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Changes in the Behavior of Healthcare Organizations Following the Introduction of Drug Utilization Review Evaluation Indicators in the Healthcare Quality Evaluation Grant Initiative (의료질평가지원금 제도의 의약품안전사용서비스 평가지표 도입에 따른 의료기관의 행태 변화)

  • Hyeon-Jeong Kim;Ki-Bong Yoo;Young-Joo Won;Han-Sol Jang;Kwang-Soo Lee
    • Health Policy and Management
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    • v.34 no.2
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    • pp.178-184
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    • 2024
  • Background: This study aimed to determine the effectiveness of drug utilization review (DUR) evaluation indicators on safe drug use by comparing the changes in DUR inspection rates and drug duplication prescription prevention rates between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative. Methods: This study used DUR data from the Health Insurance Review and Assessment Service in 2018 (pre-implementation) and the evaluation results of the Healthcare Quality Evaluation Grant Initiative in 2023 (post-implementation). The dependent variables were the DUR evaluation indicators, including DUR inspection rate and drug duplicate prescription prevention rate. The independent variable was the implementation of the DUR evaluation indicators, and the control variables included medical institution characteristics such as type, establishment classification, location, DUR billing software company, and number of beds. Results: The results of the analysis of the difference in the prevention rate of drug duplicate prescriptions between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative showed that the prevention rate of drug duplicate prescriptions increased statistically significantly after the implementation of the DUR evaluation indicators. Conclusion: The policy implications of this study are as follows: First, ongoing evaluation of DUR systems is needed. Second, it is necessary to establish a collaborative partnership between healthcare organizations that utilize DUR system information and the organizations that manage it.

An Analysis of Accessibility to Hydrogen Charging Stations in Seoul Based on Location-Allocation Models (입지배분모형 기반의 서울시 수소충전소 접근성 분석)

  • Sang-Gyoon Kim;Jong-Seok Won;Yong-Beom Pyeon;Min-Kyung Cho
    • Journal of the Society of Disaster Information
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    • v.20 no.2
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    • pp.339-350
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    • 2024
  • Purpose: This study analyzes accessibility of 10 hydrogen charging stations in Seoul and identifies areas that were difficult to access. The purpose is to re-analyze accessibility by adding a new location in terms of equity and safety of location placement, and then draw implications by comparing the improvement effects. Method: By applying the location-allocation model and the service area model based on network analysis of the ArcGIS program, areas with weak access were identified. The location selection method applied the 'Minimize Facilities' method in consideration of the need for rapid arrival to insufficient hydrogen charging stations. The limit distance for arrival within a specific time was analyzed by applying the average vehicle traffic speed(23.1km/h, Seoul Open Data Square) in 2022 to three categories: 3,850m(10minutes), 5,775m(15minutes), 7,700m(20minutes). In order to minimize conflicts over the installation of hydrogen charging stations, special standards of the Ministry of Trade, Industry and Energy applied to derive candidate sites for additional installation of hydrogen charging stations among existing gas stations and LPG/CNG charging stations. Result: As a result of the analysis, it was confirmed that accessibility was significantly improved by installing 5 new hydrogen charging stations at relatively safe gas stations and LPG/CNG charging stations in areas where access to the existing 10 hydrogen charging stations is weak within 20 minutes. Nevertheless, it was found that there are still areas where access remains difficult. Conclusion: The location allocation model is used to identify areas where access to hydrogen charging stations is difficult and prioritize installation, decision-making to select locations for hydrogen charging stations based on scientific evidence can be supported.

