• Journal of dental hygiene science
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• v.15 no.5
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• pp.666-672
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• 2015

This paper was trying to investigate the periodontal health recognition and self oral hygiene behaviors and figure out that relationship. The results having analyzed 592 questionnaires returned patient who had visited the dental clinic which is selected randomly were following. There were relationships between the periodontal health recognition and self oral hygiene behaviors. Self oral hygiene behaviors were significantly high when, women did than men did, education level, subjective oral health status, and periodontal health recognition about managements were higher and periodontal health recognitions about treatment were lower. It was the periodontal health recognition that was influential the most in the independent variables. Therefore, knowledge related to the periodontal health should be educated to the patients visiting the dental clinic, and the patients should receive helps to perform self oral hygiene behaviors by inducing the transition of attitude to periodontal health.

• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.80-92
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• 1999

The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. I t is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(k=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay $10.9{\pm}6.7$ days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.

• Journal of Preventive Medicine and Public Health
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• v.41 no.5
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• pp.287-294
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• 2008

Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.

• The Journal of the Korea Contents Association
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• v.17 no.11
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• pp.410-422
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• 2017

The purpose of this study was to investigate the correlation between knowledge related to disease(KRD), illness attitude, and quality of life(QOL) in relation to the Chronic Obstructive Pulmonary Disease(COPD). According to the study result, there were significant differences with regard to KRD in accordance with subjects' education, monthly income, mMRC(modified Medical Research Council) Dyspnea Scale, inhaled bronchodilator and antibiotic treatment. In addition, there were significant differences with respect to illness attitude according to monthly income and mMRC. In case of the QOL, there were significant differences in accordance with age, marital status, monthly income, inpatient status, history of hospital admission, oxygen use, comorbidity, mMRC, and inhaled steroid. It has shown that there was a significant correlation between KRD and QOL(r=-.438, p<.001), illness attitude and QOL(r=.279, p=.001). Thus, it is important to grasp monthly income and mMRC, which are correlated with the three elements in common. As per assessment about COPD patients in the clinical situation, it is necessary to develop a multi-disciplinary approach, health coaching program for improving KRD and having a positive attitude based on the low-income group with taking interest in the circumstances of mMRC as well as objective test results.

• The Journal of the Korea Contents Association
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• v.20 no.10
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• pp.385-394
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• 2020

This study was carried out to investigate the post stroke depression (PSD) occurrence in acute stroke patients and to identify the factors that influence PSD. The study subjects were 104 adults in their 20s or older who were scheduled to be discharged due to inpatient treatment for ischemic stroke in two hospitals. Data were collected using Post Stroke Depression Scale for PSD, Multidimensional Scale of Perceived Social Support for social support, National Institutes of Health Stroke Scale for stroke severity, and Modified Rankin Scale for disability. The average length of stay after stroke onset of the study subjects was 5.9±2.1 days, and 79.8% were within 7 days. Stroke severity score was an average of 2.4±2.5 out of 42 points, and disability score was an average of 1.6±1.1 out of 6 points. Among the subjects, 32.7% had mild or more severe depression after stroke. The subjects with no religion, severe disability, high stroke severity, and less family support had a higher likelihood of experiencing PSD. These results show that depression can appear in the early stages of stroke onset. Therefore, it is necessary to develop nursing guidelines for depression intervention after acute stroke, including continuous early assessment of depression from the acute phase of stroke and religion or family support.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.4
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• pp.97-109
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• 2017

Objectives The aim of this study is to analyze the patients who have low back pain through registry. Methods We registered patients with low back pain who visited department of korean rehabilitation medicine in university hospitals on study. We collected data from 116 subjects consisted of 51 inpatients and 65 outpatients and ruled out 8 who didn't have pattern identification data at the point of inpatient or outpatient visit so we analyzed 108 in total. We used Pearson's product moment correlation to find correlationship among variables, and analyzed statistical data using Phyton scipy library stats package. Results We set general features, region of the pain, physical examination, ROM, questionnaire results, pattern identification as variables and draw a conclusion by analyzing these variables. Conclusions Registry aimed at low back pain patients was established in department of korean rehabilitation medicine of university hospitals and exploratory analysis based on data were made. Through the registry, we expect that more advanced studies will be performed; for example, executing research which verifies effectiveness and stability of korean medical treatment or developing tools to fill the gap between pattern identification and disease identification.

• The Korean Society of Law and Medicine
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• v.20 no.1
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• pp.243-279
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• 2019

During the main ruling in 2018, it is difficult to find a new judiciary, which is understood to be due to a certain degree of jurisprudence established and focusing mainly on contentious disputes within the framework of damages. The cases in which the court's judgment is reversed helped to understand the reason and the judiciary, and it was confirmed that the dispute in the medical lawsuit became more and more intense. Decisions on responsibility restrictions and medical records were also noticeable, with a significant increase in the number of verdicts relating to the doubt about medical records. This is considered to be part of the increasing number of cases in which the parties raise questions about medical records, and several cases were categorized and introduced at this opportunity. We also introduce the case of forced discharge of long-term hospitalized patients and medical fee bill, because it was judicial interest after the Supreme Court ruling that the cost of treatment for the after-effects of medical malpractice can not be claimed to the patient.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6705-6709
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• 2015

