• Title/Summary/Keyword: delivery interval

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Impact of Changes in Medical Aid Status on Health Care Utilization

  • Kim, Woorim;Nam, Chung Mo;Lee, Sang Gyu;Park, Sohee;Kim, Tae Hyun;Park, Eun-Cheol
    • Health Policy and Management
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    • v.29 no.4
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    • pp.513-522
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    • 2019
  • Background: South Korea operates a Medical Aid (MA) program targeting selected low-income individuals to ensure medical service delivery to the disadvantaged while enhancing self-sufficiency of work-capable beneficiaries. However, as reasons behind welfare exits are diverse and do not always infer poverty relief or the provision of appropriate levels of health care services, this study aimed to investigate the association between changes in MA status and health care utilization. Methods: This study used the 2006 to 2015 National Health Insurance claims data. The impact of changes in annual MA status on health care utilization (yearly number of outpatient visits, inpatient visits, length of stay, and emergency department [ED] visits) was investigated using the generalized estimating equation model. Results: In 117,943 adult subjects aged 20 to 64, compared to the 'MA to MA' group, the 'MA to MA exit' group showed general decreases in utilization (outpatient visits: β=-3.93, p<0.0001; hospital admissions: relative risk [RR], 0.87; 95% confidence interval [CI], 0.83-0.91; length of stay: β=-3.64, p<0.0001; ED visits: RR, 0.83; 95% CI, 0.77-0.90). Similar patterns were found in the 'MA exit to MA exit' group (outpatient visits: β=-5.72, p<0.0001; admissions: RR, 0.91; 95% CI, 0.87-0.94; length of stay: β=-5.87; p<0.0001; ED visits: RR, 0.81; 95% CI, 0.75-0.88). Likewise, in 74,747 older adult subjects aged 65 or above, the 'MA to MA exit' group showed reduced levels of utilization (outpatient visits: β=-1.51; p=0.0020), as well as the 'MA exit to MA exit' group (admissions: RR, 0.92; 95% CI, 0.89-0.95; length of stay: β, -5.45; p<0.0001; ED visits: RR, 0.90; 95% CI, 0.83-0.97). Conclusion: MA exit was associated with general decreases in health care utilization. Utilization patterns of individuals with experiences of receiving MA benefits should be monitored to promote the ideal use of health care services while preventing potential financial barriers present in accessing medical care.

Effect of MBCP block as carrier of rhBMP-2 in combination with ePTFE membrane on bone formation in rat calvarial defects

  • Shin, Chul-Woo;Cho, Kyoo-Sung;Jung, Sung-Won;Kim, Chang-Sung;Choi, Seong-Ho;Yun, Jeong-Ho
    • Journal of Periodontal and Implant Science
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    • v.38 no.sup2
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    • pp.325-334
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    • 2008
  • Purpose: The carrier used as delivery agent for bone morphogenetic proteins(BMPs) should also act as a scaffold for new bone formation. Moreover, bone formation should be predictable in terms of the volume and shape. This study examined the osteogenic effect of macroporous biphasic calcium phosphate (MBCP) block combined with ePTFE membrane as a carrier for recombinant human bone morphogenetic proteins (rhBMP-2). In addition, the additive effect of ePTFE membrane on bone formation was evaluated. Materials and Methods: Eight-millimeter critical sized calvarial defects were created surgically in 28 male Sprague-Dawley rats. The animals were divided into 2 groups containing 14 animals each. The defects were treated with either rhBMP-2/MBCP block (rhBMP-2/MBCP group) or rhBMP-2/MBCP block/ePTFE membrane (rhBMP-2/MBCP/ePTFE group). A disc-shaped MBCP block (3 mm height and 8 mm diameter) was used as the carrier for the rhBMP-2 and ePTFE membrane was used to cover the rhBMP-2/MBCP block. The histologic and histometric parameters were used to evaluate the defects after 2- or 8-week healing period (7 animals/group/healing interval). Results: The level of bone formation in the defects of both groups was significantly higher at 8 weeks than that at 2 weeks (P < 0.05). The ePTFE membrane has no additional effect compared with the rhBMP-2/MBCP block only. However, at 8 weeks, rhBMP-2/MBCP/ePTFE group showed more even bone formation on the top of the MBCP block than the rhBMP-2/MBCP group. Conclusion: These results suggest that the ePTFE membrane has no additive effect on bone formation when a MBCP block is used as a carrier for rhBMP-2.

