• Journal of Korean Neurosurgical Society
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• v.63 no.1
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• pp.69-79
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• 2020

Objective : To analyze trends in the incidence and treatment of diseases associated with ischemic stroke, namely, cerebral infarction (CI), cerebral arterial stenosis (CASTN), and moyamoya disease (MMD), based on Korean National Health Insurance Service (NHIS) data from 2008 to 2016. Methods : Data was extracted from the national health-claim database provided by the NHIS for 2008-2016 using International Classification of Diseases codes. The crude and age-standardized incidences of each disease (CI, CASTN without a history of CI, and MMD) were calculated; additional analyses were conducted according to age and sex. Trends in the number of patients undergoing treatment according to treatment method were analyzed for each disease using the Korean Classification of Diseases procedure codes. Results : In 2016, the total number of adults with newly diagnosed CI was 83939, reflecting a 9.4% decrease from that in 2008. The age-standardized incidence of CI in adults was 153.2 per 100000 person-years in 2016, reflecting a 37.2% decrease from that in 2008, while that of CASTN was 167.3 per 100000 person-years in 2016, reflecting a 73.3% increase from that in 2008. Among treated cases, the number of patients who underwent intra-arterial (IA) treatment, including IA fibrinolysis and mechanical thrombectomy, showed the most prominent increase, increasing at an annual rate of 25.8%. For CASTN, the number of cases treated with carotid artery stenting or balloon angioplasty (CAS) showed the most prominent increase, increasing at a rate of 69.8% over the 9-year period. For MMD, the total number of patients with newly diagnosed MMD and that with adult MMD demonstrated significantly increasing trends, while the number of pediatric patients with newly diagnosed MMD declined by 18.0% over the 9-year period. The age-standardized incidences of pediatric and adult MMD in 2016 were 2.4 and 3.4 per 100000 person-years, respectively. Conclusion : Although the incidence of CI showed a declining trend over a 9-year period, the number and proportion of patients treated for CI increased. Meanwhile, the incidence of CASTN and the number of patients treated for CASTN have demonstrated increasing trends since 2008. On the other hand, the number of patients diagnosed with pediatric MMD decreased, despite no significant change in the incidence. In contrast, the number of patients and the incidence of adult MMD increased. These trends reflect changes in the population structure, gains in the accessibility of imaging examinations, and the development of endovascular techniques.

• Journal of Korean Neurosurgical Society
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• v.65 no.5
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• pp.741-750
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• 2022

Objective : In March 2020, World Health Organization declared a global pandemic caused by a novel coronavirus (SARS-CoV-2). The disease caused by this virus is called COVID-19. Due to its high contagiousness, many changes have occurred in overall areas of our daily life including hospital use by patients. The aim of this study was to investigate the impact of COVID-19 on volume of spine surgery in South Korea using the National Health Insurance database and compare it with the volume of a homologous period before the pandemic. Methods : Data of related to spine surgery from January 2019 to April 2021 were obtained from the National Health Insurance and Health Insurance Review and Assessment Service database. Primary outcomes were total number of patients, rate of patients per 100000 population, and total number of procedures. The number of patients by hospital size was also analyzed. Results : COVID-19 outbreaks occurred in South Korea in March, August, and December of 2020. Compared to the previous year, the total number of patients who underwent spinal surgery showed a decrease for 2-3 months after the first and second outbreaks. However, it showed an increasing trend after the third outbreak. The same pattern was observed in terms of the ratio of the number of patients per 100000 population. Between 2019 and 2021, the mean number of spine surgeries per month tended to increase. Mean annual medical expenses increased over the years (p=0.001). When the number of spine surgeries was analyzed by hospital size, proportion of tertiary general hospital in 2021 increased compared to those in 2019 and 2020 (vs. 2019, p=0.012; vs. 2020, p=0.016). The proportion of general hospital was significantly decreased in 2020 compared to that in 2019 (p=0.037). Conclusion : After the COVID-19 outbreak, patients tended to postpone spinal surgery temporarily. The number of spinal surgeries decreased for 2-3 months after the first and second outbreaks. However, as the ability to respond to the COVID-19 pandemic at the hospital and society-wide level gradually increased, the number of spine surgeries did not decrease after the third outbreak in December 2020. In addition, the annual number of spine surgeries continued to increase. However, it should be noted that patients tend to be increasingly concentrated in tertiary hospitals for spinal surgery.

