• The Journal of Pediatrics of Korean Medicine
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• v.28 no.3
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• pp.17-30
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• 2014

Objectives The purpose of this study is to report the effectiveness of Korean medicine treatment on 69 infant and young child atopic dermatitis patients. Methods 69 infants and young child atopic dermatitis patients who had visited oriental medical clinics from 2011.1.9 to 2012.1.31 were studied. All of them were continually treated for 3 to 9 months, and were analyzed by Objective SCORAD Index (OSI). A detailed analysis of OSI was done according to gender, age, using of topical steroid ointment, family history of atopic disease, treatment period, and intensity. Results 1. Male and female percentage of the study group was 56.5%: 43.5%. The average period of treatment was 6.09 months. 71.0% used topical steroid ointment, and 65.2% had family history of atopic disease. 2. The average period of treatment was significantly longer in patients who used topical steroid ointment, or who had family history of atopic disease. 3. 95.7% of total patients reported decrease in OSI score at the final visit. OSI was significantly lowered after 3, 6, and 9 months of treatment. The longer period of treatment, the lower average post-treatment OSI. 4. 85.5% of the study group had severe dermatitis, and 14.5% was moderate case based on the OSI intensity assessment at initial visit. These percentages got changed at the final visit as 34.8% of severe, 58.0% of moderate, and 7.2% of mild cases. The average treatment period of patients who were diagnosed as severe at the initial visit was 6.18 months, and their final OSI improvement rate was 39.58%. 58% of them were improved to be mild or moderate at the final visit. Conclusion The Korean medicine treatment is effective in treating infant and young child atopic dermatitis patients. There was significant decrease in OSI score after 3, 6, and 9 months of treatment. The difference increase with the treatment period.

• Journal of Korea Entertainment Industry Association
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• v.15 no.7
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• pp.235-247
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• 2021

The purpose of this study was to examine whether the motivation for visiting experiential tourism can be maximized by revitalization of domestic tourism according to tourist image and visit satisfaction. In order to achieve this purpose, the four factors of educational motive, experiential motive, cultural motive, and communion motive of experiential tourists who visited domestic experiential tourist destinations, as well as the image of tourist destination, and suggestions for revitalizing domestic tourism through visit satisfaction were proposed. Therefore, the implications of this study are as follows. First, theoretical significance can be found by establishing the concept of domestic experience tourists' visit motives, image of tourist destinations and results related to visit satisfaction in the COVID-19 according to this study. It suggests that it is an essential condition for promoting a new change in which tourists participate in experiential tourism motives in the era of the pandemic by providing experiential tourism programs that are tailored to the level of tourists through research on the image of tourist destinations and their satisfaction with their visit motives. are giving Second, in terms of experiential tourism programs operated by domestic experiential tourism companies, it should be possible to promote the image of a safe tourist destination utilizing the characteristics of untact services that can provide non-face-to-face services. In addition, in an environment where visits to experiential tourism activities are somewhat limited in the era of the pandemic corona, it will help to revitalize domestic tourism and the local economy by expanding the non-face-to-face service to discover and develop direct experience programs in the region.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.10 no.1
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• pp.5-14
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• 2003

Recently, there has been an increasing need for long-term care and comprehensive health care services in community settings. The Ministry of Health and Welfare introduced the Hospital-Based Home Nursing Care Program in 2000. Before this initiative, there was a Home Nursing Demonstration Center, affiliated with the Seoul Nurse Association, had offered home nursing services with the financial support from the local government. since 1993, the Center's nursing staff has been engaged in a general hospital in an effort to provide home nursing care services within Korea's health care system. The purpose of this study was to analyze and identify characteristics of community-based home nursing care supplied by a community-based home nursing team engaged in a general hospital. Also. visit nursing care services provided by public health centers were evaluated in terms of accessibility and supply versus demand, to enhance the accessibility of low-income patients living in Seoul to home nursing care services. Data were collected from home nursing insurance reimbursement claims submitted by the community-based home nursing care team from March 1 to October 30 in 2001 and a questionnaire survey on home-visit nursing services of 25 public health centers in Seoul. The subjects consisted of 197 patients and 12 public health centers. The result were as follows. First, medical institution's community-based home nursing care program was better in technical quality than health-center-based home-visit nursing care. In addition. the pattern of the subject patients was similar to that of hospital-based home nursing care program. Second, there was a high demand for community-based home nursing care while only a small number of home-visiting nurses served at public health centers in Seoul. As a result, many patients could not receive adequate care. Finally, we suggest that community-based home nursing care program should be introduced in the national health system to meet the at-home care needs of severely ill low-income patients. Furthermore, to better utilize home nursing and visit-nursing care resources and offer continued care for patients in community settings, an efficient referral network should be built among related institutions. This would require improvement of reimbursement system and amendment of the law related to health insurance system and community-based home nursing care services.