Cases and Legal Issues For 119paramedics in Mental Emergency Situations (정신응급상황에서 119구급대원 대응사례와 법적쟁점)

  • Young Pyo Hong
    • The Korean Society of Law and Medicine
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    • v.25 no.1
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    • pp.87-115
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    • 2024
  • In Korea, exposure to stress has been accompanied by mental pain in the process of achieving many growth along with rapid development, various social problems, and the frequency of emergency hospitalization is increasing.. In the case of mentally ill patients, "unwanted hospitalization" is a problem, and police and 119 paramedics try to suppress the body of mentally ill patients, and many problems are exposed This is because the constituent requirements of the provisions of emergency hospitalization under the Mental Health and Welfare Act do not reflect reality, and each institution has a different position on one mentally ill person, and emergency hospitalization does not proceed smoothly or leads to friction between related organizations, and the safety of the mentally ill or others is not secured. Emergency hospitalization is defined as "a person who finds a person who is presumed to be mentally ill and is at high risk of harming his or her health or safety or others," and if the situation is so urgent that he or she cannot afford time to go through the hospitalization procedure to decide on his or her own hospitalization, he or she can request emergency hospitalization with the consent of a doctor and a police officer. In this case, 119 paramedics are escorted to a psychiatric institution. This provision of emergency hospitalization poses many problems in the process of transferring to psychiatric institutions. If a police officer or 119 paramedics in charge of practice use "physical force" during the emergency hospitalization process, side effects will inevitably occur, and professional negligence can be a problem. Specifically, when exercising physical force, the minimum necessary physical restraint based on laws and regulations and proportional principles is required, and the lack of the duty of care of 119 paramedics or police officers under the laws and regulations will eventually be resolved by applying other laws and regulations. Accordingly, it will be an opportunity for mentally ill patients to be transferred to psychiatric institutions in a safe environment by changing the subject of emergency hospitalization provisions under the Mental Health Welfare Act, defining and prescribing the use of physical protection guards as the enforcement regulations of the Mental Health Act, setting the duty of care for 119 paramedics and police officers, and creating an environment for transportation so that mentally ill patients can be treated safely.

A Study on the Classification System of Cadastral Cultural Heritage : Focusing on LX museum collection (지적 문화유산 분류체계 연구 - LX국토정보박물관 소장품을 중심으로 -)

  • Kim, Ji-Hyun
    • Journal of Cadastre & Land InformatiX
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    • v.54 no.1
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    • pp.63-74
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    • 2024
  • The fundamental basis for revitalizing cultural resources and developing content is national heritage(cultural property). In national heritage, cultural heritage is a tangible cultural heritage that represents the uniqueness of history and tradition, identity, and changes in life. In the case of museums, the collections (a museum-owned cultural heritage) represent the unique characteristics of the institution. In South Korea, it is recommended that museum collections be registered and used in the Cultural Heritage Standard Management System so that cultural heritage can be managed and utilized in connection with academics, industry, and administration. However, due to a lack of awareness of modern and contemporary heritage, the thematic classification chronology of the system was set mainly before the Joseon Dynasty, and a cultural heritage classification system suitable for national land information has not been established. Therefore, this study aims to propose a classification system for cadastral cultural heritage, based on the modern era when cadastral terminology was first used, using the cultural heritage owned by the LX Museum. Cadastral cultural heritage is characterized by the fact that although it is a field of specialized technology, the surveying or the production of it is not done by specific individuals only, and that while the production is professional, there are many educational aspects in its use. Therefore, unlike other specialized museum collections that are classified based on the functional aspects of their production methods, intended use, and creators, the classification method for cadastral cultural artifacts should be based on the characteristics of the cadastral tools and the outputs. This classification follows a three-tier stages with reference to the items in the Cultural Heritage Standard Management System. This classification aims at the effective use of knowledge by categorizing concepts and systematizing the subjects of data into a series of orders. A safe conservation and management environment for cadastral cultural heritage can be established, and academic and socio-cultural interpretation of the collection is possible by this classfication. Moreover, It is also expected to serve the basis for the national land information as well as searching for the national land information research, planning a exhibition, and the field of education in museum.

