• Journal of Korean Society of Health-System Pharmacists
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• v.35 no.4
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• pp.409-417
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• 2018

Background : Febrile neutropenia (FN) is one of the side effects in the patients treated with chemotherapy, and the patients who have FN generally need immediate treatment with extended-spectrum antibiotics and hospitalization. Pegfilgrastim and pegteograstim, which are used for the prevention of FN as a granulocyte-colony stimulating factor (G-CSF), have been granted insurance coverage in the Republic of Korea for certain breast cancer patients using doxorubicin and cyclophosphamide (AC) from September 2016. Methods : The data of the patients with breast cancer using AC regimen and G-CSF were collected retrospectively. This study involves cost-utility analysis of pegfilgrastim and pegteograstim. In this study, we constructed a simple decision tree model for short-term observation and calculated quality-adjusted life year (QALY) and the direct medical costs from the medical provider's perspective. Results : From September 2016 to May 2017, 15 patients were treated with pegfilgrastim and 15 patients were treated with pegteograstim. As a result of dividing the average cost by QALY for each treatment group, it was observed that pegfilgrastim and pegteograstim were consumed 24,923,384 won and 22,808,336 won per 1QALY, respectively. Consequently, incremental cost effectiveness ratio (ICER) showed 2,115,048 won more per pegfilgrastim than pegteograstim per 1QALY, and the cost per 1QALY of both the drugs was lower than 30,500,000 won; the Koreans were willing to pay this amount. Conclusions : This study suggests that pegfilgrastim and pegteograstim can be used to improve the quality of life of breast cancer patients undergoing AC therapy. Among the two drugs, pegteograstim seems to be more cost-effective. However, since this study was conducted as a retrospective observation method on a small scale, it is associated with many limitations. Therefore, a long-term prospective cohort study is needed to supplement the present findings.

• Journal of Digital Convergence
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• v.10 no.1
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• pp.413-422
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• 2012

In this study, we developed the severity-adjusted length of stay (LOS) model for acute myocardial infarction patients using data from the hospital discharge survey and proposed management of medical quality and development of policy. The dataset was taken from 2,309 database of the hospital discharge survey from 2004 to 2006. The severity-adjusted LOS model for the acute myocardial infarction (AMI) patients was developed by data mining analysis. From decision making tree model, the main reasons for LOS of AMI patients were CABG and comorbidity. The difference between severity-adjusted LOS from the ensemble model and real LOS was compared and it was confirmed that insurance type and location of hospital were statistically associated with LOS. And to conclude, hospitals should develop the severity-adjusted LOS model for frequent diseases to manage LOS variations efficiently and apply it into the medical information system.

• The Korean Society of Law and Medicine
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• v.11 no.2
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• pp.181-208
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• 2010

Maternity services is often perceived as a troublesome business and obstetric litigation is on the increase in Western countries. Overall, the number of claim and cost of litigation to the NHS Litigation Authority (NHSLA) from maternity services in the UK is increasing every year. Maternity services account for 60-70% of the total sum paid. This has widespread implications for both the individual practitioners and the institutions where they work, due to increasing malpractice insurance premiums. Fear of litigation is also attracting fewer medical graduates into the specialty, leading to a recruitment crisis in obstetrics and gynaecology. The litigation process can cause pain, suffering and distress to clinicians as well as to the patients and their families. Litigation in maternity services is the result of a complex of events when malpractice (presumed or real) impacts on the attitude of pregnant women and their environment. In such complexity, information is mandatory but may often be misinterpreted. If messages are not tailored to the receiver's capacity, communicating well with the pregnant patient becomes crucial. Therefore, to reduce medicallegal issues in obstetrics, increasing attention and an applicable standard of obstetric care to avoid negligence and medical errors should go along with other measures. Considering UK's experiences, NHS redress scheme make it easier to pursue small claims and birth related claims, without necessarily reducing the number of claims processed through the conventional legal system and perhaps encouraging even more of them. The task of dealing with the greater number of inquiries into their practice would inevitably create an added burden for clinicians and hospital managers. Thus further proposals are required to limit the cost of processing inflated claims and to consider whether clinicians should be given some protection from litigation alleging a failure to prevent birth related impairment.

