• Title/Summary/Keyword: ST25.ST36

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An analytic study of acupoint locations described in "WaHyul" of "ChimGuKyungHumBang" and their modern application ("침구경험방(鍼灸經驗方)" "와혈(訛穴)"의 취혈법(取穴法) 분석에 따른 현대적 적용 연구)

  • Lee, Yun-Hee;Cha, Wung-Seok;Kim, Nam-Il;Park, Hi-Joon;Ahn, Sang-Woo
    • Korean Journal of Acupuncture
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    • v.25 no.4
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    • pp.31-47
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    • 2008
  • Objectives : The objective of this study is to apply the contents of "WaHyul(訛穴 : The errors of acupoint locations"of "ChimGuKyungHumBang" to modern acupoint locations. Methods : The text of "WaHyul" was closely examined and analyzed. "WHO standard acupuncture point locations in the western pacific region" was reviewed based on its contents. Results : According to the analysis, the correct 少商(LU11) was mentioned as a spot appropriately distanced from the corner of the nail root under the skin. This is the most accurate and reasonable synthesis of other related texts. Furthermore, the necessity of defining the locations of all the well points was also emphasized and their locations were mentioned that could be located by the same method. There is no further discussion of other acupoints apart from descriptions of their locations from other texts. Some parts that were pointed out as common errors included not only commonly made mistakes, but errors made in acupuncture texts as were true for 神門(HT7) and 肩井(GB21). The standards of 少商(LU11), 合谷(LI4) and 足三里(ST36) presented in the WHO Standardization are not only similar to what 「WaHyul」 indicated as errors in acupoint locations, but also deviate other acupuncture texts; appropriate corrections must be made. The standard of 肩井(GB21) presents a new acupoint locating method never mentioned before in received classic acupuncture texts and so a rediscussion is in need. Other standards, such as the 絶骨(GB39), had some points of controversy, yet somewhat incomplete while HT7 did not go beyond the bounds of "WaHyul". Conclusions : "WaHyul" can be used to revise WHO standards, and has practical value in modern acupoint locating.

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Effects of Acupuncture Stimulation on the Radial artery's Pressure Pulse Wave in Healthy Young Participants: Protocol for a prospective, single-Arm, Exploratory, Clinical Study

  • Shin, Jae-Young;Ku, Boncho;Kim, Tae-Hun;Bae, Jang Han;Jun, Min-Ho;Lee, Jun-Hwan;Kim, Jaeuk U.
    • Journal of Pharmacopuncture
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    • v.19 no.3
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    • pp.197-206
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    • 2016
  • Introduction: This study aims to investigate the effects of acupuncture stimulation on the radial artery's pressure pulse wave, along with various hemodynamic parameters, and to explore the possible underlying mechanism of pulse diagnosis in healthy participants in their twenties. Methods and analysis: This study is a prospective, single-arm, exploratory clinical study. A total of 25 healthy participants, without regard to gender, in their twenties will be recruited by physicians. Written informed consent will be obtained from all participants. The participants will receive acupuncture once at ST36 on both sides. The radial arterial pulse waves will be measured on the left arm of the subjects by using an applicable pulse tonometric device (KIOM-PAS). On the right arm (appearing twice), electrocardiogram (ECG), photoplethysmogram (PPG), respiration and cardiac output (CO) signals, will be measured using a physiological data acquisition system (Biopac module), while the velocity of blood flow, and the diameter and the depth of the blood vessel will be measured using an ultrasonogram machine on the right arm (appearing twice). All measurements will be conducted before, during, and after acupuncture. The primary outcome will be the spectral energy at high frequencies above 10 Hz ($SE_{10-30Hz}$) calculated from the KIOM-PAS device signal. Secondary outcomes will be various variables obtained from the KIOM-PAS device, ECG, PPG, impedance cardiography modules, and an ultrasonogram machine. Discussion: The results of this trial will provide information regarding the physiological and the hemodynamic mechanisms underlying acupuncture stimulation and clinical evidence for the influence of acupuncture on the pressure pulse wave in the radial artery. Ethics and dissemination: This study was approved by the Institutional Review Board (IRB) of Kyung Hee University's Oriental Medical Center, Seoul, Korea (KOMCIRB-150818-HR-030). The study findings will be published in peer-reviewed journals and presented at national and international conferences. Trial registration number: This trial was registered with the Clinical Research Information Service (CRIS) at the Korea National Institute of Health (NIH), Republic of Korea (KCT0001663), which is a registry in the World Health Organization's (WHO's) Registry Network.

