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Analysis on the Relationship between the Number of Clinics and the Use of Preventable Hospital Service: focusing on asthma patients (지역 내 의원 수와 예방 가능한 병원 서비스 이용 간의 관계분석: 천식 환자를 중심으로)

  • Lee, Hyun-Ji;Park, You-Hyun;Cho, Hyung-Kyung;Seol, Jin-Ju;Kwak, Jin-Mi;So, Ye-Kyeong;Park, Su-Jin;Lee, Kwang-Soo
    • Korea Journal of Hospital Management
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    • v.25 no.4
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    • pp.94-102
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    • 2020
  • Purposes: The purpose of this study was to analyze the trends of hospitalization and emergency room visits of asthma patients over the three years in 25 districts of Seoul. And analyzed the relationship between preventable hospital service uses and number of clinics for asthma patients. Methods: Data was collected from a customized database of the NHI(National Health Insurance) for 2016 to 2018. The number of clinics means Internal Medicine, Pediatrics, Ear-Nose-Throat, and Family Medicine clinics. The hospital service means the number of adults admission for asthma and the number of total asthma emergency visits. This study used kappa analysis to assess the agreements of indicators between years, and structural equation modeling analysis was applied to analyze the relationship. Findings: The kappa value of the number of adults admission for asthma was compared between 2016 and 2017(kappa score=0.68), and was lowered when compared between 2016 and 2018(kappa score=0.26). And the value of kappa in the number of total asthma emergency visits due to asthma between 2016 and 2017(kappa score=0.51) was lower than that of between 2016 and 2018(kappa score=0.60). And the results showed that the number of clinics significantly negatively related to the uses of hospital services in asthmatic patients(β=-0.5, p=0.005). Practical Implication: This research could provide policy implications for strengthening primary care services that can contribute to the reduction of preventable hospital services.

Identification and functional prediction of long noncoding RNAs related to intramuscular fat content in Laiwu pigs

  • Wang, Lixue;Xie, Yuhuai;Chen, Wei;Zhang, Yu;Zeng, Yongqing
    • Animal Bioscience
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    • v.35 no.1
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    • pp.115-125
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    • 2022
  • Objective: Intramuscular fat (IMF) is a critical economic indicator of pork quality. Studies on IMF among different pig breeds have been performed via high-throughput sequencing, but comparisons within the same pig breed remain unreported. Methods: This study was performed to explore the gene profile and identify candidate long noncoding RNA (lncRNAs) and mRNAs associated with IMF deposition among Laiwu pigs with different IMF contents. Based on the longissimus dorsi muscle IMF content, eight pigs from the same breed and management were selected and divided into two groups: a high IMF (>12%, H) and low IMF group (<5%, L). Whole-transcriptome sequencing was performed to explore the differentially expressed (DE) genes between these two groups. Results: The IMF content varied greatly among Laiwu pig individuals (2.17% to 13.93%). Seventeen DE lncRNAs (11 upregulated and 6 downregulated) and 180 mRNAs (112 upregulated and 68 downregulated) were found. Gene Ontology analysis indicated that the following biological processes played an important role in IMF deposition: fatty acid and lipid biosynthetic processes; the extracellular signal-regulated kinase cascade; and white fat cell differentiation. In addition, the peroxisome proliferator-activated receptor, phosphatidylinositol-3-kinase-protein kinase B, and mammalian target of rapamycin pathways were enriched in the pathway analysis. Intersection analysis of the target genes of DE lncRNAs and mRNAs revealed seven candidate genes associated with IMF accumulation. Five DE lncRNAs and 20 DE mRNAs based on the pig quantitative trait locus database were identified and shown to be related to fat deposition. The expression of five DE lncRNAs and mRNAs was verified by quantitative real time polymerase chain reaction (qRT-PCR). The results of qRT-PCR and RNA-sequencing were consistent. Conclusion: These results demonstrated that the different IMF contents among pig individuals may be due to the DE lncRNAs and mRNAs associated with lipid droplets and fat deposition.

