• Journal of Preventive Medicine and Public Health
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• v.14 no.1
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• pp.89-96
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• 1981

Of 2,740 industries in Jeonbug area which are covered by industrial insurance policy, 462 facilities which the accidents related to industry occured during the year of 1979 were studied. and the results are summarized as follows: 1. The accidents related to industry occured in 462 industries of the total 2,740 industrial facilities in Jeonbug area as of 1979. 2. The incidence rate of accident per 1,000 workers was 34.3 (49.2 in male workers and 12.8 in female workers), the frequency rate of the total industries in jeonbug area was 13.36, and severity rate was 1.3. 3. The frequency rates and severity rates by type of industry in study area were quite different to compare with those of national rates. 4. The incidence rate of construction industry was 223.6 per 1,000 workers, and that of transportation-communication industries were 78.6. 5. The proportion of industrial accidents of $20{\sim}24$ age group was 22.1 per cent of the total accidents, and the proportions decreased according to age increase. 6. The incidence rate in the industry having less than 49 workers was 20.6 per 1,000 workers, that of industry with $50{\sim]99$ workers was 26.7, that of industry with $100{\sim}199$ was 51.9, that of industry with $200{\sim}499$ was 80.2 and that of with more than 500 worker was 40.7. 7. The accidents which occured in the workers with experience of less than one year was 69.4 per cent of the total accidents, otherwise, the longer the workers have worked the less accident they have. 8. The most accidents occured in tile shift between 10 to 12 o'clock, and 16 to 18 hour 9. The primary causes of the industrial accidents were found to be collisions, machinery falling objects and falls. 10. The site of injury by type of industry were quite different, and the major site of injury was finger. 11. The laceration and open injuries of the accidents related to industry were 37.2 per cent of the total cases, and fractures or dislocations were 23.5 per cent, and contusions were 6.5 per cent. 12. Death rate of industrial accident was 5.0 per 10,000 workers, and those of industry were 47.6 in transportation, 42.8 in construction industry, 24.4 in mine industry, and 2.0 in manufacturing industry.

• The Journal of the Korea Contents Association
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• v.16 no.3
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• pp.22-32
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• 2016

As the number of aged population rapidly goes up, the cases of stroke and the related medical expenses continuously increase. The purpose of this study is to investigate the mortality of stroke patients based on CCI(Charlson Comorbidity Index) by utilizing the Korea National Hospital Discharge Injury Survey, analyzing the factors associated with the mortality of stroke patients. We analyzed 21,494 cases which are classified as the death of strokes aged over 20 years by using the Korea National Hospital Discharge Injury Survey between the year 2005 and 2010. In order to find out the mortality based on CCI and status of comorbidity, we used the technical statistics. We performed a logistic regression analysis to examine the reasons for the mortality of the strokes. We found that the independent variables for the influence of the mortality of strokes include age, type of insurance, residence urban size, size of hospital beds, the location of hospital, admission route, physical therapy, brain surgery, type of stroke, and CCI. This indicates that the effective monitoring on the age, types of stroke, comorbidity is needed. In addition to this, more medical support toward medicaid patients are needed, too. We believe that these results will be used positively for the evaluation of the stroke patients, providing the basic materials for the further research on the establishment of the health-related policy.

• Journal of Hospice and Palliative Care
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• v.18 no.2
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• pp.128-135
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• 2015

Purpose: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. Methods: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed ${\chi}^2$ tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. Results: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). Conclusion: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.