• Health Policy and Management
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• v.25 no.3
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• pp.185-196
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• 2015

Background: Issues concerning with the classification accuracy of Korean Outpatient Groups (KOPGs) have been raised by providers and researchers. The KOPG is an outpatient classification system used to measure casemix of outpatient visits and to adjust provider risk in charges by the Health Insurance Review & Assessment Service in managing insurance payments. The objective of this study were to refine KOPGs to improve the classification accuracy and to evaluate the refinement. Methods: We refined the rules used to classify visits with multiple procedures, newly defined chemotherapy drug groups, and modified the medical visit indicators through reviews of other classification systems, data analyses, and consultations with experts. We assessed the improvement by measuring % of variation in case charges reduced by KOPGs and the refined system, Enhanced KOPGs (EKOPGs). We used claims data submitted by providers to the HIRA during the year 2012 in both refinement and evaluation. Results: EKOPGs explicitly allowed additional payments for multiple procedures with exceptions of packaging of routine ancillary services and consolidation of related significant procedures, and discounts ranging from 30% to 70% were defined in additional payments. Thirteen chemotherapy drug KOPGs were added and medical visit indicators were streamlined to include codes for consultation fees for outpatient visits. The % of variance reduction achieved by EKOPGs was 48% for all patients whereas the figure was 40% for KOPGs, and the improvement was larger in data from tertiary and general hospitals than in data from clinics. Conclusion: A significant improvement in the performance of the KOPG was achieved by refining payments for visits with multiple procedures, defining groups for visits with chemotherapy, and revising medical visit indicators.

• Journal of agricultural medicine and community health
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• v.44 no.1
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• pp.28-38
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• 2019

Objectives: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in South Korea. Method: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in Korea. Results: There are three types of home care nursing in Korea. Public health center provides home visit nursing to vulnerable population by registered nurses for free, based on community health act in public health center. As of 2017, 1,261,208 people were enrolled in the visiting health program of public health center. Health behavior and disease management has been improved and showed having cost-benefit effect among the enrolled people in visiting health program. Visiting nursing care in long-term care services is provided by registered nurses or nurse aid, based on long-term care act. The cost is paid as the unit price according to service time. 1,095,764 older people used long-term care services in 2017, only 0.2% of total cost used for home visiting nursing. Even though the number of user of home visiting nursing, it was reported that users spent less medical cost and hospitalized shorter. Hospital-based home care nursing is provided to patients and their families under the prescription of a doctor by family nurse specialists who are employed by medical institute based on medical law. Four hundred sixty family nurse specialists worked for hospital-based home care nursing and hospital-based home care services accounted for 0.038% of total medical expenses in 2017. Conclusion: Even though home visit nursing care services are different in aspect of legal basis, personnel, running institutes, and cost basis, home visit nursing care showed cost-benefit effect and good health outcomes. In order to advance home visit nursing care, the integrated home visiting care, improvement of working condition, and revision of legal basis should be considered.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.3
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• pp.168-174
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• 2016

Purpose: The management and clinical course in pediatric patients who had ingested foreign body were investigated retrospectively to evaluate the frequency and factor associated with successful removal of fishbone foreign body. Methods: Based on the medical records of patients younger than 15 years old who visited emergency room because of foreign body ingestion from January 1999 to December 2012, the authors reviewed clinical characteristics including type of ingested foreign bodies, time to visits, managements and complications. Results: Fishbone (50.1%) was the most common ingested foreign body in children. Among 416 patients with ingested fishbone, 245 (58.9%) were identified and removed using laryngoscope, rigid or flexible endoscope from pharynx or upper esophagus by otolaryngologists and pediatric gastroenterologists. The kind of ingested fish bone in children was diverse. The mean age of identified and removed fishbone group was 7.39 years old, and higher than that of unidentified fishbone group (5.81 years old, p<0.001). Identified and removed fishbone group had shorter time until hospital visit than the unidentified fishbone group (2.03 vs. 6.47 hours, p<0.001). No complication due to ingested fishbone or procedure occurred. Conclusion: Older age and shorter time from accident to hospital visit were the different factors between success and failure on removal of ingested fish bone in children.

• Journal of the Korean Institute of Landscape Architecture
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• v.26 no.1
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• pp.1-11
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• 1998