• Herbal Formula Science
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• v.23 no.1
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• pp.77-89
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• 2015

Objectives : This Study aims to extract the actual prescriptions used frequently in the clinical settings and the frequently used prescription list of textbook on herbal formulae by comparing the prescriptions recorded in the textbook on herbal formulae, and to examine the range of the efficacies of the corresponding prescription on the basis of the records of the Electronic Medical Record (EMR). Methods : By making comparison of the herb weight ratios of the prescriptions recorded in the textbook on herbal formulae with those recorded in EMR, the frequency is measured on the basis of the textbook on herbal formulae prescription and the frequency indication is computed for the clinical prescriptions with lower level of differences. Results & Conclusions : On the basis of the details of the clinical prescriptions used at the P Hospital, Yugmijihwang-tang, Samlyeongbaegchul-san, Jugyeobseoggo-tang, Maegmundong-tang, Olyeong-san and Baegho-tang, among the similar prescriptions for which the title prescriptions of the textbook on herbal formulae and the herbal composition coincide by more than 80%, are not included in the list of prescriptions covered under the national health insurance system even though they are frequently used prescriptions.

• Journal of dental hygiene science
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• v.17 no.5
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• pp.447-453
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• 2017

The purpose of this study was to analyze the relationship between objective oral health status determined by dentists, self-perceived subjective oral health status, and oral health related quality of life (OHRQoL) in the elderly. The related factors affecting OHRQoL in the elderly were also surveyed. Four hundred and thirty elderly individuals who visited the three public health centers and four dental clinics in Busan were selected by convenience sampling. Twelve dental hygienists investigated the subjective oral health status and OHRQoL using the 14-item Oral Health Impact Profile (OHIP-14) and twentyone dentists examined the objective oral health status, including healthy remaining teeth, treated remaining teeth, functional remaining teeth, missing teeth, and non-treated missing teeth. Data were analyzed using SPSS ver. 12.0. OHRQoL was higher when oral and periodontal status was perceived as healthy, when there was no toothache, no interference in mastication, and when study subjects had the ability of food softening. It was also higher when study subjects had ${\geq}20$ remaining teeth and <9 missing teeth, and were wearing denture. The related factors affecting OHRQoL of the elderly were the type of medical insurance, toothache, ability of food softening, perception of periodontal status, and the number of healthy remaining teeth. There was a significant relationship between the subjective-objective oral health status and OHRQoL in the elderly. A continuous oral health care system aimed at retaining ${\geq}20$ healthy remaining teeth is needed to improve oral health and OHRQoL for the elderly, especially for the elderly receiving medical aid.

• Physical Therapy Korea
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• v.10 no.2
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• pp.71-84
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• 2003

The purpose of this study was to provide information on driving characteristics in persons with spinal cord injury through basic statistic analysis of the survey results. The survey was administered to 44 drivers with spinal cord injury. The subjects' general, neurologic and driving characteristics were analyzed, as well as the degree of difficulty in using their vehicles between tetraplegia and paraplegia. The results were as follows: thirty-five (79.6%) of forty-four respondents was men. The average age was 35.0 years old and the age at the time of injury was 29.0 years old. Their neurologic characteristics were tetraplegics 12 (27.3%) and paraplegics 32 (72.2%). Among complete lesions, the highest level those who could drive independently was C7. All the vehicles were equipped with special devices, including "power steering", "automatic transmission" and "hand controls". The vehicles for cervical cord injury were equipped with "grip bars" as well as for the degree of difficulty in using their vehicles, all the subjects felt that "moving the wheelchair in and out of their vehicles" was too difficult for them to do. We suggest that the driver training should be an essential part of the rehabilitation program for patients with spinal cord injuries to maximize their mobility in the community. This training seems to be essential in order to modify the standards of the Handicapped Drivers Ability Test and to aid the driver rehabilitation program in the health insurance payment system. Also, the driver rehabilitation training program should include instruction in that moving wheelchairs in and out of vehicles.

• Journal of agricultural medicine and community health
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• v.25 no.2
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• pp.413-425
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• 2000

The purpose of this study was to compare the health services information need between urban area and rural area in Sooncheon City. For accomplishing this purpose, we selected 1,060 adults randomly, 744 urban residents and 314 rural residents were surveyed from 1st, December to 31st, December in 1999. Compared the difference between two areas by cross tabulation, and chi-square test were used. The results of this study are as follows: 1. There were statistically difference in sociodemographic characteristics between urban residents and rural residents, such as age, education, job, income, and insurance payment(p<0.001). 2. According to the health utilization behavior, types of health facility, satisfaction of medical cost, and satisfaction of medical results were statistically different between the two areas(p<0.001). Also utilization of the health service center, and accessibility were statistically different between urban and rural areas(p<0.001). 3. Experiencing the health service information, type of health service information, methods of information, effectiveness, and satisfaction were statistically different between the two areas(p<0.001). 4. And experience of using computer, and internet and preference of method of health service information were statistically different between urban and rural areas. Therefore, the construction of health information system should be carefully reviewed by community health service centers and they should consider the different residents information needs, and accessibility and convenience of community residents.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.20 no.2
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• pp.76-81
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• 2009