• Journal of Radiation Protection and Research
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• v.30 no.4
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• pp.185-196
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• 2005

Although medical exposure from diagnostic radiology procedures such as conventional x-rays, CT and PET scans is necessary for healthcare purposes, understanding its characteristics and size of the resulting radiation dose to patients is much of worth because medical radiation constitutes the largest artificial source of exposure and the medical exposure is in a trend of fast increasing particularly in the developed society. Annual collective doses and per-caput effective doses from different radiology procedures in Korea were estimated by combining the effective dose estimates per single medical procedure and the health insurance statistics in 2002. Values of the effective dose per single procedure were compiled from different sources including NRPB reports, ICRP 80, MIRDOSE3.1 code and independent computations of the authors. The annual collective dose reaches 27440 man-Sv (diagnostic radiology: 22880 man-Sv, nuclear medicine: 4560 man-Sv) which is reduced to the annual per-caput effective dose of 0.58 mSv by dividing by the national population of 47.7 millions. The collective dose is far larger than that of occupational exposures, in the country operated 16 nuclear power plants in 2002, which is no more than 70 man-Sv in the same year. It is particularly noted that the collective dose due to CT scans amounts 9960 man-Sv. These results implies that the national policy for radiation protection should pay much more attention to optimization of patient doses in medicine.

• Journal of Digital Convergence
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• v.14 no.8
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• pp.319-329
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• 2016

This study aimed to identify nurses' participation motivation, its influence factors, and their job training need. A survey was conducted on 345 nurses of general hospitals in Gyeonggi-do. Data was collected from October 5th to 18th, 2016 and was analyzed through t-test, ANOVA, Bonferroni post-test, and multiple regressions using SPSS 21.0. Participation motivation was high in 'expertise capability improvement and development' and low in personal gain and job stability. Job training need was the highest in nosocomial infection management and CPR and was the lowest in hospice and rehabilitation nursing. Participation motivation had significant differences depending on age, marital status, educational level, and clinical experience, and was influenced by the job training need of professional nursing and medical knowledge for disease treatment. Therefore, it is necessary to plan medical educational programs to enhance job training effectiveness, establish a strategy to increase participation motivation; and expand various job training support.

• Journal of Digital Convergence
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• v.12 no.3
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• pp.299-308
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• 2014

Nowadays, dental tourism becomes phenomenon because of its cost-effectiveness, improvement of quality and technology, dental infrastructure, and attractive tourism. Korea as one of popular destination country had established dental system. On the other hand, Indonesia with high number of population is potential market for dental tourism. The aim of this study is to compare the knowledge, attitude, and experience towards dental tourism among Indonesian and Korean. Two cross-sectional descriptive surveys were conducted to collect the data. This study was used one questionnaire in two different languages due to nature of the study population. Data from a total 923 of Indonesian from 33 provinces in Indonesia was collected during the period from April through July 2010. On the other hand, during May until August 2010 data from a total of 312 Korean were obtained. It was found that the majority of participants in both countries had never heard about dental tourism. Among those who had heard about dental tourism, the most common source was internet. Ownership of dental insurance had significant relationship with knowledge of dental tourism among Indonesian while level of education and monthly internet usage had it among Korean (p<0.05). Attitudes of Indonesian and Korean people about dental tourism were negative due to assumption that dental services in their home country were satisfactory. 100% of Korean had no experience on dental treatment in other countries while 2.4% of Indonesian had experience with it. In conclusion, regarding all these evidences, comprehensive and positive information about dental tourism is needed to enhance people's knowledge, attitude, and experience.

• Radiation Oncology Journal
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• v.34 no.2
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• pp.88-95
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• 2016