Development of prediction model identifying high-risk older persons in need of long-term care (장기요양 필요 발생의 고위험 대상자 발굴을 위한 예측모형 개발)

  • Song, Mi Kyung;Park, Yeongwoo;Han, Eun-Jeong
    • The Korean Journal of Applied Statistics
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    • v.35 no.4
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    • pp.457-468
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    • 2022
  • In aged society, it is important to prevent older people from being disability needing long-term care. The purpose of this study is to develop a prediction model to discover high-risk groups who are likely to be beneficiaries of Long-Term Care Insurance. This study is a retrospective study using database of National Health Insurance Service (NHIS) collected in the past of the study subjects. The study subjects are 7,724,101, the population over 65 years of age registered for medical insurance. To develop the prediction model, we used logistic regression, decision tree, random forest, and multi-layer perceptron neural network. Finally, random forest was selected as the prediction model based on the performances of models obtained through internal and external validation. Random forest could predict about 90% of the older people in need of long-term care using DB without any information from the assessment of eligibility for long-term care. The findings might be useful in evidencebased health management for prevention services and can contribute to preemptively discovering those who need preventive services in older people.

The Effects of Oral Administration of Deer Antler Extracts on an Osteoporosis-induced Animal Model: A Systematic Review and Meta-analysis (골다공증 유발 동물모델에서 녹용 추출물의 경구 투여 효과: 체계적 문헌고찰 및 메타분석)

  • Lee, Jung Min;Kim, Nam Hoon;Lee, Eun-Jung
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.2
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    • pp.65-81
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    • 2022
  • Objectives This study aimed to assess the effects of oral administration of deer antler extracts on an osteoporosis-induced animal model. We analyzed the results of using deer antler single extracts on animal models with osteoporosis through a systematic review and meta-analysis. Methods We included osteoporosis studies in animal experiments that administrated deer antler extracts orally. We searched the following 13 databases without a language restriction: PubMed, EMBASE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China National Knowledge Infrastructure (CNKI), Wanfang, Korean Medical Database (KMbase), National Digital Science Library (NDSL), Korean Traditional Knowledge (Koreantk), Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Sharing Service (RISS), Korea Institute of Science and Technology Information (KISTI), and Koreanstudies Information Service System (KISS). We used Systematic Review Centre for Laboratory Animal Experimentation's risk of bias tool for assessing the methodological quality of the included studies. Results A total of 299 potentially relevant studies were searched and 11 were included for a systematic review. Nine studies used a single deer antler extract. A study compared the effects of single extracts of deer antler and antler glue, while another study compared the effects of three single extracts of deer antler, old antler, and antler glue. For evaluating the intervention effect, bone mineral density (BMD) was measured as the primary outcome, while the histomorphometric indicators of the bone and serum alkaline phosphatase and osteocalcin levels were used as the secondary outcome variables. On conducting a meta-analysis of studies on single deer antler extract, BMD was observed to be significantly increased compared to that in control group (standardized mean difference [SMD]=2.11; 95% confidence interval [CI]=1.58~2.65; Z=7.75; p<0.00001; I2=56%). As a result of meta-analysis, according to the concentration of deer antler, the group with high concentration showed statistically significantly higher BMD than the group with low concentration (SMD=1.28; 95% CI=0.74~1.82; Z=4.63; p<0.00001; I2=9%). Conclusions The research shows that the deer antler extracts have significant anti-osteoporotic effects on the osteoporosis-induced animal model. However the studies included in this research had a high methodological risk of bias. This indicates the requirement of considerable attention in the interpretation of the study results.

