• Journal of Preventive Medicine and Public Health
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• v.48 no.6
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• pp.301-309
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• 2015

Objectives: To investigate trends in the prevalence of allergic disease over a 9-year period. Methods: Using National Health Insurance Service (NHIS) data, the annual number of patients with allergic disease was obtained for each regional subdivisions (small cities, counties, and districts) from 2003 to 2011. Annual populations for each sub-region were obtained and used to calculate the standardized prevalence. To compare prevalence within the study period, data was standardized spatially and temporally. For standardization, demographic data was used to obtain the registered population and demographic structure for 2010, which was used to perform direct standardization of previous years. In addition, a geographic information system (GIS) was used to visualize prevalence for individual sub-regions, and allergic diseases were categorized into five groups according to prevalence. Results: The nationwide outpatient prevalence of allergic rhinitis increased approximately 2.3-fold, from 1.27% in 2003 to 2.97% in 2013, while inpatient prevalence also increased approximately 2.4-fold,. The outpatient prevalence of asthma increased 1.2-fold, and inpatient prevalence increased 1.3-fold. The outpatient prevalence of atopic dermatitis decreased approximately 12%, and inpatient prevalence decreased 5%. Conclusions: There was a large difference between prevalence estimated from actual treatment data and prevalence based on patients' self-reported data, particularly for allergic rhinitis. Prevalence must continually be calculated and trends should be analyzed for the efficient management of allergic diseases. To this end, prevalence studies using NHIS claims data may be useful.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.13
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• pp.5265-5270
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• 2014

Background: In Korea, the National Health Insurance program has initiated various copayment policies over a decade in order to alleviate patient financial burden. This study investigated healthcare spending and utilization in the last 12 months of life among patients who died with lung cancer by various copayment policy windows. Materials and Methods: We performed a retrospective cohort study using nationwide lung cancer health insurance claims data from 2002 to 2012. We used descriptive and multivariate methods to compare spending measured by total costs, payer costs, copayments, and utilization (measured by length of stay or outpatient days). Using 1,4417,380 individual health insurance claims (inpatients: 673,122, outpatients: 744,258), we obtained aggregated healthcare spending and utilization of 155,273 individual patient (131,494 inpatient and 103,855 outpatient) records. Results: National spending and utilization is growing, with a significant portion of inpatient healthcare spending and utilization occurring during the end-of-life period. Specifically, inpatients were more likely to have more spending and utilization as they got close to death. As coverage expanded, copayments decreased, but overall costs increased due to increased utilization. The trends were the same in both inpatient and outpatient services. Multivariate analysis confirmed the associations. Conclusions: We found evidence of the higher end of life healthcare spending and utilizations in lung cancer patients occurring as coverage expanded. The practice pattern within a hospital might be influenced by coverage policies. Health policy makers should consider initiating various health policies since these influence the long-term outcomes of service performance and overall healthcare spending and utilization.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4779-4783
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• 2013

Background: This study aimed to evaluate the baseline white blood cell (WBC), neutrophil, lymphocyte, monocyte, basophil, eosinophil count, total prostate-specific antigen (TPSA), free PSA (FPSA) level, neutrophilto- lymphocyte and neutrophil-to-monocyte ratios among patients with prostate cancer and benign prostatic hyperplasia (BPH), as well as healthy individuals. Materials and Methods: 2005-2012 laboratory files of 160 patients with prostate cancer at Kayseri Training and Research Hospital, Oncology Outpatient Clinic, 285 patients who were pathologically diagnosed with BPH in Urology Outpatient Clinic and 200 healthy individuals who were admitted to Internal Medicine Outpatient Clinic were retrospectively analyzed. Baseline WBC, neutrophil, lymphocyte, monocyte, basophil, eosinophil count, TPSA, FPSA level, neutrophil-to-lymphocyte ratio and neutrophil-to-monocyte ratio were recorded and compared across groups. Results: Patients with prostate cancer had a lower lymphocyte level compared to the patients with BPH and healthy controls (p<0.001). The mean monocyte count, leukocyte-to-monocyte ratio, and leukocyte-to-lymphocyte ratio were higher in patients with prostate cancer, but without significance. The mean WBC and leukocyte count were lower in patients with prostate cancer, but again without statistical significance (p=0.130). The mean TPSA and FPSA were 39.4 and 5.67, respectively in patients with prostate cancer, while they were 5.78 and 1.28 in patients with BPH. There was a significant difference in the mean TPSA and FPSA levels between the patient groups (p<0.001). Conclusions: Our study results showed that patients with prostate cancer had a lower level of lymphocytes, neutrophils and WBCs and a higher level of monocytes with a significant difference in lymphocyte count, compared to healthy controls. We suggest that lymphocyte count may be used in combination with other parameters in the diagnosis of prostate cancer, thanks to its ease of assessment.

