• Title/Summary/Keyword: Propensity-score matching

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Clinical Outcomes Associated with Degree of Hypernatremia in Neurocritically Ill Patients

  • Yun Im, Lee;Joonghyun, Ahn;Jeong-Am, Ryu
    • Journal of Korean Neurosurgical Society
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    • v.66 no.1
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    • pp.95-104
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    • 2023
  • Objective : Hypernatremia is a common complication encountered during the treatment of neurocritically ill patients. However, it is unclear whether clinical outcomes correlate with the severity of hypernatremia in such patients. Therefore, we investigated the impact of hypernatremia on mortality of these patients, depending on the degree of hypernatremia. Methods : Among neurosurgical patients admitted to the intensive care unit (ICU) in a tertiary hospital from January 2013 to December 2019, patients who were hospitalized in the ICU for more than 5 days and whose serum sodium levels were obtained during ICU admission were included. Hypernatremia was defined as the highest serum sodium level exceeding 150 mEq/L observed. We classified the patients into four subgroups according to the severity of hypernatremia and performed propensity score matching analysis. Results : Among 1146 patients, 353 patients (30.8%) showed hypernatremia. Based on propensity score matching, 290 pairs were included in the analysis. The hypernatremia group had higher rates of in-hospital mortality and 28-day mortality in both overall and matched population (both p<0.001 and p=0.001, respectively). In multivariable analysis of propensity score-matched population, moderate and severe hypernatremia were significantly associated with in-hospital mortality (adjusted odds ratio [OR], 4.58; 95% confidence interval [CI], 2.15-9.75 and adjusted OR, 6.93; 95% CI, 3.46-13.90, respectively) and 28-day mortality (adjusted OR, 3.51; 95% CI, 1.54-7.98 and adjusted OR, 10.60; 95% CI, 5.10-21.90, respectively) compared with the absence of hypernatremia. However, clinical outcomes, including in-hospital mortality and 28-day mortality, were not significantly different between the group without hypernatremia and the group with mild hypernatremia (p=0.720 and p=0.690, respectively). The mortality rates of patients with moderate and severe hypernatremia were significantly higher in both overall and matched population. Interestingly, the mild hypernatremia group of matched population showed the best survival rate. Conclusion : Moderate and severe hypernatremia were associated with poor clinical outcomes in neurocritically ill patients. However, the prognosis of patients with mild hypernatremia was similar with that of patients without hypernatremia. Therefore, mild hypernatremia may be allowed during treatment of intracranial hypertension using hyperosmolar therapy.

Effect of tranexamic acid on blood loss reduction in patients undergoing orthognathic surgery under hypotensive anesthesia: a single-center, retrospective, observational study

  • Keisuke Harada;Noritaka Imamachi;Yuhei Matsuda;Masato Hirabayashi;Yoji Saito;Takahiro Kanno
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.2
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    • pp.86-93
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    • 2024
  • Objectives: Orthognathic surgery is a surgical procedure performed by intraoral approach with established and safe techniques; however, excessive blood loss has been reported in rare cases. In response, investigative efforts to identify methods to reduce the amount of blood loss have been made. Among such methods, the administration of tranexamic acid was reported to reduce the amount of intraoperative blood loss. However, few studies to date have reported the effect of tranexamic acid in orthognathic surgery under hypotensive anesthesia. The present study aimed to investigate the effect of the administration of tranexamic acid on intraoperative blood loss in patients undergoing bimaxillary (maxillary and mandibular) orthognathic surgery under hypotensive anesthesia. Patients and Methods: A total of 156 patients (mean age, 27.0±10.8 years) who underwent bimaxillary orthognathic surgery under hypotensive anesthesia performed by the same surgeon between June 2013 and February 2022 were included in this study. The following data were collected from the medical records of each patient: background factors (age, sex, and body mass index), use of tranexamic acid, surgical procedures, previous medical history, duration of surgery, American Society of Anesthesiology physical status findings before surgery, intraoperative blood loss as a primary outcome, in-out balance, and blood test results. Descriptive statistics were calculated for statistical analysis, and a t-test and the chi-squared test were used for between-group comparisons. Group comparisons were performed after 1:1 propensity score matching to adjust for confounding factors. Statistical significance was set at P<0.05. Results: Comparison between the groups based on the use of tranexamic acid revealed a significant difference in operation time. Propensity score matching analysis revealed that intraoperative blood loss was significantly lower in the tranexamic acid group. Conclusion: The administration of tranexamic acid was effective in reducing intraoperative blood loss in patients undergoing bimaxillary orthognathic surgery under hypotensive anesthesia.

