• Korean Journal of Clinical Pharmacy
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• v.33 no.1
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• pp.8-21
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• 2023

Background: Gastrointestinal (GI) drugs are often co-prescribed with other medications to prevent GI complications. This study aimed to evaluate the prescribing pattern of potentially unnecessary GI drugs in patients with acute cystitis who were prescribed oral antibiotics and investigate the influencing factors affecting this. Methods: We identified female patients ≥20 years with acute cystitis who visited the outpatient clinic and were prescribed oral antibiotics between July and December by analyzing Health Insurance Review and Assessment Service (HIRA)-National Patients Sample (NPS)-2019 data. Patients with no prior history of GI disorders within 180 days prior to acute cystitis, excluding or including the date of diagnosis of acute cystitis, were selected (Group A and B). Multiple logistic regression analysis was performed to estimate the factors affecting the prescription of potentially unnecessary GI drugs. Results: A total of 1,544 in Group A and 552 patients in Group B were included for the final analysis. Potentially unnecessary GI drugs were prescribed in 1,176 patients in Group A (76.2%) and 231 patients in Group B (41.8%). Third generation cephalosporines and sulfonamides showed the lower odds ratio for prescribing GI drugs than penicillins. Prescribers from Urology clinics showed more than twice odds ratio for the prescription of GI drugs compared to prescribers from internal medicine clinics. Conclusion: The results of this study showed that potentially unnecessary GI drug prescriptions for patients with acute cystitis were high in South Korea. The positive risk factors affecting the prescription of unnecessary GIs were not patient-related factor but healthcare facility and prescriber-related factors.

• Physical Therapy Korea
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• v.29 no.2
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• pp.94-105
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• 2022

Background: As South Korea enters an aged society, the government has emphasized the need for a soft landing of the older adults into the community after the acute and recovery periods under a national policy of "community care." However, the institutionalization of community rehabilitation services to implement this is insufficient. Japan had already entered an aged society when the Long-Term Care Insurance System was introduced in 2000. Thus, the case of Japan's institutionalization of the system is expected to have implications for us in supplementing a suitable system for the aged society. Objects: This study compared the institutionalization process of the Long-Term Care Insurance System in South Korea and Japan and the services currently being implemented in each country. Methods: To examine the institutionalization process and services of the system, related legal rules and regulations, government reports, and articles were reviewed. To examine the operation status of the system, statistical data provided by each country's government were analyzed. Results: Japan recognized the importance of community rehabilitation even before the enactment of Long-Term Care Insurance. Thus, community rehabilitation services, such as home-visit rehabilitation and health facilities, were already stipulated in the law. Under such institutional legacy, Long-Term Care Insurance was able to establish a service system, which balanced welfare and health-related services, including various types of services with enhanced rehabilitation functions. In South Korea, rehabilitation policies were not much considered in the process of institutionalizing the system; thus, it was composed mainly of services focusing on care and recuperation. Conclusion: In order to realize community care, rehabilitation services need to be developed in Long-Term Care Insurance System in various forms such as home-visit services, daily services, short stay, and facility services.

• Korean Journal of Schizophrenia Research
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• v.22 no.2
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• pp.34-41
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• 2019

Objectives: This study was performed to examine the effects of the public attention to 'crime of schizophrenia' on the use of mental health services in patients with schizophrenia using big data analysis. Methods: Data on the frequency of internet searches for 'crime of schizophrenia' and the patterns of mental health service utilization by patients with schizophrenia spectrum disorders by month were collected from Naver big data and the Health Insurance Review and Assessment Services in Korea, respectively. Their correlations in the same and following month for lagged effect were examined. Results: The number of outpatients correlated negatively with public attention to 'crime of schizophrenia' in the same month. The lagged relationship between public attention and the number of admissions in psychiatric wards was also found. In terms of sex differences, the use of outpatient services among female patients correlated negatively with public attention in the same month while the number of male patients' admissions in both same and following month correlated positively with public attention. Conclusion: These findings suggested that public attention to 'crime of schizophrenia' could negatively affect illness behavior in patients with schizophrenia.