Research Trends of the Traditional Korean Medicine Treatment for Atopic Dermatitis -Based on the Journal of Pediatrics of Korean Medicine- (아토피 피부염의 한의학적 치료에 대한 연구 동향 -대한한방소아과학회지를 중심으로-)

  • Jin, Qi Ying;Lee, Jin Yong
    • The Journal of Pediatrics of Korean Medicine
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    • v.31 no.1
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    • pp.25-42
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    • 2017
  • Objectives The goal of this review was to investigate clinical, experimental and literature studies of Korean medicine on atopic dermatitis (AD) of Korean children in Korean medicine literature, seeking for the better research methods for more effective treatments. Methods Electronic investigations were practiced on AKOP (The Association of Korean Oriental Pediatrics, http://www.akop.or.kr) to collect theses which were published by J Pediatr Korean Med. The key word 'Atopy' was used for searching to ensure that every related thesis was collected. The publication date was limited from 1996 to 2016. The selected literatures were assessed mainly according to distributions of study type, publication year, scale, treatment and its efficacy. Results 55 papers were selected from 59 studies. In these collected 55 related theses, there were 29 experimental studies (52.73%), 18 clinical studies (32.73%), 8 review studies (14.55%). In the 29 experimental studies, there were 20 studies (68.97%) using NC/Nga mouse as subjects. The mite antigen was used to trigger AD by 8 studies (27.59%). The studies have been utilizing DNCB and DNFB instead of mite antigen since 2011. All the experimental studies showed that the Korean medicine was effective in AD. In total 18 clinical studies, 3 studies (16.67%) were case reports, only 1 thesis (5.56%) was conducted by case control study and the rest were case series studies. 7 studies (38.89%) of 18 studies diagnosed AD according to Hanifin and Rajka's diagnostic criteria (1980), only 1 study (5.56%) according to the Korean standard and the rest 10 studies (55.56%) didn't mention diagnostic criteria. 12 clinical studies (66.67%) showed efficacy in treating AD. There were 10 studies (55.56%) only employing internal treatments and 1 thesis (5.56%) didn't mention the exact prescription. Naesowhajungtang-kamibang, Saenghyeoryunbue-um were used 3 times (16.67%) as the internal medicine respectively. 5 theses (27.78%) were combined with acupuncture therapy. Hegu (LI4), Sanyinjiao (SP6) were used in 4 theses, and Taichong (LR3), Quchi (LI11), Zusanli (ST36) in 3 theses. The number of acupoints chosen from The Spleen meridian of Foot-Taiyin was the largest. There were 8 review theses. 2 were about the foreign oriental medicine, 3 were about the external medicine or external treatment methods, and 3 other studies were about severity scoring systems, the methodological study in the latest clinical study, overview for pattern and results of herbal medicine-derived AD clinical researches. Conclusions The experimental studies and clinical studies showed the effectiveness of Korean medicine treatments. However, this study still needs improving by conducting more comparative studies and using better research methods, in order to find more effective treatments to improve clinical efficacy.

