• Journal of Preventive Medicine and Public Health
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• v.22 no.3 s.27
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• pp.398-405
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• 1989

A change in the consumer's surplus was measured in order to evaluate the social benefit to be derived from expanding health insurance to the entire population. The most refined and correct way to measure a project's net benefit to society is to determine a change in the consumer's surplus. Benefits from introducing the health insurance program to the uninsured people can be classified into two elements. The first is the pricing-down effect(E1) which results from applying the insurance price system, which is lower than the actual price, to the uninsured patients. The second effect(E2) is a decrease in actual payment because an insured patient pays only a portion of the total medical bill(copayment). We collected medical price information from the data banks of 93 hospitals, and obtained information of medical utilization by referring to the results of other research and from data published by the Korean Medical Insurance Societies. The total net benefit was estimated as \214 billion, comprising the first effect(E1) of \57 billion and the second effect(E2) of \157 billion. The price elasticity of physician visits is less than that of hospital admissions: however, benefits from the increase in physician visits are greater than those from hospital admissions because there are considerably more of physician visits than hospital admissions. The sensitivity analysis also shows the conclusion that expansion of the health insurance program to the entire population would result in a positive net benefit. Therfore, we conclude that the National Health Insurance Program is socially desirable.

• Journal of Korean Clinical Nursing Research
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• v.25 no.3
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• pp.275-284
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• 2019

Purpose: The purpose of this study was to analyze the current state of home health nursing (HHN) for elders and to provide basic data on policy alternatives for establishing home medical care in the advanced general hospital. Methods: This study was conducted as a secondary data analysis, using electronic medical record (EMR) data of older patients who received HHN more than once from the S advanced general hospital between January 2016 and December 2018. Results: A total of 1,790 patients received HHN visits, with 22,477 visits being made. The mean age was 76.8±7.3 years old, 96.0% of elders had health insurance and 24.6% had orthopedics problems. Of the 1,168 people who visited emergency rooms, the most frequent symptom was pain (23.4%) and all patients visited the hospital at least once and at most 163 times outpatient care during HHN. Causative diseases were degenerative knee joint osteoarthritis (0.6%), surgery for right knee replacement (4.0%), and for dressings (9.7%) in the HHN service content analysis. Conclusion: The progress towards an aging society and the introduction of community care are expected to further enhance the need for HHN which should be able to provide comprehensive and continuous visiting health care services to the older patients. The results of this study are expected to help doctors solve problems not solved by HHN, reduce unnecessary emergency room or outpatient visits, and readmission, while at the same time contributing to the improvement of patient quality of life through efficient patient health care.

• Journal of Preventive Medicine and Public Health
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• v.51 no.6
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• pp.265-274
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• 2018

Objectives: A positive association between air pollution and both the incidence and prevalence of diabetes mellitus (DM) has been reported in some epidemiologic and animal studies, but little research has evaluated the relationship between air pollution and diabetic coma. Diabetic coma is an acute complication of DM caused by diabetic ketoacidosis or hyperosmolar hyperglycemic state, which is characterized by extreme hyperglycemia accompanied by coma. We conducted a time-series study with a generalized additive model using a distributed-lag non-linear model to assess the association between ambient air pollution (particulate matter less than $10{\mu}m$ in aerodynamic diameter, nitrogen dioxide [$NO_2$], sulfur dioxide, carbon monoxide, and ozone) and emergency department (ED) visits for DM with coma in Seoul, Korea from 2005 to 2009. Methods: The ED data and medical records from the 3 years previous to each diabetic coma event were obtained from the Health Insurance Review and Assessment Service to examine the relationship with air pollutants. Results: Overall, the adjusted relative risks (RRs) for an interquartile range (IQR) increment of $NO_2$ was statistically significant at lag 1 (RR, 1.125; 95% confidence interval [CI], 1.039 to 1.219) in a single-lag model and both lag 0-1 (RR, 1.120; 95% CI, 1.028 to 1.219) and lag 0-3 (RR, 1.092; 95% CI, 1.005 to 1.186) in a cumulative-lag model. In a subgroup analysis, significant positive RRs were found for females for per-IQR increments of $NO_2$ at cumulative lag 0-3 (RR, 1.149; 95% CI, 1.022 to 1.291). Conclusions: The results of our study suggest that ambient air pollution, specifically $NO_2$, is associated with ED visits for diabetic coma.