Comparison Study on the Inventory Management in SCM using Simulation (시뮬레이션을 활용한 공급사슬 내 재고관리 방법 비교 연구)

  • Lee, Jae-Hong;Gu, Seung-Hwan;Noh, Seung-Min;Jang, Seong-Yong
    • Journal of the Korea Society for Simulation
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    • v.24 no.1
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    • pp.1-8
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    • 2015
  • This research focuses on the method of inventory management to find out the best way in various SCM. There are several comparable methods of inventory management like Min-Max, regular interval, fixed target inventory that have different lead-time and demand for each product. Also, the inventory performances between the case of three-stages and two-stages in SCM are analyzed. 8 scenarios for the simulation are suggested considering order ways and stages. Input data for the simulation is from the result of the previous studies and actual data in the market. The performance measurements are selected as sales revenue, total number of sales, total delivery cost, total inventory shortages, the number of inventory shortage occurrence, the loss for inventory shortages, average inventory, handling cost, net profit. According to the results of the simulation, fixed target inventory management is better than existing inventory management method by net profit and inventory and so on. Also, it was confirmed that the increase in profit is obtained when SCM stages is reduced from three-stages to two-stages in existing SCM. The result of the research provides significant meaning that newly introduced target inventory management system shows good performance and SCM performance can be improved by reducing the stages.

A Study on the Dose Changes Depending on the Shielding Block Type of Irradiation During Electron Beam Theraphy (전자선치료 시 조사부위 차폐물 형태에 따른 선량변화 연구)

  • Lee, Sun-Yeb;Park, Cheol-Soo;Lee, Jae-Seung;Goo, Eun-Hoe;Cho, Jae-Hwan;Kim, Eng-Chan;Moon, Soo-Ho;Kim, Jin-Soo;Park, Cheol-Woo;Dong, Kyung-Rae;Kweon, Dae-Cheol
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.253-260
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    • 2010
  • The primary focus of this study was to explore the variation in dose distributions of electron beams between different types of construction structure of cut-out blocks embodied in electron cones, given that the structure is considered one of the causes of multiple scattered radiation from electrons which may affect dose distributions. For evaluation, two types of cut-out blocks, divergency and straight, manufactured for this study, were compared in terms of area of interval in distribution of dose, and flatness and symmetric state of surface being radiated. The results showed that divergency cut-out blocks reduced the lateral scattering effects on the thickness of cut-out blocks more substantially than straight ones, leading to more uniform dose distribution at baseline depth. Notably in divergency cut-out blocks, the high dose area decreased more significantly, and more uniform dose distribution was observed at the edge of the irradiated field. This points to a need to consider the characteristics of dose distribution of electron beams when setting up radiotherapy planing at the venues. Therefore, this study is significant as an exploratory work for ensuring high accuracy in dose delivery for patients.

A study on digital locking device design using detection distance 13.4mm of human body sensing type magnetic field coil (인체 감지형 자기장 코일의 감지거리 13.4mm를 이용한 디지털 잠금장치 설계에 관한 연구)

  • Lee, In-Sang;Song, Je-Ho;Bang, Jun-Ho;Lee, You-Yub
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.1
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    • pp.9-14
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    • 2016
  • This study evaluated a digital locking device design using detection distance of 13.4mm of a human body sensing type magnetic field coil. In contrast to digital locking devices that are used nowadays, the existing serial number entering buttons, lighting, number cover, corresponding pcb, exterior case, and data delivery cables have been deleted and are only composed of control ON/OFF power switches and emergency terminals. When the magnetic field coil substrates installed inside the inner case detects the electric resistance delivered from the opposite side of the 12mm interval exterior contacting the glass body part, the corresponding induced current flows. At this time, the magnetic field coil takes the role as a sensor when coil frequency of the circular coil is transformed. The magnetic coil as a sensor detects a change in the oscillation frequency output before and after the body is detected. This is then amplified to larger than 2,000%, transformed into digital signals, and delivered to exclusive software to compare and search for embedded data. The detection time followed by the touch area of the body standard to a $12.8{\emptyset}$ magnetic field coil was 30% contrast at 0.08sec and 80% contrast at 0.03sec, in which the detection distance was 13.4mm, showing the best level.

