• Health Policy and Management
• /
• v.25 no.3
• /
• pp.197-206
• /
• 2015

Background: The purpose of this study was to propose a method for developing a measure of hospital-wide all-cause risk-standardized readmissions using administrative claims data in Korea and to discuss further considerations in the refinement and implementation of the readmission measure. Methods: By adapting the methodology of the United States Center for Medicare & Medicaid Services for creating a 30-day readmission measure, we developed a 6-step approach for generating a comparable measure using Korean datasets. Using the 2010 Korean National Health Insurance (NHI) claims data as the development dataset, hierarchical regression models were fitted to calculate a hospital-wide all-cause risk-standardized readmission measure. Six regression models were fitted to calculate the readmission rates of six clinical condition groups, respectively and a single, weighted, overall readmission rate was calculated from the readmission rates of these subgroups. Lastly, the case mix differences among hospitals were risk-adjusted using patient-level comorbidity variables. The model was validated using the 2009 NHI claims data as the validation dataset. Results: The unadjusted, hospital-wide all-cause readmission rate was 13.37%, and the adjusted risk-standardized rate was 10.90%, varying by hospital type. The highest risk-standardized readmission rate was in hospitals (11.43%), followed by general hospitals (9.40%) and tertiary hospitals (7.04%). Conclusion: The newly developed, hospital-wide all-cause readmission measure can be used in quality and performance evaluations of hospitals in Korea. Needed are further methodological refinements of the readmission measures and also strategies to implement the measure as a hospital performance indicator.

• The korean journal of orthodontics
• /
• v.49 no.6
• /
• pp.360-371
• /
• 2019

Objective: We sought to determine the predictors of midpalatal suture expansion by miniscrew-assisted rapid palatal expansion (MARPE) in young adults. Methods: The following variables were selected as possible predictors: chronological age, palate length and depth, midpalatal suture maturation (MPSM) stage, midpalatal suture density (MPSD) ratio, the sella-nasion (SN)-mandibular plane (MP) angle as an indicator of the vertical skeletal pattern, and the point A-nasion-point B (ANB) angle for anteroposterior skeletal classification. For 31 patients (mean age, 22.52 years) who underwent MARPE treatment, palate length and depth, MPSM stage and MPSD ratio from the initial cone-beam computed tomography images, and the SN-MP angle and ANB angle from lateral cephalograms were assessed. The midpalatal suture opening ratio was calculated from the midpalatal suture opening width measured in periapical radiographs and the MARPE screw expansion. Statistical analyses of correlations were performed for the entire patient group of 31 subjects and subgroups categorized by sex, vertical skeletal pattern, and anteroposterior skeletal classification. Results: In the entire patient group, the midpalatal suture opening ratio showed statistically significant negative correlations with age, palate length, and MPSM stage (r = -0.506, -0.494, and -0.746, respectively, all p < 0.01). In subgroup analyses, a strong negative correlation was observed with the palate depth in the skeletal Class II subgroup (r = -0.900, p < 0.05). Conclusions: The findings of this study indicated that age, palate length, and MPSM stage can be predictors of midpalatal suture expansion by MARPE in young adults.

• Health Policy and Management
• /
• v.31 no.3
• /
• pp.301-311
• /
• 2021

Background: This study purposed to analyze the relationship between the local extinction index and medical service uses of chronic diseases. The local extinction index is an indicator of the demographic structure and population aging of the region. Methods: The 2014-2018 statistics of National Health Insurance Corporation and Korean Statistical Information Service data were used for the analysis. First, descriptive statistics were used to analyze the general status of research variables. Second, a panel analysis was performed to analyze the relationship between the local extinction index and medical service uses of chronic diseases (hypertension, diabetes mellitus, periodontal disease, arthritis, mental health, epidemic disease, liver disease). Medical service uses were measured by the number of visits/inpatient days and medical charges of seven chronic diseases. Results: Panel analysis results showed that higher local extinction risks (meaning lower local extinction index) had a positive relationship with the number of visits/inpatient days and medical charges of chronic diseases. But the relationships were varied when the seven chronic diseases were analyzed separately. Conclusion: This study showed a significant relationship between the local demographic structure and medical service uses of chronic disease. Analyzing the local demographic structure will be an essential prerequisite step for implementing appropriate regional health care policies.

