• 제목/요약/키워드: Medical Costs

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Aetiopathogenesis and clinical features of dysmenorrhoea (Usr-i-tamth) in traditional Unani medicine and contemporary era: A literary research

  • Sultana, Arshiya;Khan, Asma;Quwat Nawaz, Qhuddsia;Syed, Lamatunoor
    • 셀메드
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    • 제6권1호
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    • pp.4.1-4.7
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    • 2016
  • Dysmenorrhoea is the most important under diagnosed and undertreated gynaecologic disorder of all menstrual complaints. It affects 50% women of childbearing age and has a major impact on health and societal costs worldwideespecially in developing countries. Therefore, a literary exploration of traditional sources for aetiopathogenesis and clinical features of usr-i-tamth (dysmenorrhoea) were reviewed to correlate with contemporary knowledge.The traditional Unani sources viz., Al Hawi fi'l Tibb (Continens Liber),Tarjuma Kamil al-Sana'a al-Tibbiyya, Al-Qanun fi'l Tibb (Canon of Medicine), Dhakhira Khawarizam Shahi, Tibb-i-Akbar, Iksir-i-A'zam, Kitab al-Kulliyyat, and Kulliyyat-i-Qanun were reviewed. Further, recent studies in the contemporary era were also browsed on the website. The causes of usre-i-tamth as per classical sources are distemperament, uterine diseases (atresia, inflammation, amenorrhoea, cancer, prolapse, ulcer, tenuous morbid matter, and cervical obstruction), psychological disturbances, environmental factors, menstrual irregularities, obesity and young age. Recent studies also prove that obesity, psychological disturbance, menstrual irregularities, environmental factors, uterine diseases and young age lead to dysmenorrhea.Unani classical sources are very much enriched with the informative knowledge related to menstruation and uterine pain/dysmenorrhoea and recent studies in contemporary proves the same. Hence, implementation of the traditional system of medicines in present-day era may play a vital role to restore health in a holistic way.

의료 빅데이터를 활용한 CRM 기반 건강예보모형 설계 (Design of Health Warning Model on the Basis of CRM by use of Health Big Data)

  • 이상원;신성윤
    • 한국정보통신학회논문지
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    • 제20권8호
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    • pp.1460-1465
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    • 2016
  • 오늘날 많은 비용이 국가 의료보장체계의 유지를 위협하고 있다. 국가 질병 통제 및 방지 센터의 감사체계를 동반한 건강관리 역학성에 대한 연구에도 불구하고, 시간 한계, 표본 한계, 대상 질병 한계에 대한 제약이 여전히 존재하고 있다. 이러한 배경에서, 방대한 양의 전수 데이터를 활용하여, 많은 기술들이 건강의 선제적 예측이나 그 대상 질병을 확장하는 분야에 충분하게 적용되고 있다. 우리는 국민건강보험의 구조적 데이터와 소셜네트워크서비스의 비구조적 데이터를 활용하여 질병을 예측하는 모형을 설계하였다. 이 모형은 건강예보서비스를 제공함으로써, 국민건강을 증진시키고 사회적 혜택을 극대화할 수 있다. 또한, 빅데이터 분석에 근거하여, 건강보험비용의 갑작스러운 증가를 감소시키거나 적시적인 질병발생을 예측할 수도 있다. 관련된 의료 예측 사례를 살펴보았고, 제안된 모형의 검증을 위하여 시범과제를 통한 실험을 수행하였다.

