• Journal of agricultural medicine and community health
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• v.23 no.2
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• pp.175-192
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• 1998

This study was performed investigate the opinion of civil servants in Health center about Rural Health Service Improvement Project The survey by mail was carried out for 447 servants of 25 health centers in Kyungsangbuk-do and the data were collected through self-administered questionnaires to servants about need, participation, concern, and comprehension for the project and satisfied with current facility and equipment of health center. The results were as follows. Generally considered, 48.2% of the improved health center servants was satisfied with health center building and 14.0% or 24.1% of the improving or unimproved center was. About the location of health center, 37.7% of the improved health center servants was satisfied, 25.9% of the unimproved center was. Of the improved health center servants, 43% was satisfied with the medical equipment but in unimproved place, the dissatisfaction was appeared higher than any other place. 49.7% of respondents was participated in making out the Rural Health Service Improvement Project. 50.6% was interested in this project. In the improved area. 65.5% of health center servants replied that the mayor's or county executive's concern about this project was high and 46.5% in councilors but in the unimproved area. their concern was low. About the contents of the project. 24,6% of the servants in the improved center, only 15.2% in unimproved center replied that they had known well. After making out the plan, 13.6% of respondents was unsatisfied with this plan and 17.1% replied that the estimating method of selecting the project area was not good. After the improvement of institution and equipment, 86.1% of health center servants answered that the medical service provided by health center would increase but 59.2% replied that the residents' utilization rate of private medical facility would decrease. The servants of the improved health center replied that the recognition about the developing will of health service(91.2%), the efficiency(91.2%), the quality of health and medical service(93.0%), the amount of health project(91.2%) were improved. In health center which had already improved the institution and equipment, 88.5% of servants replied that the residents' utilization for health center was increased. So, this project should be continuously carried out for health center and health center must develope new project to fit region condition.

• Health Policy and Management
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• v.34 no.2
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• pp.178-184
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• 2024

Background: This study aimed to determine the effectiveness of drug utilization review (DUR) evaluation indicators on safe drug use by comparing the changes in DUR inspection rates and drug duplication prescription prevention rates between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative. Methods: This study used DUR data from the Health Insurance Review and Assessment Service in 2018 (pre-implementation) and the evaluation results of the Healthcare Quality Evaluation Grant Initiative in 2023 (post-implementation). The dependent variables were the DUR evaluation indicators, including DUR inspection rate and drug duplicate prescription prevention rate. The independent variable was the implementation of the DUR evaluation indicators, and the control variables included medical institution characteristics such as type, establishment classification, location, DUR billing software company, and number of beds. Results: The results of the analysis of the difference in the prevention rate of drug duplicate prescriptions between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative showed that the prevention rate of drug duplicate prescriptions increased statistically significantly after the implementation of the DUR evaluation indicators. Conclusion: The policy implications of this study are as follows: First, ongoing evaluation of DUR systems is needed. Second, it is necessary to establish a collaborative partnership between healthcare organizations that utilize DUR system information and the organizations that manage it.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2955-2960
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• 2012

Background: Health disparities exist among and within countries, while developing and low income countries suffer more. The aim of this study was to quantify cancer disparities with regard to socioeconomic position (SEP) in 22 districts of Tehran, Iran. Method: According to the national cancer registry, 7599 new cancer cases were recorded within 22 districts of Tehran in 2008. Based on combined data from census and a population-based health equity study (Urban HEART), socioeconomic position (SEP) was calculated for each district. Index of disparity, absolute and relative concentration indices (ACI & RCI) were used for measuring disparities in cancer incidence. Results: The overall cancer age standardised rate (ASR) was 117.2 per 100,000 individuals (120.4 for men and 113.5 for women). Maximum ASR in both genders was seen in districts 6, 3, 1 and 2. Breast, colorectal, stomach, skin and prostate were the most common cancers. Districts with higher SEP had higher ASR (r=0.9, p<0.001). Positive ACI and RCI indicated that cancer cases accumulated in districts with high SEP. Female disparity was greater than for men in all measures. Breast, colorectal, prostate and bladder ASR ascended across SEP groups. Negative ACI and RCI in cervical and skin cancers in women indicate their aggregation in lower SEP groups. Breast cancer had the highest absolute disparities measure. Conclusion: This report provides an appropriate guide and new evidence on disparities across geographical, demographic and particular SEP groups. Higher ASR in specific districts warrants further research to investigate the background predisposing factors.