Purpose: The purpose of this study was to estimate the clinical utilization of radiation therapy (RT) in Korea between 2009 and 2013. Materials and Methods: We analyzed open claims data from the Health Insurance Review and Assessment Service. The subjects were patients who had diagnostic codes C00-C97 or D00-D48 according to the 10th revision of the International Classification of Diseases, with procedure codes indicating RT treatment. Results: The total number of patients who received RT in 2009, 2010, 2011, 2012, and 2013 were 45,571, 49,593, 54,671, 59,172, and 61,485, respectively. Among them, the total numbers of male and female patients were 20,780/24,791 in 2009, 22,711/26,882 in 2010, 24,872/29,799 in 2011, 27,101/32,071 in 2012, and 27,941/33,544 in 2013. The five cancers that were most frequently treated with RT between 2009 and 2012 were breast, lung, colorectal, liver, and uterine cervical cancers. However, the fifth most common cancer treated with RT that replaced uterine cervical cancer in 2013 was prostate cancer. The three leading types of cancer among the male patients were lung, colorectal, and liver cancers, whereas in female patients, they were breast, uterine cervical, and lung cancers. The type of cancer most commonly treated by RT was cancer of the central nervous system in patients aged 20 years or less, breast cancer in patients aged 30-50 years, and lung cancer in patients aged 60 years or more. Conclusion: Data from this study provided the clinical utilization of RT in Korea between 2009 and 2013.

• Kidney Research and Clinical Practice
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• v.36 no.1
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• pp.48-57
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• 2017

Background: Hepatic steatosis measured with controlled attenuation parameter (CAP) using transient elastography predicts metabolic syndrome in the general population. We investigated whether CAP predicted metabolic syndrome in chronic kidney disease patients. Methods: CAP was measured with transient elastography in 465 predialysis chronic kidney disease patients (mean age, 57.5 years). Results: The median CAP value was 239 (202-274) dB/m. In 195 (41.9%) patients with metabolic syndrome, diabetes mellitus was more prevalent (105 [53.8%] vs. 71 [26.3%], P < 0.001), with significantly increased urine albumin-to-creatinine ratio (184 [38-706] vs. 56 [16-408] mg/g Cr, P = 0.003), high sensitivity C-reactive protein levels (5.4 [1.4-28.2] vs. 1.7 [0.6-9.9] mg/L, P < 0.001), and CAP (248 [210-302] vs. 226 [196-259] dB/m, P < 0.001). In multiple linear regression analysis, CAP was independently related to body mass index (${\beta}=0.742$, P < 0.001), triglyceride levels (${\beta}=2.034$, P < 0.001), estimated glomerular filtration rate (${\beta}=0.316$, P = 0.001), serum albumin (${\beta}=1.386$, P < 0.001), alanine aminotransferase (${\beta}=0.064$, P = 0.029), and total bilirubin (${\beta}=-0.881$, P = 0.009). In multiple logistic regression analysis, increased CAP was independently associated with increased metabolic syndrome risk (per 10 dB/m increase; odds ratio, 1.093; 95% confidence interval, 1.009-1.183; P = 0.029) even after adjusting for multiple confounding factors. Conclusion: Increased CAP measured with transient elastography significantly correlated with and could predict increased metabolic syndrome risk in chronic kidney disease patients.

• Tuberculosis and Respiratory Diseases
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• v.39 no.5
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• pp.417-424
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• 1992

