• Clinical Endoscopy
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• v.57 no.3
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• pp.342-349
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• 2024

Background/Aims: Nonagenarians will purportedly account for 10% of the United States population by 2050. However, no studies have assessed the outcomes of nonvariceal upper gastrointestinal bleeding (NVUGIB) in this age group. Methods: The National Inpatient Sample database between 2016 and 2020 was used to compare the clinical outcomes of NVUGIB in nonagenarians and octogenarians and evaluate predictors of mortality and the use of esophagogastroduodenoscopy (EGD). Results: Nonagenarians had higher in-hospital mortality than that of octogenarians (4% vs. 3%, p<0.001). EGD utilization (30% vs. 48%, p<0.001) and blood transfusion (27% vs. 40%, p<0.001) was significantly lower in nonagenarians. Multivariate logistic regression analysis revealed that nonagenarians with NVUGIB had higher odds of mortality (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.3-1.7) and lower odds of EGD utilization (OR, 0.86; 95% CI, 0.83-0.89) than those of octogenarians. Conclusions: Nonagenarians admitted with NVUGIB have a higher mortality risk than that of octogenarians. EGD is used significantly in managing NVUGIB among nonagenarians; however, its utilization is comparatively lower than in octogenarians. More studies are needed to assess predictors of poor outcomes and the indications of EGD in this growing population.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.311-329
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• 1996

This study was designed to compare the level of medical utilization between the urban and rural areas of Korea and to explain the differences between the two regions. Data from the National Health Interview Survey performed by the Korean Institute of Health & Social Affairs in 1992 were used for this study utilizing a sample size of 21,841 people. The level of medical utilization such as the number of physician visits and the number of hospital admissions was compared between the regions with ANOVA. Various determinants for medical use were also compared by univariate analysis. Statistical models which included enabling factors, predisposing factors, need factors and region were constructed for bivariate analysis in order to further elucidate the level of medical utilization. The results were as follows: 1. There was greater medical use, both in terms of physician visits and inpatient care in the rural areas in spite of insufficient health resources. The particular reasons for higher medical utilization in rural areas were attributed to a higher number of initial physician visits as well as a longer the length of stay per hospital admission. Therefore, indicators representing the degree of met need (utilization/need) showed no significant difference between rural and urban areas in spite of the fact that the medical need is larger in rural areas. 2. Use of public health facilities received a significant portion of physician visits in the rural area. The government's effort to enhance primary health care through health centers, health subcenters and the nurse practitioner's post in rural areas has contributed to the increase of access to medical care in the rural areas. 3. There were some differences in the socio-demographic characteristics between two regions ; There were more elderly people over the age of 65: unstable marital status, less education and lower incomes also characterized the rural areas. Therefore, among rural people, there were more predisposing factors for medical use. Additionaly, need factors such as poor self-reported health status and high morbidity level were also high in the rural area. 4. In contrast it was learned that, the supply of health resources was mostly concentrated in the urban areas except for public health facilities. Therefore, geographical access to medical care was lower in the rural area both in terms travel time and travel cost. 5. The coefficient of the region variable was insignificant in the regression model which controlled the supply factor only. However, utilization was significantly higher in urban areas if the model included predisposing factors and need factors in addition to the supply factor. The results were interpreted as rural people have greater medical needs.

• The Journal of Korean Medicine
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• v.33 no.3
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• pp.46-53
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• 2012

Objectives: Many cancer patients have been using Korean medicine with conventional medical care. This study aimed to look into current status of Korean medicine in cancer patients in Korea. Methods: We reviewed utilization of Korean medicine for cancer by searching DB (KoreaMed, KMbase, KISS, NDSL, KISTI, National Assembly Library, OASIS, Korean Traditional Knowledge Portal). The first search keyword used was "cancer" and the second keyword used was either "oriental", "alternative" or "complementary". Results: The utilization rate of Korean medicine was 31.0%. In terms of patient's disease characteristics, most of them were suffering from stomach cancer, lung cancer and colon cancer. Most of them were diagnosed as fourth stage of cancer. Ginseng (14.8%) was a favorite Korean medicine, followed by medicinal treatment (8.1%), acupuncture (3.1%), moxibustion (3.0%), and cupping (2.1%). Conclusions: In Korea, one third of cancer patients are using Korean medicine. We need to know the expectations and demand for Korean medicine for treating cancer and establish our strategy to attract public attention.