Efficacy and Safety of a Newly Developed Self-Expanding Open-Cell Type Nitinol Stent for Peripheral Arteries: A Preclinical Study in Minipigs (새로 개발된 말초동맥용 자가팽창성 개방형 니티놀 스텐트의 유효성 및 안전성 평가: 미니피그 전임상실험)

  • Min Uk Kim;Jae Hwan Lee;Chang Jin Yoon;Won Seok Choi;Saebeom Hur;Jin Wook Chung
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.899-911
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    • 2020
  • Purpose To evaluate the safety and efficacy of the newly designed open-cell type self-expandable nitinol stent (NiTi-stent) for peripheral arteries. Materials and Methods Twenty-eight limbs of 14 minipigs were randomly assigned to the NiTistent group or conventional nitinol stent group. Stents were symmetrically implanted into the iliac arteries of each animal using carotid artery approach and were observed for 1 month (n = 5) and 6 months (n = 9). The angiographic lumen diameter (ALD), late lumen loss, angiographic stenosis, histomorphometric lumen area, neointimal area, and area stenosis were analyzed and compared between the groups. Results Stent migration, stent fracture, or thrombus formation were not observed in either group. At the 1-month follow-up, the neointimal area (p = 0.008) and area stenosis (p = 0.016) were significantly smaller in the NiTi-stent group than in the control group. At the 6-months followup, the NiTi-stent group showed significantly larger ALD (p = 0.014), less late lumen loss (p = 0.019), less angiographic stenosis (p = 0.014), larger lumen area (p = 0.040), and smaller neointimal area and area stenosis (p = 0.004 and p = 0.014, respectively) compared with the control group. Conclusion The NiTi-stent is as safe and effective as the conventional nitinol stent and induces less neointimal hyperplasia in a minipig iliac artery model.

Traumatic Hemothorax Caused by Thoracic Wall and Intrathoracic Injuries: Clinical Outcomes of Transcatheter Systemic Artery Embolization (흉벽 및 흉곽 내 장기 손상으로 인한 외상성 혈흉: 전신 동맥 색전술의 임상 결과)

  • Chang Mu Lee;Chang Ho Jeon;Rang Lee;Hoon Kwon;Chang Won Kim;Jin Hyeok Kim;Jae Hun Kim;Hohyun Kim;Seon Hee Kim;Chan Kyu Lee;Chan Yong Park;Miju Bae
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.923-935
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    • 2021
  • Purpose We aimed to assess the clinical efficacy of transcatheter arterial embolization (TAE) for treating hemothorax caused by chest trauma. Materials and Methods Between 2015 and 2019, 68 patients (56 male; mean age, 58.2 years) were transferred to our interventional unit for selective TAE to treat thoracic bleeding. We retrospectively investigated their demographics, angiographic findings, embolization techniques, technical and clinical success rates, and complications. Results Bleeding occurred mostly from the intercostal arteries (50%) and the internal mammary arteries (29.5%). Except one patient, TAE achieved technical success, defined as the immediate cessation of bleeding, in all the other patients. Four patients successfully underwent repeated TAE for delayed bleeding or increasing hematoma after the initial TAE. The clinical success rate, defined as no need for thoracotomy for hemostasis after TAE, was 92.6%. Five patients underwent post-embolization thoracotomy for hemostasis. No patient developed major TAE-related complications, such as cerebral infarction or quadriplegia. Conclusion TAE is a safe, effective and minimally invasive method for controlling thoracic wall and intrathoracic systemic arterial hemorrhage after thoracic trauma. TAE may be considered for patients with hemothorax without other concomitant injuries which require emergency surgery, or those who undergoing emergency TAE for abdominal or pelvic hemostasis.