Background: There were many reports about the clinical aspect and outcomes of pulmonary tuberculosis in health center but few in a medium sized general hospital. The purposes of this study were to find any characteristic differencies in the patients and the general outcomes of the treatments and also to give some suggestive points for the insurance policy making. Methods: We made a retrograde analysis of the medical records of 1981 patients (male 992 female 1,059) who attended our clinics of the 4th internal department, Daedong general hospital during two years from January 1989 to December 1990. Result: 1) Of 1981 patients, 96 were diagnosed as pulmonary tuberculosis taking relatively large proportion in the prevalence. The ratio of prevalence between male and female was 7.81% to 2.27%. The 61.46% were the first diagnosis & initial treatment cases and the remaining 38.54% were the retreatment cases with no statistical significance between sex. 2) The most prevalent age group was between 21~40 years old and the prevalence rate was 45.45% of male and 76.76% of female. The lowest age group in male patient was above 61 showed 3.03%, and there was no female patients above age 60 years old. This phenomena could be thought as the negligence for the treatment of pulmonary tuberculosis in the old age groups rather than true tuberculosis prevalence and it could be proved by the higher rates towards old age groups in the national tuberculosis prevalence survey. 3) There were 57.07% of the minimal case, 48.96% of the moderate, 18.75% of the far advanced. The sputum examination showed 37.07% were culture positive, 46.88% were the negative, and 15.63% of the patients had no stutum examination. Moreover, uncoperatives among the far advanced cases were notable showing 22.22% of the stutum examination, where 16.13% in the minimal cases. The stutum positive rate among the initial treatment cases were 41.07% and 55.00% for the retreatment cases. The sputum no examination rates were 17.86% and 12.50% respectively. 4) The classfication of the mode of disease onset showed 68.75% with gradual onset, 9.38% hemoptic, 3.13% acute pneumonic and 18.75% was found through the radiologic examination in various occasions. 5) The percentages of patients who continued their treatment for more than 8 month were 35.71% (for initial treatment), 25.00% (for retrement), 16.13% (for the minimal), 27.78% (for the far advanced). 6) The group of patients who were treated more than 8 months showed the negative conversion rate of 80% on sputum and marked improvement on chest x-ray in 56.67%. However, in far advanced or retreatment cases, the rate of negative conversion on sputum and the rate of improvement on chest x-ray were low being 60% and 20% for the former and 60% and 10% for the latter, each respectively. Conclusion: It would be strongly emphasized that the improvement of National medical insurance system and social welfare system in Korea must be definite to improve overall treatment and control of tuberculosis diseases as well as physician's devotious National tuberculosis control policy.

• The Korean Society of Law and Medicine
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• v.16 no.2
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• pp.159-193
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• 2015

Owing to causes such as population aging, increased use of various medical devices, long-term hospitalization of various patients with reduced immune function such as cancer, diabetes, and organ transplant patients, and the growing size of hospitals, hospital infections are continuing to increase. As seen in the MERS crisis of 2015, hospital infections have become a social and national problem. In order to prevent damage due to such hospital infections, it is necessary to first strictly implement measures to prevent hospital infections, while, on the other hand, providing proper relief of damage suffered due to hospital infections. However, the mainstream attitude of judicial precedents relating to hospital infection cases has been judged to in fact shift responsibility over damages due to hospital infections on the patient. In light of the philosophy of the damage compensation system, whose guiding principle if the fair and proper apportionment of damages, there is a need to seek means of drastically relaxing the burden of proof on the patient's side relative to conventional legal principles for relaxing the burden of proof, or the theory of de facto estimation. In relation to such need, the German civil code (Burgerliches Gesetzbuch), which defines contracts of medical treatment as typical contracts under the civil code, and has presumption of negligence provisions stipulating that, in cases such as hospital infections which were completely under the control of the medical care providers, if risks in general medical treatment have been realized which cause violations of the life, body, or health of patients, error on the part of the person providing medical care is presumed, was examined. Contracts of medical treatment are entered into very frequently and broadly in the everyday lives of the general public, with various disputes owing thereto arising. Therefore, it is necessary to, by defining contracts of medical treatment as typical contracts under the civil code, regulate the content of said contracts, as well as the proof of burden when disputes arise. If stipulations in the civil code are premature as of yet, an option may be to regulate through a special act, as is the case with France. In the case of hospital infection cases, it is thought that 'legal presumption of negligence' relating to 'negligence in the occurrence of hospital infections,' which will create a state close to equality of arms, will aid the resolution of the realistic issue of the de facto impossibility of remedying damages occurring due to negligence in the process of occurrence of hospital infections. Also, even if negligence is presumed by law, as the patient side is burdened with proving the causal relationships, such drastic confusion as would occur if the medical care provider side is found fully liable if a hospital infection occurs may be avoided. It is thought that, alongside such efforts, social insurance policy must be improved so as to cover the expenses of medical institutions having strictly implemented efforts to prevent hospital infections in the event that they have suffered damages due to a hospital infection accident, and that close future research and examination into this matter will be required.