Effect of Acupuncture on Patients with Hypertension : A Review of Clinical Studies in the Republic of Korea (고혈압의 침치료에 대한 문헌고찰 : 국내 임상 연구를 중심으로)

  • Sang Yeon, Jung;Ye-Chae, Hwang;Seung-Yeon, Cho;Han-Gyul, Lee;Seungwon, Kwon;WooSang, Jung;Sang-Kwan, Moon;Jung-Mi, Park;Chang-Nam, Ko;Seong-Uk, Park
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.23 no.1
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    • pp.25-40
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    • 2022
  • ■Objectives This study aimed to collect and analyze clinical studies on the significance of acupuncture in the treatment of hypertension among Korean patients. ■Methods Among Korean patients with a blood pressure (BP) of 120 mmHg or higher and a diastolic BP of 80 mmHg or higher, those, treated with acupuncture only, were included. A literature search was conducted through 'Embase', 'Medline', 'Science and Technology Information Integration Service (NDSL)', 'Traditional Korean Knowledge Portal (OASIS)', 'PubMed', and 'Scopus'. The search keywords were (hypertension OR 'blood pressure') AND acupuncture. The papers, published before the day of the search (02. January 2022), were included in this study. ■Results Among the 12 selected papers, seven involved randomized controlled trial (RCT), four before-and-after studies, and one case series. The number of RCTs has increased yearly. The treatment methods used in the studies included needle acupuncture in eight studies, auricular acupuncture in two, pharmacopuncture in one, and si-acupuncture in one. The average numbers of patients enrolled in RCTs, before-and-after studies, and case series were 21.1, 30, and 23 respectively. Six studies were conducted on prehypertensive patients, two on stage 1 hypertension patients, and four on stage 2 hypertension patients. The involved acupoints have been reported to be ST36 in eight papers, LI11 in four papers, and PC6 in three papers. The treatment period lasted for < 1 week in eight studies and 8 weeks in four studies. Acupuncture successfully lowered blood pressure in nine out of 12 studies ■Conclusions Acupuncture is a viable alternative treatment option for prehypertensive patients, who are not taking medications. Additionally, it is also useful in further lowering the BP of patients with stage 1 and stage 2 hypertension in the short term. Large-scale and long-term studies on acupuncture for hypertension should be conducted.

A Case of Cold Hypersensitivity of Hands and Feet Treated with Korean Medicine Including Gyejifabuja-tang-gmibang and Acupuncture in a Patient with Lumbar Spinal Herniated Intervertebral Disc - A Case Report (한방병원에 입원한 수족냉증을 동반한 추간판탈출증 환자에 대한 한방 치료 1례)

  • Sang-hun Yun;Sang-yoon Kim;Yen-min Wang;Gil-geun Baek;Yu-jin Lee;Hyung-chul Lee;Man-ho Kang;Sung-hwan Park
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.1071-1082
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    • 2023
  • Objective: The purpose of this study is to report the efficacy of using Korean medicine treatment with cold hypersensitivity of the hands and feet with lumbar spinal herniated intervertebral disc. Case presentation: We used Korean medicine treatment (Gyejigabuja-tang, acupuncture) to treat a hospitalized patient with cold hypersensitivity of the hands and feet with lumbar spinal herniated intervertebral disc. To evaluate the treatment, we used the Numerical Rating Scale (NRS). The degree of cold hypersensitivity of the hands and feet was also evaluated using evaluation paper. The generic health status was measured using the European Quality of Life-5 Dimensions (EQ-5D) scale. The 31-year-old female underwent 13 days of inpatient treatment. Her pattern identification was that both hands and feet are cold (BiYangHeo) types. The treatments were herbal medicine and acupuncture. She took Gyejigabuja-tang for 13 days. She also received acupuncture for 20 minutes twice a day at LI11 (曲池), L14 (合谷), TE5 (外關) on her hands, LR3 (太衝), SP6 (三陰交), SP9 (陰陵泉) ST36 (足三里), GB41 (足臨泣) on Feet, GV4 (命門), GV3 (腰陽關), BL23 (腎兪), BL24 (氣海兪), BL25 (大腸兪), and BL26 (關元兪) on the low back. After 2 weeks of treatment, the NRS scale of her cold hypersensitivity of hands and feet symptoms dropped from NRS 7 to NRS 3, and her low back pain dropped from NRS 6 to NRS 3. Her cold hypersensitivity of hands and feet evaluation paper score decreased from 64 to 32, and her EQ-5D increased from 0.487 to 0.681. After the end of treatment, continued symptom improvements and no significant side effects were confirmed. Results: These findings suggest that Korean medical treatment (Gyejigabuja-tang, acupuncture) may be effective for treating cold hypersensitivity of hands and feet with lumbar spinal herniated intervertebral disc. The NRS, evaluation paper, and EQ-5D scores improved after treatment, with no side effects.

