• Korean Journal of Clinical Pharmacy
• /
• v.33 no.4
• /
• pp.242-253
• /
• 2023

Background: Arrhythmia due to QT prolongation is one of the most serious adverse events with drug interactions in the elderly. This study aimed to examine the incidence of arrhythmia in Korean elderly patients who administered both cytochrome P450 3A4 (CYP3A4) substrates and inhibitors. Methods: Patients using CYP3A4 substrate and inhibitor were selected from the 2017 elderly patient dataset (the Korean Health Insurance Review and Assessment Service - Aged Population Sample). Selection criteria were patients with a medication possession ratio over 80%, medication duration of at least 7 days, and a follow-up period of 3 months or more. The patient's basic information is age, gender, health insurance type, and comorbidities. The top 50 drug pairs and comorbidity with high-incidence arrhythmia were presented. Results: In patients with drug combinations for over 7 days, there were 981 incidences of arrhythmia, and 351 incidences in those with combinations for over 30 days. The comorbidities of congestive heart failure and myocardial infarction had a significant association with incidence of arrhythmia. Among patients with 7 days or longer, the drug pairs [substrates-inhibitors] with significant adjusted odds ratio (aOR) were [propranolol-cimetidine] (aOR, 2.25; 95% confidence interval [CI], 1.66-3.04). Among patients with 30 days or longer, the drug pairs with significant aOR were [tramadol-amiodarone] (aOR, 2.87; 95% CI, 1.97-4.19). Conclusions: In elderly patients, the incidence of arrhythmia was high with drug interactions of CYP3A4 substrates and inhibitors. The comorbidity of congestive heart failure was the risk factor.

• Korean Circulation Journal
• /
• v.53 no.5
• /
• pp.313-327
• /
• 2023

Background and Objectives: Pulmonary arterial hypertension (PAH) is a rare but fatal disease. Recent advances in PAH-specific drugs have improved its outcomes, although the healthcare burden of novel therapeutics may lead to a discrepancy in outcomes between developing and developed countries. We analyzed how the epidemiology and clinical features of PAH has changed through the rapidly advancing healthcare infrastructure in South Korea. Methods: PAH was defined according to a newly devised 3-component algorithm. Using a nationwide health insurance claims database, we delineated annual trends in the prevalence, incidence, medication prescription pattern, and 5-year survival of PAH in Korea. Cumulative survival and potential predictors of mortality were also assessed among 2,151 incident PAH cases. Results: Between 2002 or 2004 and 2018, the prevalence and incidence of PAH increased 75-fold (0.4 to 29.9 per million people) and 12-fold (0.5 to 6.3 per million person-years), respectively. The proportion of patients on combination PAH-specific drug therapy has also steadily increased up to 29.0% in 2018. Among 2,151 incident PAH cases (median [interquartile range] age, 50 [37-62] years; 67.2% female), the 5-year survival rate and median survival duration were 71.8% and 13.1 years, respectively. Independent predictors of mortality were age, sex, etiology of PAH, diabetes, dyslipidemia, and chronic kidney disease. Conclusions: This nationwide study delineated that the prevalence and incidence of PAH have grown rapidly in Korea since the early 2000s. The use of combination therapy has also increased, and the 5-year survival rate of PAH in Korea was similar to those in western countries.

• The Korean Journal of Pain
• /
• v.37 no.1
• /
• pp.73-83
• /
• 2024

Background: Failed back surgery syndrome (FBSS) is a chronic condition that is characterized by persistent back pain following one or more spinal surgeries. Pharmacological interventions, such as the use of opioids and gabapentinoids, are frequently used in the treatment of FBSS. However, prolonged and excessive use of these medications can lead to dependence and adverse effects. This study investigates trends in opioid and gabapentinoid prescriptions among patients with FBSS in Korea from 2016 to 2020. Methods: Data from the Health Insurance and Review Agency were analyzed, and claims listing FBSS were selected for the study. Prescription patterns of opioids and gabapentinoids were classified based on the number of days prescribed per year. Results: Of the 390,095 patients diagnosed with FBSS, 41.6% of the patients were prescribed gabapentinoids, and 42.0% of them were prescribed opioids, while 10.6% of the patients were classified as long-term gabapentinoid users, 11.4% as long-term opioid users, and 7.4% of the patients were found to have long-term prescriptions for both drugs. The proportion of patients who received both gabapentinoid and opioid prescriptions increased annually. The doses of opioids prescribed have also increased along with the increase in the number of patients receiving opioid prescriptions. Conclusions: The prescription rates of opioids and gabapentinoids among patients with FBSS in Korea continue to increase steadily, posing potential risks of addiction and adverse effects. Further research is needed to better understand the actual status of addiction in patients with FBSS.

