• The Journal of the Korea Contents Association
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• v.22 no.10
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• pp.22-38
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• 2022

Recently, due to the temporary closure and isolation of facilities for developmental disabilities due to the prolonged COVID-19, the pain suffered by consumers is getting worse, and there is no clear solution due to the lack of information on inpatient services. Therefore, there is a need for a service system that can prevent institutional and psychological problems for consumers. The purpose of this study is to provide systematic inpatient treatment guides, post-discharge management, and correct education for children with developmental disabilities and their guardians. After deriving the needs and improvement factors of consumers through domestic service case analysis, we conducted co-creation with end-users using the double diamond methodology. A possible service concept was derived. Accordingly, a collaborative sharing app service was proposed, and the usefulness of the service was confirmed through the usability evaluation and verification of various stakeholders. It is expected that the results of this study will be utilized in the development of an assistance system for the developmental disability ward based on user experience.

• The Journal of Korean Medicine
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• v.42 no.2
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• pp.62-71
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• 2021

Objectives: This study was aimed to share the development process of the critical pathway (CP) for the treatment and management of stroke patients admitted to a Korean medicine hospital. Methods: A draft CP was prepared based on a review of relevant literature and medical records in the hospital, and its validity was reviewed by the in-hospital CP review committee. Each member evaluated all items in the CP on a 5-point Likert scale. Items with an average score of 3.5 or higher or an agreement rate of more than 80% were considered valid. In addition, free described opinions to improve the CP were also received from the review committee. Results: The horizontal axis of the CP was composed of a time domain, including 7 time points from hospitalization to discharge. The vertical axis was composed of 9 domains of medical practice. All items in the CP satisfied the validity criteria. The CP was revised, supplemented, and completed by reflecting the opinions of the committee. Conclusions: This CP will be taught to in-hospital users and will continue to be used with regular monitoring and a feedback plan. This study is expected to serve as a useful reference for standardizing the treatment process and delivering measures to improve the adequacy of Korean medicine treatment for stroke patients.

• Health Policy and Management
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• v.9 no.4
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• pp.1-14
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• 1999

The purpose of this study was to estimate the magnitude of patient's actual cost-sharing for hospital services in the National Health Insurance which has been estimated with only a few hospitals or limited number of patients. Also we aimed at analysis of factors influencing the magnitude. Sources of analyzed data were two databases. 1997 medical benefits record of the National Federation of Medical Insurance and 1997 Statistics for Hospital Management from the Korea Institute of Health Services Management(KIHM). We merged two databases and related records for 224 hospitals. based on the identification details of each hospital. The average percent of patients' cost-sharing was 51.7% of total hospital revenues from the insurance. with 40.3% of revenue in inpatient and 67.4% in outpatient. respectively. The contributing hospital factors to the magnitude of cost-sharing were size of hospitals. teaching status. location. number of employed physicians. etc. Larger and university hospital. urban location. and with more physicians were positively correlated with higher level of cost-sharing. Additionally, the higher the expenses of inpatient's treatment was, the higher the size of patient's cost-sharing was. These findings suggest that present level of patients' cost-sharing is quitely high and it is urgent to reduce the patient's cost-sharing to the reasonable level. It would be necessary to extend the coverage of insurance benefits and to develop policies focusing on larger hospitals and inpatient services.

• Korean Journal of Clinical Pharmacy
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• v.31 no.2
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• pp.153-159
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• 2021

Background: With increasing economic evaluation studies on the treatment of or screening tools for liver diseases that cause hepatocellular carcinoma (HCC), interest in the analysis of the medical utilization and costs of HCC treatment is increasing. Therefore, we aimed to estimate the medical utilization and costs of HCC patients, and calculate the cost of main procedures for HCC treatment, including liver transplant (LT), hepatic resection (HR), radiofrequency ablation (RFA), and transarterial chemoembolization (TACE). Methods: We analyzed claim data from January to December 2018 from the Health Insurance and Review and Assessment Service-National Patient Sample (HIRA-NPS-2018) dataset, including data of patients diagnosed with HCC (Korean Standard Classification of Diseases code C22.0) who had at least one inpatient claim for HCC. Results: A total of 715 HCC patients were identified. In 2018, the yearly average medical cost per HCC patient was ₩18,460K (thousand), of which ₩14,870K was attributed to HCC. Among the total medical costs of HCC patients, the inpatient cost accounted for the largest portion of both the total medical and HCC-related costs. The major procedures of HCC treatment occurred most frequently in the order of TACE, RFA, HR, and LT. The average medical cost per treatment episode was the highest for LT (₩87,280K), followed by HR (₩10,026K), TACE (₩4,047K), and RFA (₩2,927K). Conclusion: By identifying the medical costs of HCC patients and the costs of the main procedures of HCC treatment, our results provide basic information that could be utilized for cost estimation in liver disease-related economic evaluation studies.