Effect of Myers-Briggs Type Indicator(MBTI) Personality Type, Emotional Intelligence, Sress Coping Strategies on Nursing student's Adjustment to College Life (간호대학생의 MBTI성격유형, 감성지능, 스트레스 대처방식이 대학생활적응에 미치는 영향)

  • Han, Young-Mi;Kim, Sun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.8
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    • pp.124-134
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    • 2017
  • The purpose of this study was to investigate the MBTI personality type, emotional intelligence, and stress coping strategies of nursing students and to examine the influence of these factors on their level of college adjustment.The subjects were 267 nursing students who are located in Chonnam city. The survey was conducted from March 6th to March 31st, 2017. The level of college adjustment showed a close correlation with the emotional intelligence(r=.29, p<.001) and stress coping strategies(r=.27, p<.001), and the level of MBTI personality type was not statistically insignificant in the nursing students. It was found that the effect of the emotional intelligence and stress coping strategies on the college life adjustment was 17.5%(F=8.03, p<.001). According to the results of this study, it is necessary to develop a systematic management program to integrate the educational curriculum and extra-curricular activities(in order to enhance the) emotional intelligence and stress coping strategies in nursing students. In addition, the type of psychological function and psychological temperament of the MBTI personality type were found not to have influenced the level of college adaptation of the nursing students and this should be confirmedin a large scale sample.

Giant Coronary Artery Aneurysm Presenting as a Calcified Mediastinal Mass a, Coronary Artery Fistula - A case report - (종격동 종양으로 오인된 거대관상동맥류와 관상동맥루 - 치험 1례 -)

  • Yoon, You-Sang;Lee, Cheol-Joo;Choi, Ho;Kang, Jun-Kyu;Choi, Jin-Wook;Kim, Hyung-Tae
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.787-791
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    • 2001
  • Coronary artery aneurysm is a rare disorder. It is defined as abnormal dilatation of coronary artery with diameter exceeding 1.5 times the adjacent normal segments. The incidence of coronary aneurysm is 2.6% in Caucasians and 0.25% in Asians. Over half of the former were associated with atherosclerotic coronary artery disease. However, 70 percents of the latter were nonobstructive coronary artery aneurysms. Coronary artery fistula is a rare disorder. It has been identified in only 0.2% of routine cardiac angiographic studies conducted over a 10-year period. The clinical spectrums are various, asymtomatic, asymptomatic murmur, dyspnea on exertion, fatigue, and congestive heart failure. The right coronary artery (56%) and left coronary artery(36%) are mainly involved in the origin site of congenital coronary artery fistula. The draining site of fistula are right ventricle(39%), right atrium(33%), and pulmonary artery(20%) and so on. This 54 years-old woman had intermittent chest tightness and an abnormal mediastinal shadow on chest roentgenogram and chest C-T examination, which was diagnosed as a mediastinal mass such as teratoma. We performed the operation under left anterolateral thoracotomy for mass excision. However, we knew the mass had the pulsating arterial blood flow through a fine needle puncture of the mass and that it was attached to the left ventricle. We believed the excision of mass on beating heart would be very dangerous. Therefore, we closed the wound without excising the mass. After several days, we performed an echocardiography and coronary angiography, We knew it was cardiac tumor. Incidentally, the patient had a tortuous coronary fistula from the right coronary artery to pulmonary trunk. Using cardiopulmonary bypass with moderate systemic hypothermia, the mass was resected and the fistula was clipped with surgical clips. Pathology of the specimen was a giant coronary arterial aneurysm.

