• Korean Journal of Clinical Pharmacy
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• v.27 no.3
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• pp.186-194
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• 2017

Objectives: A significant concern has been raised about the emerging resistance that is largely caused by the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study investigated the trend of respiratory tract infections (RTIs) and the use of antibiotics. Methods: Utilizing the national level health insurance claims data from 2005 to 2008, we examined encounter days, antibiotic use, and the prescription rate for respiratory tract infections including upper respiratory tract infections (URTIs), lower respiratory tract infections (LRTIs), and otitis media in outpatient settings. The antibiotic use was measured as defined daily dose per 1,000 patients per day (DDD/1,000 patients/day). Results: The visit for URTI increased from 141,693,465 in 2005 to 120,717,966 in 2008 and the visit for LRTI decreased from 61,778,718 to 66,930,122. For RTIs, prescription rates of antibiotics decreased from 65.2% to 58.5% for URTIs and 76.9% to 68.3% for LRTIs from 2005 to 2008. The antibiotic use decreased to 20.85 DDD/1,000 patients/day after a significant increase of 22.01 DDD/1,000 patients/day in 2006. Among antibiotics, J01CR had the highest use- 7.93 DDD/1,000 patients/day followed by J01DC of 3.71 DDD/1,000 patients/day and J01FA of 3.2 DDD/1,000 patients/day. One notable trend is that J01FA presented a continuous increase in antibiotic use from 2.3 in 2005 to 3.26 DDD/1,000 patients/day in 2008. Conclusion: The use of antibiotics had poor compliance to guidelines for RTIs. Despite decrease in the use of antibiotics, prescription rates for URTIs were still about 50% indicating that the delayed prescribing antibiotics (or wait-and-see) were not observed.

• Proceedings of the Korean Operations and Management Science Society Conference
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• 2003.11a
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• pp.211-214
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• 2003

Recently mobile SFA(Sales Force Automation) system makes rapidly progress specially in industries like insurance, manufacture, and distribution. However, there are some problems that information about products and trades is not promptly shared among sales agents or customers, since the current mobile SFA system has simply extended the existing systems for sales management. In order to improve these weaknesses, we introduce LBS(Location Based Service) and mobile P2P(Peer to Peer) service into the existing systems, then design and implement the enhanced system (or mobile SFA using them. Through this improvement, our system makes it possible for customers or sales agents to quickly share various information and increases the efficiency of sales activity by facilitating the competition and cooperation among sales agents and reducing time-cost.

• Health Policy and Management
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• v.24 no.2
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• pp.120-127
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• 2014

Background: Since December 2010, online computerized prospective drug utilization review (pDUR) has been implemented in Korea. pDUR involves the review of each prescription before the medication is dispensed to the individual patient. The pDUR is performed electronically by Health Insurance Review & Assessment Service (HIRA), which is a Korean governmental agency, and then HIRA provides medical institutions and pharmacies with information that can be helpful to them in preventing potential drug problems such as drug/drug interactions or ingredient duplication. The aim of this study was to assess the impact of the Korean pDUR implementation on the proportion of drug-drug interactions (DDIs) using claims data from HIRA. Methods: A before-after comparison of the prevalence of DDIs between prescription was conducted, using HIRA administrative claims data of medical institution from January 2010 to December 2011. The analysis unit was the prescription issued and pairs before and after. The main outcome measures were the proportion of DDIs within- (control group) or between- physician encounters. To examine the difference, a paired t-test was applied. Results: We found that DDIs proportion between prescription decreased significantly (t=3.04, p=0.0026) after the implementation of pDUR, whereas there is no significant reduction within prescription (t=1.15, p=0.2518). With respect to the prevalence of DDIs between drug groups, the most dramatic reduction was occurred between 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors and anti-fungal agents. Conclusion: It seems effective that giving a direct feedback to prescribers by a prospective DUR. Further research is needed to assess the impact of DUR to final outcomes such as hospitalization.