Development of a model for animal health monitoring system in Gyeongnam I. Design, data and frequencies of selected dairy cattle diseases

  • Kim, Jong-shu;Kim, Yong-hwan;Choi, Min-cheol;Kim, Gon-sup;Kim, Chung-hui;Park, Jeong-hee;Hah, Dae-sik;Heo, Jung-ho;Jeong, Myeong-ho;An, Dong-won
    • 대한수의학회지
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    • 제39권4호
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    • pp.730-737
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    • 1999
  • A national animal health monitoring system(NAHMS) in Gyeongnam area was started from 1997 to develop statistically valid data for use in estimating disease frequencies in dairy cattle, and the associated costs. The objectives of this study were to : (1) discribe what was done to implement and maintain the system in Gyeongnam ; (2) present selected disease frequencies ; (3) discuss the epidemiological consideration of what was done and implications for the results obtained. Veterinary Medical Officers(VMOs-professors and graduate students from Gyeongsang National University, Faculty of Gyeongnam Livestock Promotion Institute, and Clinic veterinarians) served as data collectors. After training on current disease and management problems of dairy cattle, interview techniques, sampling methods, and data collection instruments, the VMOs participated in selection of the sample herds and data gathering. Forty of 167 dairy herds were selected randomly and the VMOs visited farms once a month for 12 months to collect data about management, disease, inventory, production, preventive treatment, financial and any other relevant data. Strict data quality control devices were used. Specific feed-back was developed for the producers and data collectors. Of the three age groups studied, cows had the greatest number of disease problems. The six disorders found most frequently were (from the highest to the lowest) breeding problems, clinical mastitis, birth problems, gastrointestinal problems. metabolic problems, and lameness. In young stock, respiratory, multiple system, breeding problems, and gastrointestinal problems were pre dominant, whereas in calves, gastrointestinal, respiratory, and integumental problems were major.

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Impact of the Outpatient Prescription Incentive Program on Reduction of Pharmaceutical Costs of Clinics in South Korea

  • Kwon, Seong Hee;Han, Kyu-Tae;Park, Sohee;Moon, Ki Tae;Park, Eun-Cheol
    • 보건행정학회지
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    • 제27권3호
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    • pp.247-255
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    • 2017
  • Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

흉부둔상환자에서 인공호흡기 관련 폐렴환자의 임상적 분석 (Clinical Analysis of Ventilator-associated Pneumonia (VAP) in Blunt-chest-trauma Patients)

  • 오중환;박일환;변천성;배금석
    • Journal of Trauma and Injury
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    • 제26권4호
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    • pp.291-296
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    • 2013
  • Purpose: Prolonged ventilation leads to a higher incidence of ventilator-associated pneumonia (VAP), resulting in weaning failure and increased medical costs. The aim of this study was to analyze clinical results and prognostic factors of VAP in patients with blunt chest trauma. Methods: From 2007 to 2011, one hundred patients undergoing mechanical ventilation for more than 48 hours were divided into two groups: a VAP-negative group, (32 patients, mean age; 53 years, M:F=25:7) and a VAP- positive group, (68 patients, mean age; 60 years, M:F=56:12). VAP was diagnosed using clinical symptoms, radiologic findings and microorganisms. The injury severity score (ISS), shock, combined injuries, computerized tomographic pulmonary findings, transfusion, chronic obstructive lung disease (COPD), ventilation time, stay in intensive care unit (ICU) and hospital stays, complications such as sepsis or disseminated intravascular coagulation (DIC) and microorganisms were analyzed. Chi square, t-test, Mann-Whitney U test and logistic regression analysies were used with SPSS 18 software. Results: Age, sex, ISS, shock and combined injuries showed no differences between the VAP - negative group and - positive group (p>0.05), but ventilation time, ICU and hospital stays, blood transfusion and complications such as sepsis or DIC showed significant differencies (p<0.05). Four patients(13%) showed no clinical symptoms eventhough blood cultures were positive. Regardless of VAP, mortality-related factors were shock (p=0.036), transfusion (p=0.042), COPD (p=0.029), mechanical ventilation time (p=0.011), ICU stay (p=0.032), and sepsis (p=0.000). Microorgnisms were MRSA(43%), pseudomonas(24%), acinetobacter(16%), streptococcus(9%), klebsiela(4%), staphillococus aureus(4%). However there was no difference in mortality between the two groups. Conclusion: VAP itself was not related with mortality. Consideration of mortality-related factors for VAP and its aggressive treatment play important roles in improving patient outcomes.

