• 대한조현병학회지
• /
• 제22권1호
• /
• pp.8-13
• /
• 2019

Objectives: The aim of this study was to explore the prevalence of type 1 diabetes in patients with schizophrenia and their total medical costs and risk of hospitalization. Methods: This study used Health Insurance Review and Assessment Service data in Korea. To examine total medical costs and risk of hospitalization, we selected 1,510 subjects with schizophrenia (half with and half without type 1 diabetes) that were 1:1 matched via propensity score matching. In health care system perspective, total medical costs included out-of-pocket and insurer's costs. Logistic regression models were used to examine the risk of hospitalization. Results: The prevalence of type 1 diabetes in patients with schizophrenia was 3.87 per 1,000 person year. Among patients with schizophrenia, the amount of total average medical costs and hospitalization costs in patients with type 1 diabetes was 1.49 and 1.59 times higher than those in patients without it, respectively. The odds of hospitalization were higher among patients with type 1 diabetes compared with those without it (odds ratio, OR=1.97 ; 95% CI 1.60-2.43). Conclusion: This study showed that medical costs and risk of hospitalization were higher in schizophrenia patients with type 1 diabetes. Therefore, these individuals may require specific care programs.

• 한국의료질향상학회지
• /
• 제27권2호
• /
• pp.45-56
• /
• 2021

Purpose: Repeated hospitalization could be a proxy of unnecessary or preventive admission in South Korea where barriers to hospitalization are relatively low. This study aimed to estimate the current status of repeated hospitalization due to ambulatory care sensitive conditions (ACSC) in South Korea. Methods: Using the National Health Information Database, repeated hospitalization databases were constructed in units of episodes for patients who had been admitted more than twice between January 2017 and December 2018. The number of hospitalizations, total in-hospital days, and total medical expenditure were calculated and compared by patient characteristics in both of the entire patient group and the ACSC patient group. Results: Of total hospitalization episodes, 26.6% reported repeated admission, and 6.7% of repeated hospitalization was due to ACSC. A total of 183,110 patients with ACSC had been admitted an average of 2.9 times and spent an average of KRW5,630,118. In other words, KRW1,309 billion had been spent for repeated hospitalization due to ACSC. The scale of medical expenditure was relatively large in the highest and lowest socioeconomic status. Conclusion: Repeated hospitalization for ACSC can be considered a simple and intuitive indicator when assessing unnecessary hospitalizations or evaluating healthcare policy.

• 대한예방한의학회지
• /
• 제11권2호
• /
• pp.175-188
• /
• 2007

The purpose of this study was to confirm the reasons why the medical institutes avoid the traffic accident victims covered by the automobile insurance. For this purpose, a university hospital was sampled to comparatively analyze days of hospitalization, average medical cost per day, ratio of optional medical cost, average cost by injury/age group/department, distribution of MRI photographing, etc., between health insurance and automobile insurance patients. Accordingly, in order to assure automobile patients of a reasonable rights of medical services, it is deemed necessary to arrange a fair system encouraging them reduce the days of their hospitalization as well as a complementary mechanism preventing unnecessary expensive medical services due to the hazard.

• 보건행정학회지
• /
• 제31권2호
• /
• pp.173-179
• /
• 2021

Background: In Korea, the length of stay and medical expenses incurred by medical aid patients are increasing at a rate faster than the national health insurance. Therefore, there is a need to create a management strategy for each type of hospitalization to manage the length of stay of medical aid patients. Methods: The study used data from the 2019 National Health Insurance Claims. We analyzed the factors that affect the length of stay for 186,576 medical aid patients who were hospitalized for more than 31 days, with a focus on the type of hospitalization in long-term care hospitals. Results: The study found a significant correlation between gender, age, medical aid type, chronic disease ratio, long-term care hospital patient classification, and hospitalization type variables as factors that affect the length of hospital stay. The analysis of the differences in the length of stay for each type of hospitalization showed that the average length of stay is 291.4 days for type 1, 192.9 days for type 2, and 157.0 days for type 3, and that the difference is significant (p<0.0001). When type 3 was 0, type 1 significantly increased by 99.4 days, and type 2 by 36.6 days (p<0.0001). Conclusion: A model that can comprehensively view factors, such as provider factors and institutional factors, needs to be designed. In addition, to reduce long stays for medical aid patients, a mechanism to establish an early discharge plan should be prepared and concerns about underutilization should be simultaneously addressed.

• Journal of Preventive Medicine and Public Health
• /
• 제42권6호
• /
• pp.416-423
• /
• 2009

Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.

• 대한한방부인과학회지
• /
• 제33권2호
• /
• pp.124-144
• /
• 2020

Objectives: The purpose of this study is to report the effects of Korean medical hospitalization on six breast cancer patients who received chemotherapy. Methods: Six patients were diagnosed with breast cancer, and were admitted after chemotherapy. The patients were treated by Traditional Korean Medicine such as herb medication, acupuncture and moxibustion. Results: After the treatment, the adverse effects of chemotherapy such as general weakness and digestion disorder were improved. Conclusions: The case report shows that Korean medical hospitalization can be an effective option for treating breast cancer patients who received chemotherapy.

