• Title/Summary/Keyword: benefit analysis

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A Study of Task and Approach for the Insurance Fee Application of Packed Medical Herbs (첩약의 보험급여 적용을 위한 과제 및 접근방안에 대한 연구)

  • Park Yong-Sin;Cho Byung-Hee;Kim Ho;Lee Si-Baek
    • Journal of Society of Preventive Korean Medicine
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    • v.7 no.1
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    • pp.17-28
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    • 2003
  • We met results like the followings through the literatures and questionnaires about the tasks and solutions about the insurance fee of packed medical herbs. 1) It's turned out that 74.8% of herb doctors agrees to the insurance fee of packed medical herbs. However, in comparison with the same survey of the herb doctor association the percentage of general approval went somewhat lower, and especially the percentage of 'positive approval' became notably lower$(43.7%{\rightarrow}26.5%)$ and the percentage of 'active objection' raised about 2 times$(6.8%{\rightarrow}12.9%)$. Inquiring into the approval reasons on the insurance fee application of packed medical herbs some heads such as 'development toward treatment medical science' and 'decrease of publics burden' were higher than the one of 'management income and expenditure.' 2) As a result of the research, 36.0% of the patients and 42.8% of the residents recognized that the pay range of Chinese herb health insurance is narrow. They recognized that less people have the experiences of Chinese medical hospital use and internal application of the packed medical herbs as they are older, men rather than women. 85.4% of the patients and 74.9% of the residents agreed on the insurance pay of packed medical herbs. It's shown that they agree on the Chinese medical hospital use more as the economic standard is lower, on the insurance pay as they have ever taken the packed medical herbs. In the aspect of increase of insurance fee, 66.7% of the patients and 44.3% of the residents agreed on the insurance pay of packed medical herbs, and 18.1% and 36.1% disagreed on the insurance pay of packed medical herbs. The main objective reason why they disagree on the insurance pay of packed medical herbs was 'because the insurance fee goes up higher,' which answered 95.2% of the patients and 78.8% of the residents. 7.22% of the patients and 1.80% of the residents answered that they can pay more insurance fee in case of the insurance pay of packed medical herbs. However, in the priority order of the insurance pay, it hold the 5th position between 2 target research groups which was less than medical examination, charges for hospital accommodation and taking MRI. 3) According to the result of analysis about the cost of packed medical herbs, current practice price is 115,000 won and the average prime cost of a packed medical herb is 73,000 to 106,000 won. It's examined that the herb doctors regard that 95,000 won will be reasonable when the packed medical herb is payed in insurance. However, it was found out that the public generally thinks that the price would be appropriate on the level of 30,000 to 40,000 won and the percentage of the answers of 20,000 won to 30,000 was fairly high. 4) the central system of a prescription should be change into the central system of demonstration and the sick and wounded. 5) To solve this problem, the government should regulate it to pass by the circulation gradation of [importer, $peasantry{\rightarrow}manufacturer{\rightarrow}wholesaler{\rightarrow}distributor$(Chinese medical hospital, pharmacy dispensary of Chinese medicine)]And it should intervene into the quality and the circulation steps of Chinese medicine through 'the office or organization which is in charge of certification of Chinese medicine' and 'the office or organization which is in charge of the circulation of Chinese medicine.' And some actions such as simple severance, lavation, drying should be included into the conception of manufacture and the boundary between food and medical supplies should be made at a manufactory. And the regulation of standardized goods at one's own house should be improved so that, the peasantry can sell the materials of Chinese medicine only to the manufacturer. 6) In company with the insurance pay of packed medical herbs, the study about the separation of dispensary from medical practice in the Chinese medicine should be accomplished.

