• Health Policy and Management
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• v.32 no.3
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• pp.282-292
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• 2022

Background: Aging societies face social problems of increased medical expenses for older adults due to increased geriatric diseases. This study aims to analyze the relationship between the state change of multiple chronic conditions (MCC) and out-of-pocket medical expenses in the elderly aged 60 or older. Methods: The 2014-2018 Korean Longitudinal Study of Aging data were used for 2,202 elderly people. Four status change groups were established according to the change in the number of chronic diseases. The association between the change of MCC and the out-of-pocket medical cost was analyzed using the generalized estimating equation model analysis. Results: The average out-of-pocket total medical costs were 1,384,900 won for participants with MCC and 542,700 won for those without MCC, which was a statistically significant difference (p<0.0001). Compared to the reference group (simple chronic disease, SCD→SCD), the change in multiple chronic conditions significantly increased the total out-of-pocket medical expenses in MCC→MCC and SCD→MCC groups (MCC→MCC: 𝛽=0.8260, p<0.0001; SCD→MCC: 𝛽=0.6607, p<0.0001). Conclusion: In this study, it was confirmed that the prevalence of MCC increased with age, and the out-of-pocket medical cost increased in the case of MCC. Continuity of treatment can be achieved for patients with MCC, and the system and management of treatment for MCC are required to receive appropriate treatment.

• Hip & pelvis
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• v.36 no.2
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• pp.144-154
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• 2024

Purpose: The objective of this study was to assess postoperative direct medical expenses and medical utilization of elderly patients who underwent either hemiarthroplasty (HA) or internal fixation (IF) for treatment of a femoral intertrochanteric fracture and to analyze differences according to surgical methods and age groups. Materials and Methods: Data from the 2011 to 2018 Korean National Health Insurance Review & Assessment Service database were used. Risk-set matching was performed for selection of controls representing patients with the same sex, age, and year of surgery. A comparative interrupted time series analysis was performed for evaluation of differences in medical expenses and utilization between the two groups. Results: A total of 10,405 patients who underwent IF surgery and 10,405 control patients who underwent HA surgery were included. Medical expenses were 18% lower in the IF group compared to the HA group during the first year after the fracture (difference-in-difference [DID] estimate ratio 0.82, 95% confidence interval [CI] 0.77-0.87, P<0.001), and 9% lower in the second year (DID estimate ratio 0.91, 95% CI 0.85-0.99, P=0.018). Length of hospital stay was significantly shorter in the IF group compared to the HA group during the first two years after time zero in the age ≥80 group. Conclusion: A noticeable increase in medical expenses was observed for patients who underwent HA for treatment of intertrochanteric fractures compared to those who underwent IF over a two-year period after surgery. Therefore, consideration of such findings is critical when designing healthcare policy support for management of intertrochanteric fractures.

• Journal of Environmental Impact Assessment
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• v.8 no.2
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• pp.65-71
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• 1999

Characteristics of food garbage discharged from primary schools in Seoul Metropolitan city were analysed from a recycling point of view. The results of study are epitomized as follows : 1. Factors of generation of food garbage are mainly an unbalanced diet habit, indifference of class teachers, and worn-out cooking equipments. 2. Measures of reduction are principally a written message to parents, broadcasting in the school, and instructions. 3. Methods of recycling are mainly feed stuff, composting by school itself, composting on commission, and making feed stuff on commission. 4. Obstacles of food garbage recycling are a nasty smell of composting apparatus, an excessive fuel consumption of composting apparatus, a high concentration of salt, and an unstable demand for feed stuff and compost produced from food garbage. 5. Correlation factors are like follows : the number of feeding children and food garbage weight after cooking is 0.35, total food garbage generated and monthly treatment cost of food garbage is 0.20, individual school lunch expenses and food garbage weight after cooking is -0.10, individual school lunch expenses and food garbage generated per capita is 0.02, and individual school lunch expenses and monthly treatment cost of food garbage is 0.03.

• Journal of Korean society of Dental Hygiene
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• v.20 no.5
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• pp.707-716
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• 2020

Objectives: This study aims to provide basic data for high-quality dental services. In addition, we will promote the operation of preventive dentistry that implements preventive measures. It was conducted to study the change of patient's treatment behavior and treatment cost due to the discontinuation of preventive dentistry in university dental hospitals. Methods: This study collected data using the integrated medical information system of the C University Dental Hospital. From September 1, 2017 to August 31, 2019, data were analyzed using frequency, percentage, mean, standard deviation, chi-square test using SPSS version 24.0 statistical program, and T-test. Results: There was a significant difference in the number of preventive dental treatment cases from 58.3% of preventive dental operation periods to 41.7% of preventive dental operation periods. As a result of comparing the medical expenses, the total medical expenses during the preventive dental operation period decreased from 521,308,872 won to 379,724,995 won during the discontinuation period, 141,583,877 won. The number of medical treatments by treatment behavior decreased 3,835 (28.4%) from a total of 13,520 preventive dental operation periods to 9,685. Conclusions: This study is meaningful as the first study to confirm the change in the treatment behavior and the change in the cost of treatment due to the discontinuation of the operation of preventive dentistry at university dental hospitals. In conclusion, it is thought that there is a possibility of the lack of accessibility and the limitation of professional preventive care due to the discontinuation of preventive dentistry.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.8
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• pp.407-414
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• 2016