An Analysis of Policy Effects of Export Infrastructure Strengthening Program on Export of Food Distribution Companies (수출인프라강화사업이 식품유통기업 수출에 미치는 정책효과 분석)

  • Huang, Seong-Hyuk;Ji, Seong-Tae
    • Journal of Distribution Science
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    • v.16 no.1
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    • pp.87-99
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    • 2018
  • Purpose - The Export Infrastructure Strengthening Program(EISP) is a project to expand exports of agri-food products through providing customized export information to food distribution companies and supporting overseas information activities. A total of 39.6 billion won was provided by 2016. So, the purpose of this study is to analyze whether EISP is effective for expanding exports of agri-food products. Research design, data, and methodology - A simple average difference between the export performance of the policy beneficiaries and the non-policy beneficiaries can be biased if the export capacity or inherent characteristics of the enterprise are not taken into consideration. In order to solve the problem of such a bias, the propensity score matching(PSM) method has been employed in this study. PSM is a method of converting the characteristics of an export company into an index through logit analysis and then reducing the matching to one dimension to improve the accuracy of the performance measurement. Results - The balancing test was conducted to determine how the characteristics of the policy beneficiary group and the matched policy non-beneficiary group corresponded to each other. As a result of the test, we could not reject the null hypothesis that there was no difference between the two groups, so that after the matching, the two groups were similar and the explanatory variables were well controlled. Using the nearest neighbor matching with propensity score estimating through logit analysis, we estimated average treatment effect on the treated(ATT). The food companies participating the EISP had the effect of increasing the exports of $ 5.88 million. As a result, the number of export contracts increased by 11.77, the number of exporting countries by 7.52, the number of export items by 47.51, and the number of buyers' consultation by 3.50. And overseas marketing expenses increased by 35.92 million won. Except for the number of export contracts, other export performance results showed statistically significant results. Conclusions - As the EISP has a positive effect on the expansion of agro-food exports, efforts should be made to find out the limitations or problems of the policy in the future and to make a greater contribution to the increase of exports.

Analysis of Total Hospital Charges, Length of Stay, and Cost of Rehabilitation by Hospital and Stroke Type (의료기관별 뇌졸중 유형에 따른 진료비, 재원일수 이학요법료의 차이분석)

  • Kim, Sun-Mi;Kim, Da-Yang;Lee, Kwang-Soo
    • The Korean Journal of Health Service Management
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    • v.11 no.1
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    • pp.91-105
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    • 2017
  • Objectives : This study analyzed the differences in length of stay(LoS), total hospital charges(THC), and cost of rehabilitation(CoR) between two types of stroke patients, intracerebral hemorrhage(ICH) and cerebral infarction(CI). Factors associated with these differences were also assessed. Methods : Data were obtained from the 2011 National Inpatient Sample data of Health Insurance Review and Assessment Service. We used propensity score matching to match the characteristics of the two types of stroke patients, and conducted a regression analysis to analyze their associations. Results : The differences between THC, LoS, and CoR by stroke and hospital types were shown. Each type of hospital showed different results. Conclusions : A rapidly aging population will accelerate the number of stroke patients requiring effective management. Studies evaluating healthcare utilization of stroke patients will provide evidence for both healthcare resources allocation and healthcare policy decisions.

The Effect of Government Intervention on the Market Failure in firm Training in Korea (기업교육훈련에 대한 정부 개입과 그 효과)

  • Kim, Ahn-Kook
    • Journal of Labour Economics
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    • v.32 no.2
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    • pp.125-150
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    • 2009
  • This article analysed the effect of government intervention on the market failure in firm training in Korean. I used the Employment Insurance DB and the KISLINE DB and joined two data by the firm identification number 2004-2006 year. I estimated the effect of intervention of government by propensity score matching and difference-in-difference method to avoid of participation selection and endogeneity problem. The result is that government intervention on the firm training have made positive effect but it is not significant statistically. We have to investigate the market failure in firm training and to reassess the level of optimal firm training in Korea. After the study, the government intervention on the firm trainig will have to be rearranged.

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Assessment Model for Industrial Accidents Prevention Policy (산업재해 예방정책에 대한 평가모형)

  • Kim, Youngsun;Jo, Jinnam;Baik, Jaiwook
    • Journal of Applied Reliability
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    • v.17 no.1
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    • pp.38-49
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    • 2017
  • Purpose: The purpose of this study is to introduce the assessment model for industrial accidents prevention policy. Methods: 10 years of industrial accidents data are explored through EDA approach. Case control study is tried in order to assess the effectiveness of the measures taken by Korea Safety and Health Agency, Civilian, and 'Ministry of Employment and Labor'. Propensity score matching is used to match the characteristics of the two groups compared, and then case control study is again conducted. Next, logistic and Poisson regressions are used to assess the risk factors. Results: According to case control study involvement of 'Korea Safety and Health Agency' and 'Ministry of Employment and Labor' were not effective, but Civilian was. Propensity score matching leads to the same conclusion. Poisson regression reveals the impact of the risk factors on the industrial accidents. Industrial accidents occur more often as the number of employees grows. Mining, farming, fishing, 'transportation storage and telecommunication' and forestry have a higher level of industrial accidents but service industry has a lower level. It is odd that more involvement of Korea Safety and Health Agency, Civilian, and Ministry of Employment and Labor means more industrial accidents. Conclusion: 'Korea Safety and Health Agency', Civilian, and 'Ministry of Employment and Labor' seem to visit those industries with more industrial accidents.