Difference in the Incidence Rate of Kidney Cancer in Korea by Relative Level of Household Income and SEER Stage at Diagnosis (우리나라 신장암의 소득 수준별 발생률과 진단시 병기의 차이)

  • Hwang, Jeong-In;Ki, Myung;Son, Mia
    • The Journal of the Korea Contents Association
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    • v.22 no.9
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    • pp.561-569
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    • 2022
  • A study was conducted to determine whether there is a difference in the incidence of kidney cancer according to income level and the difference in delayed diagnosis. To this end, the incidence of kidney cancer in Korea was analyzed by income level and by stage. From 2015 to 2017, a national kidney cancer cohort was established by linking the KCCR(Korea Central Cancer Registry), NHISS(National health insurance sharing service), and the HIRA(Health insirance review and assessment service) database to calculate the kidney cancer incidence by stage and income level. During the study period, the incidence of kidney cancer in Korea increased in all income deciles, but decreased only in the medical aid population. The incidence of kidney cancer in Korea was 7.35 per 100,000 people, and 83.54% of them were locoregional kidney cancer. In the top 20% of the income decile, there was a high incidence of 21.46 cases per 100,000 people, among which 18.37 cases were locoregional kidney cancer. On the other hand, even after adjusting for risk factors related to kidney cancer, it was confirmed that the lower the income level, the higher the risk of being diagnosed with kidney cancer with distant metastasis (lowest income 20% adj.OR 1.807, 95% CI 1.411-2.222). In the insured population, the risk ratio of being diagnosed with unknown stage was 1.926 (95% CI 1.317, 2.816). The higher the income level, the higher the frequency of early cancer diagnosis, but the lower the income level, the higher the risk of being diagnosed with metastatic kidney cancer or an unknown stage, so health inequality according to income level was observed.

The Age and Sex-specific Quality of Life by Chronic Disease Using the EQ-5D Index : Based on the 2017-2019 Korea National Health and Nutrition Examination Survey (EQ-5D 지수를 활용한 만성질환별 삶의 질의 성별 및 연령에 따른 변화: 2017~2019년 국민건강영양조사 자료를 이용하여)

  • Gyung-Jun Chae;Se-Ho Park;Seung-A Song;Jun-Kyu Lee;Jong-min Hong;Jae Seok Song;Nam Jun Kim
    • Journal of agricultural medicine and community health
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    • v.48 no.2
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    • pp.81-90
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    • 2023
  • Objectives: This study analyzed the decline in quality of life according to age in the chronic disease patient group, quantified it as a quantitative index, and compared it by sex and chronic disease. Methods: In the 2017-2019 Korea National Health and Nutrition Examination Survey database, 11,473 adults aged 19 years or older, excluding cancer patients, were analyzed for age-specific changes in the EQ-5D Index by chronic disease. The decline in quality of life according to age in patients with chronic diseases was analyzed by linear regression analysis while controlling for general characteristics. Then, linear regression analysis was performed according to sex. Results: In the case of the control group, the quality of life decreased by 0.0004 for every 1-year increase in age(P<0.001). By chronic disease, asthma(β=0.0019, P<0.001), arthritis(β=0.0017, P=0.002), thyroid dis- ease(β=0.0016, P=0.015), dyslipidemia(β=0.0011, P=0.020), and hypertension(β=0.0009, P=0.027) mostly showed a greater decrease in quality of life than the control group. In addition, when divided into two groups by sex, hypertension(β=0.0012, P=0.029), thyroid disease(β=0.0041, P=0.038), and arthritis(β=0.0022, P<0.001) showed a significant decrease in quality of life only in male. Diabetes(β=0.0056, P=0.038), dyslipi- demia(β=0.0022, P=0.001) significantly decreased quality of life only in female. Conclusions: Chronic disease had a negative impact on patients perception of quality of life, and the more severe the pain and activity limitation due to the chronic disease, the more severe it was. It also showed different patterns according to sex. Therefore, it is necessary to allocate more medical resources and provide policy support to prevent chronic diseases, which are serious social problems.