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Prediction Model of Exercise Behaviors in Patients with Arthritis (by Pender's revised Health Promotion Model) (관절염 환자의 운동행위 예측모형 (Pender의 재개정된 건강증진 모형에 의한))

  • Lim, Nan-Young;Suh, Gil-Hee
    • Journal of muscle and joint health
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    • v.8 no.1
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    • pp.122-140
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    • 2001
  • The aims of this study were to understand and to predict the determinent factors affecting the exercise behaviors and physical fitness by testing the Pender's revised health promotion model, and to help the patients with rheumatoid arthritis and osteoarthritis perform the continous exercise program, and to help them maximize the physical effect such as muscle strength, endurance, and functional status and mental effects including self efficacy and quality of life, and improve the physical and mental well being, and to provide a basis for the nursing intervention strategies. Of the selected variables in this study, the endogenous variables included the physical fitness, exercise score, exercise participation, perceived benefits of action, perceived barriers of action to exercise, activity-related affect(depression) and perceived self-efficacy, interpersonal influences(family support), situational factors(duration of arthritis, fatigue) and the exogenous variables included personal sociocultural factor(education level), personal biologic factor(body mass index), personal psychologic factor(perceived health status) and prior related behavior factors(previous participation in exercise, life-style). We analyzed the clinical records of 208 patients with rheumatoid arthritis and degenerative arthritis who visited the outpatient clinics at H university hospital in Seoul. Data were composed of self reported qustionnaire and good of fitness score which were obtained by padalling the ergometer of bicycle for 9 minutes. SPSS Win 8.0 and Window LISREL 8.12a were used for statistical analysis. Of 75 hypothetical paths that influence on physical fitness, exercise participation, exercise score, perceived benefits of action, perceived barriers of action to exercise, activity-related affect(depression) and perceived self-efficacy, interpersonal influences(family support), situational factors(duration of arthritis, fatigue), 40 were supported. The physical fitness was directly influenced by life-style, perceived health status, education level, family support, fatigue, which explained 12% of physical fitness. The exercise participation were directly influenced by life-style, education level, past exercise behavior, perceived benefits of action, perceived barriers of action, depression and duration of arthritis, which explained 47% of exercise participation. Exercise score were directly affected by perceived self efficacy. BMI, life-style, past exercise behavior, perceived benefits of action, family support, perceived health status. perceived barriers of action, and fatigue, which explained 70%. Perceived benefits of action was directly influenced by BMI, life-style, which explained 39%. Perceived barriers of action were directly influeced by past exercise behavior, perceived health status, which explained 7%. Perceived self efficacy were directly influeced by level of education, perceived health status, life-style, which explained 57%. Depression were directly influeced by past exercise behavior, BMI, life-style, which explained 27%. Family support were directly influeced by life-style, perceived health status, which explained 29%. Fatigue were directly influeced by BMI, life-style, perceived health status. which explained 41%. Duration of arthritis were directly influeced by life-style, past exercise behavior, BMI, which explained 6%. In conclusion, important variables for physical fitness were life-style, and variable affecting exercise participation were life-style. Perceived self-efficacy of exercise was a significant predictor of exercise score. BMI, Life-style, perceived benefits of action, family support, past exercise behavior showed direct effects on perceived self-efficacy. Therefore, disease related factor should be minimized for physical performance and well being in nursing intervention for patients with rheumatoid arthritis, and plans to promote and continue exercise should be seeked to reduce disability. In addition, Exercise program should be planned and performed by the exact evaluation of exercise according to the ability of the patients and the contents to improve the importance of exercise and self efficacy in self control program, dedicated educational program should be involved. This study suggest that the methods to reduce the disease related factors, the importance of daily life-style, recognition of benefit of exercise, and educational program to promote self efficacy should be considered in the exercise behavior promotion and nursing intervention for continous performance. The significance of this study is also thought to provide patients with chronic arthritis the specific data for maximal physical and mental well being through exercise, chronic therapeutic procedure, daily adaptation and confrontation in nursing intervention.