• Journal of Acupuncture Research
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• v.20 no.6
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• pp.120-127
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• 2003

Objective : The purpose of this study was to analyze the small animal patients treated by Oriental medicine and develop the treatment strategies for small animal patients. Methods : 58 cases of small animal patients treated in the department of integrated medicine, Veterinary Medical Center, University of Minnesota, USA, from Jan 1 2003 to Aug 30 2003 were surveyed. Results : 1. The number of dog patients was more than that of cat patients and the female patients were more than the male patients. 2. The highest incidence was shown in the age of 6 to 15 on dogs and 11 to 15 on cats, respectively. 3. The number of patients via other hospital was as much as that of the first visitor to this department. 4. The most frequent disease was the musculoskeletal problems in dog patients and the internal medicine problems in cats patients. 5. The improvement rate was 85% in dogs and 86% in cats, respectively. Conclusions: Oriental medicine is supposed to be effective on relieving the symptoms and signs in small animal patients.

• Health Policy and Management
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• v.20 no.4
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• pp.97-113
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• 2010

The purpose of this study was to analyze the relationship between the locational characteristics of areas surrounding oriental medicine hospitals and the number of patients who visited study hospitals. Administrative data collected from the annual report of 5 ward offices in Daejeon used to assess the geographical attributes. Two oriental medicine hospitals operated in Daejeon provided data for the number of inpatient and outpatient. Number of patients who visited study hospitals was calculated in each Dong which is the smallest administrative district. The geographical attributes of Daejeon were evaluated by the demographic and economic factors which were assumed to influence the health care demand. Each criterion was measured from each Dong. Weights of factors was calculated by Analytic Hierarchy Process (AHP) method. Evaluation scores which representing the geographical attributes of Dong was computed by multiplying the eight factors and weights. Results showed positive correlation coefficients between the evaluation scores of Dong and the number of patients. One hospital which was more closely located to areas with high evaluation scores had higher number of patients than that of the other hospital. Buffering analysis with varying size support the analysis results. This finding proposed the importance of location for the management of oriental medicine hospitals in a metropolitan city. Applying study model to other cities will enhance the validity of study results.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.10
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• pp.2959-2965
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• 2009

This research is based on the medical information record of a university hospital on analysis of outpatients, inpatients and delivery related information in gynecology area. The result of application having analysis of patients as basic material for hospital management is as follows. The number of new patients in average was 140.9, and as the year passes by, it seemed to decrease noticeably(p=0.000). In the first year (2001) the number was only 212.6, but increased to 140 by the year of 2007, showing increase of 80.9. The actual number of patients in the hospital was 124.6 in average and it showed noticeable decrease after each year (p=0.000), from 144.6 patients on the first year 2001, to 104.8 patients in 2007, showing approximately 40 patients decreased. Multiple regression analysis was performed having independent variables as characteristics of patients and cause of delivery related factors, and dependent variables as the number of patients in the hospital. According to analysis, the cause of affecting the number of patients in the hospital was selected as the number of new patients, the number of delivery per year. The reliability rate was recorded as 62.8%. Therefore, apart from the services on marketing and patient management which must come first, the effect of inviting them cannot be avoided, which directly links to trust resulting from the consideration to patients.