This study was conducted to provide basic data to evaluate the appropriateness of convalescent hospitalization treatment by investigating the number of hospitalization days and the total treatment expenses of a total of 44,037 monthly billing statements requested from the Health Insurance Review and Assessment Service. Evaluated data consisted of medical care expenses of patients of the diem payment system hospitalized at convalescent hospitals in Daejeon, Chungnam, Chungbuk and Sejong from January through December of 2014. According to the analysis result of the general characteristics of the study objects and the canonical correlation analysis of the top 15 main diagnosis names, 7 canonical functions have been deducted. Among them, six canonical functions were shown to be statistically significant (p<0.001), and canonical function 1 had a chi-squared value of 5955.49 and 98 degrees of freedom at p<0.001 level. Overall, the results indicated that if health and welfare service in the regional society is magnified, social hospitalization can be reduced.

• The Journal of Pediatrics of Korean Medicine
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• v.37 no.3
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• pp.1-16
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• 2023

Objectives We aimed to investigate the effectiveness of the Korean medical critical pathway (CP) in treating childhood anorexia. Methods In total, 21 patients who met the criteria and agreed to provide information were assigned to the CP group, while 24 patients who met the criteria, agreed to provide information, but disagreed with CP application were assigned to the non-CP group. Demographic, clinical, and economic indices were compared between the two groups. Clinical indices before and after treatment were also compared between the two groups. Results In the CP group, height, weight, body mass index (BMI), BMI percentile, and food approach (FAP) increased significantly after treatment, and numeric rating scale (NRS) and food avoidance (FAV) scores decreased significantly. In the non-CP group, height, weight, weight percentile, BMI, BMI percentile, and FAP increased significantly, whereas NRS and FAV decreased significantly after treatment. Compared to the non-CP group, CP application increased FAP and decreased FAV, medical expenses per consultation, and the total treatment period. Conclusions The application of the Korean medical critical pathway for childhood anorexia is an effective cure system that decreases overall medical expenses with good-quality treatment by means of the standardization of medical practices.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.3
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• pp.159-175
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• 2013

Objectives Herniated Intervertebral Disc of C-spine is one of the most common diseases that causes posterior neck pain. This study was designed to analyze the general distribution and hospital cost by day and case of Korean medical treatment for Cervical Herniated Intervertebral Disc (HIVD). Methods The 132 impatients for treatment of HIVD were analyzed according to the distribution of sex, age, the duration of HIVD, the contributory factors, the Clinical grade at admission, the clinical findings at admission, the duration of hospitalization, the clinical grade at admission and the hospital cost per day and case. Results 1) The total hospital cost per case averaged 1,985,600 Won, which was consisted of room charge 584,044 Won (29.41%), performance fee 511,463 Won (25.76%), herbal medication 381,517 Won (19.21%), Korean medical physiotherapy 296,310 Won (14.92%), food expenses 199,997 Won (10.07%) in order. 2) The total hospital cost per day averaged 137,285 Won, which was consisted of room charge 39,036 Won (28.43%), performance fee 33,594 Won (24.47%), herbal medication 30,642 Won (22.32%), food expenses 12,870 Won (9.37%), and the average duration of hospitalization was 15.1 days. 3) There was statistically significant difference in the consultation fee, room charge, and herbal medication on the part of sex. 4) There was statistically significant difference not only in the performance and consultation on the part of duration of hospitalization but also the in the duration of average duration of hospitalization. 5) There was statistically significant difference in the Korean medical physiotherapy and herbal medication on the part of clinical findings. 6) There was statistically significant difference in the Korean medical physiotherapy and herbal medication on the part of duration of HIVD. 7) There was statistically significant difference in the Korean medical physiotherapy and herbal medication on the part of clinical outcome. 8) There was not only statistically significant difference in the performance, but also in the herbal medication on the part of clinical grade at admission. Conclusions This study provides plenty of information to design out the specific terms of Korean medical expenses of Cervical HIVD inpatients hospitalized at Korean medicine hospital.