• Journal of The Korean Society of Emergency Medicine
• /
• v.29 no.6
• /
• pp.616-623
• /
• 2018

Objective: The shock index (SI), as a trauma triage tool, is a capable clinical indicator of hemodynamic instability and hypovolemic shock, but the conception of SI is contradictory to shock. The reverse shock index (RSI) was introduced recently, but its utility has not been sufficiently proven. Methods: This study examined the RSI utility by evaluating the procedures performed at an emergency department (ED) and the associated outcomes when the RSI is used alone or in combination with the Korean Triage and Acuity Scale (KTAS). This was a retrospective study conducted by including data of 4,789 adult trauma patients for a year. The clinical variables, procedures performed on patients, and outcomes were investigated. The median RSI was 0.9 in the RSI<1 group. Results: Patients in the RSI<1 group had a higher odds of requiring procedures at the ED and for experiencing worse outcomes: intubation (odds ratio [OR], 5.4; 95% confidence interval [CI], 2.3-13.1; P<0.001), chest tube insertion (OR, 6.5; 95% CI, 0.4-111.84; P<0.001), use of emergency drugs (OR, 3.6; 95% CI, 1.5-8.5; P<0.001), circulatory support (OR, 5.4; 95% CI, 2.3-12.9; P<0.001), intensive care unit admission (OR, 3.5; 95% CI, 1.8-6.8; P<0.001), and mortality during the ED stay (OR, 20.4; 95% CI, 5.5-75.7; P<0.001). In the group with KTAS 1-3, trends similar to those in the RSI<1 group were observed. Patients with RSI<1 had more severe injuries and poorer outcomes than those with $RSI{\geq}1$, regardless of whether the RSI was used alone or in combination with KTAS. Conclusion: RSI can provide an appropriate triage with concurrent KTAS use.

• Journal of the Architectural Institute of Korea Structure & Construction
• /
• v.36 no.5
• /
• pp.177-185
• /
• 2020

The building energy performance indicator, called Energy Performance Index (EPI), has been used for the past decades in South Korea. It has a list of design variables assigned with weighting factors (a, b). Unfortunately, the current EPI method is not performance-based but very close to a prescriptive rating. With this in mind, this study aims to propose a new performance-based EPI method. For this purpose, a global sensitivity analysis method, Sobol, is employed. The Sobol method is suitable for complex nonlinear models and can decompose all the output variance due to every input. The Sobol sensitivity index of each variable is defined as 0 to 1 (0 to 100%), and the sum of all sensitivity indices is equal to 1 (100%). In this study, an office building was modeled using EnergyPlus and then the Latin Hypercube Sampling (LHS) was conducted to generate a surrogate model to EnergyPlus. The sensitivity index was suggested to replace weight (a) in the existing EPI. In addition, the discrete weight (b) in the existing EPI was replaced by a set of continuous regression functions. Due to the introduction of the sensitivity index and the continuous regression functions, the new proposed approach can provide far more accurate outcome than the existing EPI (R²: 0.83 vs. R²: 0.01 for cooling, R²: 0.66 vs. R²: 0.01 for total energy). The new proposed approach proves to be more rational, objective and performance-based than the existing EPI method.

• Journal of Environmental Science International
• /
• v.29 no.12
• /
• pp.1223-1237
• /
• 2020

This study focused on comparing the meteorological conditions in the Atmospheric Boundary Layer (ABL) on high-event days and non-event days in the Seoul Metropolitan Area (SMA). We utilized observed PM10 and meteorological variables at the surface as well as at the upper heights. The results showed that high-event days were consistently associated with lower wind speed, whereas wind direction showed no particular difference between high-event and non-event days with frequent westerlies and northwesterlies for both cases. During high-event days, the temperature was much warmer than the monthly normal values with a sharp increasing trend, and Relative Humidity (RH) was higher than the monthly normal, especially on high-event days in February. During high-event days in spring, a double inversion layer was present at surface and upper heights. This indicates that stability in the multi-layer is an important indicator of higher PM10 concentrations. Net radiation in spring and winter is also closely associated with higher PM10 concentrations. Strong net radiation resulted in large sensible heat, which in turn facilitated a deeper mixing height with diluted PM10 concentrations; in contrast, PM10 concentrations were higher when sensible heat in spring and winter was very low. We also confirmed that convective and friction velocity was higher on non-event days than on high-event days, and this was especially obvious in spring and winter. This indicated that thermal turbulence was dominant in spring, whereas in winter, mechanical turbulence was dominant over the SMA.