• Korea Journal of Hospital Management
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• v.24 no.3
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• pp.1-10
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• 2019

Purpose: The purpose of this study was to investigate determinants of purchasing indemnity private health insurance and its impact on the healthcare utilization among outpatients with chronic disease. Methods: The study analyzed 4,997 chronic ill patients using 2015 Korean Health Panel data. Logistic regression analysis was conducted to analyze the factors affecting the purchase of indemnity private health insurance and multiple regression analysis was conducted to analyze the effect of private health insurance on the number of outpatient visits and outpatient expenditures. Findings: The age, education level, and number of chronic diseases were significant factors affecting the purchasing of indemnity private health insurance among chronic patients. As a result of analyzing the impact of indemnity private health insurance on healthcare utilization, the number of outpatient visits for those who enrolled in the indemnity private health insurance was higher than the number of outpatient visits for those who did not. But there was no statistically significant difference in outpatient medical expenses. Practical Implications: The results of this study shows that indemnity private health insurance may cause inequality in the healthcare utilization of the socially vulnerable. It is necessary to seek ways to strengthen the health security of chronic disease patients and high-risk elderly people who need more healthcare.

• Journal of Forest and Environmental Science
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• v.38 no.1
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• pp.55-63
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• 2022

The African swine fever virus (ASFV) remains contagious for a long time, not only in the carcass, but also in the bone marrow of an infected animal. The scavenging activity of various animals on ASFV-infected carcasses is a likely risk factor for ASFV transmission. Thus, we conducted this study to determine whether scavengers are potential vectors for ASFV. In nonprotected wild boar carcasses on the forest floor, we investigated the seasonal patterns of carcass decomposition and scavenger visits for feeding on them. The duration from fresh to early skeletonization (only bones and leather remaining) of adult carcasses was 37.6±23.1 days (n=3, range=11-51 days) in winter. The duration from fresh to later skeletonization (only bones and some fur remaining) of all carcasses, including subadult carcasses, was 8.3±2.5 days (n=4, range=7-12 days) in summer. At all three study sites, leopard cats (30.3%), large-billed crows (21.6%), and golden eagles (18.1%) were the frequently visiting species, representing more than 10% of the total visits (343 visits) in winter, whereas raccoons (21.9%), grey-backed thrushes (39.4%), and eyebrowed thrushes (14.7%) were the most frequent visitors in summer. In winter, crows or cinereous vultures were the first animals to arrive at a carcass; in summer, raccoons or crows arrived first. Our results showed that wild boars, raccoons, and leopard cats relatively frequently visited wild boar carcasses and stayed there for a long time. Wild rodents chewing on or staying near carcasses were photographed during winter. In addition to wild boars, thus, mammals, such as raccoons, leopard cats and rodents, and birds, such as accipitrids and thrushes, may be spreaders of ASFV in South Korea.

• The Journal of Pediatrics of Korean Medicine
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• v.36 no.2
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• pp.1-12
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• 2022

Objectives We analyzed visiting patterns to medical institutions and cost per visit according to the common cold patients aged 0-19 years. We analyzed Korean medical treatment for common cold. Methods Using the Pediatric Patient Sample data of the Health Insurance Review and Assessment Service (HIRA-PPS), we analyzed the data on health insurance claims of approximately 1 million people from 2017 to 2019. The data included the number of patients who visited the hospital due to common cold for the first and second time, the ratio of second visits by type of medical institution, and the status of prescriptions in Korean medical institutions. Results The number of patients visiting healthcare providers for common cold was higher in Western medical institutions than in Korean medical institutions. However, the number of second visits was higher in Korean medical institutions. Acupuncture is the most commonly used medical treatment in Korean medical institutions for common cold. Herbal medicine for common cold was usually prescribed for 2-3 days for children and adolescents. Conclusions Although the average medical cost of Korean medical institutions was higher than that of Western medical institutions, the rate of second visits to Korean medical institutions was higher because of the demand for Korean medical treatment

• The Journal of Korean Medicine
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• v.44 no.2
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• pp.10-19
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• 2023

Objectives: This study aimed to find out the characteristics of patients with facial palsy based on the National Health Insurance(NHI) statistical yearbook and provide the information pertaining to supplement Coverage of NHI. Methods: Based on the data of NHI between 2004 to 2021 for facial palsy(G51) obtained from the Ministry of Health and Welfare, the analyses were carried out according to the distribution of gender and the number of patients, visits, reimbursed days, and medical expenses by using the SAS 9.4. Results: The crude rate of facial palsy was reported as 361.71(2021) comparable with 419.60(2004) and 534.11(2009). The rate of men increased from 293.96(2004) to 302.27(2021) but the rate of women decreased from 450.88(2014) to 420.80(2021). The number of patients maintained around 190,000, however, it declined for patients treated Korean medicine(KM) after 2010. As the medical expenses were elevated, especially Western medicine(WM), that of WM exceeded KM's since 2018. The expenses of women were higher than men's in KM. By contrast, there was no difference with gender in WM. For reimbursed days per visits, it has been increased in WM but there was no difference in KM. Conclusion: Although the rate of patients with facial palsy in KM was high with no difference in the whole number of patients and reimbursed days per visits in KM annually, the number of patients in KM decreased but medical expenses elevated. According to this, it is necessary for reinforcing Coverage of NHI to research other factors related to KM.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.4
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• pp.189-198
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• 2023

