• Journal of Preventive Medicine and Public Health
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• 제55권4호
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• pp.379-388
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• 2022

Objectives: Throughout history, societies have been impacted by inequality. Many studies have been conducted on the topic more broadly, but only a few have investigated inequalities in out-of-pocket health payments (OHP). This study measures OHP inequality trends among the Iranian households. Methods: This study used data from the Iranian Statistics Center on Iranian household income and expenditures. The analysis included a total of 995 300 households during the 36 years from 1984 to 2019. The Gini coefficient, Atkinson index, and Theil index were calculated for Iranian OHP. Results: Average Iranian household OHP increased from 33 US dollar (USD) in 1984 to 47 USD in 2019. During this 36-year span, the average±standard deviation Gini coefficient for OHP was 0.73±0.04, and the Atkinson and Theil indexes were 0.68±0.05 and 1.14±0.29, respectively. The Gini coefficients for the subcategories of OHP of outpatient diagnostic services, medical assistant accessories, hospital inpatient services, and addiction cessation were 0.70, 0.61, 0.84, and 0.64, respectively. Conclusions: In this study, we scrutinized trends of inequality in the OHP of Iranian households. Inequality in OHP decreased slightly over the past four decades. An analysis of trends among different subgroups revealed that affluent households, such as households with insurance coverage and households in higher income deciles, experienced higher inequality. Therefore, lower inequality in health care expenditures may be related to restricted access to health care services in Iran.

• 대한한방소아과학회지
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• 제37권1호
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• pp.45-57
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• 2023

Objectives This study aimed to provide a basis for the research on the trend and safety of Korean herbal medicines among children and adolescents. Methods Patients aged <19 years who received outpatient treatment at the Korean pediatrics department of Kyung Hee University Hospital from January 1, 2017 to October 31, 2022 were included. The current state of annual visits and herbal medicine prescriptions was analyzed. A retrospective chart review was conducted by examining the medical records of subjects who received herbal medicines, including deer antler. Adverse drug reactions in patients who received herbal medicine were also investigated. Results A total of 57,457 people visited the Korean pediatrics department, and 51,768 people (90.1%) were prescribed herbal medicine. Among these, 21,826 patients (42.2%) were prescribed with deer antler. A total of 117 adverse drug reactions were reported among the patients who received herbal medicines. Conclusions This study aimed to determine the trends and safety of herbal medicine treatment, particularly deer antlers, in children and adolescents. Well-designed, long-term, multi-institutional follow-up studies are required to expand the field of Korean pediatrics.

• 한국치위생학회지
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• 제11권4호
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• pp.489-497
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• 2011

Objectives : Based on data collected from patients who suffered from dental caries during the period between 1990 and 2008, the number of patients and their trends were analyzed as a source of evidence to conduct the oral health plan. Methods : A population of sample design for patient survey data was derived from computerized data saved at medical institutions accredited by National Health Insurance Corporation. Large institutions such as dental hospitals were included for the complete enumeration test, while the rest of medical institutions, for example, dental clinic, relatively small institutions, were used for the sample survey. Most of patients with dental caries were outpatients and their disease was treated at the dental hospital or dental clinic in general, therefore, main analysis was carried out at those institutions. Results : The rate of patients who suffered the dental caries has decreased to 56.8% in 2008 from 78.5% in 1990. The rate of patients who visited the dental hospital for treatment has increased to 4.8% in 2008 from 0.5% in 1990, whereas the percentage of those who visited the dental clinic has fallen to 97.9% from 99.5% during the same period. The ratio by age, in the meantime, it showed that patients aged 40s has increased to 13.5% in 2008 from 7.2% in 1990, and the number also has risen in 50s from 5.6% in 1990 to 9.9% in 2008. However, the number of children aged 0 to 9 who visited hospital for treatment of dental caries has fallen to 17.0% in 2008 from 33.9% in 1990. Conclusions : By figuring out the trends of patients with the dental caries during the period between 1990 and 2008, fundamental data for the oral health policy have been collected. As a result, the necessity of a new medical treatment system for managing the dental caries in terms of patient ages as well as the oral health policy and campaign was taken into consideration.