A Study on Information Exchange Scheme for Reliability in the Wireless Multicasting (무선 멀티캐스팅에서 신뢰성을 위한 정보 교환 기법에 관한 연구)

  • Im, Ji-Yeong;Jeong, Tae-Myeong
    • The KIPS Transactions:PartC
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    • v.9C no.2
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    • pp.247-256
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    • 2002
  • In a wireless multicasting when a mobile host moves to the new bate station being in the same multicast group it needs to exchange information about data delivery between base stations to receive data from the new base station at once. However it is inefficient to use the existence schemes because it takes too much time to exchange information and many overheads. The next, a mobile host moving to the base station not being in the same multicast group, the old base station will pre-forward data to neighboring base stations to avoid transmission delay. However, if other mobile hosts move at short interval, the old base station may retransmit the same data to the same neighboring base stations. In this paper we proposed called Information Exchange Scheme (IES). In IES in the same multicast grope the base stations exchange information locally so it takes the minimum time and overheads to use IES. Also in IES the neighboring base stations delay to delete data for continuous moving of other MHs. We also present how our scheme is efficient by producing cost ad simulating.

Neoadjuvant Chemotherapy and Prognosis of Pregnancy-Associated Breast Cancer: A Time-Trends Study of the Korean Breast Cancer Registry Database

  • Bae, Soo Youn;Kim, Ku Sang;Kim, Jeong-Soo;Lee, Sae Byul;Park, Byeong-Woo;Lee, Seok Won;Lee, Hyouk Jin;Kim, Hong Kyu;You, Ji-Young;Jung, Seung Pil;Korean Breast Cancer Society
    • Journal of Breast Cancer
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    • v.21 no.4
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    • pp.425-432
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    • 2018
  • Purpose: Pregnancy-associated breast cancer (PABC) is rare, and its cause and prognosis are not well known. Additionally, treatment is limited with respect to the risk to the fetus. The purpose of this study was to investigate the characteristics and treatment trends of PABC and the survival rate according to the treatment. Methods: In the Korean Breast Cancer Society Registry database, women younger than 50 years and who were diagnosed with breast cancer from 1996 to 2015 were included. PABC was defined as breast cancer diagnosed during pregnancy or within 1 year after delivery. Results: We examined 411 patients with PABC and 83,381 patients with non-PABC. Over time, the proportions of patients undergoing breast-conserving surgery and sentinel lymph node biopsy increased, and neoadjuvant chemotherapy and radiation therapy administration rates also increased. In the past, the overall survival of patients with PABC was poorer than that of patients with non-PABC, but there was no difference in overall survival rates in more recent years. There was no difference in overall survival rates between patients who received neoadjuvant chemotherapy (hazard ratio [HR], 1.28; 95% confidence interval [CI], 0.66-2.49; p=0.459), but PABC conferred poorer prognosis than non-PABC in patients receiving adjuvant chemotherapy (HR, 1.63; 95% CI, 1.27-2.08; p<0.001). Conclusion: There was no difference in the prognosis between patients with PABC and those with non-PABC receiving neoadjuvant chemotherapy. The increase in neoadjuvant chemotherapy according to current treatment guidelines is expected to improve the survival rate of patients with PABC.

Association of Pre- and Perinatal Risk Factors With Tourette Syndrome or Chronic Tic Disorders in a Korean School-Age Population