• Journal of Trauma and Injury
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• v.35 no.3
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• pp.195-201
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• 2022

Purpose: The objective of this study was to determine the effects of coronavirus disease 2019 (COVID-19) on the volume of trauma patients, the number of orthopedic trauma operations, and the severity of injuries. We also investigated the correlations between social distancing and these variables. Methods: This was a retrospective review of trauma patient cases at a single focused training center for trauma in Korea from January 2017 to April 2021. The COVID-19 group included patients treated from January 1 to April 30 in 2020 and 2021, and the control group included patients treated during the same months from 2017 to 2019. The volume of trauma patients according to the level of social distancing was evaluated among patients treated from August 2, 2020 to November 23, 2020. Results: The study included 3,032 patients who presented to the emergency department with traumatic injuries from January to April 2017 to 2021. The average number of patients was 646.7 and 546.0 in the control and COVID-19 groups, respectively. The percentage of patients injured in traffic accidents (TAs) decreased from 25.0% to 18.2% (P<0.0001). The proportions of in-car TAs and pedestrian TAs also decreased from 6.7% and 10.8% to 3.5% and 6.0%, respectively (P=0.0002 and P<0.0001). The percentage of bicycle TAs increased from 2.4% to 4.0% (P=0.0128). The proportion of patients with an Injury Severity Score above 15 and the mortality rate did not change significantly. As the level of social distancing increased, the number of trauma patients and the number of trauma injuries from TAs decreased. The number of orthopedic trauma operations also depended on the social distancing level. Conclusions: The number of trauma patients presenting to the emergency department decreased during the COVID-19 period. The volume of trauma patients and orthopedic trauma operations decreased as the social distance level increased.

• Korea Journal of Hospital Management
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• v.13 no.4
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• pp.1-26
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• 2008

This study examines the statistical relationship between medical specialists and managerial performance, using regression analysis with the number of medical specialists per 100 beds as the independent variable and the managerial performance index as the dependent variable. Managerial performance index incorporated the number of out-patients per specialist, the number of in-patients per specialist, the volume of revenue per specialist, the number of beds per specialist, and the average length of stay. To compare different groups of hospitals, dummy variable was applied to five groups of hospitals according to size: 100-299 beds, 300-599 beds, 600-899 beds, 900-1199 beds, and more than 1200 beds. The data consisted of 181 general hospitals with more than 100 beds, which included 28 public hospitals, 73 corporate hospitals, 64 university hospitals and 16 private hospitals. Of those, 87 hospitals were located in big cities and 94 hospitals in medium to small cities. This study used hospitals from the Korean Hospital Association, and data published in 2004. The collected data sample was analyzed using the SPSSWIN 12.0 version, and the study hypothesis was tested using regression analysis. The findings of this study are summarized as follows: Hypothesis 1 predicting a negative effect of the number of medical specialists on the number of out-patients per specialist was supported with statistical significance. The analysis of dummy variable showed causality in all the hospital groups larger than the group of 100-299 beds. Hypothesis 2 predicting a negative effect of the number of medical specialists on the number of in-patients per specialist was supported with statistical significance. The analysis of dummy variable showed causality in the hospital group of 300-599 beds when compared to the group of 100-299 beds. Hypothesis 3 predicting a negative effect of the number of medical specialists on the volume of revenue per specialist was not supported. However, the analysis of dummy variable showed that the volume of revenue per specialist increased in the hospital groups of 600-899 beds, 900-1199 beds, and over 1200 beds, when compared to the group of 100-299 beds. Hypothesis 4 predicting a negative effect of the number of medical specialists on the average length of stay was supported with statistical significance. The analysis of dummy variable showed causality in the hospital group of 300-599 beds, when compared to the group of 100-299 beds. Results of this study show that the number of the medical specialists per 100 beds is an important factor in hospital managerial performance. Most hospitals have tried to retain as many medical specialists as possible to keep the number of patients stable, to ensure adequate revenue, and to maintain efficient managerial performance. Especially, the big hospitals with greater number of beds and medical specialists have shown greater revenue per medical specialist despite the smaller number of patients per medical specialist. Findings of this study explains why hospitals in Korea are getting bigger.