• Journal of Physiology & Pathology in Korean Medicine
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• v.32 no.3
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• pp.149-156
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• 2018

Traditional medicines (TM) in Korea, China, and Japan share most of the theories and therapeutic tools, but there are also differences due to their unique histories and cultures. Here, we aim to identify the differences in the utilization of TM theory between three countries by analyzing herb usage data in terms of the related traditional theories. Herb usage data of each country was collected from "Investigation of Korean medicine use and herbal medicine consumption survey" (Korea), "Analytical report on circulation of key Chinese medicinal materials" (China), and "Survey report on raw material crude drug usage" (Japan). Fifty five herbs with sixty features belonging to five theoretical categories (four properties, five tastes, targeting meridians, treatment strategies, and herbal parts) were selected and analyzed. Weight Sum Model (WSM) and Network-Based Group Features (NBGF) were used to compare the theoretical characteristics of TM between three countries. For the statistical evaluation, we developed and applied Herb Set Enrichment Analysis (HSEA) for WSM and NBGF results. HSEA for WSM results revealed the kidney meridian were targeted more in Korea than Japan, while the spleen meridian were targeted more in Japan than Korea. Herbs with sour taste were used more in Japan than China. HSEA for NBGF results found that NBGF including warm, neutral, sweet, and tonifying features were more dominant in Korea and than Japan, while NBGF including cold, bitter, heat-clearing features were more dominant in Japan than the others. These results suggest that TM in Korea, China, and Japan have unique aspects of practice patterns and theoretical utilization.

• Journal of Society of Preventive Korean Medicine
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• v.16 no.2
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• pp.67-81
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• 2012

Objective : This study aimed to analyze the utilization of Korean Medicine clinics, and high-frequent diseases by sex, age, and region of outpatients and inpatients Methods : The data for this study were "Report on Usage Patterns of Korean Medicine Clinics" issued by the Ministry of Health and Welfare in 2008. Descriptive analysis and correspondence analysis were used to find the patterns of patient's utilization by sex, age and region Results : Diagnosis and examination methods mostly consisted of the pulse for diagnosis. Treatment methods consisted of acupuncture, medical herbs in package, and insurance extract powder. Fee for consultation was paid by Korean Medicine insurance. Usage increased when people's age was over 20 and climaxed among people who were in their 40s and 50s and decreased gradually afterwards. Also, there were differences between the sexes. There were differences in high-frequent diseases by regions, and in usage of Korean Medicine clinics according to sex and age. Conclusion : It was found that there were differences in usage and patterns of Korean Medicine Clinics according to sex, age, and region.

• Korean Journal of Oriental Medicine
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• v.8 no.2 s.9
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• pp.47-65
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• 2002

This project is planned to grasp the present situation of traditional medicine part in our country and to study protection method about this by the intellectual property which is the international concerning point recently. Through this, we will be able to devise means to deal with protection method of traditional medicine being developed by WIPO now. Traditional medicine field In our country Is organized with specific condition separated into the part of institution and the part of non-institution. So, because of the closed peculiarity, we have experienced the difficulties to understand the real facts about traditional medicine. We cannot be indifferent to the matter anymore. Because the expectation of object people is high, we could expect the realization of research content. In 1 detail project, we investigated the situation of traditional medicine in our country through various collecting methods for excavation of oriental treatment technique and herb medicine which is worth protecting. With it, we sorted again into 56 kinds of 11 parts through analysis of validity in the way of oriental medicine. And we tried to link this up 2 detail project which is about legal and institutional guarantee concerning protection. furthermore, we tried to find approach ways for security of objectivity into 4 steps with the example of model disease. we could complete practical classification of traditional medicine in our country. In 2 detail project, we studied the protection method by the intellectual property through research result in 1 detail project. For this, we observed an outline of the intellectual property including a patent application analysis in folk traditional medicine part, and problems of traditional medicine protection and world trend by traditional knowledge protection tendency and the patent law In domestic traditional medicines, the aspects unprotectable with the patent law now were remained. So, we suggested supplementary plan. And we also suggested the freedom of utilization between traditional medicine possession countries (in-situ utilization) and the demand compensation payment for a third country (ex-situ utilization) in connection with international movement.

