• Title/Summary/Keyword: health care costs

Search Result 406, Processing Time 0.031 seconds

Impact of antimicrobial resistance in the $21^{st}$ century

  • Song, Jae-Hoon
    • Proceedings of the Korean Society for Applied Microbiology Conference
    • /
    • 2000.04a
    • /
    • pp.3-6
    • /
    • 2000
  • Antimicrobial resistance has been a well-recognized problem ever since the introduction of penicillin into clinical use. History of antimicrobial development can be categorized based on the major antibiotics that had been developed against emerging resistant $pathogens^1$. In the first period from 1940 to 1960, penicillin was a dominating antibiotic called as a "magic bullet", although S.aureus armed with penicillinase led antimicrobial era to the second period in 1960s and 1970s. The second stage was characterized by broad-spectrum penicillins and early generation cephalosporins. During this period, nosocomial infections due to gram-negative bacilli became more prevalent, while those caused by S.aureus declined. A variety of new antimicrobial agents with distinct mechanism of action including new generation cephalosporins, monobactams, carbapenems, ${\beta}$-lactamase inhibitors, and quinolones characterized the third period from 1980s to 1990s. However, extensive use of wide variety of antibiotics in the community and hospitals has fueled the crisis in emerging antimicrobial resistance. Newly appeared drug-resistant Streptococcus pneumoniae (DRSP), vancomycin-resistant enterococci (VRE), extended-spectrum ${\beta}$-lactamase-producing Klebsiella, and VRSA have posed a serious threat in many parts of the world. Given the recent epidemiology of antimicrobial resistance and its clinical impact, there is no greater challenge related to emerging infections than the emergence of antibiotic resistance. Problems of antimicrobial resistance can be amplified by the fact that resistant clones or genes can spread within or between the species as well as to geographically distant areas which leads to a global concern$^2$. Antimicrobial resistance is primarily generated and promoted by increased use of antimicrobial agents. Unfortunately, as many as 50 % of prescriptions for antibiotics are reported to be inappropriate$^3$. Injudicious use of antibiotics even for viral upper respiratory infections is a universal phenomenon in every part of the world. The use of large quantities of antibiotics in the animal health industry and farming is another major factor contributing to selection of antibiotic resistance. In addition to these background factors, the tremendous increase in the immunocompromised hosts, popular use of invasive medical interventions, and increase in travel and mixing of human populations are contributing to the resurgence and spread of antimicrobial resistance$^4$. Antimicrobial resistance has critical impact on modem medicine both in clinical and economic aspect. Patients with previously treatable infections may have fatal outcome due to therapeutic failure that is unusual event no more. The potential economic impact of antimicrobial resistance is actually uncountable. With the increase in the problems of resistant organisms in the 21st century, however, additional health care costs for this problem must be enormously increasing.

  • PDF

Increased Readmission Risk and Healthcare Cost for Delirium Patients without Immediate Hospitalization in the Emergency Department

  • Ma, I Chun;Chen, Kao Chin;Chen, Wei Tseng;Tsai, Hsin Chun;Su, Chien-Chou;Lu, Ru-Band;Chen, Po See;Chang, Wei Hung;Yang, Yen Kuang
    • Clinical Psychopharmacology and Neuroscience
    • /
    • v.16 no.4
    • /
    • pp.398-406
    • /
    • 2018
  • Objective: Hospitalization of patients with delirium after visiting the emergency department (ED) is often required. However, the readmission risk after discharge from the ED should also be considered. This study aimed to explore whether (i) immediate hospitalization influences the readmission risk of patients with delirium; (ii) the readmission risk is affected by various risk factors; and (iii) the healthcare cost differs between groups within 28 days of the first ED visit. Methods: Using the National Health Insurance Research Database, the data of 2,780 subjects presenting with delirium at an ED visit from 2000 to 2008 were examined. The readmission risks of the groups of patients (i.e., patients who were and were not admitted within 24 hours of an ED visit) within 28 days were compared, and the effects of the severities of different comorbidities (using Charlson's comorbidity index, CCI), age, gender, diagnosis and differences in medical healthcare cost were analyzed. Results: Patients without immediate hospitalization had a higher risk of readmission within 3, 7, 14, or 28 days of discharge from the ED, especially subjects with more severe comorbidities ($CCI{\geq}3$) or older patients (${\geq}65years$). Subjects with more severe comorbidities or older subjects who were not admitted immediately also incurred a greater healthcare cost for re-hospitalization within the 28-day follow-up period. Conclusion: Patients with delirium with a higher CCI or of a greater age should be carefully considered for immediate hospitalization from ED for further examination in order to reduce the risk of re-hospitalization and cost of healthcare.