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Serum 25-Hydroxy Vitamin $D_3$ Analysis of Korean People (한국인 일반인의 혈청 25-Hydroxy Vitamin $D_3$의 분석)

  • Kim, Bo-Kyung;Jung, Hyun-Mi;Kim, Yun-Kyung;Kim, So-Young;Kim, Jee-Hyun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.133-137
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    • 2010
  • Purpose: The main function of vitamin D is the mineralization of the brain by increase of calcium and phosphorus, in case it is insufficient in children, lime deposition on cartilage cannot occur so it leads to rachitis, and in adults, it leads to osteomalacia or osteoporosis. It is also strongly believed in the academic world that vitamin D can restrict the growth of cancer cells and prevent heart diseases, which is also somewhat proven in epidemiological researches. While the right density of vitamin D is still being studied, 20-32 ng/mL is believed to be the most ideal density. Therefore, I wanted analyze how much density of 25-Hydroxyvitamin D3 that Koreans possess. Materials and Methods: From February 20th, 2008 to April 21st, 2009, the collection of 2800 serums, from medical examination treated subjects by Neodin Medical Institute, have been tested. The targets were tested by 25-Hydroxyvitamin D (125I Kit: Diasorin, USA), and were analyzed by dividing into many different categories (gender, age, season, region). Results: The average density of male were 20 ng/mL, female 17.08 ng/mL. Per age groups, the density of males were as follows: 10~20-18 ng/mL, 21~30-17 ng/mL, 31~40-19 ng/mL, 41~50-21 ng/mL, 51~60-22 ng/mL, 61~70-22 ng/mL, 71~80-22 ng/mL and 81~90-19.9 ng/mL. Average density of females per age groups, were as follows: 10~20-16 ng/mL, 20~30-15.26 ng/mL, 30~40-16 ng/mL, 40~50-17 ng/mL, 50~60-19 ng/mL, 60~70-19 ng/mL, 70~80-19 ng/mL, and 80~90-17 ng/mL. Per seasons, From December to May, the subjects showed the density of 15.97 ng/mL, while from June to November, it showed 21.60 ng/mL. On density of males from January to April regionally, Seoul+Gyeonggi-Do-15.52 ng/mL, Gangwon-Do-15.33 ng/mL, Choongchung-Do-18.03 ng/mL, Jeonla-Do-18.68 ng/mL, Gyungsang-Do-18.76 ng/mL and Cheju Do-21.23 ng/mL. Conclusions: The vitamin D of Koreans is has been insufficient compared to the suggested amount. Ultraviolet rays, which is the main source of vitamin D is critical, therefore it is suggested that more outdoor activities can definitely help.

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A Study on Public Nuisance in Seoul, Pusan and Daegu Cities Part I. Survey on Air Pollution and Noise Level (공해(公害)에 관(關)한 조사연구(調査硏究) 제일편(第一編) : 서울, 부산(釜山), 대구(大邱) 지역(地域)의 대기오염(大氣汚染) 및 소음(騷音)에 관(關)한 비교조사(比較調査) 연구(硏究))