• Tuberculosis and Respiratory Diseases
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• 제70권4호
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• pp.307-314
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• 2011

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability worldwide and one of the most prevalent diseases in Korea. We examined trends and risk factors of health care utilization for COPD in Korea. Methods: We retrospectively analyzed the database of Patient Surveys from 1990 through 2008, which were nationwide surveys of health services utilization through outpatient department (OPD) visits and hospitalization. Physician-diagnosed COPD patients whose ages were 45 years and older were included. Results: OPD visits and hospitalization of COPD patients between 1990 and 2008 were estimated to be 68,552 and 17,774 persons, respectively. Trends in OPD visits and hospitalization for COPD significantly increased from 1990 through 2008 (p=0.019, p=0.001, respectively). The increment rate for OPD visits was 2.0 fold over those years; for hospitalization it was 3.3 fold. Risk factors for OPD visits for COPD were male gender (odd ration [OR], 1.41; 95% confidence interval [CI], 1.39~1.43), those aged 65 years and older (OR, 1.50; 95% CI, 1.47~1.53), residential area other than a metropolis (OR, 1.08; 95% CI, 1.07~1.010) and access to a physician's office (OR, 1.17; 95% CI, 1.14~1.21). Risk factors for hospitalization were male gender (OR, 2.15; 95% CI, 2.07~2.23), those aged 65 year and older (OR, 2.86; 95% CI, 2.72~3.00), residential area other than a metropolis (OR, 1.98; 95% CI, 1.90~2.07) and access to a hospital (OR, 2.88; 95% CI, 2.59~3.22) (p<0.001, both). Conclusion: Health care utilization for COPD subjects increased from 1990 to 2008. Risk factors for the utilization were male gender, older age, and residential area other than a metropolis.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권3호
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• pp.187-193
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• 2024

Background: Patients with autism spectrum disorder (ASD) present challenges in dental treatment cooperation owing to deficits in communication skills and social interaction. Behavioral guidance, sedation, and general anesthesia may be employed to ensure the quality of dental care for individuals with ASD. This study aimed to examine the trends in dental treatment for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital, an oral health center for the disabled in the Gyeonggi region, over the past 10 years. Methods: This study utilized the order communication system to gather data on sex, age, cooperation level, number of quadrants treated, and administration of sedation or general anesthesia for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital between January 2013 and December 2022. Results: The total number of patients with ASD increased annually, possibly due to an increase in ASD prevalence and the hospital's designation as a center for disabled oral health. General anesthesia was predominant before 2017, with a shift towards N₂O-O₂ sedation. The most common age group for sedation or general anesthesia was 6-9 years, with a higher prevalence in males than in females. Notably, N₂O-O₂ and midazolam sedation resulted in better cooperation and fewer treated teeth than general anesthesia. Conclusion: This study highlights the evolving trends in dental treatment for individuals with ASD, indicating a shift towards outpatient methods, particularly N₂O-O₂ sedation. The sex distribution aligns with national statistics, emphasizing a higher prevalence of ASD in males than in females. These findings underscore the need for further research to establish evidence-based guidelines for optimal dental care strategies tailored to the unique needs of individuals with ASD.

• Journal of Microbiology and Biotechnology
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• 제26권1호
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• pp.145-150
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• 2016

In order to perform an epidemiological characterization of opportunistic mycosis infections, we collected health insurance data between the years 2006 and 2010 from the Health Insurance Corporation and analyzed the data to determine the prevalence of opportunistic mycoses and treatment management of opportunistic mycoses. The prevalence within the study increased consecutively by 0.02% to 0.12% every year. The annual prevalence of opportunistic mycoses increased from 2.437% in 2006 to 2.709% in 2010. The average annual prevalence was 2.605%. Candidiasis occurred the most frequently, followed by aspergillosis, zygomycosis, and cryptococcosis. The regions with the highest incidences were the capital areas, Gyeonggi and Seoul. By sex, the prevalence in females (4.851%) was 14 times higher than that in males (0.352%). Interestingly, the adults from the 20- to 49-year-old age group showed higher prevalence than children and the elderly. The average duration of hospitalized treatment was 17.31 days and of outpatient treatment was 2.21 days; 3,577 hundred million won was used in total for medical expenses. This study provides useful data to study trends of opportunistic mycoses.

• 한방재활의학과학회지
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• 제24권1호
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• pp.55-63
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• 2014

Objectives The aim of this study was to offer the fundamental data for the physical therapies of Korean medicine through analyse the database of one university hospital. Methods As this study was retrospective analysis, following items were selected and analysed in the electronic medical record (EMR) database. (1) sex, (2) inpatient or outpatient, (3) medical department, (4) diagnosis, (5) kind of insurance. Results Although all kind of physical therapies were used, interferential current therapy (ICT) was the most used physical therapy. And department of rehabilitation medicine of Korean medicine prescribed physical therapies most among the 8 specialty departments. As physical therapies were used in various kinds of diseases, they were especially used in musculoskeletal diseases and nervous system diseases. Conclusions The analysis of actual condition of using physical therapies in a real clinical setting of Korean medicine could be a useful fundamental data for the application of modernized physical therapies.