Proposed Application Design for Community-Based Rehabilitation Services Access in Community Care System: Occupation and Activity Based (커뮤니티케어 제도 내 지역사회중심재활 서비스 접근을 위한 애플리케이션 디자인의 제안 : 작업과 활동 중심으로)

  • Bae, Seong-Hwan;Jang, Yeon-Sig;Baek, Ji-Young
    • Journal of Korea Entertainment Industry Association
    • /
    • v.15 no.4
    • /
    • pp.325-335
    • /
    • 2021
  • Chronic diseases have been increasing recently as the average life expectancy of humans has been extended, and this trend has caused problems such as the widespread demand for health and rehabilitation services and rising medical costs. In order to solve this problem, the community-based rehabilitation has been developed and strengthened in Korea and gradually promoted since 2019. It is important to secure access to clients who want to use services to revitalize community-based rehabilitation. So in this study, as part of the community-based rehabilitation, intends to devise smartphone applications designs and develop a prototype to secure access to community-based occupational therapy services based on occupation and activities. For Occupational Therapy Practice Framework (OTPF), International Classification of Functioning, Disability and Health (ICF), and Allen Diagnostic Module-2 (ADM-2) were used to devise and categorize occupation and activity based application content, and link OTPF, ICF, and ADM-2 through prior research analysis and expert meetings. The derived content was visualized through literature review and activity analysis, and was implemented to enable direct playback within the application using the YouTube API, and finally developed a prototype application. The Android Studio 3.5.2 for Windows 64-bit was used to build the application prototype. In further research, converging various digital technologies for user convenience and additionally researching community-based occupational therapy service providers opinions and service user satisfaction will improve accessibility to community-based occupational therapy services for clients who have difficulty occupational performance in the community.

Elderly Sarcopenia and Vitamin B Deficiency: A Relationship? (비타민 B 결핍에 의한 노인성 근감소증)

  • Kisang Kwon;Hye-Jeong Jang;Sun-Nyoung Yu;Soon-Cheol Ahn;O-Yu Kwon
    • Journal of Life Science
    • /
    • v.33 no.7
    • /
    • pp.574-585
    • /
    • 2023
  • Sarcopenia is a leading cause of increased medical and nursing care costs among the elderly. In Korea, preventive measures for sarcopenia are mostly targeted toward the general elderly population without specific diseases. However, it is also necessary to implement measures for elderly individuals living in nursing homes and hospitals, where the prevalence of sarcopenia is high. Currently, computed tomography and/or magnetic resonance imaging are considered standard diagnostic tools. However, their complexity and time-consuming nature make them unsuitable for clinical use. The exact pathophysiological mechanisms of sarcopenia are unclear, as they involve various molecular biological pathways, including decreased exercise, protein and nutrient intake, changes in testosterone and growth hormone, and inflammation. Sarcopenia symptoms can lead to several diseases, such as osteoporosis, fractures, dementia, diabetes, and cardiovascular disease. Vitamin B deficiency is a significant factor in sarcopenia induction, with B vitamins being directly involved in energy and protein metabolism and nerve function. Vitamin B deficiency can lead to neuromuscular and neurogenic disorders, which often overlap with sarcopenia. Suboptimal intake of B vitamins, malabsorption, and anorexia are common among the elderly. This study aims to provide information on the role of water-soluble B vitamins in preventing and controlling muscle mass loss and deterioration among the elderly with sarcopenia. In addition, we discuss the potential of myokines from the B vitamin family in modulating sarcopenia.

A Study on e-Healthcare Business Model: Focusing on Business Ecosystem Approach (e헬스케어 비즈니스모델에 관한 연구: 비즈니스생태계 접근 중심으로)

  • Kim, Youngsoo;Jung, Jai-Jin
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
    • /
    • v.14 no.1
    • /
    • pp.167-185
    • /
    • 2019
  • As most G-20 countries expect medical spending to grow rapidly over the next few decades, the burden of healthcare costs continues to grow globally due to an increase in the elderly population and chronic illnesses, and the ongoing quality improvement of health care services. However, under the rapidly changing technological environment of healthcare and IT convergence, the problem may become even bigger if not properly recognized and not properly prepared. In the context of the paradigm shift and the increasing problem of the medical field, complex responses in technical, institutional and business aspects are urgently needed. The key is to derive a business model that is appropriate for businesses that integrate IT in the medical field. With the arrival of the era of the 4th industrial revolution, new technologies such as Internet of Things have been applied to eHealthcare, and the need for new business models has emerged.In the e-healthcare of the Internet era, it became a traditional firm-based business model. However, due to the characteristics of dynamics and complexity of things Internet in the Internet of things, A business ecosystem-based approach is needed. In this paper, we present and analyze the major success factors of the ecosystem based on the 3 - layer structure of the e - healthcare business ecosystem as a result of research on e - healthcare business ecosystem based on emerging technology such as Internet of things. The three-layer business ecosystem was defined as (1) Infrastructure Layer, (2) Character Layer, and (3) Stakeholder Layer. As the key success factors for the eHealthCare business ecosystem, the following four factors are suggested: (1) introduction of the iHealthcare concept, (2) expansion of the business ecosystem, (3) business ecosystem change process innovation, and (4) business ecosystem leadership innovation.

