• Journal of Society of Preventive Korean Medicine
• /
• v.21 no.1
• /
• pp.57-66
• /
• 2017

Objectives : This study aimed to analyze the structure and the trend of utilization and expenditure for Korean Medicine (KM) in Korea. Methods : Data were drawn from the 2008-2013 annual Korea Health Panel (Version 1.2.2), a national representative sample. We combined the data of household members with the data of outpatient KM service use. The volume of KM use was estimated based on the frequency of use and co-payment. Results : The KM utilization rate slightly increased in recent years, and it is presumed to be resulted from the increase of elderly population. Most KM outpatient visits were being concentrated in treating musculoskeletal diseases, and the procedures used frequently were acupuncture, moxibustion, cupping, and physical therapy. The imbalance of KM use between lower income group and higher income group was deepening. Conclusions : To expand restricted disease areas KM covered, the more herbal prescriptions should be insured and the insured form of herbal medicines need to be diversified.

• The Journal of Internal Korean Medicine
• /
• v.40 no.6
• /
• pp.1303-1310
• /
• 2019

Objectives: Drug-induced Parkinsonism has similar symptoms to Parkinson's disease, but each has different causes. Drug-induced Parkinsonism accounts for the largest proportion of secondary Parkinsonism We report a outpatient case of drug-induced Parkinsonism after taking Risperidone, an atypical antipsychotic. Method: With discontinuing of antipsychotic drug, modified Yigan-san extract was administered for 12 weeks, and acupuncture and electroacupuncture procedures were performed 20 times. Results: Abnormal Involuntary Movement Scale (AIMS) score decreased from 23 to 3 during 59 days of treatment period without adverse events and worsening of depression. The Patient was highly satisfied. Conclusion: Modified Yigan-san and electroacupuncture (GB34) can be used as an treatment option in patients with drug-induced Parkinsonism.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.4 no.1 s.6
• /
• pp.17-20
• /
• 2004

Chronic periodontitis is one of the most common disease in clinical dentistry, which needs various surgical interventions to treat the moderate to severe destruction of supporting periodontium. Most patients have fear and anxiety to these surgical procedures and some dentists also have problems to deal with these patients. Applying the conscious sedation technique in outpatient units, periodontists have become to manage their patients successfully without any fear and anxiety and increased the level of patients' satisfaction. Particularly, periodontal treatments require relative long chair-time and patients are usually reluctant to the periodontal instruments used in the oral cavity. This study is focused on the sedation procedure with intravenous midazolam infusioon performed in Department of Periodontology, Ewha Womans University Hospital. The whole procedure of intravenous midazolam sedation is briefly reviewed from patient selection to patient discharge.

• Journal of East-West Nursing Research
• /
• v.27 no.1
• /
• pp.61-69
• /
• 2021

Purpose: This study aims to determine the association between fear of falling, falls efficacy, and fall prevention behaviors in older adults in outpatient and identify the factors affecting fall prevention behaviors. Methods: This was a descriptive study. A total of 137 older adults aged 60 or older with more than one disease in an outpatients setting were recruited from a university hospital in Seoul. Data were collected from March 11 through April 8, 2016. Results: The experience of a fall was significantly associated with age (t=-2.71, p=.008), gender (𝛘²=14.32, p<.001), education (𝛘²=6.05, p=.049), income (𝛘²=9.93, p=.019), physical activity status (𝛘²=16.84, p<.001), and the number of diseases (t=-2.89, p=.004). Fall experience was not significantly associated with marital status (𝛘²=3.79, p=.285). Multiple regression analysis revealed that the most influential factor of fall prevention behaviors was the fear of falls (β=-.37, p<.001), followed by the number of diseases (β=-.20, p=.013). Conclusion: It is necessary to provide preventive fall education with older adults in outpatients settings considering the fear level of falling and the numbers of accompanying diseases.

• Journal of Korean Foot and Ankle Society
• /
• v.21 no.1
• /
• pp.12-16
• /
• 2017

Purpose: Anterior drawer and varus stress radiographs are commonly to diagnose chronic lateral ankle instability. We compared the preoperative stress radiographs with the intraoperative radiographs under anesthesia to determine the accuracy and efficacy of stress radiographs in an outpatient clinical environment. Materials and Methods: Data was collected from patients who underwent a modified $Brostr{\ddot{o}}m$ operation for painful chronic unilateral lateral ankle instability between January 2014 and June 2016. Subjects were divided into three groups-complete tear, partial tear, and instability without rupture-according to the status of preoperative MRI findings of the anterior talofibular ligament. The anterior drawer and varus stress radiographs were taken preoperatively and intraoperatively under anesthesia. Results: Ninety-six patients, with a mean age of 29.63 years, were enrolled. There were 39, 46, and 11 patients in the complete tear, partial tear, and instability without rupture groups, respectively. On the anterior drawer and varus stress radiographs of the affected limb, talar anterior translation and varus tilting were significantly increased by 2.56 mm and $2.0^{\circ}$. The gaps between the unaffected limbs were also increased by 2.47 mm and $1.32^{\circ}$ after anesthesia. Although the stress radiographs were taken under anesthesia, the results were often smaller than the diagnostic value. Conclusion: Stress radiographs for painful chronic lateral ankle instability taken at the outpatient clinic might be inaccurate for diagnosis.