• Journal of the Korean Society of Radiology
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• v.8 no.5
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• pp.249-254
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• 2014

Medical linear accelerator is used for radiotherapy since it was developed in 1952, the utilization rate is further increased. It is used high energy radiotherapy using the energy of the photon of 6 MeV or more is universal at present, but the creation of the neutron by photonuclear reaction cause a problem that is radiation exposure of patients and operators. Therefore, in this study, to analyze the spectrum of the photon beam of 6 to 24 MV that occurred in the medical linear accelerator using the Monte Carlo code MCNPX, the number of photons of 7.41 MeV or more, which is a neutron production threshold energy of tungsten and average energy. The result of 24 MV in the beginning and the 8 MV was 0.59% of the total number of detected photons and it was founded that the number of photons are increased which are possible to cause the photonuclear reaction.

• Journal of Microbiology and Biotechnology
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• v.33 no.11
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• pp.1521-1530
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• 2023

An α-L-rhamnosidase gene from Thermoclostridium. stercorarium subsp. thermolacticum DSM 2910 (TstRhaA) was cloned and expressed. The maximum TstRhaA activity of the protein reached 25.2 U/ml, and the molecular mass was approximately 106.6 kDa. The protein was purified 8.0-fold by Ni-TED affinity with an overall recovery of 16.6% and a specific activity of 187.9 U/mg. TstRhaA activity was the highest at 65℃ and pH 6.5. In addition, it exhibited excellent thermal stability, better pH stability, good tolerance to low concentrations of organic reagents, and high catalytic activity for p-nitrophenyl-α-L-rhamnopyranoside (pNPR). Substrate specificity studies showed that TstRhaA exhibited a high specific activity for rutin. At 60℃, pH 6.5, and 0.3 U/ml enzyme dosage, 60 g/l rutin was converted to 45.55 g/l isoquercitrin within 150 min. The molar conversion rate of rutin and the yield of isoquercitrin were 99.8% and 12.22 g/l/h, respectively. The results suggested that TstRhaA could be used for mass production of isoquercitrin.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.1
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• pp.61-69
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• 2022

Purpose: Studies in adults have shown an increasing incidence of Clostridioides difficile infection (CDI) in patients hospitalized with acute pancreatitis (AP). There is lack of epidemiological data on CDI and its impact on hospitalized pediatric patients with AP. Methods: We analyzed the National Inpatient Sample and Kids' Inpatient Database between the years 2003 and 2016 and included all patients (age <21 years) with a primary diagnosis of AP using specific International Classification of Diseases codes. We compared clinical outcomes between children with CDI and those without CDI. Our primary outcome was severe AP and secondary outcomes included length of stay and hospital charges. Results: A total of 123,240 hospitalizations related to AP were analyzed and CDI was noted in 0.6% of the hospital. The prevalence rate of CDI doubled from 0.4% (2003) to 0.8% (2016), p=0.03. AP patients with CDI had increased comorbidities, and also underwent more invasive surgical procedures, p<0.05. AP patients with CDI had a higher in-hospital mortality rate and increased prevalence of severe AP, p<0.001. Multivariate regression models showed that CDI was associated with 2.4 times (confidence interval [CI]: 1.91 to 3.01, p<0.001) increased odds of severe AP. CDI patients had 7.24 (CI: 6.81 to 7.67, p<0.001) additional hospital days while incurring $59,032 (CI: 54,050 to 64,014, p<0.001) additional hospitalization charges. Conclusion: CDI in pediatric patients with AP is associated with adverse clinical outcomes and increased healthcare resource utilization. Further studies are needed to elucidate this association to prevent the development of CDI and to improve outcomes.