• Journal of Preventive Medicine and Public Health
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• v.35 no.1
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• pp.41-48
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• 2002

Objectives : To review the drug prescription pattern of antiulcerative agents for elderly inpatients, Methods : The study population comprised inpatients of community hospitals who were members of the Korean Elderly Pharmacoepidemiologic Cohort (KEPEC), aged 65 years or over, beneficiaries of the Korea Medical Insurance Corporation (KMIC) and residing in Busan city in 1993. The drug prescription information was collected from the claims data of hospitals where the cohort members received medical care between January 1993 and December 1594. The information included personal identification, age, gender, diagnosis, drug dosage, date of hospital admission and name of medical institutions where the study subjects received drug prescriptions. The data analysis produced outcomes in terms of distribution of antiulcerative agents by class and by medical institution and trend of relative prescription, Analysis was also performed in terms of combined prescriptions of antiulceratives and drugs that could induce risk from drug interaction with antiulceratives. Results : The number of patients prescribed antiulcerative agents was 1,059 (64,9%) male and 1,724 (65.5%) female among the total inpatients. An antacid and composite agent was the most frequently prescribed antiulcerative agent (70.8%), followed by $H_2$ antagonist (16.0%), Among the potential drugs that could induce risk from drug interaction with the antiulcerative agents, diazepam was the most frequently prescribed. The proportion of diazepam co-prescription was 22.5% of the total cimetidine prescriptions and 14.5% of the fetal omeprazole prescriptions. Conclusions : Antiulcerative drugs were frequently prescribed in the elderly inpatients. The adverse drug reaction could possibly be due to drug interaction. The study results could be used as fundamental data for further drug utilization review of antiulceratiye agents.

• Journal of Korean Medical Science
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• v.33 no.44
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• pp.276.1-276.10
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• 2018

Background: The National Health Insurance Service (NHIS) established a healthcare claim database for all Korean citizens. This study aimed to analyze the NHIS data and investigate the patterns of breast cancer treatments. Methods: We constructed a retrospective female breast cancer cohort by analyzing annual incident cases. The annual number of newly diagnosed female breast cancer was compared between the NHIS data and Korea National Cancer Incidence Database (KNCIDB). The annual treatment patterns including surgery, chemotherapy, radiation therapy, endocrine therapy and targeted therapy were analyzed. Results: A total of 148,322 women with newly diagnosed invasive breast cancer during 2006-2014 was identified. The numbers of newly diagnosed invasive breast cancer cases were similar between the NHIS data and KNCIDB, which demonstrated a strong correlation (r = 0.995; P < 0.001). The age distribution of the breast cancer cases in the NHIS data and KNCIDB also showed a strong correlation (r = 1.000; P < 0.001). About 85% of newly diagnosed breast cancer patients underwent operations. Although the proportions of chemotherapy use have not changed during 2006-2014, the total number of chemotherapy prescriptions sharply increased during this period. The proportions of radiotherapy and anti-hormonal therapy increased. Among the anti-hormonal agents, tamoxifen was the most frequently prescribed medication, and letrozole was the most preferred endocrine treatment in patients aged ${\geq}50$ years. Conclusion: Along with the increased breast cancer incidence in Korea, the frequencies of breast cancer treatments have increased. The NHIS data can be a feasible data source for future research.

• Archives of Craniofacial Surgery
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• v.22 no.5
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• pp.254-259
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• 2021

Background: Prophylactic antibiotics are commonly used in craniofacial surgeries. Despite the low risk of surgical site infection after nasal surgery, a lack of consensus regarding the use of antibiotic prophylaxis in the closed reduction of nasal bone fractures has led to inappropriate prescribing patterns. Through this study, we aimed to investigate the status of prophylactic antibiotic use in closed reductions of nasal bone fractures in Korea. Methods: This retrospective cohort study was conducted using data from the National Health Insurance Service-National Sample Cohort of Korea from 2005 to 2015. We analyzed the medical records of patients who underwent closed reduction of nasal bone fractures. The sex, age, region of residence, comorbidities, and socioeconomic variables of the patients were collected from the database. Factors that affect the prescription of perioperative antibiotics were evaluated using multivariate logistic regression analysis. Results: A total of 3,678 patients (mean±standard deviation of age, 28.7±14.9 years; 2,850 men [77.5%]; 828 women [22.5%]) were included in this study. The rate of antibiotic prescription during the perioperative period was 51.4%. Approximately 68.8% of prescriptions were written for patients who had received general anesthesia. The odds of perioperative prophylactic antibiotic use were significantly higher in patients who received general anesthesia than who received local anesthesia (odds ratio, 1.59). No difference was found in terms of patient age and physician specialty. Second-generation cephalosporins were the most commonly prescribed antibiotic (45.3%), followed by third- and first-generation cephalosporins (20.3% and 18.8%, respectively). In contrast, lincomycin derivatives and aminoglycosides were not prescribed. Conclusion: The findings of this study showed that there was a wide variety of perioperative antibiotic prescription patterns used in nasal bone surgeries. Evidence-based guidance regarding the prescribing of antimicrobial agents for the closed reduction of nasal bone fractures should be considered in future research.

