• Journal of Preventive Medicine and Public Health
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• v.53 no.6
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• pp.455-464
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• 2020

Objectives: The distribution of hospitals in Korea is unbalanced in terms of accessibility. Many local public health centers (PHCs) exempt out-of-pocket payments (OOPs) based on local government laws to increase coverage. However, this varies across administrative regions, as many make this exemption for the elderly, while others do not. This study aimed to evaluate the effects of the OOP exemption at local PHCs among elderly individuals. Methods: This study used online data on Korean national law to gather information on individual local governments' regulations regarding OOP exemptions. Individual-level data were gathered from the 2018 Community Health Survey and regional-level data from public online sources. Results: The study analyzed 132 regions and 44 918 elderly people. A statistical analysis of rate differences and 2-level multiple logistic regression were carried out. The rate difference according to whether elderly individuals resided in areas with the OOP exemption was 1.97%p (95% confidence interval [CI], 1.07 to 2.88) for PHC utilization, 1.37%p (95% CI, 0.67 to 2.08) for hypertension treatment, and 2.19%p (95% CI, 0.63 to 3.74) for diabetes treatment. The regression analysis showed that OOP exemption had an effect on hypertension treatment, with a fixed-effect odds ratio of 1.25 (95% CI, 1.05 to 1.48). Conclusions: The OOP exemption at PHCs can affect medical utilization in Korea, especially for hypertension treatment. The OOP exemption should be expanded to improve healthcare utilization in Korea.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.53-59
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• 2016

Background: The purpose of this study is to evaluate the concentration of cardiovascular surgical procedures in a metropolitan area and investigate the perception of specialists regarding governmental policies to resolve this imbalance. Methods: From March to May 2015, surveys were distributed to members of the Thoracic and Cardiovascular Surgery Association. The final pool of research subjects consisted of 75 respondents. Subjects were queried regarding the concentration of cardiovascular operations in metropolitan areas, alternatives to the imbalance, and governmental policies to resolve the inequalities. Results: Survey participants responded that South Korea needs governmental policies to alleviate the concentration of cardiovascular surgery patients in large metropolitan hospitals. Participants agreed that the freedom to choose medical institutions and improved accessibility to metropolitan hospitals due to advanced transportation systems were some of the causes for the concentration. A majority (98.7%) of respondents thought establishing thoracic and cardiovascular surgery centers in provinces was an appropriate solution to alleviate the concentration. Thoracic and cardiovascular surgery specialists were ranked as the number one group on which to focus development. Conclusion: Developing and carrying out policies to establish thoracic and cardiovascular surgery centers in provinces will alleviate the regional imbalance in available heart surgery services and an overall improvement in cardiovascular disease treatment in South Korea.

• Journal of Preventive Medicine and Public Health
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• v.30 no.4 s.59
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• pp.870-883
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• 1997

The health center has to play an important role in promoting community health and satisfying a variety of community health needs and demands in the decentralized Korea. The nearly enacted Community Health Act compels every health center to make its own health plans which intend to deal with local health problems and plan its future health care. This obligation is obviously a big burden to most health centers. They do not have experiences in and abilities of making local health care plans. In order to establish a systematic community health plan, health centers have to concentrate their efforts on enhancing the ability of making health care plan through gathering and analysing the local health informations. However, it is very difficult in reality. This is simply because it will take long time to accomplish these activities. It seems natural that various professionals and researchers participate in carrying out the process of making community health plan in the initial stage. No standardized methodology and analysing framework exist even in the health professional society. Nonetheless, it is common to introduce survey research methodologies in analysing consumer's health care utilization and cost, and in identifying factors influencing health behaviors. Many researchers and professionals have applied social survey methodologies in obtaining information on providers and health policy makers as well. The authors have found that few studies have ever utilized local health data stored at the self-employed medical insurance society as the data source of planning activities. The purpose of this study is to illustrate the usefulness of the data stored at the Sung-Dong Gu Self-employed Medical Insurance Society in establishing the community health plan. The major contents of this study are as follows ; 1. frequency of utilization by age, area, sex, type of medical care institutions, and some major diseases 2. Medical treatment by type of medical care institutions, by classification of 21 diseases, by frequency of three-character categories 3. Medical treatment of major neoplasm and some chronic diseases by age, sex, and area. The conclusion of this study is that it is of great potentiality to find out the local health problems and to use them in blueprinting the community health plan through comparing the frequency of medical utilization analyzed by a variety of variables with NHI health data or the health data from survey research.