• Journal of Korean Academy of Nursing Administration
• /
• v.11 no.4
• /
• pp.361-369
• /
• 2005

Purpose: The purpose of the study was to analyze the present status of community health practitioner activities and efforts to improve the job performance. Method: This study employed descriptive exploratory design. The sample consisted of 1,892 community health practitioners which was 90 % of population of community health practitioners. The data was analyzed by using SPSS Windows 10.0. Result: The most popular activities of community health practitioners were women's health, chronic degenerative disease management, elderly health, and outpatient care of primary health care. The activities that community health practitioners want to strengthen were outpatient care, disease prevention, rehabilitation, health promotion, and counseling. The efforts to improve the job performance were consult to other health care professionals, discussion with patient and families to choose effective treatment options. Community health practitioners knew that they were exposed to malpractice and hould try to make many efforts to improve their performance. Conclusion: The roles and activities of community health practitioners should be changed to the shift of health care environment and systems.

• Health Policy and Management
• /
• v.29 no.3
• /
• pp.288-302
• /
• 2019

Background: The one-person households (OPH) are rapidly increasing and vulnerable to socioeconomic and health problems. Because it is predicted to be inequitable to health care utilization, we would like to find out about the equity of health care utilization of the OPH by comparison with the multi-person households (MPH). Methods: This study followed the theoretical framework of Wagstaff and van Doorslaer (2000), O'Donnell and his colleagues (2008), where the horizontal inequity index is the difference between the concentration indices of actual health care utilization and health care needs. This study employed the 9th Korea Health Panel survey, and a total of 10,807 cases were analyzed. Health care needs were measured by age, sex, subjective health status, chronic disease count, Charlson's Comorbidity Index, limitation of activities, and disability. Results: Compared with the MPH, there were pro-poor inequities in hospitalization, emergency utilization, hospitalization out-of-pocket payments, and pro-rich inequities in outpatient out-of-pocket payments for the OPH. The decomposition of the concentration index revealed that chronic disease count made the largest contribution to socioeconomic inequality in outpatient utilization. Age, health insurance, economic activities, and subjective health status also proved more important contributors to inequality. The variables contributing to the hospitalization and emergency utilization inequity were age, education, Charlson's Comorbidity Index, marital status, and income. Conclusion: Because the OPH was more vulnerable to health problems than the MPH and there were pro-poor inequities in medical utilization, hospitalization, and emergency costs, it is necessary to develop a policy that can correct and improve the portion of high contribution to medical utilization of the OPH.

• Clinical Endoscopy
• /
• v.55 no.5
• /
• pp.630-636
• /
• 2022

Background/Aims: Transoral incisionless fundoplication (TIF) is an accepted anatomic treatment for gastroesophageal reflux disease in selected patients. In this report, we analyze our institution's programmatic allocation of resources during the safe implementation of TIF as a new procedure. Methods: A retrospective analysis of all patients who underwent TIF from January 2020 to February 2021 at our institution was performed. The process of initially allocating the operating room (OR) with overnight admission and postoperative esophagram for added safety, and subsequently transitioning TIF to the endoscopy suite (ES) as an outpatient procedure was described. Patient safety and outcomes were evaluated during transition. Results: Thirty patients who underwent TIF were identified. The mean age was 51.2±16.0 years. TIF was performed in an OR in nine patients (30%) and 21 (70%) in the ES. All the OR patients were admitted overnight and had routine esophagogram. In contrast, four (19%) from the ES group required clinically-indicated admission and three (14.2%) required esophagram. The mean procedure duration was significantly lower in the ES group (65.7 min vs. 84 min, p=0.02). Conclusions: A stepwise, resource-efficient process was described that allowed safe initiation of TIF as a new technique and its effective transition to a fully outpatient procedure.

• Journal of Korean Biological Nursing Science
• /
• v.25 no.3
• /
• pp.172-182
• /
• 2023

Purpose: This study investigated the differences in physical function, self-efficacy (SE), and health-related quality of life (HRQoL) categorized by disease severity in community-dwelling patients with chronic obstructive pulmonary disease (COPD). Methods: This cross-sectional study included 182 patients with COPD selected from the pulmonology outpatient department of a tertiary hospital. Disease severity was measured using forced expiratory volume in 1 second (FEV1). Physical function, SE, and HRQoL were measured with the six-minute walking distance, Pulmonary Rehabilitation Adapted Index of Self-Efficacy (PRAISE), and St. George's Respiratory Questionnaire (SGRQ). Disease duration, FEV1, and 12-month history of exacerbations were obtained from medical records. Patients were categorized by Global Initiative for Chronic Obstructive Lung Disease (GOLD) category. Data were analyzed using the χ² test, and one-way ANOVA. Results: Most of the participants were male and nonsmokers. The disease duration was 10.76 ± 10.03 years, the mean FEV1% was 62.13 ± 22.80, and 70.3% of the participants were in GOLD category 2 (moderate) or milder. Half of the participants reported modified Medical Research Council scores ≥ 2. Patients in GOLD categories 1 and 3 (mild and severe) exhibited significantly higher PRAISE scores than those in the other groups (F = 8.23, p < .001). The total SGRQ scores were highest in GOLD 4 (very severe), indicating the lowest HRQoL. Significant differences were identified among GOLD 1, GOLD 2 and 3, and GOLD 4 (F = 9.92, p < .001). Conclusion: We identified potentially useful variables to comprehensively assess disease severity and tailor management strategies, including airflow limitation, and to determine the consequences of COPD from patients' perspectives.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.16 no.2
• /
• pp.244-248
• /
• 2003

Paranasal sinusitis is a common disease in the otorhinolaryngology area. It is the change of inflammation at the mucous membrane which surrounds paranasal sinus. Chronic paranasal sinusitis is a chronic inflammation disease with purulent, mucous rhinorrhea, postnasal drip and cough. The attacked period continues above three months and it repeats exacerbation and remission. We diagnosed and treated an outpatient who complains postnasal drip of chronic paranasal drip of chronic paranasal sinusitis based on the Oriental medical theories and had good result.