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Accessibility Analysis in Mapping Cultural Ecosystem Service of Namyangju-si (접근성 개념을 적용한 문화서비스 평가 -남양주시를 대상으로-)

  • Jun, Baysok;Kang, Wanmo;Lee, Jaehyuck;Kim, Sunghoon;Kim, Byeori;Kim, Ilkwon;Lee, Jooeun;Kwon, Hyuksoo
    • Journal of Environmental Impact Assessment
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    • v.27 no.4
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    • pp.367-377
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    • 2018
  • A cultural ecosystem service(CES), which is non-material benefit that human gains from ecosystem, has been recently further recognized as gross national income increases. Previous researches proposed to quantify the value of CES, which still remains as a challenging issue today due to its social and cultural subjectivity. This study proposes new way of assessing CES which is called Cultural Service Opportunity Spectrum(CSOS). CSOS is accessibility based CES assessment methodology for regional scale and it is designed to be applicable for any regions in Korea for supporting decision making process. CSOS employed public spatial data which are road network and population density map. In addition, the results of 'Rapid Assessment of Natural Assets' implemented by National Institute of Ecology, Korea were used as a complementary data. CSOS was applied to Namyangju-si and the methodology resulted in revealing specific areas with great accessibility to 'Natural Assets' in the region. Based on the results, the advantages and limitations of the methodology were discussed with regard to weighting three main factors and in contrast to Scenic Quality model and Recreation model of InVEST which have been commonly used for assessing CES today due to its convenience today.

Risk Factors for the Failure of Non-operative Reduction of Intussusceptions (장중첩증에서 비수술적 정복의 실패 위험인자)

  • Ko, Kwang-Min;Song, Young-Wooh;Je, Bo-Kyung;Han, Jae-Joon;Woo, Chan-Wook;Choi, Byung-Min;Lee, Jung-Hwa
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.110-115
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    • 2008
  • Purpose: Intussusceptions are one of the most common causes of intestinal obstruction in infants and young children. Although it is easily treated by non-operative reduction using barium, water or air, this treatment is very stressful for young patients and may cause bowel perforation, peritonitis and shock. In this study, we identified the risk factors associated with the failure of non-operative reduction, to identify a group of children that would benefit from the procedure and those who would not. Methods: We reviewed the medical records of patients with intussusception who were treated at the Korea University Medical Center Ansan hospital from March 1998 to July 2006. Three hundred fourteen children with intussusception were identified. Among them, non-operative reductions were performed in three hundred. Clinical and radiological variables were compared according to the failure or success of the non-operative reduction. Results: Non-operative reductions were successful in 243 (81%) and failed in 57 (19%). The group that had failed procedures had a younger age (12.3${\pm}$17.2 months vs. 18.0${\pm}$15.8 months, p=0.03), longer symptom duration before reduction (33.6${\pm}$29.0 hr vs. 21.5${\pm}$20.3 hr, p<0.01), more vomiting and lethargy (p<0.01), but less abdominal pain and irritability (p<0.01), compared with the group that had a successful procedure. Logistic regression analysis showed that the factors associated with the failure of non-operative reductions were a younger age, less than 6 months of age (odds ratio: 2.5, 95% confidence interval: 1.2~5.2, p=0.01), duration of symptoms, longer than 24 hrs before reduction (odds ratio: 2.1, 95% confidence interval: 1.2~4.2, p=0.03), bloody stool (odds ratio: 4.8, 95% confidence interval: 1.9~12.2, p<0.01), lethargy (odds ratio: 3.4, 95% confidence interval: 1.1~10.4, p=0.04), and abdominal pain or irritability (odds ratio: 0.2, 95% confidence interval: 0.1~0.4, p<0.01). Conclusion: For children with intussusception, an age younger than 6 months, and duration of symptoms more than 24 hrs before reduction, as well as the presence of bloody stools, lethargy and abdominal pain or irritability were variables associated with failure of a non-operative reduction. Knowledge of these variables should be considered in making clinical decisions for therapeutic interventions.