• The Journal of Korean Medical History
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• v.25 no.1
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• pp.5-10
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• 2012

The aim of this study is to create a catalogue of amnesia synonyms in Traditional Korean Medicine for database utilization. A two-staged literature search was carried out. First, two databases(China National Knowledge Infrastructure:CNKI, Oriental Medicine Advanced Searching Integrated System:OASIS) were searched for eligible articles, and a set of candidate words was identified from the articles. Second, the candidate words were searched in 30 medical classics to check the frequency of use. As a result, 9 candidate words including 喜忘(huimang), 善忘(seonmang), 多忘(damang), 好忘(homang), 健忘(geonmang), 遂忘(sumang), 遺忘(yumang), 忘事(mangsa), and 易忘(imang) were identified from the 10 eligible articles. Among the 9 candidate words, 健忘(geonmang) was a descriptor and 7 other words including 喜忘(huimang), 善忘(seonmang), 多忘(damang), 好忘(homang), 遂忘(sumang), 遺忘(yumang), 忘事(mangsa) were non-descriptors. 易忘(imang) was not an adequate synonym for amnesia.

• Health Policy and Management
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• v.30 no.3
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• pp.326-334
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• 2020

Background: Korea has gradually expanded the coverage of medical care services in its national health insurance system. On April 1, 2018, it implemented a policy that expanded the coverage for an ultrasonography in the upper abdomen. In this study, we aimed to investigate the effect of the policy on the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals. Methods: Using the dataset of the Health Insurance Review and Assessment Service, we explored changes in the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals from July 1, 2017 to November 30, 2018 through the difference-in-difference (DID) mixed-effects-model method. Facility factor, equipment factor and personnel factors, type of hospital, the total amount of medical care expenses, and geographic region were considered as control variables. Results: On average, the utilization of the ultrasonography in the upper abdomen increased by 228% after the coverage expansion policy. However, the results of DID mixed-effects-model method analysis showed that the utilization increased by 73%. As for the number of beds, the utilization was higher with a group of 844-930, 931-1,217, and 1,218 or greater compared with a group of 843 or fewer, while the utilization of the number of ultrasonic devices was lower with a group of 45-49 compared with a group of 44 or fewer. The utilization decreased with the number of interns and the number of nurse assistants. Besides, relative to Seoul, the utilization was lower in the other metro-cities and provinces. Conclusion: The coverage expansion policy in the national health insurance system increased service utilization among people. Future research needs to investigate the degree to which such coverage expansion policy reduces the unmet medical care needs among the deprived in Korea.

• Journal of Preventive Medicine and Public Health
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• v.23 no.2 s.30
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• pp.185-193
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• 1990

The purpose of this study is to observe the pattern of change in medical care utilization over time in early years of insurance coverage. The source of data is the benefit records file of a voluntary medical insurance society for covering the four-year period, from 1982 to 1985. The measure of medical care utilization used in this study is the age-sex standardized percentage of the enrollee who have visited a physician over total analytical population during a three-month period. For six cohorts by the year of enrollment ($1979{\sim}1984$), the relationship between the utilization and duration of insurance coverage was examined controlling for the calender year and season. In the analysis, logistic multiple regression and residual analysis were employed. It was observed that medical care utilization rapidly increased during the early stage of insurance coverage, and after then increased at a slower rate over time to become almost stable in about twenty months.

• Journal of Society of Preventive Korean Medicine
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• v.19 no.2
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• pp.13-22
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• 2015

Objective : The aim of this study was to review the use of Korean medicine (KM) or Complementary and Alternative Medicine (CAM) therapies among children with cerebral palsy (CP). Method : Literature searches were performed using Pudmed, CNKI, J-STAGE and four Korean databases. We investigated the frequency, types, predictors of the use of KM or CAM therapies used in children with CP. Results : Thirteen survey studies including use of KM or CAM among children with CP were selected - six Korean studies and seven overseas studies. The utilization rate of CAM among children with CP varied 26.8~56.0% according to the studies. CP children used KM or CAM more than other children with chronic disease. Acupuncture and Korean herbal medicine was the major treatment used in Korea, however physical manipulations such as massage, osteopathy and chiropractic were in high demand in western country. Disease severity of CP, use of CAM in the past by the parent or family member and high education of parent are the factors that significantly affect CAM utilization. Conclusion : Further studies on effectiveness and safety of KM therapies combined with conventional rehabilitation treatment would be required to expand the implementation of KM treatment for CP children.