The purpose of this paper is twofold : to identify loyalty applicable to segmentation of theme park users and to find characteristics of the segments. Thetheme park was regarded as a product and Lotte World was regarded as a brand. One hundred thirty five college students were selected by nonprobability sampling for two waves thirty of data collection. Both behavioral and attitudinal dimension of loyalty were measured in the first wave by the proportion of visit of the Lotte World to 3 major theme parks for one year, including the Lotte World, and by calculating the mean score of selected 7 attitudinal items, respectively. After 14 weeks, the same respondents were asked the number of actual visits of the Lotte World. Medians of two dimensions and cluster analyses were utilized to classify the respondents into 4 categories : high, spurious, latent, and low loyalty. Then ANOVA and $$\chi$^2$ test of independence were conducted to find the difference in intention to visit the Lotte World and actual visitation of it among groups. Only intention was significantly different by the group and the mean score of intention was highest in the high loyalty group. Although no statistical difference was found in actual visitation among groups, the theory of planned behavior provided a theoretical support to conclude that the loyalty is a useful variable for segmentation of theme park users because intention is an antecedent variable to the behavior. Discriminant analyses showed that characteristics of each loyalty group can be differentiated by motivations and constraints. When median was a group classification criterion, 73.2 percent of high loyalty group was correctly classified. A few comments were suggested on data collection, and inclusion of new discriminant variables was discussed for the future research.

• Health Policy and Management
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• v.21 no.3
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• pp.397-413
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• 2011

Purpose: The purpose of this study is to examine the relationship between the income level and the healthcare utilization by health insurance type in all cancer patients in year 2005. Methods: The target population was cancer patients with health insurance who used healthcare as a diagnosis code (C00-C97) from January 1 to December 31 of 2005. The Korea Central Cancer Registry Center's Cancer Patient Registry Data, the list of cancer patients of the National Health Insurance Corporation, and the claim data of the Health Insurance Review & Assessment Service were used. The I was the wealthiest, followed by II, III, IV. The V was the poorest in this study. For the analysis, the $x^2$-test, ANOVA (and Kruskal-Wallis test), and regression were used. Results: Outpatient and hospitalization medical expenses, and outpatient visit days of cancer patients with self-employed health insurance were highest in I (p<.001, respectively), and the hospitalization days were the highest in II (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days of cancer patients with occupational health insurance were the highest in I (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days in cancer patients were higher in I compared to V, and higher in II and III, IV compared to V (p<.001, respectively). Conclusion: Supporting plan for cancer patients' outpatient healthcare utilization are necessary. Moreover, we should make specialized strategy for low income cancer patients with self-employed health insurance when we develop quality improvement policy for inpatient service.

• Korea Journal of Hospital Management
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• v.22 no.1
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• pp.1-9
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• 2017

Purpose : Many studies showed that having a usual source of care improved the efficient access of healthcare service. However in Korea there have been few studies on the usual source of care. So this study aims to find whether having a usual source of care affect the medical utilization and expense. Methodology/Approach : We used the Korean Health Panel data in 2012, 2013 to examine the change of utilization and expenses in ambulatory care affected by having a usual source of care. We selected 1,215 hypertension patients without usual source of care in 2012 and performed linear regression analysis to identify the difference between treatment group(with usual source of care in 2013) and control group(without usual source of care in 2013). Then we performed analysis again separated by the age group. Findings : Among study population, 711(58.5%) reported that they have a usual source of care in 2013. Treatment group reported 1.85 less increase in outpatient visits and 69,234 won less increase in expense than control group with weak significance(visit ${\beta}$ -1.85 p-value 0.0807, expense ${\beta}$ -69,234 p-value 0.0541). People under the age of 65 showed significant change in outpatient visits for tertiary hospital (visit ${\beta}$ -0.78 p-value 0.0154, expense ${\beta}$ -91,462 p-value 0.0168). The analysis which focused outpatient for mild disease showed similar trend. Practical Implications : This study supports the positive effect of having usual source of care which decrease inefficient outpatient utilization. Promoting physician-patient relationships is important for efficiency of healthcare service.

• The Korean Journal of Pain
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• v.30 no.3
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• pp.214-219
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• 2017

Background: As herpes zoster progresses via postherpetic neuralgia (PHN) to well-established PHN, it presents its recalcitrant nature to the treatment. At this point, the well-established PHN is fixed as a non-treatable, but manageable chronic painful neuropathic disorder. This study evaluated the incidence of complete relief from PHN according to PHN duration at their first visit, and the other factors influencing it. Methods: A retrospective chart review was performed on patients with PHN at a university-based pain clinic over 7 years. The responders were defined as patients who had complete relief from pain after 1 year of active treatment. Age, sex, PHN duration at their first visit, dermatomal distribution, and underlying disorders were compared in the responder and non-responder groups. Responders were also compared according to these factors. Results: Among 117 PHN patients (M/F = 48/69), 35 patients (29.9%) had complete relief from PHN. Mean ages were $64.3{\pm}10.6$ and $66.9{\pm}10.7$ years, numbers of male to female patients were 11/24 and 37/45, and mean durations of PHN at their first visit were $8.5{\pm}6.3$ and $15.3{\pm}10.7$ months in the responder and non- responder groups, respectively. In addition, PHN patients who visited the clinic before 9 months showed a better result. Dermatomal distribution and underlying disorders did not show significant differences. Conclusions: Almost 30% of PHN patients received complete relief. Those who sought treatment in a pain clinic before 9 months received a better result.