未完工干拓地의 定住生活 實態分析 (III) - 部落의 生活環境 - (Analysis on the Settlement Conditions in the Troubled Reclaimed Areas Under State Control (III) - Living Conditions in Rural communities -)

  • 최수명;황한철
    • 한국농공학회지
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    • 제33권3호
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    • pp.73-80
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    • 1991
  • In Korea, small-scale reclaimed areas have been suffering from many problems because of the lack of comprehensive developing strategy although considerable investments have been inputed by the public sector since 1970's. For 3 reclaimed sites in Chonnam Province chosen as case study areas, the analysis, the third attempt of widely-spanned studies on areal conditions, concentrated on their living conditions. Its results were as follows : 1. Although rural residents have increased their concern on health and medical services, the public sector can only serve basic and emergent level of them, and therefore, the private sector, which is mostly placed in urban areas and costed much higher than public one, has the dominant share of those services. So, because those costs are a great expense to rural residents, their supplying system should be planned with special reference to lightening the economic burden of them. 2. By the development of locally fitted programs and innovative systems, the rural education should be qualitatively improved to deal successfully with its small scale. That will result in increasing the schooling rate to schools in rural communities, lightening the economic burden of rural residents on education services and finally activating them to contribute the betterment of rural education. 3. Servicing level of water supply, sewerage and garbage disposal in the reclaimed areas has been remaining at the lower order even in other rural areas. In the design of rural water supply, average daily consumption per capita should be changed according to the composition rate of fishing households and variety of the source of water supply. 4. Most of rural residents in the reclaimed areas want to establish the welfare facilites for the infant, youth, aged and public bath However in the long-term basis, the cooperative production and processing facilities should be considered for modernized efficient farming.

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차대차 추돌사고 재현시험을 통한 경추염좌 상해 위험도 연구 (Whiplash Injury Case Studies through Low Speed Rear-end Crash Tests)

  • 임남경;심상우;정현철
    • 한국자동차공학회논문집
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    • 제24권4호
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    • pp.432-438
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    • 2016
  • Whiplash injuries in low-speed rear-end collisions are the most common injuries and has been a social issue in insurance industry, such as excessive medical claim costs along with exaggerated injuries of victims and treatments from hospitals. According to the Korea Insurance Development Institute reports, the number of claims by rear-end collision was approximately 703,000, which accounts for 53.6 % of the total car-to-car collisions in 2014. Part of the neck injury claims in the Korea car insurance was approximately 28.3 %. Furthermore, approximately 98.4% of the injured persons in rear-end collisions sustained minor injuries under AIS2. In order to improve this situation as well as find out the severity of neck injuries from rear-end collision, the Korea Automobile Insurance Repair Research and Training Center conducted car-to-car rear-end crash tests that striking vehicles(SUV) collided into different sizes of struck-vehicles(small, middle, and large sedan) at the impact speeds of 8 km/h ~ 16 km/h. In order to analyze the whiplash injury, the BioRID-II was seated in each struck-vehicles, and the neck injury criteria(NIC), head contact time, maximum vehicle accelerations, and mean vehicle accelerations were calculated from values from the accelerations of the dummy and the struck-vehicles.

한국형 외래환자분류체계의 개발과 평가 (Development and Evaluation of Korean Ambulatory Patient Groups)