• Clinics in Shoulder and Elbow
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• v.23 no.2
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• pp.80-85
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• 2020

Background: Atelocollagen has been studied for restoration of rotator cuff tendon. In this study, we attempted to evaluate the clinical outcome of ultrasound-guided atelocollagen injection in an outpatient clinic for patients with partial rotator cuff tear. Methods: We recruited 42 outpatients who visited our hospital from May 2019 to September 2019. Atelocollagen injection was performed in patients with partial rotator cuff tear diagnosed by magnetic resonance imaging and ultrasound. American Shoulder and Elbow Surgeons (ASES), Constant, Korean Shoulder Score (KSS) and Simple Shoulder Test (SST) scores, and range of motion were assessed before injection and after 2 months. Statistically, we analyzed the clinical results using the Wilcoxon signed-rank test. Results: Finally, 15 patients were enrolled for analysis. There was no significant difference between pre- and post-injection in terms of range of motion, ASES (57.0 vs. 60.4), Constant (56.4 vs. 58.9), KSS (64.6 vs. 68.5), and pain-visual analog scale (4.2 vs. 3.7), except function-visual analog scale (F-VAS; 6.3 vs. 7.1) and SST (6.6 vs. 6.9). A significant difference was found in SST (P=0.046) and F-VAS (P=0.009). According to the ultrasound results at 2 months, we found hyperechoic materials in three of seven patients. The most common complication of atelocollagen injection was post-injection pain (53%, 8/15). Conclusions: Ultrasound-guided atelocollagen injection for partial rotator cuff tear showed no significant change in terms of clinical outcomes, except for F-vas and SST score. Tendon regeneration was not clear due to the remnants of atelocollagen present at 2-month follow-up ultrasound. There seems to be alarming post-injection pain for 2 to 3 days in the patients who received atelocollagen injection in an outpatient clinic.

• Korea Journal of Hospital Management
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• v.25 no.1
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• pp.13-20
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• 2020

Purposes: This study has the purpose to the improvement of health promotion for local residents through delivery of high-quality medical service by improving imbalance of medical use and seeking an improvement plan for accessibility of effective medical service by understanding the pattern of medical use by region. Methodology: As for the method, this study derived results at the significance level of p<0.05 through chi square test(χ² test) and Generalized Estimating Equation(GEE) SAS 9.4 version by using the data of the 7th Korean Longitudinal Study of Ageing 2018. Findings: Study results show that local residents use medical service such as hospitalization care and outpatient visit more as compared to the residents in Gyeonggi-do/large or medium-sized cities. The more the number of chronic disease, the more they select hospitalization care rather than outpatient visit. Results also show that patients engaged in labour tend to select outpatient treatment rather than hospitalization treatment. Meanwhile, severity of disease turned out to be higher amongst medical care beneficiaries than that of national health insurance patients when comparing the types of medical security. Practical Implications: In stead of solving the problem of the difference in medical use by region from the aspect of income and economic level, an integrative solution shall be provided putting viewpoint on the social phenomenon suited to the changes of the times. This study suggests a plan for using a health and medical community care center that acts as a gate keeper of regional medical service.

• Korea Journal of Hospital Management
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• v.28 no.3
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• pp.47-57
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• 2023

Purpose: Health expenditure and utilization of Korean medicine are increasing every year. Since Chuna Manual Therapy was covered by National Health Insurance in 2019, it is predicted that the usage of Chuna Manual Therapy would be also increasing. However, there are few studies about Chuna Manual Therapy using Korean National Health Insurance claims database. Therefore, we will investigate the utilization trend of outpatient's Chuna Manual Therapy using Korean National Health Insurance database and suggest political implications. Methodology: The Korean National Health Insurance claims database was used to identify outpatient's Chuna Manual Therapy usage spanning 4 years from 2019-2023 and the number of Chuna Manual Therapy claims were approximately 18.61 million. Findings: The number of Chuna Manual Therapy claims and patients, health expenditure of Chuna Manual Therapy have been increasing spanning 4 years among over 65 aged. In the case of female patients, the number of Chuna Manual Therapy claims was more than male patients and health spending related to Chuna Manual Therapy was also higher than male patients. Most patients visited Korean medicine clinics due to musculoskeletal diseases, and most claims were from rural regions. Practical Implication: Since Chuna Manual Therapy was covered by National Health Insurance in 2019, Utilization of Chuna Manual Therapy has been increased overall. In particular, Chuna Manual Therapy is mostly implemented in the elderly, Korean medicine clinics, and local areas, thus policy managers will need to consider this.