• Journal of The Korea Institute of Healthcare Architecture
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• v.22 no.1
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• pp.17-28
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• 2016

Purpose: The purpose of this paper is to analyze the spatial configurations of a sample of Korean regional emergency medical centers (REMCs) to explore its underlying genotypes and thus produce a base line data for the analysis and evaluations of future REMCs designs using space syntax theory. Methods: Space syntax analysis was used as a major tool for the analysis and exploration of Genotype. The measures of Integration(overall integration with exterior and without exterior as well as the integration of individual clinical spaces for each center), base difference factor (DF) and Space link ratio were calculated for a sample of seven Korean REMCs. Results: The result shows a strikingly similar pattern of Syntactic measures across the sample, the mean integration of sample ranges from 0.82-0.99 with exterior (while considering the exterior space as a root) and 0.81-1.01 without exterior (considering the connections of interior spaces only with no outside connection). The base difference factor (DF) of the sample varies from 0.60-0.81 with exterior and from 0.59-0.82 without exterior. Case number-1 was identified as non-genotype with differing order of Syntactic values. Although the genotype had different forms, layouts and even sizes, these results cannot be explained by Phenotypical comparisons. Implications: This study will contribute to the configurational analysis and evaluation of existing and future Korean REMCs design and practice of emergency healthcare delivery system in Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4181-4186
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• 2013

In the article were observed the epidemiological aspects of malignant tumors of the central nervous system (MT CNS) in Kazakhstan in a retrospective study for the years 2004-2011. The material of the study was consolidated accounting data of oncology centers on patients with MT CNS (C70-72) with first time established diagnosis. Calculated were crude, age, standardized (world standard), aligned and predicted incidence of MT CNS among both male and female populations. It was found that over the studied period, there were 4,604 cases of MT CNS. The average annual crude incidence rate of MT CNS in total population was $3.7{\pm}0.1^0/_{0000}$. Trends in aligned incidence rates in the whole country had a tendency to increase (T=+0.9%). Defined levels of morbidity MT CNS in the whole population in different regions of Kazakhstan: low up to $2.87^0/_{0000}$, the average from 2.87 to $4.45^0/_{0000}$ and high from $4.45^0/_{0000}$ and above on the basis of which was given the space-time estimate. Age and sex differences in MT CNS incidence were also clearly established.

• The Korean Journal of Health Service Management
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• v.5 no.3
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• pp.63-76
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• 2011

The objective of this study is to analyze the utilization patterns of other region inpatients in general hospitals located in Seoul area. For the analysis, the study utilize the nationwide data on '2008 Survey of Patients' of Ministry of Health & Welfare. The statistical methodology used in the study is the logistic regression model. This study has three major findings. First, the significant affecting sociodemographic factors in selecting general hospitals located in Seoul area was sex, age, type of payment and inpatients residence region. Second, compared to other disease groups, the inpatients on both 'congenital malformation, deformity and chromosomal abnormalities' and 'neoplasm' groups are more likely to utilize general hospitals in Seoul area. Furthermore, in 'neoplasm' disease group, inpatients with 'bones and articular cartilage malignant neoplasm' are more likely to utilize general hospitals in Seoul area. Finally, hospitals with more than 1,000 beds was chief factor in selecting Seoul-based hospitals by other region inpatients. In conclusion, the study showed that other region inpatients are more likely to utilize general hospitals located in Seoul area in case of severe disease, rare case and surgical case. Therefore, central and local authority is required to monitor local hospitals on quality of the medical service as well as support them to establish specialized medical centers by providing human and physical resources.