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The Predictors of Cerebral Infarction in Mitral Stenosis (승모판협착증 환자에서 뇌경색발생의 예측인자)

  • Kim, Hyung-Jun;Kim, Woong;Lee, Jong-Suk;Hong, Gue-Ru;Park, Jong-Sean;Sin, Dong-Gu;Kim, Young-Jo;Shim, Bong-Sup
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.75-81
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    • 2000
  • Background: Systemic embolism, especially, cerebral infarction is one of the most important complications in patients with mitral stenosis. The authors analyzed the some factors that could predict the development of cerebral infarction in cases of mitral stenosis and propose preventive therapeutic measures. Methods: Retrospective study of 127 patients with rheumatic mitral stenosis was performed by analyzing their medical records for transthoracic(TTE) or transesophageal echocardiography(TEE) over a 12 months period. The patients were divided into two groups according to the presence (Group I: n=26, age: $55.0{\pm}13$ years) or absence (Group II: n=101, age: $48.5{\pm}13$ years) of cerebral infarction. No significant difference was observed between the two groups with respect to sex and functional class. Results: Patients in group I were older ($55.0{\pm}13$ vs $48.5{\pm}13$;p<0.05). had more dilated left atrial size($5.10{\pm}0.48$ vs $4.81{\pm}0.70$;p<0.05) and smaller mitral surface area($1.01{\pm}0.39$ vs $1.21{\pm}0.45$;p<0.05). In Group 1. the incidence of atrial fibrillation(22 out of 26 vs 57 out of 101;p<0.05) and spontaneous left intra-atrial contrast phenomenon(22 out of 26 vs 44 out of 101;p<0.05) was more frequently observed. On multivariate analysis. atrial fibrillation and anticoagulant therapy were the independent predictive factors. Conclusion: Age, left atrial dilatation, the severity of mitral stenosis, the presence of spontaneous contrast, and especially the presence of atrial fibrillation are the main predictive factors of the development of cerebral infarction in mitral stenosis. Patients presenting one or several of these factors may benefit from prophylactic anticoagulant treatment.

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A Study on Ensuring Biosafety of Biotechnology Product under Debate about Trade and the Environment (DDA 무역-환경 논의와 생명공학제품의 안전성 확보)

  • Sung, Bong-Suk;Yoon, Ki-Kwan
    • Environmental and Resource Economics Review
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    • v.13 no.3
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    • pp.519-547
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    • 2004
  • This paper analyze problems about scope of specific trade obligations(STOs), principle of dispute settlement procedure, and non-parties in context of the Cartagena Protocol on Biosafety(POB), which based on sub-paragraph 31(i) of DDA WTO Ministrial Declaration. The implications based on result of this study are as follows. First, to accept the wider scope of STOs under POB in Korea, importing country, won't be harmful to LMOs and Bioindustry. Instead, it will ensure a high level of biosafety concerning the import of LMOs. Exporters can take different kinds of trade measures to countervail adverse effect on the export of LMOs in this case. Therefore importer will endure the aftereffect. However, if korea were in exporter's place, to accept the wider scope STOs under POB will not have a good influence on the export of LMOs. Korea, therefore, should devise scheme for responding to debate about the STOs in MEAs, which have to be based on cost-benefit analysis and scenarios taking into account of speed and level in biotechology progress, status and trend of LMOs R&D and production, and condition of other industries. Second, it is not easy to agree with applying to what's rule between the POB and WTO for settlement dispute. Because there is the incompatibility between the POB characterized according to social rationality and WTO's rules for safety and environmental protection characterized according to scientific rationality. This issue have to be discussed for long period due to gap like that. Accordingly Korea, one of major LMOs importing countries, should suggest continuously that the effort is needed to ensure an adequate level of protection in transboundary movements of LMOs and scientific, environmental and socio-economic study. Third, in case of dispute between party and non-party of the POB, the duties under the WTO of non-party of the POB(if WTO member country) is valid. The country, therefore, will try to settle dispute based on WTO's rules. However, international society have to ensure for sound and safe use of LMOs in the field of transboundary movements. Accordingly Korea should devise scheme for preventing the possibility of dispute between party and non-party of the POB(if WTO member country), which is supported by policy options under the POB.

