• Journal of Korean Foot and Ankle Society
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• v.23 no.3
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• pp.121-130
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• 2019

Purpose: To investigate the spatial distribution of diabetes-related lower limb amputations and analyze the relationship between the spatial distribution of diabetes-related lower limb amputations and regional factors. Materials and Methods: This study was performed based on the data from the Korean Health Insurance Review and Assessment Service, in 2016. The unit of analysis was the administrative districts of city·gun·gu. The dependent variable was the age- and sex-adjusted incidence of diabetes-related lower limb amputations and the regional variables were selected to represent two aspects: socioeconomic factors, and health and medical factors. Along with traditional ordinary least square (OLS) regression analysis, geographically weighted regression (GWR) was applied for spatial analysis. Results: The age- and sex-adjusted incidence of diabetes-related lower limb amputation varied according to region. OLS regression showed that the incidence of diabetes-related lower limb amputation had significant relationships with the health and medical factors (number of healthcare institution and doctors per 100,000 population). In GWR, the effects of regional factors were not consistent. Conclusion: The spatial distribution of the incidence of diabetes-related lower limb amputations and the effects of regional factors varied according to the regions. The regional characteristics should be considered when establishing health policy related to diabetic foot care.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.152-158
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• 2012

Purpose: To understand the epidemiology of head trauma and the utilization of brain CT in Korea, we analyzed a national sampling data set, the National Patient Sample obtained from the Health Insurance Review and Assessment Service. Methods: We retrospectively collected and analyzed demographic and clinical data on enrolled patients from the National Patient Sample based on medical claims data for 2009. The data included patient's age, sex, treatment date, diagnosis codes, procedure codes related with CT, holiday or night consultation fee, and fee for emergency management services. Results: In 2009, the estimated population with head trauma was 819,059(1.8%), and the rate of brain CT utilization was 22.4%. Children ages 5 to 15 were the most commonly injured group(22.8%), but had the lowest brain CT utilization(16.5%). The mean age of the estimated population with head trauma was $34.9{\pm}0.5years$ old, and male patients accounted for 60.5% of that population. Intracranial injury was found in 8.6% of all head traumas, and the rate of intracranial injury in children was lower than it was in adults(4.1% vs. 10.9%, p<0.001). Twenty- three percent of patients with head trauma visited the emergency department (ED). More patients with head trauma visited medical facilities in the daytime on weekdays(66.5% vs. 33.5%, p<0.001), but head CT was performed more frequently at night or on weekends/holidays(16.1% vs. 34.7%, p<0.001) There is low incidence of head trauma in the winter in children (p<0.001). In the multivariate logistic regression analysis, patients who were adults, female, or ED visitors were more likely to undergo brain CT (odds ratio (OR): 1.65, 95% confidence interval (CI): 1.47-1.84; OR: 1.40, 95% CI: 1.27-1.54; OR: 7.80, 95% CI: 6.91-8.80, respectively). Conclusion: In this study, we analyzed the national epidemiologic trend for head trauma, and the pattern of utilization of brain CT.

• Journal of Society of Preventive Korean Medicine
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• v.17 no.1
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• pp.181-197
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• 2013

Objectives : This study aimed to assess the differences in treatment behavior by reviewing data of a medical institution that studies treatment behavior in URI and assessing the treatment efficacy in Korea. Methods : We analyzed the behavior of medical customers and providers of upper respiratory infection medications using the NPS published by the Health Insurance Review Assessment Service. We created an operational definition for complications, and confirmed the difference in complication distribution between medical specialties. We also performed a multivariate analysis using a mixed model to elucidate the factors influencing the occurrence of complications. Results : The outcomes of analyzing factors to influence the difference in practice patterns of the diagnosing URI between the physicians are as follows; (1) Analysis of antibiotics prescriptions rate showed significant difference from medical departments (pediatrics; 49.7%, internal medicine; 54.2%, otorhinolaryngology; 69.6%, family medicine; 61.6%, general surgery; 57.5%, p<0.001). Analysis of steroid prescriptions rate showed significant difference from medical departments (pediatrics; 3.8%, internal medicine; 4.5%, otorhinolaryngology; 5.4%, family medicine; 3.0%, general surgery; 11.2%, p<0.001). (2) In patients who visited medical institutes with the common cold, the complication distribution differed according to the medical specialty, which suggests that specific complications arise depending on the particular medical specialty (p<0.001). (3) Moreover, through multivariate analysis, we found that the complication rate is higher in clinics than in hospitals, depending on the institute's size. (p<0.001; odds ratio of 4.67 in clinics than in hospitals, 95% CI 2.66-8.21) Conclusions : We observe a deviation between the behavior of patients diagnosed with URI and medication providers. This may arise from the interaction between providers and consumers, wherein the complications are associated with the choice of outpatient department and the prevention of cutting incentives. These findings suggest that the health policies should be improved to prevent inappropriate medical practice in the treatment of pediatric URI.