Purpose: This study aims to investigate the preferences of hot spring users regarding the utilization of Asan's hot springs after the COVID-19 pandemic. Methods: A survey was conducted on 340 hot spring users visiting hot spring resorts in the Onyang, Dogo, and Asan hot spring districts. The survey was conducted twice from November 5th to November 7th, 2021, and from May 25th to 26th, 2022. The survey included general questions, such as the frequency of hot spring usage, the purpose of visits, and the intention for future visits. Specific questions were related to Asan hot springs, focusing on the reasons for choosing Asan, its perceived advantages, and improvement suggestions. Results: The survey revealed that the average number of visits to hot springs was less than five in the past five years, and the main reason for visiting was to recover from fatigue. A percentage of respondents said they would use hot springs more often when the COVID-19 pandemic ends. When asked about their reasons for visiting Asan hot springs, responses varied by age. However, across all groups, the majority considered "good water" as an advantage of Asan hot springs, while improvements to "hot spring facilities" was the highest response among all age groups. Thus, despite the decline in the number of customers due to COVID-19, the overall perception of hot springs remains positive. This suggests a promising future for the hot spring industry, with the potential for a return to pre-pandemic usage levels. Conclusion: These results provide valuable foundational data for informing policy development aimed at revitalizing the hot spring industry in the post-COVID-19 era.

• The Korean Journal of Emergency Medical Services
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• v.27 no.3
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• pp.47-58
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• 2023

Purpose: The purpose of this study was to analyze the characteristics of patients who canceled their ED visits and to determine the factors that influence ED cancellation. Methods: Retrospective study that analyzed data from the electronic medical records(EMR) and Prehospital Care Reports(PCRs) of 305 patients who cancelled their appointments at a single emergency medical center over a six-month period from October 12, 2022, to April 12, 2023. Results: ED cancellations were 2.287 times higher if the patient presented to the ambulance after outpatient hours(09:00~17:00) (p=.007), and ED cancellations were 3.712 times higher if the patient presented to the ambulance under the influence of alcohol(p=.011). For patients' symptoms, medical diseases were associated with a 1.965 times increase in cancelled ED visits compared to other modes of transport (p=.005), while mental and chronic diseases were associated with a 67.3% decrease in cancelled ED visits compared to other modes of transport (OR=0.327, CI=[0.130-0.822], p=.018). symptomatic improvement was associated with a 2.482 times increase in presentations to a 119 ambulance compared to delayed waiting time(p=.022). Conclusion: Emergency medical centers should consider improving the legal system, such as increasing emergency medical care fees, to reduce the number of patients who cancel their appointments.

• Journal of the korean academy of Pediatric Dentistry
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• v.50 no.4
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• pp.452-468
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• 2023

This study aims to investigate changes in dental service use among pediatric patients during the COVID-19 pandemic. The analysis was performed by collecting information about the number of visits, age, gender, diagnoses, and treatments for patients at the Pediatric Dentistry Department of Seoul National University Dental Hospital from January 2017 to December 2022. Compared with the period from 2017 to 2019, the total number of visits decreased during the COVID-19 pandemic, with a substantial decline in 2020. Patients in all age groups, except those aged 10 - 14, experienced decreased visits, and there was no significant gender difference. Z29.8 (need for other specified prophylactic measures) declined in all age groups, especially among those aged 0 - 4, except for those 20 years and older. K02.1 (caries of dentine) was sought by the age groups in the following order: 10 - 14, 15 - 19, 5 - 9, and 0 - 4 years, with the most significant decrease in the 0 - 4 years age group compared to others. K07.4 (malocclusion, unspecified) decreased in younger groups aged 9 and below but increased in older groups aged 10 and above. During the period from 2020 to 2022, preventive, restorative, pulp, and trauma treatments decreased, but surgical and orthodontic treatments increased compared with the previous three years. The use of sedation decreased and general anesthesia increased during COVID-19 compared to pre-pandemic. This study describes the impact of the COVID-19 pandemic on pediatric dentistry, making it a valuable reference for future pandemics.