The Intention of Having a Second Child by the Employment Status of Married Women (취업여부에 따른 기혼여성의 둘째자녀 출산의도)

  • Chung, Hye-Eun;Chin, Mee-Jung
    • Korea journal of population studies
    • /
    • v.31 no.1
    • /
    • pp.147-164
    • /
    • 2008
  • The goal of this study was to examine the economic and cultural factors that influenced the intention of having a second child. In particular, this study intended to examine whether the factors related to the intention of having a child differed by the employment status of married women. The data for this study were drawn from the National Survey on the Trend of Marriage and Birth. This survey was conducted in 2005 by Korean Institute for Health and Social Affairs. The sample consisted of 690 married women who had one child(282 employed and 408 unemployed). The data were analyzed by logistic regression with SAS 9.1 program. The results showed that the employed women's intention of having a second child was affected by the husband's hours of housework, having a own mother(child's grandmother) and the perception of value of child. The employed women's intention of having a second child was affected by the perception of emotional value of child, and the sex of the first child. In sum, there were differences between the employed women and the unemployed women in the variables affecting the intention of having a second child. Perception of value of child was found important for both the employed and the unemployed women. Besides husband's hours of housework, having a mother and the needs for public support about child birth and rearing were found significant for the employed women. For the unemployed women, the costs of child care/education and the sex of the first child were found significant. The findings of this study suggested that different policy interventions be developed to satisfy the needs of the employed women and the unemployed women.

On the Audible Band Hearing Measurement of Both Ears Considering Age (연령이 고려된 양쪽 귀의 가청대역 청력측정에 관한 연구)

  • Kim, Bong-Young;Bae, Myung-Jin
    • The Journal of the Convergence on Culture Technology
    • /
    • v.7 no.1
    • /
    • pp.570-575
    • /
    • 2021
  • Since humans live while feeling rich in their five senses, care must be taken not to damage their hearing in order to lead a happy life. Hearing damage suffered in a living environment is common in a partial band where a specific frequency band is first damaged. However, since the initial pain of hearing damage does not appear much, it is difficult to determine the symptoms in the early stages. In this paper, we proposed a high-speed measurement method that can easily and quickly self-measure hearing damage through a simple app. In this method, 9 pure tones compensated for gain for each voice soub-band are alternately heard in both ears, so that one's own hearing damage can be detected at high speed. When 18 tone pulses were heard for 30 seconds per person, 1 out of 12 subjects was identified as suspected of partial hearing damage. And when the test subjects were informed of the hearing determination method for the number of hearings, the participants themselves immediately determined whether their hearing was damaged. This measurement method simply judges the hearing of both ears within 30 seconds with a smart phone, so that hearing measurements that took more than 10 minutes in hospitals are relatively accurate, and it was found that hearing health can be maintained while reducing time and costs.

A Review of the Legal Responsibility of Dog Owners regarding Dog Bite Accidents - Focused on a Comparison with American Dog Bite Legislation - (개물림 사고에 대한 소유자의 법적 책임에 관한 소고 - 미국의 개물림 법제와의 비교를 중심으로 -)

  • Baek, Kyoung-Hee;Shim, Young-Joo
    • Journal of Legislation Research
    • /
    • no.54
    • /
    • pp.261-301
    • /
    • 2018
  • In South Korea, the number of households that rear companion animal has been gradually increasing. With the rise of household dogs, the frequency of humans that are being bitten by another's dog has also increased. This type of accident, which is known as a dog bite accident throughout the United States. It can cause significant physical and emotional damage to the victims and may result in grave injuries or death. Dog bite accidents are serious public health problems and can cause immeasurable hidden costs to the community. South Korea has enacted several laws to address dog bite accidents, which include the Animal Protection Act, the Civil Act, and the Criminal Act. On March 20, 2018, the Animal Protection Act was amended to reinforce the current legislation. These amendments addressed the duty of care owed by a companion dog owner to society members and the punishment that an owner of a fierce dog would face in the event of a dog bite accident. Conversely, several states in the United States have enacted a single law that regulates the details regarding dog bite accidents, such as the type of dog or animal, the type of damage, the scope of compensation for damages, and the scope of recognition of liabilities. This paper is intended to review the present situation of dog bite legislation in several states in the United States, which have a variety of laws that address dog bite accidents, and compare them with current South Korean dog bite legislation. Through this research, this paper will discuss what issues may exist in South Korean's current dog bite laws, analyze the responsibility of companion dog owners, and provide solutions to any issues that are discovered.