Single Center Experience of the Balloon-Stent Technique for the Treatment of Unruptured Distal Internal Carotid Artery Aneurysms: Sharing a Simple and Reliable Tip to Use Scepter-Atlas Combination (원위내경동맥에 위치한 비파열성 동맥류의 치료에 있어 풍선-스텐트 테크닉에 대한 단일기관의 경험: Scepter-Atlas 조합을 사용하기 위한 간단하지만 확실한 방법)

  • Yu-jung Park;Jieun Roh;Seung Kug Baik;Jeong A Yeom;Chul-Hoo Kang;Hee Seok Jeong;Sang Won Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1258-1273
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    • 2021
  • Purpose The balloon-stent technique (BST) has certain strengths as an assisted technique for the treatment of complex aneurysms. After Atlas release, the BST can be executed without an exchange maneuver of the balloon to the stent-delivery catheter. The purpose of this article is to share our experience with the BST using the Scepter-Atlas combination. Materials and Methods Device inspection led us to a simple method to avoid failure in loading Atlas to the Scepter. From March 2018 to December 2019, 57 unruptured distal internal carotid artery (dICA) aneurysms were treated with coil embolization; among which, 25 aneurysms in 23 patients were treated with BST. Clinical and angiographic data were retrospectively collected and reviewed. Results The technical success rate of the Scepter-Atlas combination increased from 50% to 100% after careful inspection. BST angiographic results were comparable to the stent-assisted coil (SAC) group treated during the immediately post-embolization same period (modified Raymond-Roy classification [MRRC] 1 & 2 84% in BST, 96.3% in SAC) and during short-term follow-up (MRRC 1 & 2 95.8% in BST, 88.4% in SAC). A small number of patients showed periprocedural complications, but none had clinical consequences. Conclusion BST using the Scepter-Atlas combination can provide an effective and safe method for the treatment of dICA aneurysms. Scepters can be used as delivery catheters for Atlas.

First-Pass Recanalization with EmboTrap II in Acute Ischemic Stroke (FREE-AIS): A Multicenter Prospective Study

  • Jang-Hyun Baek;Byung Moon Kim;Sang Hyun Suh;Hong-Jun Jeon;Eun Hyun Ihm;Hyungjong Park;Chang-Hyun Kim;Sang-Hoon Cha;Chi-Hoon Choi;Kyung Sik Yi;Jun-Hwee Kim;Sangil Suh;Byungjun Kim;Yoonkyung Chang;So Yeon Kim;Jae Sang Oh;Ji Hoe Heo;Dong Joon Kim;Hyo Suk Nam;Young Dae Kim
    • Korean Journal of Radiology
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    • v.24 no.2
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    • pp.145-154
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    • 2023
  • Objective: We aimed to evaluate the efficacy of EmboTrap II in terms of first-pass recanalization and to determine whether it could yield favorable outcomes. Materials and Methods: In this multicenter, prospective study, we consecutively enrolled patients who underwent mechanical thrombectomy using EmboTrap II as a front-line device. The primary outcome was the first pass effect (FPE) rate defined by modified Thrombolysis In Cerebral Infarction (mTICI) grade 2c or 3 by the first pass of EmboTrap II. In addition, modified FPE (mFPE; mTICI grade 2b-3 by the first pass of EmboTrap II), successful recanalization (final mTICI grade 2b-3), and clinical outcomes were assessed. We also analyzed the effect of FPE on a modified Rankin Scale (mRS) score of 0-2 at 3 months. Results: Two hundred-ten patients (mean age ± standard deviation, 73.3 ± 11.4 years; male, 55.7%) were included. Ninety-nine patients (47.1%) had FPE, and mFPE was achieved in 150 (71.4%) patients. Successful recanalization was achieved in 191 (91.0%) patients. Among them, 164 (85.9%) patients underwent successful recanalization by exclusively using EmboTrap II. The time from groin puncture to FPE was 25.0 minutes (interquartile range, 17.0-35.0 minutes). Procedure-related complications were observed in seven (3.3%) patients. Symptomatic intracranial hemorrhage developed in 14 (6.7%) patients. One hundred twenty-three (58.9% of 209 completely followed) patients had an mRS score of 0-2. Sixteen (7.7% of 209) patients died during the follow-up period. Patients who had successful recanalization with FPE were four times more likely to have an mRS score of 0-2 than those who had successful recanalization without FPE (adjusted odds ratio, 4.13; 95% confidence interval, 1.59-10.8; p = 0.004). Conclusion: Mechanical thrombectomy using the front-line EmboTrap II is effective and safe. In particular, FPE rates were high. Achieving FPE was important for an mRS score of 0-2, even in patients with successful recanalization.