• The Journal of Internal Korean Medicine
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• v.42 no.3
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• pp.444-454
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• 2021

Objectives: High natural killer cell activity (NKA) is associated with a clinically favorable status in patients with cancer. This study explores whether traditional Korean medicine (TKM) improves NKA in patients with cancer. Methods: We report three clinical cases involving patients with cancer who underwent NKA tests while they received TKM treatment, including acupuncture, moxibustion, wild ginseng pharmacopuncture, and Korean herbal medicines. We analyzed the treatment process and NKA test results of each patient. Results: The NKA of all three patients presented with an increasing tendency during the treatment process. Patient 1, who had been diagnosed with breast cancer, received inpatient treatment 3 times between September 16, 2017 and February 27, 2019. The NKA increased from 7.2 pg/mL to 571.7 pg/mL. Patient 2, who had thyroid cancer, was hospitalized 4 times between July 23, 2019 and August 27, 2020. The NKA improved from 317.4 pg/mL to 2000 pg/mL. Patient 3, who had liver cancer, received inpatient treatment 4 times between May 27, 2016 and January 10, 2017. The NKA increased from 22.2 pg/mL to 459.5 pg/mL. The chief complaints of these patients also were alleviated. Conclusions: TKM may be an effective treatment for accelerating NKA. Further research is needed to establish evidence that TKM stimulates NKA.

• Journal of Preventive Medicine and Public Health
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• v.34 no.1
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• pp.28-34
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• 2001

Objectives : To investigate the changing pattern of medical utilization claims following the economic crisis in Korea. Methods : The original data consisted of the claims of the 'Medical insurance program of self-employees' between 1997 and 1998. The data was selected by medical treatment day ranging between 8 January and 30 June. Medical utilizations were calculated each year by the frequency of claims, visit days for outpatients, length of stay for inpatients, total days of medication, and the sum of expenses. Results : The length of stay as an inpatient in 1998 was decreased 4.7 percent in comparison to 1997. However, inpatient expenses in 1998 increased 10.8 percent as compared to 1997. Inpatient hospital claims in 1998 increased 6.2 percent over 1997, although general hospital inpatient claims in 1998 decreased 3.3 percent in comparison to 1997. The outpatient claim frequency decreased 7.3 in 1998 percent as compared to 1997 Outpatient visit days of in 1998 were decreased 8.5 percent in comparison to that recorded in 1997. Outpatient claim frequencies of 'gu region' in 1998 decreased 10.5 percent comparison to that in 1997, but 'city and gun region' decreased less than 'gu region'. Conclusions : Medical utilization in 1998 deceased in relation to 1997 Medical utilization by outpatients decreased more than that of inpatients. Medical utilization by 'gu region' decreased mere than the other regions.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.35 no.4
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• pp.95-105
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• 2022

Objectives : The purpose of this study is to retrospectively analyze 3 years of inpatient dermatologic and surgical consultation to Korean medicine ophthalmology, otolaryngology & dermatology department in Korean medicine hospital. Methods : We classified dermatological and surgical inpatient consultations between September 1st, 2019 and August 31st, 2022, based on electronic medical record by gender, age, hospitalized department, categories of diseases. Results : Total number of consultations were 336. The proportion of female and male were 2.5:1, and the average of age was 65.6 and 60, respectively. The most frequently referred skin disease category was infectious skin disease(39.9%), followed by eczema(20.2%), dermatoses due to physical forces(10.1%), pigment anomalies(7.1%), nevi and tumors(4.8%), diseases of the skin appendages(4.2%), urticaria(3.9%), and others(4.9%). Consultations from department of Korean rehabilitation medicine, and Korean internal medicine were most common, because they have a comparatively large number of inpatients and long hospitalization period. In case of infectious disease and skin ulcer, patients from Korean internal medicine were frequently consulted due to characteristics of stroke and internal diseases. Conclusions : This study identified the frequency of consultation and the disease group with many requests for each department. Identifying the characteristics of diseases with a high frequency of consultation will prevent various dermatological problems that may occur by department. In addition, it was found that a prompt consultation was needed for accurate diagnosis and treatment in dermatological problem.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.36 no.4
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• pp.19-29
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• 2023