Complementary and Alternative Medicine Treatment for Burns and Sequela : A Scoping Review of Randomized Controlled Trials (화상 및 후유증의 보완 대체 의학 치료 : 무작위 대조 시험에 대한 주제범위 문헌고찰)

  • Byung-Soo Kang;Seok-Yeong Yoon;Min-Yeong Jung;Soo-Yeon Park;Jung-Hwa Choi;Jong-Han Kim
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
    • /
    • v.36 no.3
    • /
    • pp.42-73
    • /
    • 2023
  • Objectives : In order to investigate the current status of recent clinical evidence related to complementary and alternative medicine(CAM) treatment for burns and to inform research and treatment strategies for future, we publish a scoping review(ScR) of randomized controlled trials(RCTs). Methods : The research question of the ScR was "Are there any RCTs of CAM treatment for burn?". RCTs published from 2000 to 2022 were identified in 7 databases(PubMed, Cochrane, CNKI, OASIS, RISS, KCI, KMbase) in March 2023. Data were tabulated and analyzed descriptively with respect to the research questions. Results : 41 RCTs were included. 21(51.2%) were conducted in China, 13(31.7%) in Iran. The main treatment criteria were herbal medicine in 28 cases, acupuncture in 9 cases, chuna therapy in 4 cases, and psychotherapy in 3 cases. Among the herbal medicine, there were 19 topical medications, 5 injections(intravenous pharmacopuncture), 4 aerosol drugs(aromatherapy), and 1 oral drug. Among the acupuncture, there were 4 plum blossom needles(seven-star needles), 2 wrist-ankle acupunctures, 2 press needles, and 1 electroacupuncture. CAM treatments were effective in treating burns. It reduced pain and pruritus at the burn site, helped recovery and management of the donor site, reduced anxiety and pain during dressing change, improved hematological problems and vital signs, and finally lowered the mortality rate. CAM treatments also lowered health care costs. Conclusions : CAM treatments for burns is prospective, and that it deserves to make high-quality studies including additional large-scale RCTs.

Indoleamine 2,3-Dioxygenase in Hematopoietic Stem Cell-Derived Cells Suppresses Rhinovirus-Induced Neutrophilic Airway Inflammation by Regulating Th1- and Th17-Type Responses

  • Ferdaus Mohd Altaf Hossain;Seong Ok Park;Hyo Jin Kim;Jun Cheol Eo;Jin Young Choi;Maryum Tanveer;Erdenebelig Uyangaa;Koanhoi Kim;Seong Kug Eo
    • IMMUNE NETWORK
    • /
    • v.21 no.4
    • /
    • pp.26.1-26.28
    • /
    • 2021
  • Asthma exacerbations are a major cause of intractable morbidity, increases in health care costs, and a greater progressive loss of lung function. Asthma exacerbations are most commonly triggered by respiratory viral infections, particularly with human rhinovirus (hRV). Respiratory viral infections are believed to affect the expression of indoleamine 2,3-dioxygenase (IDO), a limiting enzyme in tryptophan catabolism, which is presumed to alter asthmatic airway inflammation. Here, we explored the detailed role of IDO in the progression of asthma exacerbations using a mouse model for asthma exacerbation caused by hRV infection. Our results reveal that IDO is required to prevent neutrophilic inflammation in the course of asthma exacerbation caused by an hRV infection, as corroborated by markedly enhanced Th17- and Th1-type neutrophilia in the airways of IDO-deficient mice. This neutrophilia was closely associated with disrupted expression of tight junctions and enhanced expression of inflammasome-related molecules and mucin-inducing genes. In addition, IDO ablation enhanced allergen-specific Th17- and Th1-biased CD4+ T-cell responses following hRV infection. The role of IDO in attenuating Th17- and Th1-type neutrophilic airway inflammation became more apparent in chronic asthma exacerbations after repeated allergen exposures and hRV infections. Furthermore, IDO enzymatic induction in leukocytes derived from the hematopoietic stem cell (HSC) lineage appeared to play a dominant role in attenuating Th17- and Th1-type neutrophilic inflammation in the airway following hRV infection. Therefore, IDO activity in HSC-derived leukocytes is required to regulate Th17- and Th1-type neutrophilic inflammation in the airway during asthma exacerbations caused by hRV infections.