• Journal of Preventive Medicine and Public Health
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• v.39 no.5
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• pp.411-418
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• 2006

Objectives: The purpose of this study was to determine whether the disabled have worse access to primary care than the non-disabled. Methods: We used the National Disability Registry data and the National Health Insurance data for the calendar year 2003, and we analyzed 807,380 disabled persons who had been registered until December 2001 and we also analyzed 1,614,760 non-disabled persons for nine ambulatory care sensitive conditions (ACSCs). The rates of physician visits and hospitalizations for the patients with ACSCs were compared between the disabled and the nondisabled. Multiple logistic regression analysis was used to evaluate the association between medical care utilization and disability and to assess the association between hospitalization and the number of physician visits while controlling for potential confounders. Results: The numbers of physician visits per 100 patients were $0.78{\sim}0.97$ times lower for the disabled than that for the non-disabled with five of nine ACSCs. The numbers of hospitalizations per 100 patients were $1.16{\sim}1.77$ times higher for the disabled than that for the non-disabled with all the ACSCs. While the ORs of a physician visit for the disabled were significantly lower than that for the non-disabled with all the ACSCs (OR: $0.44{\sim}0.70$), and the ORs of hospitalization for the disabled were significantly higher (OR: $1.16{\sim}1.89$). The lower physician visit group (number of physician visits ${\leq}$1) was more likely to be hospitalized than the higher physician visit group (number of physician visits ${\geq}$2) (OR: $1.69{\sim}19.77$). The effect of the physician visit rate on hospitalization was larger than the effect of disability on hospitalization. Conclusions: The results suggest that the disabled were more likely to be hospitalized for ACSCs due to their lower access to primary care.

• Journal of agricultural medicine and community health
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• v.21 no.2
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• pp.209-220
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• 1996

This study was performed to investigate the prevalence of chronic disease and utilization of medical facility in rural area. 5,797 persons were randomly selected from 28,883 rural residents who were over 30 years old and living in Moonkyung city in Kyungsangpook Province during the period October 1 1983 to February 28 1994. The person prevalence rate was 336 per 1,000. The prevalence rate in men(278 per 1,000) was higher than that(388 per 1,000) in women. The spell prevalence rate in men(367) was significantly higher than that(429) in women (p<0.05). The prevalence was increased with the age, 106 in the 30's. 223 in the40's, 336 in the 50's, 407 in the 60's, and 457 in the age group of 70 above. Of all chronic diseases, the prevalence of neuralgia ranked first(128), chronic gastrointestinal disorders(64), degenerative arthritis(54). hypertension (44) and diabetes (14) were followed in descending order. In men, the prevalence of neuralgia ranked first, chronic gastrointestinal disorders, degenerative arthritis, hypertension and bronchial asthma were followed in descending order. In women, the prevalence of neuralgia ranked first, degenerative arthritis, chronic gastrointestinal disorders, hypertension and diabetes were followed in descending order. The prevalences of neuralgia, degenerative arthritis and hypertension were significantly higher in women than those in men, however, those of cardiovascular disease, pulmonary tuberculosis and liver cirrhosis in men were significantly higher than those in women(p<0.05). Most patients with chronic diseases were more likely to utilize hospital and/or local clinics than public health facility or community health providers. Patients with neuralgia, degenerative arthritis and bronchial asthma tended to utilizing local clinics initially, however, they were changed to visit public health facility or community health providers afterwards. Patients with hypertension or pulmonary tuberculosis were more likely to visit public health facility, however, those with diabetes, cancer, heart failure, CVD, liver cirrhosis were more likely to visit hospital.