• Journal of Intelligence and Information Systems
• /
• v.26 no.3
• /
• pp.71-90
• /
• 2020

Recently, the global insurance industry is rapidly developing digital transformation through the use of artificial intelligence technologies such as machine learning, natural language processing, and deep learning. As a result, more and more foreign insurers have achieved the success of artificial intelligence technology-based InsurTech and platform business, and Ping An Insurance Group Ltd., China's largest private company, is leading China's global fourth industrial revolution with remarkable achievements in InsurTech and Digital Platform as a result of its constant innovation, using 'finance and technology' and 'finance and ecosystem' as keywords for companies. In response, this study analyzed the InsurTech and platform business activities of Ping An Insurance Group Ltd. through the ser-M analysis model to provide strategic implications for revitalizing AI technology-based businesses of domestic insurers. The ser-M analysis model has been studied so that the vision and leadership of the CEO, the historical environment of the enterprise, the utilization of various resources, and the unique mechanism relationships can be interpreted in an integrated manner as a frame that can be interpreted in terms of the subject, environment, resource and mechanism. As a result of the case analysis, Ping An Insurance Group Ltd. has achieved cost reduction and customer service development by digitally innovating its entire business area such as sales, underwriting, claims, and loan service by utilizing core artificial intelligence technologies such as facial, voice, and facial expression recognition. In addition, "online data in China" and "the vast offline data and insights accumulated by the company" were combined with new technologies such as artificial intelligence and big data analysis to build a digital platform that integrates financial services and digital service businesses. Ping An Insurance Group Ltd. challenged constant innovation, and as of 2019, sales reached $155 billion, ranking seventh among all companies in the Global 2000 rankings selected by Forbes Magazine. Analyzing the background of the success of Ping An Insurance Group Ltd. from the perspective of ser-M, founder Mammingz quickly captured the development of digital technology, market competition and changes in population structure in the era of the fourth industrial revolution, and established a new vision and displayed an agile leadership of digital technology-focused. Based on the strong leadership led by the founder in response to environmental changes, the company has successfully led InsurTech and Platform Business through innovation of internal resources such as investment in artificial intelligence technology, securing excellent professionals, and strengthening big data capabilities, combining external absorption capabilities, and strategic alliances among various industries. Through this success story analysis of Ping An Insurance Group Ltd., the following implications can be given to domestic insurance companies that are preparing for digital transformation. First, CEOs of domestic companies also need to recognize the paradigm shift in industry due to the change in digital technology and quickly arm themselves with digital technology-oriented leadership to spearhead the digital transformation of enterprises. Second, the Korean government should urgently overhaul related laws and systems to further promote the use of data between different industries and provide drastic support such as deregulation, tax benefits and platform provision to help the domestic insurance industry secure global competitiveness. Third, Korean companies also need to make bolder investments in the development of artificial intelligence technology so that systematic securing of internal and external data, training of technical personnel, and patent applications can be expanded, and digital platforms should be quickly established so that diverse customer experiences can be integrated through learned artificial intelligence technology. Finally, since there may be limitations to generalization through a single case of an overseas insurance company, I hope that in the future, more extensive research will be conducted on various management strategies related to artificial intelligence technology by analyzing cases of multiple industries or multiple companies or conducting empirical research.

• Journal of Korean Neurosurgical Society
• /
• v.61 no.2
• /
• pp.219-223
• /
• 2018

Objective : To investigate nationwide statistics on flow-diverting stent usage for cerebral aneurysm treatment and related mortality data. Methods : We requested data extraction from the National Health Insurance Service claims database using electronic data interchange codes (J3207064, J3207073). Patient and hospital information as well as death statistics were collected from the database. Results : A total of 169 procedures were performed using flow-diverting stents for cerebral aneurysm treatment from November 2014 to December 2016 in Korea. The majority of primary diagnosis was unruptured intracranial aneurysm. During the study period, nine subjects died, including one patient initially diagnosed with subarachnoid hemorrhage. The crude mortality rate was 5.3%. Five patients died within one month after the procedure; therefore, the estimated periprocedural mortality rate was $3.0{\pm}1.3%$. The mortality rate as of the last day of 2016 was $6.3{\pm}2.1%$. Conclusion : In a 171 person-year follow-up in a Korean series, nine deaths occurred after flow-diverting stent treatment. The crude mortality rate in Korea (5.3%) was higher than that reported in a previous meta-analysis (3.8%).

• Transactions of the Korean Society of Automotive Engineers
• /
• v.14 no.4
• /
• pp.181-191
• /
• 2006

The most common kind of vehicular accident is the low-speed rear-end impact that result in high portion of insurance claims and Whiplash Associated Disorders(WAD). The low-speed collisions have specific characteristics that differ from high speed collisions and must be treated differently This paper presents a simple continuous contact force model for the low-speed rear-end impact to simulate the accelerations, velocities and the contact force as functions of time. A smoothed Coulomb friction force is used to represent the effect of braking, which was found to be significant in simulating low-speed rear end impact. The intervehicular contact force is modeled using nonlinear damping and spring elements with coefficients and exponents. This paper presents how to estimate analytically stiffness and damping coefficients. The exponent of the nonlinear contact force model was determined to match the overall acceleration pulse shape and magnitude. The model can be used to determine ${\Delta}Vs$ and peak accelerations for the purpose of accident reconstruction and for injury biomechanics studies.