Research Trends in Korean Medicine Treatment for Sarcopenia: Scoping Review (근감소증에 대한 한의 치료 연구 동향: 스코핑 리뷰)

  • Seo-Eun Kim;Yun-Hee Han;Seung-Kwan Choi;Jung-Ho Jo;Hyeon-Jun Woo;Byeong-Hyeon Jeon;Won-Bae Ha;Jung-Han Lee
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.3
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    • pp.97-113
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    • 2023
  • Objectives This study examined the trends in domestic and international research on the treatment of sarcopenia and analyzed the effectiveness of the treatment. Based on the results, we suggest directions for future Korean medicine research on sarcopenia. Methods The study was conducted using Arksey and O'Malley's scoping review methodology. It included three international databases (PubMed, EMBASE, Cochrane Library) and five domestic databases (Korean studies Information Service System, Korean Medical database, Oriental Medicine Advanced Search Integrated System, Research Information Sharing Service, ScienceON) were used. Literatures published until April 30, 2023, including the contents of 'sarcopenia' and Korean Medicine treatment', were searched. Results A total of 45 studies were included in the analysis. The number of studies on Korean medicine treatments for sarcopenia is steadily increasing, with the majority of studies coming from Asian countries. Of the 45 studies, 30 were conducted in the field of medicine, and the study design was analyzed into 10 clinical studies and 35 non-clinical studies. Among the 10 clinical studies, the most common treatment interventions were herbs (n=4), followed by Daoist exercises (n=3). The most common diagnostic criteria used in clinical studies were those published by the Asian working group for sarcopenia, and various physical examinations and laboratory tests were used as outcome measures. Conclusions The future direction of Korean medicine research on sarcopenia should be to expand the number of clinical studies applying Korean medicine treatment interventions.

A Systematic Review of the Korean Medicine Treatments for Torticollis (Focused on Research from 2018 to 2023) (사경증의 한방 치료에 대한 체계적 문헌고찰 (2018년부터 2023년 연구를 중심으로))

  • Kyung Jun Ser;Jong Chan Choi;Min Jun Ji;Do Young Kwon;Jae Eun Yang;Ji Hyang Gu;Eun Jung Lee;Min Seok Oh
    • Journal of Korean Medicine Rehabilitation
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    • v.34 no.2
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    • pp.29-49
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    • 2024
  • Objectives The purpose of this study is to systemically review the recent studies in the Korean medicine treatments for torticollis. Methods We search the clinical studies from January 1, 2018 to December 31, 2023. The studies were searched through 10 databases (Oriental Medicine Advanced Searching Integrated System, Korean studies Information Service System, Research Information Sharing Service, Korean Medical Database, ScienceON, PubMed, Cochrane Library, Embase, Wanfang Data, China National Knowledge Infrastructure). Results A total of 19 studies were included in the study. 12 studies were case report studies, 5 studies were randomized controlled trials, 2 studies were non-randomized controlled trials. Of the 19 interventions, Chuna was the most used in this study and of the 28 evaluation tools, Sternocleidomastoid thickness was the most used in this study except efficiency rate. All 19 studies had improvements after treatment, and 8 studies had statistically significant improvements. As a result of the study, we found that Chuna, GB, GB20, BL10, Glycyrrhiza uralensis were commonly used Korean medicine treatments for torticollis. Conclusions We analyzed the Korean medicine treatments for torticollis. Through this study, we found that the Korean medicine was effective for torticollis. However, more research is needed to confirm the more detailed effect.

Bibliometric Analysis on Health Information-Related Research in Korea (국내 건강정보관련 연구에 대한 계량서지학적 분석)