• Korean Journal of Clinical Pharmacy
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• v.26 no.4
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• pp.298-305
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• 2016

Background: This study is to investigate the prescription patterns and factors related to the number of medications treating chronic obstructive pulmonary disease (COPD) in patients under 65 years old according to GOLD guidelines. Methods: We retrospectively analyzed the medical records of patients aged 40-64 years with a diagnosis of COPD from January to March 2016. Patients were classified by combined assessment of COPD (grades A, B, C, D) using spirometry, exacerbation history, mMRC, and/or CAT results. We analyzed prescribed medications, treatment options and factors related to the numbers of COPD medications. Results: The total number of prescriptions were 251. About 35.5% of patients were classified as GOLD A, 34.2% as GOLD B, 17.1% as GOLD C and 13.2% as GOLD D. Inhaled bronchodilator was prescribed for 86.9% of patients and the most frequent COPD medication was long-acting muscarinic antagonist (LAMA) followed by inhaled corticosteroids/long acting beta agonist (ICS/LABA). The majority of low risk patients (GOLD A/B) were prescribed a monotherapy with LAMA or LABA. For high risk patients (GOLD C/D), combination treatment with ICS+LAMA+LABA was mostly prescribed. The 21.2% of patients in GOLD D received systemic corticosteroid. The average number of medications per prescription was 3.7, and this number increased with increasing COPD grade, COPD duration and lung function reduction ($FEV_1$, $FEV_1/FVC$). Conclusion: Generally high adherence to GOLD guideline recommendations was reported. Given the progressive nature of the disease, results suggest that closer attention to respiratory symptoms for early detection, diagnosis, and appropriate treatment of COPD is warranted.

• Journal of muscle and joint health
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• v.1 no.1
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• pp.88-96
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• 1994

Treatment for the arthritic is mostly on the out-patient basis. The present rheumatologists practicing in Korea do not cover the total number of the patients. Also patients with arthritis need medical treatment for long period of time. Therefore, the number of patients waiting for the treatment is huge in number. This vicious cycle need to be broken in some way. Purpose of this study is to identify the need for home care of the arthritic patients. Nineteen hundred and sixty two subjects were interviewed in one hospital for one month. The following findings were observed : 1. The rates for demanding home care were from 60% to 100% depending on the areas. 2. Reasons for no need of home care were mainly credibility and short distance from the hospital. 3. Time spent for one way transportation was more than 3.3 hours except from Seoul and Kyungki area. The longer they spend time for transportation, the more they want home care services. 4. The number of patients who asked other persons to travel for prescription was 446(22.73%) and average number was 3.26 per year in those 446 cases. 5. Average expenses for transportation and other cost for each time of hospital visit were 21,073won ranged from 8,373 won to 132,571 won. The more spend money for visiting the hospital, the more they want home care services. In order to reduce the physical and economical burden of the arthritic patients living in remote areas, hospital-based home care services are justified on the bases of patients' demand and legislative support.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.36 no.1
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• pp.96-109
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• 2023

Objectives : The objective of this study is to predict how future infectious diseases will affect healthcare utilization patterns within korean medicine hospitals and, specifically, departments of ophthalmology, otolaryngology and dermatology of Korean medicine. Methods : We retrospectively analyzed medical records of patients who visited Kyung Hee University Korean Medicine Hospital during Pre COVID-19(from March 1st, 2018 to Feb 29th, 2019) and Post COVID-19(from March 1st, 2019 to Feb 28th, 2022). The data was analyzed by visit type and diagnosed disease code. Results : 1. After the COVID-19 break-out, the number of first visit patients increased but those of revisit patients, total patients, and revisit/first visit ratio decreased in all departments. 2. In Kyung Hee University Korean Medicine Hospital, the decrease rate of the number of total patients diagnosed with diseases of respiratory system(J00-J99) was the highest, while that for diseases of circulatory system(I00-I99) was the lowest. 3. In the department of Ophthalmology and Otolaryngology of Korean Medicine, the decrease rate of the number of total patients with nose disease was the highest, followed by eye disease and ear disease. 4. In the department of Dermatology of Korean Medicine, the number of total patients with dermatitis remained consistent, while the number of total patients with skin appendage disease showed relatively high decrease rate. Conclusions : Severe or chronic diseases showed relatively low decrease rate of the number of total patients. While mild diseases or diseases with high probability of exposure to COVID-19 infection during treatment showed high decrease rate of the number of total patients.