• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.1
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• pp.32-36
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• 2014

Preoperative surgical simulation in orthognathic surgery has progressed in recent years; the movement of the mandible can be anticipated through three-dimensional (3D) simulation surgery before the actual procedure. In this case report, the mandible was moved to the intended postoperative occlusion through preoperative surgical 3D simulation. Right-side condylar movement change was very slight in the surgical simulation, suggesting the possibility of mandibular surgery that included only left-side ramal osteotomy. This case report describes a patient with a mild asymmetric facial profile in which the mandibular menton had been deviated to the right and the lips canted down to the left. Before surgery, three-dimensional surgical simulation was used to evaluate and confirm a position for the condyle as well as the symmetrical postoperative state of the face. Facial asymmetry was resolved with minimal surgical treatment through unilateral intraoral vertical ramus osteotomy on the left side of the mandible. It would be a valuable complement for the reduction of the surgical treatment if one could decide with good predictability when an isolated intraoral vertical ramus osteotomy can be done without a compensatory osteotomy on the contralateral side.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1024-1037
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• 2020

The resource-based relative value scale (RBRVS) compares the value of a medical practice to the consumption of resources, which consist of the work of the physician, practice expenses, and professional liability insurance. At the time of the 2nd revision of RBRVS, the fee for radiological examinations had been reduced due to the high preservation rate. In RBRVS, practice expenses account for most of the compensation of radiological examinations, and physicians' work is relatively undervalued. A new healthcare policy (Moon Jae-In care) consists of the expansion of the National Health Insurance (NHI) coverage, reduction of patient charges for the vulnerable class, and support for catastrophic medical expenses. However, Moon Jae-In care is expected to negatively affect the NHI in Korea financially. The expansion of the insurance coverage for ultrasonography and MRI examinations is a significant part of the Moon Jae-In care, and radiological societies should establish fair compensations for physicians' work within the field of radiology while implementing the Moon Jae-In care.

• Quality Improvement in Health Care
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• v.15 no.2
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• pp.121-130
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• 2009

Objectives : To evaluate the effect of heath examination program which introduce web-based input system, OCS(Order communicating system) and interface with national health insurance corporation, this study was done. Method : To Exam/Order and tests separately at anytime, the experimental health examination program which had web-based questionnaire input system, on-line measurement input system, interface program with national health insurance corporation and introduced OCS was developed. Experiment and old examination program were compared in terms of satisfaction and cost. Result : The 95.7% of respondents were satisfied with web-based input system, the 95.4% satisfied with OCS use, and 97.8% satisfied with test at anytime they want. The cost and time reduction between experiment and old program were 4,159,000won and $600.3{\pm}5.75$(seconds) per man input-time. Conclusion : The experimental health examination program is good for employee and hospital. If the health examination program for non-employee will be developed, it will be done efficiently and effectively, but Internet securities will be considered.

• Health Policy and Management
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• v.30 no.1
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• pp.15-25
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• 2020

While healthcare data sets include extensive information about patients, many researchers have limitations in analyzing them due to their intrinsic characteristics such as heterogeneity, longitudinal irregularity, and noise. In particular, since the majority of medical history information is recorded in text codes, the use of such information has been limited due to the high dimensionality of explanatory variables. To address this problem, recent studies applied word embedding techniques, originally developed for natural language processing, and derived positive results in terms of dimensional reduction and accuracy of the prediction model. This paper reviews the deep learning-based natural language processing techniques (word embedding) and summarizes research cases that have used those techniques in the health care field. Then we finally propose a research framework for applying deep learning-based natural language process in the analysis of domestic health insurance data.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.1
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• pp.31-34
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• 2009

Purpose: This study compared the frequency of postoperative infections in patients for a closed mandibular fracture with that without the postoperative antibiotic prophylaxis. Patients and Methods: 48 patients without any specific medical history were divided into two groups depending on whether or not antibiotics had been applied after the surgery. The 24 patients in group 1 received only a second-generation cephalosporin ($Cefotetan^{(R)}$) intravenously from admission to immediate after the surgery. Likewise, 24 patients in group 2 received 1.0g of $Cefotetan^{(R)}$ twice daily longer than the third day after surgery. The mean (SD) duration of antibiotics administration after surgery was 6.9 (${\pm}3.56$). The patients were evaluated after surgery for any postoperative infections according to the criteria: purulent drainage from a wound, spontaneous wound dehiscence accompanied by swelling, pain, and fever around the wound. Results: Postoperative infections were encountered in 2 out of 24 patients in group 1, who received antibiotic medication until shortly after surgery, and in 3 out of the 24 patients in group 2, in whom the medication was continued even after the surgery. There was no sig nificant difference in the incidence of postoperative infections between the two groups. Conclusion: From this study, postoperative use of antibiotics seems to be unnecessary with view of the little significance of the factors that could affect the wound infection.