  • Wooseok Choi;Soon-beom Hong;Johanna Inhynag Kim;Jung Lee;Soomin Jang;Yebin D Ahn;You Bin Lim;Sumin Kim;Mee Rim Oh;Bung-Nyun Kim
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.34 no.1
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    • pp.37-44
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    • 2023
  • Objectives: Tic disorders are highly heritable; however, growing evidence suggests that environmental factors play a significant role in their pathogenesis. Studies on these factors have been inconsistent, with conflicting results. Therefore, this study aimed to examine the associations of pre- and perinatal exposure to Tourette syndrome (TS) or chronic tic disorders (CTD) in Korean school-aged children. Methods: This case-control study used data from a large prospective cohort study. The primary outcome was TS/CTD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria and Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version. Demographic, pre-, and perinatal information was obtained from the maternal questionnaires. Data between the TS/CTD and control groups were compared using the chi-squared or Student's t-test, as appropriate. Two-step logistic regression analyses were used to test the association between TS/CTD and pre- and perinatal risk factors. Results: We included of 223 children (78 with TS/CTD and 145 controls). Significant differences in the demographic data between the two groups were observed. The male sex ratio, mean parental age, parental final education level, and family history of tics were included as confounders. In the final adjusted multivariable model, TS/CTD was significantly associated with antiemetic exposure during pregnancy (odds ratio [OR]=16.61, 95% confidence interval [CI] 1.49-185.22, p=0.02) and medically assisted reproduction (OR=7.89, 95% CI 2.28-27.28, p=0.01). Conclusion: Antiemetic exposure and medically assisted reproduction are significantly associated with the risk of TS/CTD. These results should be replicated in future prospective and gene-by-environment studies.

Economic Feasibility Analysis of Nationwide Expansion of Agro-meteorological Early Warning Service for Weather Risk Management in Korea (농업기상재해 조기경보서비스의 전국 확대에 따른 경제적 타당성 분석)

  • Sangtaek Seo;Yun Hee Jeong;Soo Jin Kim;Kyo-Moon Shim
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.25 no.3
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    • pp.236-244
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    • 2023
  • The purpose of this study was to examine the economic feasibility of providing services according to the nationwide expansion of early warning services. The net present value method, one of the cost-benefit analysis methods, was applied to the analysis. As a benefit item that constituted the net present value, the damage reduction amount using crop insurance data and the willingness to pay for the use of early warning services were used. The cost items included system construction and maintenance costs, and text transmission costs. As a result of the analysis, it was found that the nationwide expansion of early warning services had economic feasibility, and its economic effect varied depending on the level of text message use (10 % to 40 %, 10 %p interval) of participating farmers. In the future, the economic effect of early warning services is expected to increase further due to the increase in the number of farmers participating in early warning services and the increase in crop damage caused by climate change. It is necessary to further enhance the economic effect of early warning services by actively utilizing information delivery means through apps or the web as well as text messages.

Predictors of breast-feeding discontinuation in some followed-up hospital-delivered mothers (추적조사된 대구시내 일부 병원분만 산모에서 모유수유중단 예측변수)

  • Lee, Choong-Won;Lee, Moo-Sik;Park, Jong-Won;Lee, Mi-Young;Kang, Mi-Joung;Shin, Dong-Hoon;Lee, Se-Youp
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.4 s.51
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    • pp.845-862
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    • 1995
  • We followed prospectively some hospital-delivered mothers to identify characteristics of those not initiated breast-feeding and predictors of breast-feeding discontinuation in monthly telephone interviews. Recruits were composed of 482 mothers who delivered their babies at one university hospital and one OB/GYN clinic in September to November 1991. Breast-feeding discontinuation was defined as switch to 100% formula lasting more than one week regardless of solid foods. Average age of the study subjects was 27.3 years of age(standard deviation 3.2). Multiple logistic regression analysis indicated native place, occupation, method of delivery and method of feeding considered to be better for maternal health were statistically significant(p<0.1) between initiators and non-initiators of breast feeding. In starting cohort(N=242) of those initiated breast-feeding, that median of breast-feeding discontinuation were 5 months and 25th and 75th percentiles were 3 and 9 months respectively. In Cox's proportional hazard model, mothers with $10\sim13$ years of education were 2.63 times (95% confidence interval, CI $1.50\sim4.60$) more likely to discontinue than those with less than 9 years of education and those with more than 13 years of education were 3.55 time (95% CI $1.99\sim6.33$). Compared with house wife, mothers with part-time jobs were 1.99 times (95% CI $0.86\sim4.57$) more likely to discontinue and those with employed full-time were 1.55 times (95% CI $0.96\sim2.51$). These results suggest that the predictors of initiation and discontinuation of breast-feeding may be different and different target populations should be selected to promote initiation and to prevent discontinuation of breast-feeding according to the period after birth.

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