Ovjectives: As the attention devoted to children's mental health increases, medical costs and burdens mount as well. In the present study, we evaluated the association between socioeconomic status(SES) and major child psychiatric symptoms. Methods: The subjects of this study were children of recruited from a mental health screening program in the Seoul Sungbuk mental health center over the course of 3 months. To establish the SES of each child, we collected data about each child's medical insurance, years of parental education, household income, family structure and housing. 149 children & parents completed questionnaires including the Childhood Depression Inventory(CDI) and the Korean Attention Deficit Hyperactivity Disorder Rating Scale(K-ARS). Results: The mean K-ARS-P score was $12.1{\pm}11.1$ and the suspected prevalence of ADHD was 20.8%(n=31). The mean cm score was $12.9{\pm}7.9$, and the prevalence of suspected depression was 16.8%(25). Depressive symptoms and ADHD symptoms were both more severe than those observed in a previous epidemiologic study in Korea. Depressive symptoms were more closely associated with family SES status. Conclusion: SES status is one of the most important risk factors in the development of major child psychiatric symptoms. In our study we found that depressive symptoms in particular were most tightly associated with psychosocial factors. Evaluation of the risk factors, early screening and intervention for low SES children would be valuable mental health management tactics to implement in a community mental health system.

• The Journal of the Korean dental association
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• v.48 no.12
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• pp.893-918
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• 2010

This article is purposed of reviewing the development history of Japanese dental devices and instrument, and their related advertisement activities during the Japanese colonized period in Korea in early 20th century. Japanese dental devices and instrument were redesigned to accommodate their ergonomic shape above the simple imitation, and it implies the excessive desires brought them frustrations. The tragic earthquake on Sep. l, 1923, medical insurance law enforcement on Jan. 1, 1927, celebration of "Cavity prevention Day" started on Jun. 4, 1928, and the attack of Manchuria and China by Japan after 1931, all of these historical incidents become the preliminary requirement for the development of dental devices. On Nov. 1, 1937, Japanese government started to control dental materials, driving the campaigns for excluding foreign products and encourging the use of local products. In 1939, Nakajima dental manufacturers used this political and social atmosphere on their advertisement as saying "Our Nakajima's products have no compromise with the short raw materials, but only commitment to our quality". Since after 1940, the price and supply have been strongly under control, and the control group was appeared to manage all of supply and distribution of raw materials, regular price system, and specifications. At last, the Japanese national power were devastated in its production and distribution capacities, and get to the frustrated period. The main advertised dental devices and instruments in Korea during the Japanese colonized period were 1) dental chair, unit and cabinet, 2) dental x-ray, 3) compressors, 4) dental needles, 5) small instrument and carryon medical(emergency) kit, 6) oral hygiene and pyorrhea alveolaris, infrared rays, sunlight lamp, ultrashort wave treatment devices, 7)crown former, electric furnace, casting machine, articulator, electric lathe, and laboratory equipments, etc.

• The Journal of Korean Medicine
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• v.18 no.2
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• pp.187-198
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• 1997

The degree of KAP study on Chinease traditional medicine and doctor was examined with some chinease living yenbian district(延邊) from July 1st to August 30th in 1996. The result of the study for predicting health and ill patterns runs as fellows. 1. It is understand to strength and variety about role of chinease traditional medicine doctors and the curable disease. 2. Although most patients go to chinease traditional medicine clinic for the purpose of medicine herbs in package, acupuncture and industry-made pharm, they think the medical fee a little high(70.6%). 3. The 66.7% of respondents recognize chinease traditional medicine doctors as a profession and others think them only abundant works ; therefore it is rather low to ink chinease traditional doctors a profession. 4. Most respondents think that chinease traditional medicine should improved in the inside ; such as scientific reinforcement of theory, lack of univerality, improvment and enlargement of insurance, unkindness, shortage of publicity, dropped equipment, system of medical specialist, lack of integration with westem medicine, exact diagnosis and confidence of remedy, and low efficacy, etc. 5. Chinease likes more experienced-traditional doctor than beginner(78.3%) 6. The policy of korean government against 100 herbal prescription right by western pharmacy has taken the negative recognition(74.6%), 7. The degree that acknowleges of chinease traditional medicine through thease basic contents is average 47.3 mark. To be brief, although the step of the recognition and attitude of oriental medicine is less or very affirmative aspect, actully considerable positive factors is in the last chosen step. In conclusion KAP study connected chinease traditional medicine and doctor has very much postive factors.