• Journal of Society of Preventive Korean Medicine
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• v.26 no.2
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• pp.55-67
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• 2022

Objectives : This study is aimed to survey Korean Medicine Doctors's perceptions in Korean Medicine Clinical Practice Guideline and Standard Korean Medicine Clinical Pathways for its spread(to increase utilization in clinical sites). Methods : The research population was set at 14,831 Korean medical institutions registered with the Health Insurance Review and Assessment Service for sampling representative of Korean Medicine Doctors, and the final 2,007 subjects were selected in consideration of the research period and budget. This survey was conducted based on a telephone survey, and in some cases, a fax or e-mail survey was also conducted together. Six questions were asked about the perception of 'Korean Medicine Clinical Practice Guideline and Standard Korean Medicine Clinical Pathways', and three questions about the characteristics of the respondent. Results : The rate of recognizing Korean Medicine Clinical Practice Guideline was 36.1%. Those who worked at Korean medicine hospitals, were under 39 years of age, and had less than 11-20 years of experience as an Korean medical doctor were more likely to be aware of it. Regarding the experience of using Korean Medicine Clinical Practice Guideline, the rate of 'not used in the past and not used now' was very high at 82.9%, but the intention to use it in the future was high at 60.7%. About the Korean Medicine Clinical Pathways, 79.9% of respondents answered that they did not know. 80.6% of respondents recognized the need for the development of clinical manuals such as Korean Medicine Clinical Practice Guideline and Standard Korean Medicine Clinical Pathways. Conclusion : Their low awareness of Korean Medicine Clinical Practice Guideline seems to affect its low utilization. Therefore, active education and public relations are required in the future.

• Journal of Preventive Medicine and Public Health
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• v.18 no.1
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• pp.25-39
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• 1985

This study was conducted to assess the morbidity and medical facilities utilization patterns of the residents in urban low income area. Study population included 2,002 family members of 468 households in the low income area (LA) of Nam-san 4 Dong, Jung Gu of Taegu city and 1,709 family members of 374 households in surrounding neighbourhood control area (CA). Well trained nursing school students interviewed mainly with housewives according to the pretested questionaire between July 1 and July 30, 1984. Age-sex distribution of the study population in LA was similar to that in CA. The average monthly income of a household in LA was 236,000 won and 356,000 won in CA. Educational level of the residents in LA was lower than that in CA; average years of school education of the 20 years old or above in LA was 6.9 years compared with 8.5 years in CA. The average family members per room in LA was 2.6 and 2.2 in CA, and proportion of Medicaid program beneficiary was 29.4% in LA and 1.9% in CA. Prevalence rate of illness during 15-day period was 131 per 1,000 population in LA and 71 in CA(p<0.01) and that of the chronic illness for 1 year was 134 per 1,000 population in LA and 89 in CA(p<0.01). The most common illness experienced during 15 days was respiratory disease(24.0% in LA ana 29.8% in CA) and followed by gastro-intestinal disorders(21.0% in LA, 20.6% in CA). Injury or poisoning was 10.3% in LA and 3.3% in CA. Castro-intestinal disorder was the most common chronic illness in both LA (22.7%) and CA (21.7%), and followed by musculoskeletal disease in LA and neuralgia in CA. Mean activity restricted days among the persons with illness during 15-day period was 4.0 days in LA and 2.2 days in CA. Among persons with illness during 15 days, 17.9% in LA and 11.6% in CA did not seek any medical treatment and the most frequently utilized medical facility was pharmacy in LA (35.5%) and local clinic or hospital OPD in CA (42.1%). Among persons with chronic illness, 15.2% in LA and 9.2% in CA did not seek for medical treatment, and residents in LA as well as residents in CA utilized local clinic or hospital OPD more frequently than pharmacy or drugstores, especially those who have medical insurance. The most common reason for not treating illness experienced during 15-day period and chronic illness was economical constraint in both LA and CA. The higher prevalence rate of illness during 15-day period and chronic illness in LA than that in CA seems to be highly correlated with their lower economic status and educational level and crowded living condition. The utilization pattern of medical facilities was associated with the medical security status. A program to improve the economic status and living condition should be integrated with the health program to promote the health of the population in low income area.