Objectives : The purpose of this study is to retrospectively analyze 3 years of inpatient ophthalmology consultation to Korean medicine ophthalmology, otolaryngology & dermatology department in Korean medicine hospital. Methods : We classified ophthalmological inpatient consultations between September 1st, 2019 and August 31st, 2022, based on electronic medical record by gender, age, hospitalized department, categories of diseases. Results : Total number of consultations were 111, and the average of age was 63.6. The proportion of female and male were 2.5:1. Among the 136 cases of eye disease referred, lacriminal production and discharge diseases accounted for the most at 54 cases(39.7%), of which 44 cases were dry eyes syndrome. Excluding dry eye syndrome, conjunctival disease occurred the most with 24 cases(17.6%). Consultations from department of Korean rehabilitation medicine, and Korean internal medicine were most common, because they have a comparatively large number of inpatients and long hospitalization period. Conclusions : This study identified the frequency of consultation and the disease group with many requests for each department. When inpatients complain of eye disease, consultation to Korean medicine ophthalmology, otolaryngology & dermatology department should be encouraged as accurate diagnosis and treatment using specialized equipment is possible and can be used for the purpose of progress observation and examination.

• Journal of Korean Academy of Nursing
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• v.50 no.3
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• pp.333-348
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• 2020

Purpose: The present study investigated the association between nurse staffing and health outcomes among psychiatric inpatients in Korea by assessing National Health Insurance claims data. Methods: The dataset included 70,136 patients aged 19 years who were inpatients in psychiatric wards for at least two days in 2016 and treated for mental and behavioral disorders due to use of alcohol; schizophrenia, schizotypal and delusional disorders; and mood disorders across 453 hospitals. Nurse staffing levels were measured in three ways: registered nurse-to-inpatient ratio, registered nurse-to-adjusted inpatient ratio, and nursing staff-to-adjusted inpatient ratio. Patient outcomes included length of stay, readmission within 30 days, psychiatric emergency treatment, use of injected psycholeptics for chemical restraint, and hypnotics use. Relationships between nurse staffing levels and patient outcomes were analyzed considering both patient and system characteristics using multilevel modeling. Results: Multilevel analyses revealed that more inpatients per registered nurse, adjusted inpatients per registered nurse, and adjusted inpatients per nursing staff were associated with longer lengths of stay as well as a higher risk of readmission. More adjusted inpatients per registered nurse and adjusted inpatients per nursing staff were also associated with increased hypnotics use but a lower risk of psychiatric emergency treatment. Nurse staffing levels were not significantly associated with the use of injected psycholeptics for chemical restraint. Conclusion: Lower nurse staffing levels are associated with negative health outcomes of psychiatric inpatients. Policies for improving nurse staffing toward an optimal level should be enacted to facilitate better outcomes for psychiatric inpatients in Korea.

• The Journal of Internal Korean Medicine
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• v.26 no.2
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• pp.360-368
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• 2005

Background & Object: The aim of this study was to investigate the effects of Traditional Korean medical therapy on gastric myoelectrical activity in patients with functional dyspepsia. Methods: 29 patients(male 10, female 19) were divided into two groups; Inpatient group(N=10, male 1, female 9) and outpatient group(N=19, male 9, female 10). 10 healthy people participated in this study as normal controls. Gastric motility was recorded and analyzed by electrogastrography(EGG) during fasting and postprandial periods. Hospital treatment included electroacupuncture on ST36, acupuncture, and herbal medicine. Outpatients were treated with herbal medicine and acupuncture. Inpatients underwent hospital treatment for two weeks, and after discharge they were treated as outpatients for six weeks. In inpatient group, EGG was recorded before and after hospital treatment and it was recorded at six weeks after discharge. In outpatient group, EGG was recorded before starting treatment and it was recorded once a every six weeks for twelve weeks. Results: There was no significant difference in EGG parameters between before and after therapy in outpatient group. In inpatient group, postprandial normal slow wave increased after hospital treatment(from $33.94{\pm}14.13$ to $62.63{\pm}20.18$, p<0.05) and postprandial tachygastria decreased(from $43.53{\pm}13.99$ to $28.30{\pm}16.63$, p<0.05) and arrhythmia decreased(from $20.35{\pm}15.91$ to $5.67{\pm}6.80$, p<0.05). Conclusions: Results suggest that hospital treatment through electroacupuncture on ST36, acupuncture, and herbal medicine is useful to improve gastric myoelectrical activity in Patients with Functional Dyspepsia.