  • 박하영;강길원;고영
    • 보건행정학회지
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    • 제16권1호
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    • pp.17-40
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    • 2006
  • With the prospect of rapidly growing health insurance expenditures, particularly spending for ambulatory care, the introduction of a case-based payment method is discussed as an alternative to the current fee-for-service based method. A system to measure case mixes of providers is a core component of such payment systems. The objective of this study were to develop a classification system for ambulatory care, Korean Ambulatory Patient Group (KAPG) based on the U.S. APG version 2.0 and to evaluate the classification accuracy of the system. A database of 64,258,386 records was constructed from insurance claims submitted to the Health Insurance Review Agency (HIRA) during three months from August 2002. A total of 41,347,307 records with a single visit was used for the development and 7% random sample of the database was used for the evaluation. Additional groups were defined to include both physician and hospital fees in the classification, age splits were added to classify the entire population as well as the population older than 65, and the definition of medical groups used by the HIRA was adopted. The variance reduction in charges achieved by KAPGs was computed to evaluate the accuracy of classification. A total of 474 KAPGs was defined compare to 290 groups in the U.S. APG. The variance reduction for charges of all visits ranged from 20% to 37% depending on the type of provider, and ranged from 22% to 42% for non-outliers, that were better than those achieved by the system currently used by the .HIRA for its internal review purpose. Although further study is required to improve the classification for complicated care in larger hospitals, the results indicated that KAPGs could be used for better management of costs for ambulatory care.

스마트 실버 헬스케어를 위한 비접촉 인체감지 IOT 센서 개발 (A Development of Non-Invasive Body Monitoring IOT Sensor for Smart Silver Healthcare)

  • 강병욱;김상희
    • 융합신호처리학회논문지
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    • 제19권1호
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    • pp.28-34
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    • 2018
  • 본 논문은 적외선 온도센서를 이용한 재실인원 측정을 통한 출입자 관리 시스템, 방 내부의 움직임 파악하기 위한 PIR센서 모듈, 그리고 취침 상태를 판별하기 위한 스마트 호흡감지 모듈로 구성된다. 센싱부와 알고리즘 구동 부를 일체화 한 임베디드 형태의 센서 모듈과 통신 시스템으로 구성하였다. 고령화 사회가 가속화, 고급화됨에 따라 실버케어에 대한 사회적 비용이 증가하고 프라이버시를 보호하기 위해선 효율적인 실버케어기기 개발을 통하여 비용 감소가 필요하다. 제안된 비 영상 인체감지 IOT 센서 시스템은 하드웨어와 소프트웨어로 구현하였고 기존의 영상에 의한 감시 방법과 비교하여 우수한 성능을 확인하였다.

Comparable efficacy of silk fibroin with the collagen membranes for guided bone regeneration in rat calvarial defects

  • Kim, Jwa-Young;Yang, Byoung-Eun;Ahn, Jin-Hee;Park, Sang O;Shim, Hye-Won
    • The Journal of Advanced Prosthodontics
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    • 제6권6호
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    • pp.539-546
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    • 2014
  • PURPOSE. Silk fibroin (SF) is a new degradable barrier membrane for guided bone regeneration (GBR) that can reduce the risk of pathogen transmission and the high costs associated with the use of collagen membranes. This study compared the efficacy of SF membranes on GBR with collagen membranes (Bio-$Gide^{(R)}$) using a rat calvarial defect model. MATERIALS AND METHODS. Thirty-six male Sprague Dawley rats with two 5 mm-sized circular defects in the calvarial bone were prepared (n=72). The study groups were divided into a control group (no membrane) and two experimental groups (SF membrane and Bio-$Gide^{(R)}$). Each group of 24 samples was subdivided at 2, 4, and 8 weeks after implantation. New bone formation was evaluated using microcomputerized tomography and histological examination. RESULTS. Bone regeneration was observed in the SF and Bio-$Gide^{(R)}$-treated groups to a greater extent than in the control group (mean volume of new bone was $5.49{\pm}1.48mm^3$ at 8 weeks). There were different patterns of bone regeneration between the SF membrane and the Bio-$Gide^{(R)}$ samples. However, the absolute volume of new bone in the SF membrane-treated group was not significantly different from that in the collagen membrane-treated group at 8 weeks ($8.75{\pm}0.80$ vs. $8.47{\pm}0.75mm^3$, respectively, P=.592). CONCLUSION. SF membranes successfully enhanced comparable volumes of bone regeneration in calvarial bone defects compared with collagen membranes. Considering the lower cost and lesser risk of infectious transmission from animal tissue, SF membranes are a viable alternative to collagen membranes for GBR.