• 보건의료산업학회지
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• 제5권4호
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• pp.177-192
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• 2011

The arguments exist that private health insurance(PHI) policy holders tend to use the health care services more than non-policy holders due to their little out-of-pocket spending, resulting in the adverse effects on the finances of National Health Insurance. This study aims to increase the objective understanding of the issue and to draw a direction of further research, by reviewing the articles, reports and statistics which examined the effects of purchasing PHI policies on health care utilization. Significant differences in healthcare utilization, except for the very partial increase of utilization in outpatient settings, have been not found. The similar trends of the results have existed in a few previous studies which tried to control the endogeneity of medical use and health insurance with latent variables which affect the decision on medical use and health insurance. However, we can not exclude the potential change of healthcare utilization patterns because the portion of the insured of indemnity PHI is becoming rapidly larger in the market. For further research, we should try to obtain the objective information of subjects' past medical history, health status, health related behavior, and income affecting purchase of PHI and utilization of healthcare services. And the efforts of controlling the endogeneity of medical use and health insurance with latent variables which affect the decision on medical use and health insurance, are very considerable.

• 보건행정학회지
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• 제27권3호
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• pp.199-210
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• 2017

Background: This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2015 constructed according to the SHA2011, which is a new manual of System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analysing health accounts of OECD member countries. Particularly, financing public-private mix is parsed in depth using SHA data of both HF as financing schemes as well as FS (financing source) as their revenue types. Methods: Data sources such as Health Insurance Review and Assessment Service's publications of both motor insurance and drugs are newly used to construct the 2015 National Health Accounts. In the case of private financing, an estimation of total expenditures for revenues by provider groups is made from the Economic Census data; and the household income and expenditure survey, Korean healthcare panel study, etc. are used to allocate those totals into functional classifications. Results: CHE was 115.2 trillion won in 2015, which accounts for 7.4 percent of Korea's gross domestic product. It was a big increase of 9.3 trillion won, 8.8 percent, from the previous year. Government and compulsory schemes's share (or public share) of 56.4% of the CHE in 2015 was much lower than the OECD average of 72.6%. 'Transfers from government domestic revenue' share of total revenue of HF was 17.8% in Korea, lower than the other contribution-based countries. When it comes to 'compulsory contributory health financing schemes,' 'Transfers from government domestic revenue' share of 14.9% was again much lower compared to Japan (44.7%) and Belgium (34.8%) as contribution-based countries. Conclusion: Considering relatively lower public financing share in the inpatient care as well as overall low public financing share of total CHE, priorities in health insurance coverage need to be repositioned among inpatient care, outpatient care and drugs.

• Journal of Preventive Medicine and Public Health
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• 제53권2호
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• pp.82-88
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• 2020

Objectives: The objective of this study was to identify individual and institutional factors associated with the prescription of systemic steroids in patients with acute respiratory infections and to investigate the role of a policy measure aimed to reduce inappropriate prescriptions. Methods: We used data from the National Health Insurance Service-National Sample Cohort from 2006 to 2015 and focused on episodes of acute respiratory infection. Descriptive analysis and multiple logistic regression analysis were performed to identify individual-level and institution-level factors associated with the prescription of systemic steroids. In addition, steroid prescription rates were compared with antibiotic prescription rates to assess their serial trends in relation to Health Insurance Review and Assessment Service (HIRA) Prescription Appropriateness Evaluation policy. Results: Among a total of 9 460 552 episodes of respiratory infection, the steroid prescription rate was 6.8%. Defined daily doses/1000 persons/d of steroid increased gradually until 2009, but rose sharply since 2010. The steroid prescription rate was higher among ear, nose and throat specialties (13.0%) than other specialties, and in hospitals (8.0%) than in tertiary hospitals (3.0%) and other types of institutions. Following a prolonged reduction in the steroid prescription rate, this rate increased since the HIRA Prescription Appropriateness Evaluation dropped steroids from its list of evaluation items in 2009. Such a trend reversal was not observed for the prescription rate of antibiotics, which continue to be on the HIRA Prescription Appropriateness Evaluation list. Conclusions: Specialty and type of institution are important correlates of steroid prescriptions in cases of acute respiratory infection. Steroid prescriptions can also be influenced by policy measures, such as the HIRA Prescription Appropriateness Evaluation policy.