• The Korean Journal of Emergency Medical Services
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• v.24 no.2
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• pp.7-26
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• 2020

Purpose: This study aimed to identify the factors affecting the survival outcomes of out-of-hospital cardiac arrest based on the Sudden Cardiac Arrest Survey by the Korean Centers for Disease Control and Prevention from 2012 to 2016. Methods: Out of 84,776 cases, 57,104 cases of cardiac arrest were analyzed. To identify the factors that affect survival outcomes after a sudden cardiac arrest (SCA), we performed a logistic regression using SPSS. We also performed a multilevel analysis using SAS to determine whether the survival outcomes were affected by the socioeconomic level and health index of the communities. Results: When SCA was witnessed by someone, the possibility of discharge with survival outcomes increased by a factor of 4.54. If CPR was administered immediately in emergency situations, this possibility further increased. When defibrillation was performed before hospitalization, the possibility was increased by a factor of 10.31. The multilevel analysis reflected the personal and regional factors that had an impact on the survival outcomes. Conclusion: Because the initial response in SCA is crucial, a community response system is essential before hospitalization. It is necessary to actively publicize and educate the people because the their understanding, sympathy, and cooperation in emergency situations play a role in determining the survival outcomes of the patients.

• Korean Journal of Clinical Pharmacy
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• v.29 no.1
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• pp.1-8
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• 2019

Background: Alzheimer's dementia is the most common dementia. However, recently, choline alfoscerate is prescribed for treating Alzheimer's dementia, although it is not a treatment for this disease. Purpose: To analyze the prescription patterns of choline alfoscerate as a dementia treatment for patients with Alzheimer's disease and to analyze, as well as the factors affecting choline alfoscerate prescription. Method: The 2016 HIRA-NPS data was used in this study. The code of Alzheimer's dementia is F00 in the ICD-10 disease classification code. We analyzed the demographic, clinical, and regional characteristics associated with donepezil, rivastigmine, galantamine, memantine, and choline alfoscerate prescriptions. All statistical and data analyse were conducted by SAS 9.4 and Excel. Results: For patients with Alzheimer's disease, choline alfoscerate was the second most prescribed after donepezil. Analysis results showed that choline alfoscerate was more likely to be prescribed to men than to women, and more likely to be prescribed by local health centers than by medical institutions. Moreover, choline alfoscerate was highly likely to be prescribed at neurosurgical departments, among medical departments. Conclusions: This study confirmed that choline alfoscerate was prescribed considerably for patients with Alzheimer's dementia. Further studies valuating its clinical validity should be performed to clarify whether choline alfoscerate prescription is appropriate for treating Alzheimer's dementia.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.196-200
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• 2008

Kimura's Disease is a very rare, chronic inflammatory disorder with an unknown etiology, and this illness is primarily seen in young Asian males. The typical clinical features consist of painless subcutaneous masses in the head or neck region, and especially in the salivary gland and submandibular region. It is often accompanied with a regional lymphadenopathy, peripheral blood eosinophilia and elevated serum IgE levels. Histologically, it is characterized by prominent germinal centers in the involved lymph nodes, together with eosinophilic infiltration in these lymph nodes. The treatment modalities for this disease are steroid therapy, radiation therapy and surgical excision. Its clinical course is of a benign nature. We report here on a case of a 28 year old man who had a soft tissue mass in his left arm. We excised this mass and the microscopy confirmed that he suffered from Kimura's disease on microscopic examination in his left distal arm.

• Journal of Trauma and Injury
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• v.33 no.4
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• pp.242-247
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• 2020

Purpose: The purpose of this study was to determine the incidence and characteristics of associated injuries in patients with spine trauma. Methods: Data of 3,920 consecutive patients admitted to a regional trauma center during a 3-year period were analyzed retrospectively. Results: Of the 3,920 patients who were admitted to the trauma center during the 3-year study period, 389 (9.9%) had major spinal injuries. Among these 389 patients, 303 (77.9%) had associated injuries outside the spine. The most common body region of associated injuries was the extremities or pelvis (194 cases, 49.4%), followed by the chest (154 cases, 39.6%) and face (127 cases, 32.6%). Of these 303 patients, 149 (64%) had associated injuries that required surgical treatment such as laparotomy or internal fixation. Associated injuries were more common in patients with lumbar injuries (93.3%) or multiple spinal injuries (100%) than in those with lower cervical injuries (67.4%). There was a significant correlation between the location of the spinal injury and the body region of the associated injury. However, distant associated injuries were also common. Conclusions: Associated injuries were very common in spinal injury patients. Based on demographic groups, the trauma mechanism, and the location of spinal injury, an associated injury should be suspected until proven otherwise. Using a multidisciplinary and integrated approach to treat trauma victims is of the paramount importance.