An Empirical Study on the Effects of Public Procurement on the Productivity and Survivability of SMEs: Case of the Korean Mining and Manufacturing Sectors

  • CHANG, WOO HYUN
    • KDI Journal of Economic Policy
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    • v.39 no.1
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    • pp.1-18
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    • 2017
  • This paper empirically studies the effect of public procurement on small and medium-sized enterprises (SMEs) in the Republic of Korea using firm-level data. Public procurement, the purchase of goods and services from private firms by the public sector, is regarded as an important policy measure for providing support to firms, particularly SMEs. This study uses establishment-level panel data of the mining and manufacturing sectors from the Korean National Bureau of Statistics (Statistics Korea) and procurement history from the Korean Public Procurement Service to empirically estimate the effects of public procurement on firms' productivity (total factor productivity) and survivability. Using a propensity score matching estimation method, we find that participating firms showed higher productivity than non-participating ones in the control group only for the year of participation, that is, 2009. After two years, in 2011, they exhibited significantly lower productivity. In contrast, establishments that participated in public procurement for SMEs in 2009 were more likely to survive than those that did not do so in 2011. These results can be interpreted as the negative consequences of government intervention. The market's efficiency enhancement is hindered if underserving companies survive owing to government intervention but fail to improve efficiency.

Prognostic role of preoperative carcinoembryonic antigen levels in colorectal cancer: propensity score matching

  • Kim, Cho Shin;Kim, Sohyun
    • Journal of Yeungnam Medical Science
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    • v.34 no.2
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    • pp.216-221
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    • 2017
  • Background: This study was conducted to investigate preoperative carcinoembryonic antigen (CEA) as a prognostic factor in colorectal cancer. Methods: Between January 2000 and July 2011, 1298 patients with primary adenocarcinoma colorectal cancer without metastasis, who underwent curative resection were retrospectively identified. The patients were divided into two groups according to serum CEA level at primary diagnosis: a high CEA (HCEA) group (serum CEA ${\geq}6ng/mL$) and a normal CEA (NCEA) group (serum CEA <6 ng/mL). A 1:1 propensity score matching analysis was applied to reduce bias. Finally, 364 patients were enrolled in this study. Matched variables were age, gender, preoperative chemoradiotherapy, tumor site, cell differentiation and pathologic stage. Results: The clinicopathological characteristics of the two groups did not differ significantly difference. The systemic metastasis rate was 16.5% (30/182) and 25.3% (46/182) in the NCEA and HCEA groups, respectively (p=0.039). There were no significant differences in local recurrence or metastatic sites between groups. The 5-year disease-free survival (DFS) rate of the HCEA group was worse than that of the NCEA group; however, there was no significant difference in overall survival between the two groups. Conclusion: Elevated preoperative CEA was related to frequent systemic recurrence and low DFS. Therefore, elevated preoperative CEA could be considered a prognostic factor for worse clinical outcomes in patients with colorectal cancer.

The Impacts of Vocational Training on Earnings in Korea: Evidence from the Economically Active Population Survey (직업훈련의 임금효과 분석: 「경제활동인구조사」를 중심으로)

  • Yoo, Gyeongjoon;Kang, Changhui
    • KDI Journal of Economic Policy
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    • v.32 no.2
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    • pp.27-53
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    • 2010
  • This paper examines whether and how much vocational training raises an individual's earnings in Korea, using the Economically Active Population Survey. To overcome endogeneity of training, we apply fixed-effects and propensity-score matching (PSM) methods. Fixed-effects (PSM) results suggest that work-related training received in the previous one year increases a worker's monthly earnings by 2.6 to 4.7 (7.5 to 9.8) percent. Taken altogether, work-related training enhances a worker's earnings by a minimum of 2.6 and a maximum of 9.8 percent in Korea.

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Difference in Length of Stay and Treatment Outcome of Pulmonary Tuberculosis Inpatients between Health Insurance Types (의료보장유형에 따른 폐결핵 입원환자의 재원기간과 치료결과 차이분석)

  • Kim, Sang Mi;Lee, Hyun Sook;Hwang, Seul ki
    • Korea Journal of Hospital Management
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    • v.21 no.4
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    • pp.45-54
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    • 2016
  • The purpose of this study is to identify patient and hospital characteristics with pulmonary tuberculosis and to analyze factors which were influencing length of stay and treatment. The Korean National Hospital Discharge In-depth Injury Survey database from 2006 to 2012 was used for analysis. Study subjects were 4,704 patients and analyzed by using frequency, chi-square and logistic regression through using STATA 12.0. To avoid selection bias, we used propensity score matching. Analysis results show that the length of stay and treatment of pulmonary tuberculosis was different between insurance types. Patients characteristic(female, comorbidity, admission by outpatient department, medical insurance type) and hospital characteristic(500-999 beds, over 1000 beds) significantly influence length of stay. Admission by outpatient department and over 1000 beds are significantly influence treatment. Based on these findings, it is necessary to clarify between length of stay and treatment outcome by medical aids beneficiaries and audit hospitals follow discharge guidelines in pulmonary tuberculosis patients.