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Management of Regional Lymph Nodes in Localized Vulvar Carcinoma (국소 외음부 암에서 영역 림프절의 치료)

  • Jang, Won-Il;Wu, Hong-Gyun;Park, Charn-Il;Ha, Sung-Whan;Lee, Hyo-Pyo;Kang, Soon-Beom;Song, Yong-Sang
    • Radiation Oncology Journal
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    • v.26 no.1
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    • pp.1-9
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    • 2008
  • Purpose: To evaluate the impact of postoperative radiotherapy on loco-regional failure in patients with vulvar carcinoma and to determine the treatment strategy for inguinal lymph nodes. Materials and Methods: Sixty-six patients who received treatment for primary vulvar carcinoma at Seoul National University Hospital, from October 1979 through June 2004, were retrospectively analyzed. Sixteen patients were excluded from the analysis due to the following reasons: distant metastases in two patients; palliative intent for six patients; previous radiotherapy given to the pelvis in three patients; follow-up loss after surgery for four patient; insufficient medical records for one patient. Of 50 eligible patients, 35 were treated with surgery alone(S), ten were treated with surgery followed by radiotherapy(S+RT), and five were treated with radiotherapy alone. Results: The 5-year overall survival(OS) and disease-free survival(DFS) rates of all patients were 91% and 78%, respectively. Twelve patients(26%) experienced treatment failures and the sites of initial failure were as follows: a primary site in eight patients; regional lymph nodes in three patients; the lung in one patient. Although risk factors for failure were more common in the S+RT group than the S group of patients(p<0.05), the DFS rates were similar for the two groups(5-year DFS rates, 78% vs. 83%, p=0.66). The incidences of occult lymph node metastases was 10%. Ten of 31 patients with clinically negative lymph nodes did not received inguinal lymph node dissection, but no patient experienced regional failure. Conclusion: Postoperative radiotherapy may have a potential benefit for patients with risk factors for failure. The omission of inguinal dissection or elective radiotherapy to the inguinal lymph nodes may be considered in low-risk patients with clinically negative lymph nodes.

Clinical Application of 3-D Conformal Radiotherapy for Carcinoma of the Ethmoid Sinus : I. Comparative Analysis Between Conventional 2-D and 3-D Conformal Plans (사골동 종양의 3-차원 입체조형치료 : I. 2차원 치료계획과 3차원 치료계획의 비교분석)

  • Lee Sangwook;Kim Gwi Eon;Keum Ki Chang;Park Hee Chul;Cho Jae Ho;Han Soung Uk;Lee Kang Kyu;Suh Chang Ok;Hong Won Pyo;Park In Yong
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.287-296
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    • 1997
  • Purpose : This is study of whether 3-D conformal radiotherapy for carcino-mas of the ethmoid sinus were better than those treated with conventional 2-D plan, Materials and Methods : The 3-D conformal treatment Plans were compared with conventional 2-D plans in 4 patients with malignancy of the ethmoid sinus. Isodose distribution, dose statistics, and dose volume histogram of the planning target volume were used to evaluate differences between 2-D and 3-D plans. In addition. the risk of radiation exposure of surrounding normal critical organs are evaluated by means of point dose calculation and dose volume histogram. Results : 3-D conformal treatment plans for each patient that the better tumor coverages by the planning target volume with improved dose homo-geneity, compared to 2-D conventional treatment Plans in the same Patient. On the other hand, the radiation dose distributions to the surrounding nor-mal tissue organs, such as the orbit and optic nerves are not significantly reduced with our technique, but a substantial sparing in the brain stem and optic chiasm for each patient. Conclusion : Our findings represented the potential advantage of 3-D treatment planning for dose homogeniety as well as sparing of the normal tissue surrounding the tumor. However, further investigational studies are required to define the clinical benefit.