• Journal of Preventive Medicine and Public Health
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• v.42 no.4
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• pp.251-260
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• 2009

Objectives : To estimate the annual socioeconomic costs of stroke in Korea in 2005 from a societal perspective. Methods : We identified those 20 years or older who had at least one national health insurance (NHI) claims record with a primary or a secondary diagnosis of stroke (ICD-10 codes: I60-I69, G45) in 2005. Direct medical costs of the stroke were measured from the NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting the hospitals. Indirect costs were defined as patients and caregivers productivity loss associated with office visits or hospitalization. Also, the costs of productivity loss due to premature death from stroke were calculated. Results : A total of 882,143 stroke patients were identified with prevalence for treatment of stroke at 2.44%. The total cost for the treatment of stroke in the nation was estimated to be 3,737 billion Korean won (KRW) which included direct costs at 1,130 billion KRW and indirect costs at 2,606 billion KRW. The per-capita cost of stroke was 3 million KRW for men and 2 million KRW for women. The total national spending for hemorrhagic and ischemic stroke was 1,323 billion KRW and 1,553 billion KRW, respectively, which together consisted of 77.0% of the total cost for stroke. Costs per patient for hemorrhagic and ischemic stroke were estimated at 6 million KRW and 2 million KRW, respectively. Conclusions : Stroke is a leading public health problem in Korea in terms of the economic burden. The indirect costs were identified as the largest component of the overall cost.

• Journal of Preventive Medicine and Public Health
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• v.42 no.3
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• pp.165-170
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• 2009

Objectives : We evaluated the risk of fracture associated with hypotension-related adverse drug reaction caused by taking alpha blockers to treat benign prostatic hyperplasia (BPH). Methods : We used the Health Insurance Review and Assessment Service database from January 1st 2005 to June 30th 2006 for this study. The male patients with BPH and who had a prescription for alpha blockers following any fractures were defined as the cases. We set the 20 day long hazard period prior to the index date and the four control periods whose lengths were same with hazard period. After 1:4 matching of the hazard and control periods, conditional logistic regression was used to calculate the odds ratios for the risk of fractures as related to the alpha blocker exposure. Results : Doxazosin and tamsulosin showed the increased risk of fractures, whereas terazosin did not. After stratification using the defined daily doses, a protective effect was shown for the patients who took terazosin at the doses lower than 0.4 DDD and the hazardous effect at the doses higher than or equal to 0.4 DDD. There was no significant difference for the risk of patients taking tamsulosin at the doses higher than 1.0 DDD but there was a statistically significant increase in the risk at the doses higher than or equal to 1.0 DDD. Conclusions : Alpha blockers for BPH may increase the risk of fracture in elderly patients who have comorbidities and take the concomitant medications. Alpha blockers need to be prescribed with caution, although some have high prostate specificity.

• Journal of Preventive Medicine and Public Health
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• v.42 no.2
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• pp.117-122
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• 2009

Objectives : We tried to evaluate the agreement of the Charlson comorbidity index values(CCI) obtained from different sources(medical records and National Health Insurance claims data) for gastric cancer patients. We also attempted to assess the prognostic value of these data for predicting 1-year mortality and length of the hospital stay(length of stay). Methods : Medical records of 284 gastric cancer patients were reviewed, and their National Health Insurance claims data and death certificates were also investigated. To evaluate agreement, the kappa coefficient was tested. Multiple logistic regression analysis and multiple linear regression analysis were performed to evaluate and compare the prognostic power for predicting 1 year mortality and length of stay. Results : The CCI values for each comorbid condition obtained from 2 different data sources appeared to poorly agree(kappa: 0.00-0.59). It was appeared that the CCI values based on both sources were not valid prognostic indicators of 1-year mortality. Only medical record-based CCI was a valid prognostic indicator of length of stay, even after adjustment of covariables($\beta$ = 0.112, 95% CI = [0.017-1.267]). Conclusions : There was a discrepancy between the data sources with regard to the value of CCI both for the prognostic power and its direction. Therefore, assuming that medical records are the gold standard for the source for CCI measurement, claims data is not an appropriate source for determining the CCI, at least for gastric cancer.