Grouting Improvement through Correlation Analysis of Hydrogeology and Discontinuity Factors in a Jointed Rock-Mass (절리 암반의 수리지질 및 불연속면 특성 간 상관분석을 통한 그라우팅 계획 수립의 개선 방안)

  • Kwangmin Beck;Seonggan Jang;Seongwoo Jeong;Minjune Yang
    • The Journal of Engineering Geology
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    • v.34 no.2
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    • pp.279-294
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    • 2024
  • Large-scale civil engineering structures such as dams require a systematic approach to jointed rock-mass grouting to prevent water leakage into the foundations and to ensure safe operation. In South Korea, rock grouting design often relies on the experience of field engineers that was gained in similar projects, highlighting the need for a more systematic and reliable approach. Rock-mass grouting is affected mainly by hydrogeology and the presence of discontinuities, involving factors such as the rock quality designation (RQD), joint spacing (Js), Lugeon value (Lu), and secondary permeability index (SPI). This study, based on data from field investigations of 14 domestic sites, analyzed the correlation between hydrogeological factors (Lu and SPI), discontinuity characteristics (RQD and Js), and grout take, and systematically established a design method for rock grouting. Analysis of correlation between the variables RQD, Js, Lu, and SPI yielded Pearson correlation (r) values as follows: Lu-SPI, 0.92; RQD-Lu, -0.75; RQD-Js, 0.69; RQD-SPI, -0.65; Js-Lu, -0.47; and SPI-Js, -0.41. The grout take increases with Lu and SPI values, but there is no significant correlation between RQD and Js. The proposed approach for grouting design based on SPI values was verified through analysis and comparison with actual curtain-grouting construction, and is expected to be useful in practical applications and future studies.

Analysis of risk evaluation procedures and consideration of risk assessment issues of living modified organisms for agricultural use in Korea (농업용(사료용) 유전자변형생물체의 위해성심사 제도 분석 및 환경위해성평가 관련 쟁점에 대한 고찰)

  • Myung-Ho Lim;Sang Dae Yun;Eun Young Kim;Sung Aeong Oh;Soon-Ki Park
    • Journal of Plant Biotechnology
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    • v.50
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    • pp.275-289
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    • 2023
  • Since the implementation of the Living Modified Organisms (LMOs) Act in 2008, approximately 10 million tons of genetically modified corn, soybean, potato, canola, and other crops have been imported into South Korea. The import approval procedures have been completed for approximately 191 cases that include seven crops. Of these, approximately 90 cases, excluding crossbreeds of approved LMOs, were reviewed via consultation risk evaluation in four areas: human health, crop culture, natural ecology, and marine fishery environment. LMO developers in South Korea, who are major stakeholders in the import of LMO crops produced overseas, have raised concerns regarding procedural inefficiency in consultation reviews and the need of excessive reviews that are unsuitable for food-feed processing purposes. These procedures reflect the perspective of consultation agencies that deviate from the nature of risk assessment and demand specific supplementary data that do not reflect familiarity and substantial equilibrium. Based on frequent instances of unintentional environmental release of LMO crops imported into Korea, the ministries responsible for consultation insist on a review that considers the climate and natural environment of Korea. In addition, the ministries mandate that their reviews reflect the expertise of competent ministries and are based on risk assessment principles and methods in accordance with international guidelines. In this regard, considering that traits introduced into LMO crops involving familiar agricultural crops have been considered safe for more than two decades, we have suggested reasonable alternatives to several risk assessment items for agricultural LMOs. These alternatives can mitigate conflicts of interest among key stakeholders within the scope of the current LMO regulations.