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Breeding and characterization of 'Creamy', a new interspecific hybrid between Pleurotus ferulae and P. tuoliensis (아위느타리와 백령느타리의 종간교잡 품종 '크리미'의 육성 및 특성)

  • Oh, Min-Ji;Shin, Pyung-Gyun;Lim, Ji-Hoon;Oh, Youn-Lee;Jang, Kab-Yeul;Kong, Won-Sik
    • Journal of Mushroom
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    • v.17 no.4
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    • pp.224-229
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    • 2019
  • The two most common mushroom species grown in Korea are pearl oyster mushroom (Pleurotus ostreatus) and king oyster mushroom (P. eryngii). In recent years, the production of king oyster mushroom greatly increased due to the automation of the cultivation facilities, and it became a major export mushroom owing to its excellent shelf life. However, the increase in the production of king oyster mushroom led to a decline in its market price; thus, necessitating the development of new mushroom species that could replace king oyster mushroom, to diversify the mushroom market for the benefit of both, the producers and the consumers. The Mushroom division at the National Institute of Horticultural & Herbal Science (NIHHS) reported the development of a new interspecific hybrid between P. ferulae and P. tuoliensis, referred to as 'Creamy.' Two parental strains KMCC00430 (Bisan2ho, P. ferulae) and KMCC00461 (P. tuoliensis) were selected based on the results of genetic resource analysis, and their monokaryons were collected. About 1,000 Mon-Mon crosses were performed and 73 of them were selected. Following repeated cultivation tests and strain analyses, we selected strain 7773, which had a bright creamy pileus and a thick straight stipe, and named it 'Creamy.' Optimum temperature for mycelial growth of Creamy was 25-30℃, and that for fruiting body growth was 16℃. The pileus, which had a brighter creamy color, was small in size with a diameter of 61.2 mm. Although it was cultivated in suboptimal conditions, such as low temperature and high CO2 concentration, Creamy was characterized by its straight and smooth stipe. Field production tests and further analyses indicated that the yield of Creamy was 5% higher than that of Baekhwang. It is expected that Creamy, the new interspecific hybrid with a bright creamy pileus and a pleasant flavor, will help create new opportunities for mushroom farmers and diversify the mushroom market.

Study on Gastroesophageal Reflux according to Feeding Types (수유 종류에 따른 위식도 역류의 빈도)

  • Yun, Seok-Kang;Park, Jae-Ock
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.1-9
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    • 2001
  • Purpose: Gastroesophgeal reflux (GER) is defined as involuntary movement of gastric contents into esophagus. Relaxation of lower esophageal sphincter caused by immature anatomical development in newborn and young infants produces GER frequently. We wanted to know whether the frequency of GER is influenced by feeding types and position or not. We studied in 16 subjects according to feeding types (breast feeding group: BFG-7, formula feeding group: FFG-9) who admitted to the Soonchunhyang university hospital for recurrent regurgitation with 24 hr esophageal pH monitoring from August 1996 to July 1999. Methods: We compared two groups by number of reflux episode, reflux rate, longest episode, numbers of episodes lasting >5 minutes, longest episode in upright position and longest episode in supine position. We used Mann-Whitney test for statistical analysis. Results: 1) The subjects were 7 infants in BFG and 9 infants in FFG, 16 in total, and mean age was 2.1, and 2.6 months for BFG and FFG, respectively. 2) The reflux numbers were $244{\pm}151/day$, $275{\pm}155/day$ for BFG and FFG, respectively. 3) The reflux rate was $14{\pm}15%$ for BFG and $28{\pm}22%$ for FFG. It was lower in BFG. 4) The longest episode was $20{\pm}28$ minutes for BFG and $58{\pm}66$ minutes for FFG. It was significantly longer in FFG. 5) The numbers of episodes lasting >5 minutes were $5{\pm}6$ for BFG and $9{\pm}3$ for FFG. 6) The longest episode in upright position was $10{\pm}8$ minutes for BFG and $40{\pm}47$ minutes for FFG. It was significantly shorter in BFG. 7) The longest episode in supine position was $18{\pm}29$ minutes for BFG and $52{\pm}66$ minutes for FFG. It was significantly shorter in BFG. Conclusion: Breast feeding is strongly recommended to reduce the regurgitation in infancy. It is an another benefit of breast feeding.

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