• The Journal of Korean Physical Therapy
• /
• 제31권5호
• /
• pp.322-327
• /
• 2019

Purpose: This study examined the influence of the maximal aerobic capacity on the two-year cardiac-related re-hospitalization in patients with heart failure with a reduced ejection fraction (HFrEF) in Korean society. Methods: The maximal aerobic capacity of the study population (n=95, male 63%) was evaluated using a cardiopulmonary exercise (CPX) testing system. Each patient was followed up for two years to divide the HFrEF patients into two groups according to cardiac-related re-hospitalization: re-hospitalization (RH) group (n=29, 30%) and no re-hospitalization (NRH) group (n=66, 70%). Results: The relative peak $VO_2$ (mL/kg/min, p<0.001), exercise duration (p<0.001), respiratory exchange ratio ($VCO_2/VO_2$, p=0.001), systolic blood pressure (SBP) reserve (p=0.004), heart rate (HR) reserve (p=0.007), SBP max (p=0.02), and HR max (p=0.039) were significantly lower in the RH group than the NRH group during the CPX test. On the other hand, the ventilatory efficiency (VE/VCO2 slope, p=0.02) and age (p=0.022) were significantly higher in the RH group than in the NRH group. In binary logistic regression analysis, the relative peak $VO_2$ (p=0.001, Wald Chi-square 10.137) was the strongest predictive factor on cardiac-related re-hospitalization, which was followed by $VCO_2/VO_2$ (p=0.019, Wald Chi-square 5.54). On the other hand, age (p=0.063, Wald Chi-square 3.445) did not have a significant influence on cardiac related re-hospitalization. Conclusion: The maximal aerobic capacity, especially the relative peak $VO_2$, is the strongest factor on cardiac-related re-hospitalization within two years in patients with HFrEF in Korean society.

• 보건행정학회지
• /
• 제31권4호
• /
• pp.472-478
• /
• 2021

Background: Early identification of patients who are highly likely to develop severe illness among confirmed cases of coronavirus disease 19 (COVID-19) can be expected to lead to effective treatment. This study therefore aimed to determine whether the presence of nonalcoholic fatty liver disease (NAFLD) has an impact on the exacerbation of COVID-19 symptoms. Methods: The study used the Korean National Health Insurance claim data for treatment of COVID-19 patients in 2020. NAFLD includes nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). The outcome variables used were hospitalization and the use of medical devices. Hospitalization was defined by a length of stay exceeding one day and the use of medical devices was defined as one or more uses of a ventilator or extracorporeal membrane oxygenation. Multivariable logistic regression analysis was performed to determine if there was a difference in the hospitalization and use of medical devices of COVID-19 patients depending on the presence of NAFLD. Results: The odds ratio of hospitalization was 1.059, indicating slightly higher odds of hospitalization for patients with NAFL or NASH compared to those without the conditions, but it was not statistically significant (0.969-1.156). On the other hand, the odds ratio of use of medical devices was high at 1.667 and was statistically significant (1.111-2.501). Conclusion: The study results found NAFLD to be a risk factor that can exacerbate symptoms in COVID-19 patients. Accordingly, it is necessary to identify NAFLD patients through preemptive screening and provide them with appropriate treatments.

• 대한예방한의학회지
• /
• 제22권2호
• /
• pp.41-53
• /
• 2018

Objectives : It was to classify and its affecting factors to the patients of Korean medicine hospital with short term and long term hospitalization. Methods : I focused on long-term hospitalized patients. I was conducted on 344 hospitalized patients among the original data of usage and consumption of Korean medical report in 2014. Among those patients, I have classified them into long term inpatients(131 patients) and short term inpatients(213 patients) based on 16 days of hospitalization. Also multiple regression analysis was conducted to investigate the characteristics of the hospitalization, treatment satisfaction and dissatisfaction, the characteristics of long term hospitalization according to the sociodemographic of the subjects, the top 21 diseases and the distribution of human bodies, side effects and kinds of Korean medicine. Results : There was a statistically significant difference between the short term and long term hospitalized patients due to age, occupation, marital status, all 21 diseases and institutional fees, experience of Korean medical treatment due to traffic accidents. There was no significant difference in gender, education level, residence, income level, type of medical insurance, whether private insurance, type of medical treatment for Korean medicine, medical expenses for car accidents, reason for dissatisfaction with treatment. The number of long term patients at Korean medicine hospitals increased by a statistically significant by age in model 1 where confounding factors were differently controlled. In model 2, the number of long term patients at Korean medicine hospitals increased by a statistically significant by age, among those who earned 5,000,000 Korean won or more, and among those with nerve diseases. The number of long term patients at Korean medicine hospitals decreased by a statistically significant amount among the unemployed and others in model 2. In model 3, the number of long term patients at Korean medicine hospitals increased by a statistically significant by age, among those who earned 5,000,000 Korean won or more, and among those with nerve diseases, while the number decreased by a statistically significant amount among the married. Conclusions : These results suggest that the factors affecting the short term and long term hospitalization of patients with Korean medicine hospital are different from each other. Especially it was significant by age, over 5,000,000won Income per month, nerve disease, but decrease significant married.

• 대한한방부인과학회지
• /
• 제29권4호
• /
• pp.57-68
• /
• 2016

Objectives: This paper aims to report the effects of Korean medical treatment on a patient who underwent abdominal surgery with hyperthermic intraperitoneal chemotherapy for ovarian cancer. Methods: An ovarian cancer patient underwent abdominal surgery and got Korean medical treatment during 7-day hospitalization. About 2 years later, with metastasis to the lymph nodes detected, she had abdominal surgery with hyperthermic intraperitoneal chemotherapy and got Korean medical treatment during 10-day hospitalization. The treatment included herbal medicine and acupuncture. Numerical Rating Scale (NRS) of symptoms was measured every morning. Results: After the treatment, sequela following surgery decreased, and general conditions improved. During 1st and 2nd hospitalization, NRS of general weakness, heartburn and dorsal chill significantly decreased (10 to 5, 10 to 5 and 10 to 2, respectively) while edema in both legs remained the same. Conclusions: This case shows that Korean medical treatment is effective for a patient who underwent abdominal surgery with hyperthermic intraperitoneal chemotherapy for ovarian cancer.