• Health Policy and Management
• /
• v.14 no.1
• /
• pp.121-147
• /
• 2004

Since the pilot program for a DRG-based prospective payment system was introduced in 1997, the performance of KDRGs has been one of hotly debated issues. The objectives of this study are to refine the classification algorithm of the KDRGs and to assess the improvement achieved by the refinement. The U.S. Medicare DRGs version 17.0 and the Australian Refined DRGs version 4.1 were reviewed to identify areas of possible impro-vement. Refined changes in the classification and result of date analyses were submitted to a panel of 48 physicians for their reviews and suggestions. The refinement was evaluated by the variance reduction in resource utilization achieved by the KDRG The database of 2,182,168 claims submitted to the Health Insurance Review Agency during 2002 was used for evaluation. As the result of the refinement, three new MDCs were introduced and the number of ADEGs increased from 332 to 674. Various age splits and two to four levels of severity classification for secondary diagnoses were introduced as well. A total of 1,817 groups were defined in the refined KDRGs. The variance reduction for charges of all patients increased from 48.2％ to 53.6％ by the refinement, and from 65.6％ to 73.1％ for non-outlier patients. The r-square for length of stays of all patients was increased from 28.3％ to 32.6％, and from 40.4％ to 44.9％ for non-outlier patients. These results indicated a significant improvement in the classification accuracy of the KDRG system.

• The Korean Journal of Pain
• /
• v.31 no.1
• /
• pp.54-57
• /
• 2018

Burner or stinger syndrome is a rare sports injury caused by direct or indirect trauma during high-speed or contact sports mainly in young athletes. It affects peripheral nerves, plexus trunks or spinal nerve roots, causing paralysis, paresthesia and pain. We report the case of a 57-year-old male athlete suffering from burner syndrome related to a lumbar nerve root. He presented with prolonged pain and partial paralysis of the right leg after a skewed landing during the long jump. He was initially misdiagnosed since the first magnet resonance imaging was normal whereas electromyography showed denervation. The insurance company refused to pay damage claims. Partial recovery was achieved by pain medication and physiotherapy. Burner syndrome is an injury of physically active individuals of any age and may appear in the cervical and lumbar area. MRI may be normal due to the lack of complete nerve transection, but electromyography typically shows pathologic results.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.31 no.2
• /
• pp.80-87
• /
• 2020

Objectives: The prevalence of psychiatric disorders among young adults is different from that among younger or older age groups because of biological and environmental changes. The purpose of this study was to analyze the diagnostic distribution of psychiatric disorders in 19-30-year-old Koreans based on their age and gender using data from the Korean National Health Insurance Service (NHIS). Methods: From the 2011 medical claims sample data of NHIS of 1,375,842 people, we extracted the data of 221,038 people aged 19-30 years, including 106,232 (48.1%) men and 114,806 (51.9%) women. We evaluated the overall changes in the diagnostic distribution of psychiatric disorders over a 3-year period. Results: The diagnostic frequency in women was 13,627 (59.0%), which was significantly higher than that in men. "Other anxiety disorders" was the most common psychiatric disorder in both genders, followed by depressive episodes, somatoform disorders, "other neurotic disorders," and nonorganic sleep disorders. In men, attention-deficit/hyperactivity disorder or intellectual disabilities were not among the top 10 disorders. In women, no significant changes in major psychiatric disorders were seen over the 3-year period. Conclusion: These results reveal the trends of diagnostic distribution of mental illnesses depending on the development, particularly in young adulthood. It is necessary to identify whether such trends are due to biological or environmental factors, aging processes, or complex influences.

• Journal of Preventive Medicine and Public Health
• /
• v.48 no.4
• /
• pp.180-187
• /
• 2015

Objectives: Metabolic syndrome is an important etiologic factor in the development of certain types of cancers. The economic cost of the treatment of cancer has been steadily increasing. We therefore estimated the economic burden of cancers attributable to metabolic syndrome in Korea. Methods: We reviewed metabolic syndrome-related cancers and relative risk and then calculated population attributable fractions. We analyzed insurance claims data for metabolic syndrome-related cancers in 2012 in order to estimate the direct costs associated with these cancers, including hospitalization, outpatient visits, transportation costs, and caregivers' costs as well as indirect costs such as loss of productivity due to cancer treatment and premature death. Results: In 2012, 18 070 patients in Korea had cancers attributable to metabolic syndrome. The economic burden was USD 199.8 million and the direct and indirect costs were USD 124.5 million and USD 75.3 million, respectively. Conclusions: We estimated the economic burden of cancers attributable to metabolic syndrome in Korea and the efforts are necessary to reduce this burden.