• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.1
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• pp.76-84
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• 2022

The study was conducted to analyze the impacts of COVID-19 on the number of dental trauma patients. Based on the data provided by the Health Insurance Review and Assessment Service's Healthcare Bigdata Hub, dental trauma which occurred from 2010 to 2020 was analyzed. Since the outbreak of COVID-19, the incidence of dental trauma per 100,000 decreased compared to the average Incidence between 2017 to 2019. By age, it decreased by 5.4% (p = 0.017) for 0 - 4 years old, 30.3% (p < 0.001) for 5 - 9 years old, 39.5% (p < 0.001) for 10 - 14 years old, 14.5% (p = 0.002) for 15 - 19 years old, 1.3% for 20 - 29 years old, 0.2% for 40 - 49 years old, 2.7% for 50 - 59 years old, 1.2% for 60 years old or older, but it increased by 2.5% for 30 - 39 years old. Compared monthly, before and after the outbreak of COVID-19 confirmed patients, the number of dental trauma patients dropped sharply. After the outbreak of COVID-19, the incidence of dental trauma decreased significantly for under 20 years old, but the decrease was not significant for 20 years old or older.

• Women's Health Nursing
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• v.27 no.2
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• pp.128-140
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• 2021

Purpose: The purpose of this study was to develop a self-transcendence enhancement program and examine its effect on self-transcendence, spiritual well-being, and psychological well-being in elderly women who live alone. Methods: A self-transcendence enhancement program was developed through theory, literature review, and in-depth interviews. The theoretical framework came from the Psychoeducational Approach to Transcendence and Health intervention model based on Reed's middle-range theory of self-transcendence. The program consisted of multiple modalities in a structured, theory-based program lasting for eight weekly sessions. Using a single-group pretest-posttest design, the program was tested on a group of 40 elderly women aged 75 to 84 years living alone in Daejeon, Korea. Participants completed self-reported study questionnaires before and after the program at the elderly welfare center. Data were analyzed using SPSS version 24.0, with significance level set at .05. Paired t-test was used to compare mean differences before and after the program. Results: The mean age of the study participants was 79.1 years. After completing the program, the participants showed higher levels of self-transcendence (t=8.78, p<.001), overall spiritual well-being (t=8.30, p=.002), religious spiritual well-being (t=1.79, p=.040), existential spiritual well-being (t=6.75, p=.002), and positive affect (t=3.77, p=.001) than they did before the program. They also reported lower levels of depression (t=-7.59, p<.001) and negative affect (t=-6.15, p<.001). Conclusion: The self-transcendence enhancement program developed in this study may be effective for improving the level of self-transcendence in elderly women living alone and helping them to attain spiritual and psychological well-being.

• 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.15 no.3
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• pp.47-68
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• 2010

One of the important complaint factors by the patients using medical institutions is various kinds of waiting time. This research is about the causal relationships among waiting time(application of waiting time, perceived of waiting time, fairness of waiting, explanation of the delay, acceptance possibility), service values, and customer satisfaction. The subjects for this study were 256 out-patients currently using seven general hospitals in the Busan area. The findings of the empirical analysis are as follows: First, the good application of waiting time or fair waiting time procedure didn't actually affect perceived waiting time. Second, though the application of waiting time didn't affect acceptance possibility, the fair procedure of waiting time had an affirmative effect on acceptance possibility. Third, even when there was enough explanation about the need to wait, it could shorten perceived waiting time but failed to get sufficient sympathy or agreement from the patients. Fourth, the possibility of acceptance following the sufficient sympathy of patients had an effect on shortening perceived waiting time. Fifth, perceived waiting time lowered customer satisfaction, but had no negative effect on service values. Finally, the ranges of acceptance possibility by the patients were found to increase customer satisfaction and maximize service values. In conclusion, every medical institution needs to focus on, first of all, shortening waiting time for more customer satisfaction and improved service values.

• Health Policy and Management
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• v.22 no.1
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• pp.65-84
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• 2012

Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.

