3check lists), 2)Set up of the Aim(5), 3) Review for advanced research(3), 4) Finding an Important Index(3), 5) Review of item selection(4), 6) Developing the questions using items(5), 7) Developing Draft of Questionnaire(2), 8) 1st Survey of Reliability and Validity(2), 9) Revision and Correction of Item(1), 10) 2st Survey of Reliability and Validity(2), 11) Completion and Application(3). This study suggests the standard process in developing QPI for the first time in Korea. This following step may help A new QPI development.

A Survey on Korean Medicine Doctors' Recognition and Treatment for Developing Korean Medicine Clinical Practice Guideline of Coldness of Hands and Feet (한의표준임상진료지침 개발을 위한 수족냉증에 대한 한의사의 인식과 치료현황)

  • Lee, Dong-Nyung;Kim, Hyung-Jun;Yu, Jun-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.3
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    • pp.92-116
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    • 2017
  • Objectives: The purpose of this study were to researched a Korean medicine doctors' recognition about coldness of hands and feet, and developing of korean medicine clinical practice guidelines (CPG) for coldness of hands and feet. Methods: We conducted a questionnaire survey targeting 399 Korean medicine doctors belonging to the Association of Korean Medicine by e-mail and analyzed the answers. Results: 1. 86.86% of the respondents agreed about the necessity of CPG for coldness of hands and feet. 2. 84.2% of respondents wanted coding of Korean Standard Classification of Diseases (KCD) on coldness of hands and feet. 3. To diagnosis a coldness of hands and feet, the respondents used a Subjective symptoms (98.5%), Infrared thermographic imaging device (DITI) (26.32%) Heart rate variablity test (HRV) (17.04%), Thermometer (9.77%), Cold stress test (2.76%) 4. Causing of coldness of hands and feet, the respondents considered a constitution or heredity (84.71%), stress (73.66%), lack of exercise (64.91%), irregular eating habits (51.63%), Cold meals (32.83%), depression (31.33%), etc. 5. Treating coldness of hands and feet, the respondents used a herbal medicine (66.85%), acupuncture (70.7%) Pharmacopuncture (23.85%) and moxibustion (60.08%) for $10.91{\pm}8.03week$. Conclusions: We researched a Korean Medicine doctors' recognition of CPG, clinical diagnosis, treatment on a coldness of hands and feet, and policy they required.

A Survey of the Recognition on the Practice Pattern, Diagnosis, and Treatment of Korean Medicine of Dementia and Mild Cognitive Impairment - Focusing on the Differences between Neuropsychiatrists of Korean Medicine and General Physicians - (치매, 경도인지장애의 한의진료 현황, 진단 및 치료에 대한 한의사의 인식도 조사 연구 - 한방신경정신과 전문의와 일반의의 차이를 중심으로 -)

  • Seo, Young Kyung;You, Dong Keun;Kim, Hwan;Kim, Siyeon;Lee, Go eun;Kim, Sang-Ho;Kang, Hyung-Won;Jung, In Chul
    • Journal of Oriental Neuropsychiatry
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    • v.28 no.3
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    • pp.263-274
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    • 2017
  • Objectives: To identify the current status of Korean medical practice pattern, diagnosis and treatment of dementia through recognition survey, and to use it as a preliminary data for various dementia research. Methods: Questionnaires were developed through expert meetings. The disease was defined as dementia and mild cognitive impairment, and areas were designated to practice pattern, diagnosis and treatment. From December 18, 2016-January 18, 2017, 221 respondents, including 36 neuropsychiatrists of Korean Medicine and 185 general physicians (including other medical specialists) were included. Results: 1. In both groups, the most commonly used KCD (Korean standard classification of disease and cause of death) were in the order of Unspecified Alzheimer's Dementia (F00.9), Mild Cognitive Impairment (F06.7), and Unspecified Dementia (F03). 2. The most commonly used pattern identification were zang-fu and qi-blood-yin-yang in both groups. 3. Diagnostic evaluation tools were mainly conducted by MMSE, radiologic examination, K-DRS, GDS and CDR in both groups. 4. Both groups reported using acupuncture and herbal medicine mainly. 5. In both groups, the acupuncture method was used extensively in the order of Body, Scalp, and Sa-Am. 6. Neuropsychiatrists used a variety of herbal medicines such as Wonjiseokchangpo-san (Yuanzhushichangpu-san), Yukmijihwang-tang (Liuweidihuang-tang), Palmijihwang-won (Baweidihuang-won), Sunghyangjungki-san (Xingxiang Zhengqi-san) and Ondam-tanggami (Wendan-tangjiawei). General physicians used a variety of herbal medicines such as Ondam-tanggami (Wendan-tangjiawei), Bojungikgi-tang (Buzhongyiqi-tang), Yukmijihwang-tang (Liuweidihuang-tang). 7. Neuropsychiatrists used a variety of Korean herbal preparation products (benefit and non-benefit) such as Ekgan-sangajinpibanha (Yigan-sanjiachenpibanxia), Yukmijihwang-tang (Liuweidihuang-tang), Jodeung-san (houteng-san), Palmijihwang-won (Baweidihuang-won). General physicians used a variety of Korean herbal preparation products such as Bojungikgi-tang (Buzhongyiqi-tang), Banhabaegchulcheonma-tang (banxiabaizhutianma-tang), Yukmijihwang-tang (Liuweidihuang-tang), Ekgan-sangajinpibanha (Yigan-sanjiachenpibanxia), Palmijihwang-won (Baweidihuang-won). Conclusions: By confirming awareness of Korean medical doctors treating dementia in clinical fields and understanding differences between neuropsychiatrists of Korean medicine and general physicians, it can be used to understand guideline users' needs and confirm clinical questions during development of future clinical practice guidelines for dementia.