• Journal of Species Research
• /
• v.10 no.3
• /
• pp.246-254
• /
• 2021

Subalpine and alpine ecosystems are especially vulnerable to temperature increases. Betula ermanii Cham. (Betulaceae) is a dominant broad-leaved tree species in the subalpine zone and is designated as a 'Climate-sensitive Biological Indicator Species' in South Korea. This study aimed to predict the potential distribution of B. ermanii under current and future climate conditions in South Korea using the MaxEnt model. The species distribution models showed an excellent fit (AUC=0.99). Among the climatic variables, the most critical factors shaping B. ermanii distribution were identified as the maximum temperature of warmest month (Bio5; 64.8%) and annual mean temperature (Bio1; 20.3%). Current potential habitats were predicted in the Baekdudaegan mountain range and Mt. Hallasan, and the area of suitable habitat was 1531.52 km², covering 1.57% of the Korean Peninsula. With global warming, future climate scenarios have predicted a decrease in the suitable habitats for B. ermanii. Under RCP8.5-2070s, in particular, habitat with high potential was predicted only in several small areas in Gangwon-do, and the total area suitable for the species decreased by up to 97.3% compared to the current range. We conclude that the dominant factor affecting the distribution of B. ermanii is temperature and that future temperature rises will increase the vulnerability of this species.

• Journal of Digital Convergence
• /
• v.19 no.11
• /
• pp.499-509
• /
• 2021

The purpose of this study was to examine the mediating effect of flourishing on the relationship between role conflict and burnout as perceived by school counselors. A total of 242 school counselors participated in this study. The collected data were analyzed using the SPSS and PROCESS macro programs. The study results showed a significant positive correlation between role conflict and burnout and a significant negative correlation between flourishing and role conflict and burnout. In addition, depending on the three subtypes of role conflict (i.e., role-expectation conflict, individual-role conflict, and role ambiguity conflict), the effects on various sub-signs of burnout differed. It was found that flourishing mediated all of these variables of role conflict influencing burnout. These results suggest that flourishing can be considered an indicator for professionalism management of school counselors and a result showing that a positive psychological approach at the school level can be helpful in improving the effectiveness of school counseling by contributing positively not only to students but also to school counselors.

• The Journal of the Korea Contents Association
• /
• v.22 no.1
• /
• pp.58-73
• /
• 2022

The purpose of this study is to construct a predictable estimation model that reflects the relationship between the variables of mobile app performance and to verify how app reviews affect app performance. In study 1 and 2, the relationship between app performance indicators was derived using correlation analysis and random forest regression estimation of machine learning, and app performance estimation modeling was performed. In study 3, sentiment scores for app reviews were by using sentiment analysis of text mining, and it was found that app review sentiment scores have an effect one lag ahead of the number of daily installations of apps when using multivariate time series analysis. By analyzing the dissatisfaction and needs raised by app performance indicators and reviews of apps, companies can improve their apps in a timely manner and derive the timing and direction of marketing promotions.

• Journal of Biomedical Engineering Research
• /
• v.43 no.3
• /
• pp.161-169
• /
• 2022

Engagement is an important factor in the field of rehabilitation as it is a known factor that have a positive influence on functional gaining in people who receive rehabilitation therapy. Although a number of measurements for engagement have been recently developed, investigation of possible factors that may have influence on engagement is not well established. Currently available evidence suggests that engagement is affected by mood and it is hypothesized that a personal factor may contribute to engagement. Therefore, this study aims to test the hypothetical relationship between mood and engagement while performing a manual dexterity task through an experiment in healthy participants prior to investigation on people with medical condition who requires rehabilitation therapy. After inducing target mood (positive or negative mood) for study participants by asking them to recall autobiographical memories, change in muscle activity, which was operationalized as an indicator of engagement, was investigated. Electromyogram (EMG) was recorded from four muscle areas in non-dominant hand side to quantify muscle activity. The results show that the target moods were appropriately induced with the method. Although there were subtle differences in the level of engagement between different moods, certain variables derived from muscle activity were significantly different; mean amplitude for wrist extensor EMG showed significant difference between different moods (Z = -2.023, p < .05) indicating that muscle activities in the wrist extensor are greater for positive mood than negative mood region during manual dexterity task. Meanwhile, performance outcomes of Minnesota Manual Dexterity Test (MMDT), such as mean completion time and number of errors, between moods showed no significant difference in two different moods, resulting in MMDT administration may not be useful task in distinguishing the level of rehabilitation engagement.