Background: Venous thromboembolisms (VTEs) constitute a group of diseases including deep vein thrombosis (DVT) and pulmonary embolism (PE). They regarded as the second leading cause of death in cancer patients and several studies have confirmed that VTEs have a negative impact on survival and recurrent rate in both ovarian and endometrial cancer cases. The incidence of VTEs differs worldwide and depends on several risk factors including race, underlying disease, lifestyle, body weight, BMI and genetic risk factors. There is heterogeneity of DVT rates between Asian and Western countries. This study was conducted in order to evaluate the character and incidence of VTEs in gynecologic oncology patients in King Chulalongkorn Memorial Hospital over a 10 year period. Materials and Methods: A retrospective chart review was performed with VTEs defined as objective diagnosis of acute DVT or PE with typical symptoms and signs. Diagnoses were approved byan internist and/or confirmed with imaging studies. Data from both outpatient and inpatient sessions of the affected cases from January 2004 to December 2013 were extracted. General characteristics of the patients were collected with details of the diseases, types of cancer, stage, date of diagnosis of cancer, operative data, treatment outcome, progression free survival and overall survival. Results: Thirty cases of VTEs were identified in a total 2,316 gynecologic oncology cases. The incidence of symptomatic VTEs in total gynecologic oncology patients in our institution is 1.295%. The incidence of VTEs in ovarian cancer patients in our institution was 5.9%. Duration for VTE detection ranged from 13 months before diagnosis of cancer to 33 months after diagnosis of cancer. Most of the VTE cases were detected in ovarian cancer patients (60%). The most common cell type was adenocarcinoma (moderately to poorly differentiated) which accounted for 26.7% of the cases. The second most common cell type was clear cell carcinoma with 23.3% of the cases. Thirty percent of VTE cases developed before cancer was diagnosed, 20% were diagnosed at the same time as cancer detection and fifty percent developed after cancer was diagnosed. Median disease free survival of the gynecologic oncology patients with VTE was 7.5 months. Median overall survival (OS) was 12 months. Median progession free survivals of DVT and PE groups were 11.5 and 5.5 months, respectively. OS of DVT and PE was 12.0 and 11.5 months respectively. Conclusions: The incidence of VTE in Asian countries is believed to be lower than in European or Western countries. From our retrospective review, the incidence of VTEs in all types of gynecologic oncology was 1.295%, much lower than reported in the West. The reason for the lower incidence may genetic differences. Another factor is that VTE in this review was symptomatic, which is less than asymptomatic VTE. More than half of VTEs in this study developed in ovarian cancer patients. The results are compatible with earlier reports that among gynecologic malignancies, the incidence of VTE is highest in ovarian cancer.

• The Korean Society of Law and Medicine
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• v.16 no.1
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• pp.221-254
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• 2015

The amendment of the Korea Civil Code will take place July 1, 2013. One of the most import issues related to adult guardianship system is a part. Though more than 100 new provisions, the revised Civil Code fundamentally reformed the guardianship system to establish a system to meet the diverse and complex needs of those who need a guardian and ensure due process. The new adult guardianship system intended to respect dignity and human right of mentally incapacitated adults, to guaranee their autunomy and to minimize the public interventions for assisting them. The new guardianship system for vulnerable adult has three kinds of legal guardianship system (adult guardianship, limited guardianship and specific guardianship). Mental patients forced the hospitalization of the mental health code and will be treated as an agreement incapable person. In principle an agreement incapable person has capacity of consent. The consent of the mental patients are admitted first. It is advisable to medical care only by the consent of the guardian when the the mental patient do not agree ability. If the mental patient do not agree with the mentally ill, but there should be a supervisory capacity for a guardianship of the couple guardian supervision. In conclusion, it not lost the capacity to consent to inpatient mental illness called. Therefore, we must discuss in detail the scope of the agreement for the mental patients. Mental Health Act amendments are necessary in accordance with the amended Civil Code.

• Journal of the Korean Society of Radiology
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• v.14 no.6
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• pp.801-810
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• 2020

In this study, the health insurance application of PET and the change in the pay standard were examined, and the amount of health insurance use over the past 10 years was analyzed. Positron tomography was applied as health insurance in 2006, and after ¹⁸F-FDG was first applied as health insurance, positron tomography tests using various radioactive isotopes have been applied as health insurance. As of 2019, the number of positron emission tomography tests was 198,651 cases, and the treatment amount was about 88.3 billion won, and the number of tests according to general characteristics was higher in men than in women, and by age, the number of tests was the highest in 60s. The number of outpatient examinations was higher than that of inpatient examinations, and the number of examinations in tertiary hospitals(68.2%) was significantly higher than that of general hospitals and hospitals. As for the test site, torso test was the most common at 86.6%, and radioisotope was the most at 93.6% using ¹⁸F-FDG. The change in the use of PET for 10 years increased steadily from 2010 to 2014, but the amount of use decreased sharply afterwards as the recognition of asymptomatic long-term follow-up tests was deleted due to the government's change in health insurance application standards in 2014. As changes in health insurance standards have a great influence on changes in health insurance usage, continuous monitoring will be required in the future.