• The Korean Journal of Emergency Medical Services
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• v.27 no.3
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• pp.47-58
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• 2023

Purpose: The purpose of this study was to analyze the characteristics of patients who canceled their ED visits and to determine the factors that influence ED cancellation. Methods: Retrospective study that analyzed data from the electronic medical records(EMR) and Prehospital Care Reports(PCRs) of 305 patients who cancelled their appointments at a single emergency medical center over a six-month period from October 12, 2022, to April 12, 2023. Results: ED cancellations were 2.287 times higher if the patient presented to the ambulance after outpatient hours(09:00~17:00) (p=.007), and ED cancellations were 3.712 times higher if the patient presented to the ambulance under the influence of alcohol(p=.011). For patients' symptoms, medical diseases were associated with a 1.965 times increase in cancelled ED visits compared to other modes of transport (p=.005), while mental and chronic diseases were associated with a 67.3% decrease in cancelled ED visits compared to other modes of transport (OR=0.327, CI=[0.130-0.822], p=.018). symptomatic improvement was associated with a 2.482 times increase in presentations to a 119 ambulance compared to delayed waiting time(p=.022). Conclusion: Emergency medical centers should consider improving the legal system, such as increasing emergency medical care fees, to reduce the number of patients who cancel their appointments.

• Journal of Society of Preventive Korean Medicine
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• v.28 no.1
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• pp.1-11
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• 2024

Objectives : This study conducted a survey on the needs of Korean medicine doctors for health care education programs specializing in traditional Korean medicine. Methods : The study selected Korean medicine doctors who had experience participating in outpatient consultations. Data collected through surveys underwent frequency analysis on performance, importance, difficulty, and educational needs using SPSS 24.0. Additionally, an Importance-Performance Analysis (IPA) was conducted using importance and performance data. Results : According to the results of the IPA analysis, in the area of "keep up the good work" there were activities such as fee Claims (A3), comprehensive assessment (B4), care plan development (B5), client and caregiver interviews (C8), chronic disease monitoring (C9), musculoskeletal and other pain management, musculoskeletal rehabilitation (C10), mental health management (C11), and fall prevention (C15). In the "concentrate here" priority action area, skin care including pressure sore management (C13) was identified. Conclusions : The traditional Korean medicine community care service is expected to expand further, so it is anticipated that the developed educational programs will contribute to the activation of traditional Korean medicine health care business.

• Korea Journal of Hospital Management
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• v.28 no.4
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• pp.73-89
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• 2023

Purposes: The purpose of this study was to empirically analyze the effect of the attitude of medical staff providing medical services on the treatment satisfaction of the patients who experienced outpatient care at the hospitals and clinics. In particular, it was verified whether the courtesy of the medical staff to the outpatients has moderated the effect of the medical staff's explanation on the treatment satisfaction. Methodology: After controlling the socio-demographic factors of the outpatients with their treatment and waiting time, multiple regression analyses were conducted to figure out the effect of the attitude of the medical staff on the treatment satisfaction. And the covariance analyses were adopted to verify the moderating effect of the variables of the medical staff. Findings: At both hospitals and clinics, all attitudes of medical staff such as the way they explain to and communicate with the patients, and their courtesy showed positive effects on treatment satisfaction. Among them, the courtesy of the medical staff was the most influential variable on the satisfaction of the treatment, and it only had the control power over the effect of the way they explain on the treatment satisfaction. Practical Implication: Among the medical staff's attitudes toward patients at hospital or clinic level, the courtesy of doctors and nurses is an important factor in improving treatment satisfaction. In particular, if the level of their courtesy is low among the medical services rendered at the clinics, the satisfaction level will decrease even if the level of explanation of the medical staff is high. Therefore, in terms of hospital management, treatment satisfaction can be improved when doctors and nurses provide medical services to visitors with polite, humble and friendly manner in explaining to and communicating with the patients.

• Journal of Trauma and Injury
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• v.37 no.1
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• pp.74-78
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• 2024

Inferior vena cava (IVC) injuries can have fatal outcomes and are associated with high mortality rates. Patients with IVC injuries require multiple procedures, including prehospital care, surgical techniques, and postoperative care. We present the case of a 67-year-old woman who stabbed herself in the abdomen with a knife, resulting in an infrarenal IVC injury. We shortened the transfer time by transporting the patient using a helicopter and decided to perform direct-to-operating room resuscitation by a trauma physician in the helicopter. The patient underwent laparotomy with IVC ligation for damage control during the first operation. The second- and third-look operations, including previous suture removal, IVC reconstruction, and IVC thrombectomy, were performed by a trauma surgeon specializing in cardiovascular diseases. The patient was discharged without major complications on the 19th postoperative day with rivaroxaban as an anticoagulant medication. Computed tomography angiography at the outpatient clinic showed that thrombi in the IVC and both iliac veins had been completely removed. Patients with IVC injuries can be effectively treated using a trauma system that includes fast transportation by helicopter, damage control for rapid hemostasis, and expert treatment of IVC injuries.