• Korea Journal of Hospital Management
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• v.29 no.3
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• pp.1-10
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• 2024

Purposes: When rehabilitation services are provided remotely using information and communication technologies to patients living at home, there is an advantage in providing rehabilitation services to individuals in their everyday social and physical environment, which can improve functional outcomes and satisfaction. The purpose of this study was to analyze the effectiveness of the pilot project by analyzing the outpatient and inpatient medical use and expenses of patients who participated in the rehabilitation patient home-based care pilot project. Methodology: To analyze the effectiveness of the home-based care pilot project for rehabilitation patients, health insurance claims data from the Health Insurance Review and Assessment Service was used. The subjects of analysis were patients who had undergone major lower extremity joint replacement surgery, including hip, knee, and ankle joint replacement surgery, and patients who had lower extremity fracture surgery, which were the targets of the rehabilitation patient home-based care pilot project. To compare medical use and expenses between patients participating in the rehabilitation patient home-based care pilot project and those not participating, chi-square test, t-test, and multiple regression analysis were performed. Findings: As a result of analyzing the number of medical use cases and expenses of patients who participated and those who did not participate in the rehabilitation patient home-based care pilot project, the average outpatient medical use and outpatient medical expenses per person for participating patients were lower than those for patients who did not participate. The average hospitalization cost per person and the average length of stay per person were also lower than those of patients who did not participate. Practical Implications: Home-based care for rehabilitation patients continues to provide medical services at home, not at medical institutions, and can be expected to reduce readmissions and complications by resolving patients' emergency situations at home or on their own, thereby reducing medical use.

• Journal of Korean Neurosurgical Society
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• v.56 no.2
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• pp.157-161
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• 2014

A 49 years old male patient who suffered from deterioration of posterior neck pain, left hand numbness, left lower limb pain and gait disturbance for 3 years visited our outpatient department. He had been diagnosed as non-dysraphic cervical intradural lipoma and operated in August 1990. On the radiologic images, we found the regrowth of non-dysraphic cervical intradural lipoma from C2 to C7 level, which surrounds and compresses the cervical spinal cord. Previous subtotal laminectomy from C2 to C7 and severe cervical lordosis were also found. Appropriate debulking of lipoma mass without duroplasty was successfully done with intraoperative neurophysiological monitoring (IONM). We are following up the patient for 24 months via outpatient department, his neurologic symptoms such as hand numbness, gait disturbance, left lower limb pain and posterior neck pain have improved. We describe a rare case of regrowth of non-dysraphic cervical intradural lipoma.

• Clinical and Experimental Reproductive Medicine
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• v.40 no.3
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• pp.126-130
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• 2013

Objective: To assess the effectiveness of emergency single-dose levonorgestrel contraception in preventing unintended pregnancies among woman who visited the emergency department (ED) due to sexual assault (SA). Methods: We conducted a retrospective chart review in a university hospital in South Korea. Cases from November 10, 2006 to November 9, 2009 were enrolled. Information from the initial visit to the ED and subsequent follow-up visits to the gynecology outpatient clinic was collected. Results: In total, 1,179 women visited the ED due to SA. Among them, 416 patients had a gynecological examination and 302 patients who received emergency contraception (EC) (1.5 mg single-dose levonorgestrel) at the ED due to SA were enrolled. Ten patients did not return for follow-up examinations. In follow-up visits at the outpatient clinic, two pregnancies were confirmed, which showed the failure rate of the EC to be 0.68%. Conclusion: Single-dose levonorgestrel EC is extremely effective at preventing pregnancy among victims of SA.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.242-246
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• 2001

Objective : The short hospitalization or outpatient care for patients undergoing laminectomy is not popular practice in Korea. We evaluated the clinical and economical significance of short hospitalization for patients undergoing microdiscectomy for their lumbar disc herniation. Material and Methods : From March 1999 to December 2000, patients were hospitalized for intended short period hospitalization for lumbar disc surgery. Their radiological and clinical data were analyzed for their clinical and economical results. We compared these data with 20 patients who hospitalized conventionally. Results : Total of 64 patients were evaluated. Three were lost to follow-up. Mean postoperative hospitalization period is 2.0 days(excluding one patient). Excellent to good outcome was achieved in 90.6 % of the patients. They payed about half expenses for hospitalization compared with conventional group. Their mean number of outpatient visit was 3.0. Conclusion : Short hospitalization for lumbar disc surgery is an acceptable option in Korea. It is also economically beneficial while achieving acceptable clinical results.