• Journal of Preventive Medicine and Public Health
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• v.55 no.1
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• pp.10-18
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• 2022

Disability-adjusted life-year (DALY) estimates may vary according to factors such as the standard life expectancy, age weighting, time preference and discount rate, calculation of disability weights, and selection of the estimation method. DALY estimation methods are divided into the following 3 approaches: the incidence-based approach, the pure prevalence-based approach, and the hybrid approach. These 3 DALY estimation approaches each reflect different perspectives on the burden of disease using unique characteristics, based on which the selection of a suitable approach may vary by the purpose of the study. The Global Burden of Disease studies, which previously estimated DALYs using the incidence-based approach, switched to using the hybrid approach in 2010, while the National Burden of Disease studies in Korea still mainly apply the incidence-based approach. In order to increase comparability with other international burden of disease studies, more DALY studies using the prevalence-based approach need to be conducted in Korea. However, with the limitations of the hybrid approach in mind, it is necessary to conduct more research using a disease classification system suitable for Korea. Furthermore, more detailed and valid data sources should be established before conducting studies using a broader variety of DALY estimation approaches. This review study will help researchers on burden of disease use an appropriate DALY estimation approach and will contribute to enhancing researchers' ability to critically interpret burden of disease studies.

• Korean Journal of Occupational Health Nursing
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• v.14 no.1
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• pp.56-70
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• 2005

Objectives: The purpose of this study is to develop a linking model between industrial injury insurance organs and local organizations providing social welfare health services, for the activation of medical rehabilitation services for industrial injury patients. Method: Research design for this study was a multi-step research through literature review, field research, and group interviews with persons in charge, to compare local society-oriented medical rehabilitation programs. The term of researches Sep.1 ~ Nov. 30, 2004. Results: 1. Home nurses from Workers Accident Medical Corporation have been taken to be adequate to case managers, who link industrial accident insurance institutions to local society services for the activation of medical rehabilitation services for industrial injury patients. They have been chosen for case managers because they have richer understanding and experiences of objects of industrial accidents than any other specialists, and because they have proved to be able to provide direct home services as a specialist. We have established the center for case management affairs within the workers accident general hospital, organized the committee for case management with doctors in charge, doctors in rehabilitation, rehabilitation consultants, social welfare workers, physical therapists, and nurses, determined objects of case managements from those of long-term recuperation, and constructed a course of case management containing from case management plans to evaluation. 2. We have made files of community resources, and organized the council of industrial accident administration to have it in charge of the adjustment and linking of services in case management affairs. 3. Because there are inequality of community resources between areas, differences in experiences in and bases for linking, and disparity of core organizations with active linking in the system of linking between public and civil sectors, we have taken a system of linking between parallel organs to be the core. In our linking model, workers accident general hospital, hospitals designated for industrial injury, and rehabilitation hospitals are linked in parallel, inadequate long-term recuperation managers are trusted to an workers accident medical corporations through examination by the examination committee in Korea Labor Welfare Corporation, and are dealt with by the committee for case management. Of the hospitals designated for industrial accidents, those running a home caring center provide home caring services for the handicapped at home from industrial injury. 4. Workers Accident Medical Corporation take part in medical rehabilitation, and Korea Labor Welfare Corporation in vocational/social rehabilitation. Furthermore, in the model, the latter should construct a system for job opportunities through Internet portals and provide cyber vocational consultation and introduction. Conclusion: Improvement of systems is needed to apply the linking model to practical affairs. Because this model is centered for practical affairs, it should be put under the analysis of effects, and evaluation of its adequacy to practical application, and its effects and efficiency through experimental running in the 8 workers accident general hospital in Korea.