• Journal of the Health Care and Life Science
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• v.11 no.1
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• pp.105-114
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• 2023

This study aims to analyze the secondary data of disease distribution and medical service behavior according to gender and income by using the 17th wave data of the Korea Welfare Panel, which is being distributed in April 2023. Data for 7,865 people of raw data generated using the R language were collected, and among them, missing values (NA, - 2,012) were analyzed for 5,853 people. For analysis, average income by health status and gender, relationship with chronic diseases, outpatient visits to medical institutions by gender/age group, type of medical institution used by age group, and annual health checkup usage rate by gender/age group were examined. Through this, the medical utilization rate was higher in men than in women, and the utilization rate of hospitals and clinics was high.

• Journal of agricultural medicine and community health
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• v.25 no.1
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• pp.99-112
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• 2000

This survey was conducted to assess the utilization of health center including health sub-center and community health post and the health service demand of residents in a urban and rural unified community. Officials in Up·Myun·Dong offices visited randomly sampled 4,027 households(4.6% of total households in unified City) which included 3,337 households in urban area(4.9% of total households) and 690 households in rural area(3.7% of total households) and interviewed with heads or housewives of the households in September, 1995. There were significant differences in health-related demographic characteristics including age-sex distribution, educational level, period of residence in the community and medical insurance status of the interviewees between urban and rural areas. Of the respondents, 64.8% in urban area and 55.6% in rural replied that they had utilized the health center in the past. The most common purpose for visiting the health center was to get vaccination in urban area and to get outpatient care in rural area. The top priority health center activity that needs to be reinforced was communicable disease control and over 90% of the respondents preferred to have mobile clinic and home health care service in were also highly demanded. Eighty-six percent of the urban respondents replied that a health sub-center must be established in urban area. In the rural area, 90.3% of the respondents replied that they wanted to maintain the health sub-center and 88.3% wanted to maintain the community health post. Along with the improvement of facilities and equipments of the health center by Rural Health Service Improvement Project, new health service programs must be developed to meet the demand of the community.

• Nutrition Research and Practice
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• v.14 no.3
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• pp.218-229
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• 2020

BACKGROUND/OBJECTIVES: Type 2 Diabetes mellitus (T2DM) is a hereditary disease that is also strongly dependent on environmental factors, lifestyles, and dietary habits. This study explored the relationship between lifestyle habits and glycosylated hemoglobin management in T2DM patients to provide empirical outcomes to improve T2DM management and patient health literacy. SUBJECTS/METHODS: This study enrolled 349 diabetic patients with more than 5 care visits to a Diabetes Mellitus care network under the Health Management Plan led by Taiwan Department of Health (DOH). Based on relevant literature, an Outpatient Record Form of Diabetes Mellitus Care was designed and lipid profile tests were conducted for data collection and analysis. RESULTS: When modeling the data, the results showed that the odds for HbA1c > 7.5% in T2DM patients duration over 10 years was 3.785 (P = 0.002) times that in patients with disease duration of fewer than 3 years. The odds of HbA1c > 7.5% in illiterate patients was 3.128 (P = 0.039) times that in patients with senior high school education or above. The odds of HbA1c > 7.5% in patients with other chronic illness was 2.207 (P = 0.019) times that in participants without chronic illness. Among 5 beneficial lifestyle habits, the odds of HbA1c > 7.5% in patients with 2 or 3 good habits were 3.243 (P = 0.003) and 3.424 (P = 0.001) times that in patients with more than 3 good habits, respectively. CONCLUSION: This empirical outcome shows that maintaining a good lifestyle improves T2DM management and patients' knowledge, motivation, and ability to use health information. Patients with longer disease duration, education, or good lifestyle habits had optimal HbA1c management than those in patients who did not. Thus, effective selfmanagement and precaution in daily life and improved health literacy of diabetic patients are necessary to increase the quality of T2DM care.