• Journal of the Korean Medical Association
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• v.61 no.11
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• pp.687-698
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• 2018

Inappropriate antibiotic use significantly contributes to antibiotic resistance, resulting in reduced antibiotic efficacy and an increased burden of disease. The objective of this study was to investigate the characteristics of prescribers whose antibiotics use was high and to explore factors affecting the use of antibiotics by medical institutions. This study analyzed the National Health Insurance claims data from 2015. Antibiotic prescription data were analyzed in terms of the number of defined daily doses per 1,000 patients per day, according to the World Health Organization anatomical-therapeutic-chemical classification and methodologies for measuring the defined daily dose. We investigated the characteristics of prescribers and medical institutions with high antibiotic use. Multivariate regression analyses were performed on the basis of characteristics of the medical institution (number of patients, type of medical institution [hospital or clinic], age of the physician, etc.). The number of patients and number of beds were found to be significant factors affecting antibiotic use in hospitals, and the number of patients, region, and medical department were significant factors affecting antibiotic use at the level of medical institutions. These findings are expected to help policy-makers to better target future interventions to promote prudent antibiotic prescription.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.26
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• pp.173-199
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• 2005

The MIA 1906, s.78(4) provides that it is the duty of the assured and his agents, in all cases, to take such measures as may be reasonable for the purpose of averting or minimising a loss. In many cases the statutory duty will be unimportant, since rights, duties and liabilities declared by the Act or implied into marine insurance contracts by law may be modified by agreement, and many contracts contains a sue and labour clause which effectively reproduces and/or to modifies the statutory duty. The effect of such contractual provisions will, of course, be a matter of construction, though modern sue and labour clauses tend to reflect the principles contains in section 78. However, it must not be assumed that the terms of all contractual sue and labour clauses are, or will remain, identical, either with each other or with the statutory duty. The purpose of this study is to clarify the ambit of sue and labour.

• 한국경영정보학회:학술대회논문집
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• 2007.06a
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• pp.378-381
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• 2007

Traditional intermediaries refer to service providers such as travel agents, real estate brokers, job agencies and insurance agents which matching services for buyers and suppliers in a traditional market. The introduction of Electronic commerce resulted in the automation of many tasks provided by intermediaries and seemed to eliminate the role of many traditional intermediaries, which is called disintermediation. However, depending on their market power, traditional intermediaries either will be disintermediated or fill new roles by providing added value and assistance, which is called reintermediation. According to the research of Alina M. Chircu et al. there are three conditions for reintermediation for traditional intermediaries. Three conditions are weak appropriability of EC innovations, ownership of co-specialized assets for both market intermediation and EC innovations and economies of scale. Besides these three reintermediation conditions, we hypothesize that leveraging BPO can be a suitable strategy for traditional intermediaries to be transformed into reintermediaries. Business Process Outsourcing (BPO) is the leveraging of technology or specialist process vendors to provide and manage an organization's critical and/or non-critical enterprise processes and applications. This paper will investigate the relationship between above reintermediation conditions including BPO and reintermediation.

• Journal of Periodontal and Implant Science
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• v.52 no.3
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• pp.230-241
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• 2022

Purpose: The purpose of this study was to evaluate failed implants and reimplantation survival and to identify the relative risk factors for implant re-failure. Methods: Ninety-one dental implants were extracted between 2006 and 2020 at the National Health Insurance Service Ilsan Hospital, including 56 implants in the maxilla and 35 implants in the mandible that were removed from 77 patients. Patient information (e.g., age, sex, and systemic diseases) and surgical information (e.g., the date of surgery and location of the implants and bone grafts) were recorded. If an implant prosthesis was used, prosthesis information was also recorded. Results: In total, 91 first-time failed dental implants in 77 patients were analyzed. Of them, 69 implants in 61 patients received reimplantation after failure. Sixteen patients (22 implants) refused reimplantation or received reimplantation at a different site. Eight of the 69 reimplants failed again. The 1-year survival rate of the 69 reimplants was 89.4%. Age at reimplantation and smoking significantly increased the risk of reimplantation failure. However, a history of taking anti-thrombotic agents showed a statistically significant negative association with reimplantation failure. Of the failed implants, 66% showed early failure and 34% showed late failure of the initial implantation. All 8 re-failed implants showed early failure. Only 3 of these 8 failed reimplants were re-tried and the second reimplants all survived. Conclusions: The total survival rate of implants, which included reimplants and second reimplants was 99.2%, although the survival rate of the initial implantations was 96.3%. Previous failure did not affect the success of the next trial. Reimplantation failure was more strongly affected by patient factors than by implant factors. Therefore, each patient's specific factors need to be meticulously controlled to achieve successful reimplantation.