• Information Systems Review
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• v.18 no.2
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• pp.151-171
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• 2016

With the widespread adoption of mobile devices, such as smart phones and smart pads, as well as the rapid growth of mobile technologies, consumer shopping patterns are changing. This study investigates key factors of consumer purchasing intention in a mobile shopping mall context by incorporating trust belief into the theory of planned behavior. We posit perceived usefulness, perceived enjoyment, perceived ease of use, and trust belief as antecedents of behavioral attitude toward mobile shopping malls. Moreover, social influence and security are identified as key enablers of trust belief on mobile shopping malls. Data collected from 154 consumers with purchasing experience in mobile shopping malls are empirically tested against a research model using partial least squares. Analysis results show that behavioral attitude and perceived behavioral control significantly influence purchasing intention. Moreover, this study reveals the significant effects of perceived usefulness and perceived enjoyment on behavioral attitude. Trust belief indirectly influences purchasing intention through behavioral attitude and is significantly affected by social influence. Understanding consumer purchasing decision-making processes in mobile shopping malls can help service providers to develop effective marketing and operation strategies and campaigns.

• Information Systems Review
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• v.4 no.2
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• pp.323-341
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• 2002

Due to the development of information technology, IT industry has become the core factor of a country competence. So we recognized the importance of information network technology as a basis of IT industry. The infrastructure and service in domestic super-highway information networks show the rapid growth both in quantity and quality because of the government programs. However, foreign information network equipment companies have most of the domestic market-share and have controlled core part of the industry, thus national companies are having a difficulty in penetrating the industry market. In this paper, we will analyze domestic super-highway information network equipment industry and make its activating plan using competitive strategy model.

• Korean Journal of Ecology and Environment
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• v.53 no.1
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• pp.1-10
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• 2020

The Stream/River Ecosystem Survey and Health Assessment has been carried out regarding the ecological health of the streams by the Ministry of Environment (MOE), South Korea. However, the sources of impairment of the stream ecosystem and the interactions between the sources, stressors, and the responses of impaired streams have not been taken into consideration. The purpose of this study is to propose the establishment of diagnosis systems for the impaired stream ecosystem because of the need to incorporate the same in the making of the policy to enable the recovery and improvement of the health of the impaired streams or river ecosystem. First, we define the concept of a diagnosis of the impaired stream or river ecosystem through a literature review. Second, through case studies [e.g., US CADDIS (Causal Analysis/Diagnosis Decision Information System), AUS. Eco Evidence, EU WFD (Water Framework Directive)], we try to develop the diagnosis system for the making of policy. In this study, the diagnosis system that is proposed consists of eight steps including the basic data collection, detecting or suspecting impairment, defining the impaired stream reach, identifying the biological impaired cases and listing the candidate causes, illustrating the interactive conceptual diagrams between stressors and responses, investigating the stressors-responses in the field, verifying causes and identifying the probable causes of the impaired cases, and summarizing and proposing the restoration of the streams. The results of this study will support and enable efficient decision-making for sustainable stream restoration and management based on the diagnosis of the probable causes for the impaired complex and the diverse stream ecosystem.

• Journal of Korean Society of Transportation
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• v.23 no.3 s.81
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• pp.35-47
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• 2005

This paper is to review a literature concerning Bus Transit Route Network Design(BTRNDP), to describe a future study direction for a systematic application for the BTRNDP. Since a bus transit uses a fixed route, schedule, stop, therefore an approach methodology is different from that of auto network design problem. An approach methodology for BTRNDP is classified by 8 categories: manual & guideline, market analysis, system analytic model. heuristic model. hybrid model. experienced-based model. simulation-based model. mathematical optimization model. In most previous BTRNDP, objective function is to minimize user and operator costs, and constraints on the total operator cost, fleet size and service frequency are common to several previous approach. Transit trip assignment mostly use multi-path trip assignment. Since the search for optimal solution from a large search space of BTRNDP made up by all possible solutions, the mixed combinatorial problem are usually NP-hard. Therefore, previous researches for the BTRNDP use a sequential design process, which is composed of several design steps as follows: the generation of a candidate route set, the route analysis and evaluation process, the selection process of a optimal route set Future study will focus on a development of detailed OD trip table based on bus stop, systematic transit route network evaluation model. updated transit trip assignment technique and advanced solution search algorithm for BTRNDP.