• Journal of Preventive Medicine and Public Health
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• v.56 no.2
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• pp.145-153
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• 2023

Objectives: Although it is difficult to define the quality of stroke care, acute ischemic stroke (AIS) patients with moderate-to-severe neurological deficits may benefit from thrombectomy-capable hospitals (TCHs) that have a stroke unit, stroke specialists, and a substantial endovascular thrombectomy (EVT) case volume. Methods: From national audit data collected between 2013 and 2016, potential EVT candidates arriving within 24 hours with a baseline National Institutes of Health Stroke Scale score ≥6 were identified. Hospitals were classified as TCHs (≥15 EVT case/y, stroke unit, and stroke specialists), primary stroke hospitals (PSHs) without EVT (PSHs-without-EVT, 0 case/y), and PSHs-with-EVT. Thirty-day and 1-year case-fatality rates (CFRs) were analyzed using random intercept multilevel logistic regression. Results: Out of 35 004 AIS patients, 7954 (22.7%) EVT candidates were included in this study. The average 30-day CFR was 16.3% in PSHs-without-EVT, 14.8% in PSHs-with-EVT, and 11.0% in TCHs. The average 1-year CFR was 37.5% in PSHs-without-EVT, 31.3% in PSHs-with-EVT, and 26.2% in TCHs. In TCHs, a significant reduction was not found in the 30-day CFR (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.76 to 1.12), but was found in the 1-year CFR (OR, 0.84; 95% CI, 0.73 to 0.96). Conclusions: The 1-year CFR was significantly reduced when EVT candidates were treated at TCHs. TCHs are not defined based solely on the number of EVTs, but also based on the presence of a stroke unit and stroke specialists. This supports the need for TCH certification in Korea and suggests that annual EVT case volume could be used to qualify TCHs.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.19 no.1
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• pp.51-63
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• 2009

In the field of ergonomics, it is evident that participatory action research methodology could contribute to reduce risk factors of work related musculoskeletal disorders(WMSDs). The objective of this study was to evaluate the effectiveness of a participatory ergonomics in reducing the incidence rate and severity of WMSDs in the tire manufacturing company. In this study, an action committee comprising 13 members was organized in the tire manufacturing company. The action group participated at every research process, education and training, assessment and intervention of risk factors, and early detection and management of WMSDs during the 3 years(2004-2006). The prevention programs contributed to an overall reduction in incidence rate by approximately 37.2%, and lost workdays and workers' compensation costs by approximately 55.1%. But, the incidence rate increased 29.0%, and compensation costs increased 59.0% in the first-year setting programs, and both the incidence rate and compensation costs decreased after the second-year managing programs. And, the reduction rates(63.2%) of insurance cases is higher than that(9.7%) of non-insurance cases. The results showed that participatory ergonomics programs may be effective in reducing the incidence and severity rate of WMSDs.

• The Korea Journal of Herbology
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• v.24 no.4
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• pp.17-23
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• 2009

Objectives : This study aimed to provide basic data for future policies regarding the expansion of health insurance, through investigating the current status of Oriental herbal medicine insurance as perceived by the public. Methods : Questionnaire was developed through literature searches, in-depth interviews, item generation and item reduction. The questionnaires were further refined by a focus group. 221 surveys were retrieved from the general public. Results : The in-depth interviews, reveal that the public is aware of the various forms of Oriental herbal medicine formulas, except for the use of mixture of which are soluble granules covered by insurance. The public awareness of the soluble granules turned out to be so low that enhanced awareness of it is required. The public identified decoctions as the most preferred formula as well as the most effective formulas out of all Oriental herbal medical formulas. They also suggested that it should be the first to be included when the insurance policy expands in the future. The public had frequent experienced not choosing Oriental herbal prescription due to the high cost. Insurance coverage of Oriental herbal prescription is much needed. The public indicated that they will make frequent visits to the KMD if the insurance covers Oriental herbal prescriptions. Conclusions : The current status quo of Oriental herbal medicine insurance showed that the public identified decoctions as the most preferred, most effective and the top priority to be covered by insurance.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.4
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• pp.327-334
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• 2021

A transparotid approach, with a retromandibular or preauricular incision, is an alternative surgical approach for treating a subcondylar fracture and reducing the potential for complications such as injury to the facial nerves. However, retromandibular and preauricular incisions are both created far away from the parotid gland-dissection area. Thus, it is necessary to undermine the skin and retract it anteriorly to access the surgical field. Here, we introduce a modified approach wherein the incision allows for direct access to the fracture site. This approach may be adopted to shorten the incision length, reduce the retraction trauma at the surgical site, and help prevent injury to the facial nerve.

• Journal of Preventive Medicine and Public Health
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• v.53 no.2
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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.