• Journal of Oriental Neuropsychiatry
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• v.33 no.2
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• pp.123-131
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• 2022

Objectives: The purpose of this study was to investigate the experience and perception of using Korean medicine treatments for patients with mental disorders. Methods: The method of a qualitative analysis was used, and semi-structured interviews were conducted. The researchers developed the survey questionnaires with consultation from psychiatrists from various university hospitals. Before conducting interviews, an IRB was approved KHSIRB-21-131 (RA), and the Hankook Research Company managed the interviews. The question composition comprised 11 questions based on symptoms and treatment situations accompanying treatment due to mental distress, perception of Korean medicine, awareness of treatment costs, and awareness of treatment costs. Results: A total of six patients were interviewed. Each interviewee took 90 minutes to answer questions. Through the analysis of the data, the patients comprised four categories: characteristics, awareness of Korean medicine, awareness of Western treatment, and daily life due to mental disorder. The experience and perception of patients using Korean medicine showed positive attitudes. There was an opinion among patients that Korean medicine treatment was less dependent on drugs, and had fewer side effects, than Western medicine. Some patients said that Korean medical treatment is expensive and burdensome medical expenses. Some patients were not aware of the application of insurance to mitigate medical expenses. Conclusions: Based on the findings of the study, it is urgent to expand the application of insurance benefits to Korean medicine.

• Tuberculosis and Respiratory Diseases
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• v.81 no.3
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• pp.241-246
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• 2018

Background: The "Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Groups)" is a national program for socioeconomically vulnerable tuberculosis (TB) patients. We sought to evaluate the clinical and socioeconomic characteristics of poverty-stricken TB patients, and determined the need for relief. Methods: We examined in-patients with TB, who were supported by this project at the National Medical Center from 2014 to 2015. We retrospectively investigated the patients' socioeconomic status, clinical characteristics, and project expenditures. Results: Fifty-eight patients were enrolled. Among 55 patients with known income status, 24 (43.6%) had no income. Most patients (80%) lived alone. A total of 48 patients (82.8%) had more than one underlying disease. More than half of the enrolled patients (30 patients, 51.7%) had smear-positive TB. Cavitary disease was found in 38 patients (65.5%). Among the 38 patients with known resistance status, 19 (50%) had drug-resistant TB. In terms of disease severity, 96.6% of the cases had moderate-to-severe disease. A total of 14 patients (26.4%) died during treatment. Nursing expenses were supported for 12 patients (20.7%), with patient transportation costs reimbursed for 35 patients (60%). In terms of treatment expenses for 31 people (53.4%), 93.5% of them were supported by uninsured benefits. Conclusion: Underlying disease, infectivity, drug resistance, severity, and death occurred frequently in socioeconomically vulnerable patients with TB. Many uninsured treatment costs were not supported by the current government TB programs, and the "Tuberculosis Relief Belt Supporting Project" compensated for these limitations.

• Journal of Korean Physical Therapy Science
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• v.4 no.2
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• pp.421-432
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• 1997

To find out the actual status of treatment of physically handicapped who were stayed of home, 320 physically handicapped persons were selected among total 6,264 physically handicapped registered in Taejon city, surveyed from January 1st to March 30, 1997. Following are the results ana lysed of collected data from 201 samped persons. 1. For the cause of physically handicapped, 36.3% was congenital, 26.9% was cerebralvascular acciednt(CVA). and 14.9% was infectious diseases and others in that orders. The must frequest cause of below 20 years age group was congenital cause, but that of $20{\sim}30$ years age group and $40{\sim}50$ years age group were accident and CVA repectively. 30.0% of respondents caused by infection and others earned household living expenses. Household living expenses were higher among the respondents caused by congenital cause but those were lowest in the accidental couse group. Handicap durations were longer in the accidental cause group and infections and others group than the congenital cause group and CVA group. 2. 54.7% of studied handicapped were under treatment. But 36.3% of them were stopped treatment, and 8.9 % of them answered not treated. Most handicapped, coused by congenital and CAV, were under treatment, but most of them caused by accidental and others were stopped treatment. 3. For the medical facilities, 54.5% of them utilized welfare facility, but 25.5% utilized general hospital and 20.0% of them utilized oriental medical hospital and health centers. Congenital cause group frequently selected welfare facility for the treatment facility. But accidental cause group frequently seleced general hospitals and CVA gruop frequently selected oriental medical hospital and others. The medical cost of welfare facility, oriental medical hospitals and others were lower than that of general hospitals. 4. The proportions of under treatment were higher among yonger age higher monthly living expenses group shorter handicapped duration groups, congenital cause group and handicap grade II group. But that of stop treatment were higher among congenital cause group, infectious and others cause group, and handicap grade I & then III group. 5. For the feelings satisfacion about medical treatment, only 35.3% of under treated group responed satisfation. 55.5% of them responded so-so, but 9.1 % responed dissatisfaction. The proportion of satisfaction was higher among shorter handicap duration group.