Characteristics of Korean Poisoning Patients: Retrospective Analysis by National Emergency Department Information System (한국 중독환자의 경향: 국가응급진료 정보망을 이용한 후향적 연구)

  • Kim, Woongki;Kim, Kyung Hwan;Shin, Dong Wun;Park, Junseok;Kim, Hoon;Jeon, Woochan;Park, Joon Min;Kim, Jung Eon;Kim, Hyunjong
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.2
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    • pp.108-117
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    • 2019
  • Purpose: The study examined the poisoned patients' characteristics nationwide in Korea by using data from the National Emergency Department Information System (NEDIS). Methods: Among the patients' information sent to NEDIS from January 1, 2013 to December 31, 2015, the included subjects' main diagnosis in ED showed poisoning according to the 7th edition of the Korean Standard Disease Classification (KCD-7). We analyzed the patients' gender, age, initial vital signs, visit time, stay time of staying in ED, results of ED care, main diagnosis in ED, length of hospitalization, and results of hospitalization. Results: A total of 106,779 ED visits were included in the analysis. There were 55,878 males (52.3%), which was more than the number of females. The number of intentional poisoning was 49,805 (59.6%). 75,499 cases (70.8%) were discharged, and 25,858 cases (24.2%) were hospitalized. The numbers of poisoning patients per 1,000 ED visits were 14 in Chungnam and 11.9 in Jeonbuk. The most common cause of poisoning, according to the main diagnosis, was venomous animals. It was the same for hospitalized patients, and pesticide was next. Pesticide was the most common cause of mortality in ED (228 cases, 46.1%) and after hospitalization (584 cases, 54.9%). The incidence of poisoning by age group was frequent for patients in their 30s to 50s, and mortality in ED and post-hospitalization were frequent for patients in their 60s to 80s. Conclusion: This study investigated the characteristics of poisoning patients reported in the past 3 years. Pesticide poisoning had a high mortality rate for patients in ED and in-hospital. For mortality, there was a high proportion of elderly people over 60. Thus, policy and medical measures are needed to reduce this problem. Since it is difficult to identify the poison substance in detail due to nature of this study, it is necessary to build a database and monitoring system for monitoring the causative substance and enacting countermeasures.

A National Survey on Utilization of Pattern Identification among Korean Medicine Doctors (전국 한방의료기관 한의사 대상 한의 변증활용 현황 조사)

  • Yeo, Minkyung;Park, Kihyun;Jang, Eunsu;Lee, Youngseop
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.3
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    • pp.45-55
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    • 2015
  • Objective : The aim of this study was to survey the present utilization of pattern identification(PI) in the clinical field among Korean Medicine Doctors. Method : This survey was conducted from Oct. 1 to Oct. 31, 2014 by face-to-face interview using structured questionnaire. The subjects were 400 korean medicine doctors who worked in hospitals or clinics. The questionnaire consisted of two sections - a demographics section(i.e., sex, age, clinical experience, place of work, residence and so on) and the main research section(i.e., the PI utilization rate, the utilization of PI systems, the utilization of PI in the clinical domain and in the treatment domain, the correlation between utilization PI and so on). Results : This study revealed that subjects used the PI to 66.7% of their patients on average. The utilization rate of PI in patients was significantly higher for female physicians than for male physicians, for physicians worked in clinics than for physicians who worked in hospitals and for physicians with more than 10 years clinical experience than for physicians with less than 10 years clinical experience. In the utilization of PI systems, Visceral PI was most as 92.0%. There were significant difference on the PI utilization rate according to utilization of Meridian and Collateral PI, Triple Energizer PI, Defense, Qi, Nutrient and Blood PI, Six-Meridian PI and Six Excesses PI. As a result of analysing the PI utilization rate by clinical domain and in the treatment domain, the Treatment and the Drug Treatment showed the highest values. Among utilized PI systems, the correlation coefficients between Defense, Qi, Nutrient and Blood PI and Triple Energizer PI showed the highest value, but the correlation coefficients between Sasang Constitutional Medicine with the each PI showed substantially lower value. Conclusion : The results of this study demonstrate that usage of PI was higher than usage of U code(in KCD) usage in clinical field. we suggested that additional studies on using PI and developing more appropriate standardized tool should be conducted to widen scope of PI's utilization.