  • Jin Won Kim;Hanseul Lee
    • Journal of the Korean Society for information Management
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    • v.41 no.1
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    • pp.411-438
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    • 2024
  • This study aims to identify and comprehensively view health information-related research trends using a bibliometric analysis. To this end, 1,193 papers from 2002 to 2023 related to "health information" were collected through the Korea Citation Index (KCI) database and analyzed in diverse aspects: research trends by period, academic fields, intellectual structure, and keyword changes. Results indicated that the number of papers related to health information continued to increase and has been decreasing since 2021. The main academic fields of health information-related research included "biomedical engineering," "preventive medicine/occupational environmental medicine," "law," "nursing," "library and information science," and "interdisciplinary research." Moreover, a co-word analysis was performed to understand the intellectual structure of research related to health information. As a result of applying the parallel nearest neighbor clustering (PNNC) algorithm to identify the structure and cluster of the derived network, four clusters and 17 subgroups belonging to them could be identified, centering on two conglomerates: "medical engineering perspective on health information" and "social science perspective on health information." An inflection point analysis was attempted to track the timing of change in the academic field and keywords, and common changes were observed between 2010 and 2011. Finally, a strategy diagram was derived through the average publication year and word frequency, and high-frequency keywords were presented by dividing them into "promising," "growth," and "mature." Unlike previous studies that mainly focused on content analysis, this study is meaningful in that it viewed the research area related to health information from an integrated perspective using various bibliometric methods.

Analysis of the Issues received by Quality Improvement Department and their Management in a Medical Center (일 의료원의 통합 고충처리센터 접수 내용과 이에 대한 해결방안 분석)

  • Tark, Kwan-Chul;Park, Hyun-Ju;Chun, Ja-Hae;Kang, Eun-Sook;Moon, Ju-Young;Choi, Mi-Young;Kim, Hyun-Ju;Kang, Jin-Kyung
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.118-131
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    • 2000
  • Background : A continuous healthcare quality improvement is needed to provide high quality healthcare service as well as to maintain trust in terms of satisfying the needs of the patients. Recently it also became an essential issue. in hospital management, recognized for it's competitive potentiality among healthcare organization groups. This study was conducted to analyze patient complaints and issues received by the Quality Improvement Department. Its purpose is to improve healthcare qualities within the hospital, as well as establish policies and appropriate strategies in hospital management. Method : From July 1st to September 30th of the year 1999, we analyzed all complaints and issues made by various patients and their families, which were received through 24 hour phone consultation, numerous suggestion boxes, letters and E-mails, The issues were classified into 16 different categories based on a Patient Satisfaction Assessment Tool. All data were segregated according to the departmental frequencies and their contents. To come up with for environmental and patient satisfaction improvement, all complaints or issues were communicated with hospital administrators, medical and nursing staff and employees. Comprehensive customer satisfaction activities including improving phone etiquette were discussed in Customer Satisfaction Team, CQI Team and each Department. All opportunities for improvement were implemented. Feedback actions were discussed. Results : A total of 317 cases were collected. Issues regarding parking and other accommodation facilities were most common complaints that were 14.5% of total. Issues regarding admission rooms (10.7%), admission procedures (10.7%), waiting room environment (8.8%), nurses and nurse assistants (7.6%), physicians (6.6%) and others (23%) followed. Thirteen of 45 departments received more than 8 complaints. The Nursing Department had the most complaint, receiving 9.8% of total complaints. Complaints regarding the Nursing Department were predominantly related to the environment of patient rooms. The Department of Psychiatry for phone etiquette (4.7%), Department of Otolaryngology for the nursing staff's attitude and phone etiquette (4.4%), and the Admission Department followed. As a part of efforts to improve patient satisfaction, a new parking structure was built and reallocation of the parking space was done. Renovation of other accommodation facilities were carried out by hospital administration, Monthly phone call and answering attitude survey was done by QI Department. Based on this survey we made a phone etiquette manual and distributed throughout the hospital. Compare to the last year, Patient Satisfaction Index measured by Korea Productivity Center using National Customer Satisfaction Index was improved 7 points. According to our organization's own study, we confirmed the phone etiquette was improved 11% than last year. Conclusions : Issues related to parking and other accommodation facilities ranked first followed by complaints made regarding the patient care area, the admission and cashier process, and nurses' and doctors' attitude. The Nursing and Psychiatry Departments need improvement regarding phone etiquette. Results were shared and played a vital role in policymaking and strategic planning of the hospital. It is imperative that we keep our database updated by listening to and solving the needs of each patient. The CQI activities can be achieved only by full commitment of the hospital top management supported by related personal.

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