• Journal of Preventive Medicine and Public Health
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• v.46 no.5
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• pp.213-225
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• 2013

Objectives: The aim of this study was to evaluate the association between Agent Orange exposure and self-reported diseases in Korean Vietnam veterans. Methods: A postal survey of 114 562 Vietnam veterans was conducted. The perceived exposure to Agent Orange was assessed by a 6-item questionnaire. Two proximity-based Agent Orange exposure indices were constructed using division/brigade-level and battalion/ company-level unit information. Adjusted odds ratios (ORs) for age and other confounders were calculated using a logistic regression model. Results: The prevalence of all self-reported diseases showed monotonically increasing trends as the levels of perceived self-reported exposure increased. The ORs for colon cancer (OR, 1.13), leukemia (OR, 1.56), hypertension (OR, 1.03), peripheral vasculopathy (OR, 1.07), enterocolitis (OR, 1.07), peripheral neuropathy (OR, 1.07), multiple nerve palsy (OR, 1.14), multiple sclerosis (OR, 1.24), skin diseases (OR, 1.05), psychotic diseases (OR, 1.07) and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the division/brigade-level proximity-based exposure analysis, compared to the low exposure group. The ORs for cerebral infarction (OR, 1.08), chronic bronchitis (OR, 1.05), multiple nerve palsy (OR, 1.07), multiple sclerosis (OR, 1.16), skin diseases (OR, 1.05), and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the battalion/company-level analysis. Conclusions: Korean Vietnam veterans with high exposure to Agent Orange experienced a higher prevalence of several self-reported chronic diseases compared to those with low exposure by proximity-based exposure assessment. The strong positive associations between perceived self-reported exposure and all self-reported diseases should be evaluated with discretion because the likelihood of reporting diseases was directly related to the perceived intensity of Agent Orange exposure.

• Archives of Plastic Surgery
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• v.50 no.4
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• pp.443-444
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• 2023

Point-of-care photography and photo sharing optimize patient outcomes and facilitate remote consultation imperative for resident surgeons. This literature review and external pilot survey study highlight the risks associated with current practices concerning patient privacy and biometric security. In a survey of 30 plastic surgeon residents and attendings, we found that the majority took photos of patients with their iPhones and shared them with colleagues via Apple iMessage. These findings corroborate previous reports and highlight a lack of physician user acceptance of secure photo-sharing platforms. Finally, we frame a successful example from the literature in the context of a postulated framework for institutional change. Prioritizing the privacy and safety of patients requires a strategic approach that preserves the ease and frequency of use of current practices.

• Journal of Preventive Medicine and Public Health
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• v.47 no.1
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• pp.36-46
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• 2014

Objectives: To evaluate the association between fracture risk and levothyroxine use in elderly women with hypothyroidism, according to previous osteoporosis history. Methods: We conducted a cohort study from the Korean Health Insurance Review and Assessment Service claims database from January 2005 to June 2006. The study population comprised women aged ${\geq}65$ years who had been diagnosed with hypothyroidism and prescribed levothyroxine monotherapy. We excluded patients who met any of the following criteria: previous fracture history, hyperthyroidism, thyroid cancer, or pituitary disorder; low levothyroxine adherence; or a follow-up period <90 days. We categorized the daily levothyroxine doses into 4 groups: ${\leq}50{\mu}g/d$, 51 to $100{\mu}g/d$, 101 to $150{\mu}g/d$, and > $150{\mu}g/d$. The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with the Cox proportional hazard model, and subgroup analyses were performed according to the osteoporosis history and osteoporosis-specific drug prescription status. Results: Among 11 155 cohort participants, 35.6% had previous histories of osteoporosis. The adjusted HR of fracture for the > $150{\mu}g/d$ group, compared with the 51 to $100{\mu}g/d$ group, was 1.56 (95% CI, 1.03 to 2.37) in osteoporosis subgroup. In the highly probable osteoporosis subgroup, restricted to patients who were concurrently prescribed osteoporosis-specific drugs, the adjusted HR of fracture for the > $150{\mu}g/d$ group, compared with the 51 to 100 ${\mu}g/d$ group, was 1.93 (95% CI, 1.14 to 3.26). Conclusions: While further studies are needed, physicians should be concerned about potential levothyroxine overtreatment in elderly osteoporosis patients.