  • Cha, Chul-Hwan;Shin, Young-Soo;Lee, Young-Il;Cho, Kwang-Soo;Choo, Chong-Yoo;Kim, Kyo-Sung;Choi, Dug-Il
    • Journal of Preventive Medicine and Public Health
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    • v.4 no.1
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    • pp.41-64
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    • 1971
  • During the period from July 1st to the end of November 1970, a survey on air pollution and noise level was made in Seoul, Pusan and Taegu, the three largest cities in Korea. Each city was divided into 4-6 areas; the industrial area, the semi-industrial area, the commercial area, the residential area, the park area and the downtown area. Thirty eight sites were selected from each area. A. Method of Measurement : Dustfall was measured by the Deposit Gauge Method, sulfur oxides by $PbO_2$ cylinder method, suspended particles by the Digital Dust Indicator, Sulfur dioxide ($SO_2$) and Carbon Monoxide (CO) by the MSA & Kitakawa Detector and the noise levels by Rion Sound Survey meter. B. Results: 1. The mean value of dustfall in 3 cities was $30.42ton/km^2/month$, ranging from 8.69 to 95.44. 2. The mean values of dustfall by city were $33.17ton/km^2/month$ in Seoul, 32.11 in Pusan and 25.97 in Taegu. 3. The mean values of dustfall showed a trend of decreasing order of semi-industrial area, downtown area, industrial area, commercial area, residential area, and park area. 4. The mean value of dustfall in Seoul by area were $52.32ton/km^2/month$ in downtown, 50.54 in semi-industrial area, 40.37 in industrial area, 24,19 in commercial area, 16.25 in park area and 15.39 in residential area in order of concentration. 5. The mean values of dustfall in Pusan by area were $48.27ton/km^2/month$ in semi-industrial area, 36.68 in industrial area 25.31 in commercial area, and 18.19 in residential area. 6. The mean values of dustfall in Taegu by area were $36.46ton/km^2/month$ in downtown area, 33.52 in industrial area, 20.37 in commercial area and 13.55 in residential area. 7. The mean values of sulfur oxides in 3 cities were $1.52mg\;SO_3/day/100cm^2\;PbO_2$, ranging from 0.32 to 4.72. 8. The mean values of sulfur oxides by city were $1.89mg\;SO_3/day/100cm^2\;PbO_2$ in Pusan, 1.64 in Seoul and 1.21 in Taegu. 9. The mean values of sulfur oxides by area in 3 cities were $2.16mg\;SO_3/day/100cm^2\;PbO_2$ in industrial area, 1.69 in semi-industrial area, 1.50 in commercial area, 1.48 in downtown area, 1.32 in residential area and 0.94 in the park area, respectively. 10. The monthly mean values of sulfur oxides contents showed a steady increase from July reaching a peak in November. 11. The mean values of suspended particles was $2.89mg/m^3$, ranging from 1.15 to 5.27. 12. The mean values of suspended particles by city were $3.14mg/m^3$ in Seoul, 2.79 in Taegu and 2.25 in Pusan. 13. The mean values of noise level in 3 cities was 71.3 phon, ranging from 49 to 99 phon. 14. The mean values of noise level by city were 73 phon in Seoul, 72 in Pusan, and 69 in Taegu in that order. 15. The mean values of noise level by area in 3 cities showed a decrease in the order of the downtown area, commercial area, industrial area and semi-industrial area, park area and residential area. 16. The comparison of the noise levels by area in 3 cities indicated that the highest level was detected in the downtown area in Seoul and Taegu and in the industrial area in Pusan. 17. The daily average concentration of sulfur dioxides ($SO_2$) in 3 cities was 0.081 ppm, ranging from 0.004 to 0.196. 18. The daily average concentrations of sulfur dioxides by city were 0.092 ppm in Seoul, 0.089 in Pusan and 0.062 in Taegu in that order. 19. The weekly average concentration of carbon monoxides(CO) was 27.59 ppm. 20. The daily average concentrations of carbon monoxides by city were 33.37 ppm. in Seoul, 25.76 in Pusan and 23.65 in Taegu in that order. 21. The concentration of $SO_2$ and CO reaches a peak from 6 p. m. to 8 p. m. 22. About 3 times probably the daily average concentration of CO could be detected in the downtown area probably due to heavy traffic emission in comparison with that in the industial area. 23. As for daily variation of the concentration of $SO_2$ and CO it was found that the concentration maintains relatively higher value during weekdays in the industrial area and on the first part of the week in the downtown area.

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A Comparative Study on the Pattern of Outpatient Department Utilization at a Tertiary Level Hospital before and after Implementation of the Patient Referral System (의료전달체계 실시 전후의 3차 진료기관 외래환자 이용양상 비교)

  • Lee, Kyeong-Soo;Kim, Chang-Yoon;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.1 s.37
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    • pp.88-100
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    • 1992
  • This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1, 1988 to June 30, 1989 and the post-implementation period was from July 1, 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respectively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased from 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Departments of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments(from 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 2.2 to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased from 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.

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