• Quality Improvement in Health Care
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• v.28 no.2
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• pp.30-38
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• 2022

Purpose: The Health Insurance Review and Assessment Service (HIRA) in South Korea initiated a quality assessment (QA) program for blood transfusion healthcare services in 2020 to ensure patient safety and appropriate blood use. This study examines the quality of blood transfusion services since the first national QA program for blood transfusion services in Korea. Methods: We analyzed HIRA claims and QA investigation data based on inpatient medical records from all tertiary, general, and primary hospitals between October 2020 and March 2021. The target population was patients aged 18 years and older who received either total knee arthroplasty or red blood cell transfusion. The QA indicators for transfusion healthcare service consisted of four quality indicators and four monitoring indicators. Results: We analyzed the results of QA indicators for transfusion service from the medical records of 189,668 patients from 1,171hospitals and expressed indicators as proportions. The average results for evaluation indicators were as follows: transfusion checklist presence, 64.8%; irregular antibody tests, 61.8%; transfusions in which the hemoglobin levels before transfusion met the transfusion guidelines for patients undergoing total knee arthroplasty, 20.6%, and transfusions in patients undergoing total knee arthroplasty, 59.3%. The average results for monitoring indicators were as follows: transfusion management implementation in medical institutions, 56.9%; preoperative anemia management in anemia patients undergoing total knee arthroplasty, 43.9%; one-unit transfusions, 82.5%; and the transfusion index. Conclusion: The quality of blood transfusion healthcare varied and the assessment revealed that there is scope for improvement. Hospitals require more effective blood transfusion management and this can be facilitated by providing feedback on the QA results about blood transfusion healthcare services to medical institutions, and by disclosing the results to the public.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.2
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• pp.99-111
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• 2021

Background: Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. It has a worldwide pooled prevalence of 5.29%. The characteristics of ADHD can increase the probability of dental treatment, while special behavior management can be required to allow proper treatment. In South Korea, the use of sedation in dental treatment has rapidly increased in recent decades. The present study aimed to investigate the trend and effects of sedation in patients with ADHD undergoing dental treatment in South Korea. Methods: The study used customized health information data provided by the Korean National Health Insurance Service. Among patients with the record of sedative use during the period from January 2007 to September 2019, those with International Classification of Diseases-10 codes for ADHD (F90, F91) were selected; the data of their overall insurance claims for dental treatment were then analyzed. The patients' age, gender, sedative use, and dental treatment were analyzed per year. The annual number of general anesthesia or sedation cases was also analyzed, and changes in the method of behavior management with increasing age were examined. Results: The study involved 7,654 patients with ADHD (6,270 males; 1,384 females). The total number of dental treatments was 137,778, while the number of sedation cases was 16,109, among which 13,052 involved male patients and 3,057 female patients. The number of general anesthesia cases was 631, among which 538 involved male patients and 93 female patients. The most frequently used sedation method in the dental treatment of patients with ADHD was N2O inhalation. The percentage of sedation cases was highest in patients aged 4 years, and it decreased with increasing age. Conclusion: In South Korea, both sedation and dental treatments were slightly more common in patients with ADHD than in the general population. With increasing age, the frequency of dental treatments and the percentage of sedation cases decreased.

• Journal of Oriental Neuropsychiatry
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• v.29 no.3
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• pp.135-144
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• 2018

Objectives: The purpose of this study was to analyze the medical cost for patients with vertigo and to examine associations between chronic vertigo and mental disorder using 2014 Health Insurance Review & Assessment Service-National Patients Sample (HIRA-NPS). Methods: We analyzed sociodemographic characteristics, medical cost and medical care use pattern for vertigo patients. We used hierarchical multiple logistic regression analysis to examine odds ratio between chronic vertigo and mental disorder. Results: A total of 46,502 people and 118,504 claims data were identified for vertigo cases. Characteristics of vertigo patients have significant differences on proportion of female patients (68.36%), patients' average age (54.98) and proportion of medical assistance (5.76%) compared with non-vertigo patients. Results revealed that Korean medicine are one of frequent methods among total treatments for vertigo patients. Total days of medical care and total costs are 2.78 days and 111,362 won, respectively, and days for outpatients in Korean medical care (mean: 2.26 days) are more than those (mean: 5.05 days) in Western medical care. There is significant difference relative to sex between acute vertigo and chronic vertigo. The odds ratio between chronic vertigo and mental disorder is estimated as 1.34, that means risk of becoming chronic is 34% higher for vertigo patients with mental disorder. Conclusions: This study assessed socio-demographic characteristics, medical care use and expenses related to vertigo, and estimated associations between chronic vertigo and mental disorder. Findings provide a basis for economic evaluation studies on vertigo patients and development of clinical practice guidelines for vertigo patients with mental disorder.

• 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 Korean Journal of Applied Statistics
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• v.27 no.5
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• pp.667-679
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• 2014

National Health Insurance Service(NHIS) provide care-plans for beneficiaries in the long-term care insurance(LTCI) systems that help them use LTC services appropriately. The care-plan includes recommendations for the most adequate type of care (gold standard) for beneficiaries. This study develops a decision-support system to determine the appropriate type of care plan. To develop a model, we used a data set that well-trained assessors in the NHIS investigated as a gold standard for beneficiaries: nursing home care, home-visit care, home-visit bathing, home-visit nursing, or day and night care. The decision-support system was established through a decision-tree model, because it may be easy to explain the algorithm of a decision-support system to working groups and policy makers. Our results might be useful in evidence-based care planning in an LTCI system and contribute to the efficient use of LTC services.

• Korean Journal of Clinical Laboratory Science
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• v.44 no.4
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• pp.178-183
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• 2012

We investigated the latest trend of u-Health and relations with clinical technologist. Since 2000, Korea has become an aging society. Korea will become an aged society by 2018, and it is expected to enter the ultra-high aged society by 2026. Increase in over 65 years population means that the desire of medical service and care demand for the elderly is greatly required. In addition, many predicted Korean national health insurance would falter financially. Medical suppression policies and regulations are also amended continuously. U-Health based on the IT industry and development of related technologies and industries contains the variety concepts of telemedicine, telehealth, e-health, u-healthcare and POCT. Especially, the use of POCT supplied quick clinical examination is extending steadily in medical center and hospital, which will generate the field friction between nurses and medical technologists. In the transition situation from provider-centric service to consumer-driven health care system, this study recommended the principal role and correspondence of clinical laboratory workers and offered information about changes in healthcare market and the basic concept of expert system, measurement and the diagnosis principle to clinical technicians throughout the investigation of the recent research and government policy trends.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.6
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• pp.324-331
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• 2019

Objectives: This study investigated the types and antibiotic sensitivity of bacteria in odontogenic abscesses. Materials and Methods: Pus specimens from 1,772 patients were collected from affected areas during incision and drainage, and bacterial cultures and antibiotic sensitivity tests were performed. The number of antibiotic-resistant bacteria was analyzed relative to the total number of bacteria that were tested for antibiotic susceptibility. Results: Bacterial cultures from 1,772 patients showed a total of 2,489 bacterial species, 2,101 gram-positive and 388 gram-negative. For penicillin G susceptibility tests, 2 out of 31 Staphylococcus aureus strains tested showed sensitivity and 29 showed resistance. For ampicillin susceptibility tests, all 11 S. aureus strains tested showed resistance. In ampicillin susceptibility tests, 46 out of 50 Klebsiella pneumoniae subsp. pneumoniae strains tested showed resistance. Conclusion: When treating odontogenic maxillofacial abscesses, it is appropriate to use antibiotics other than penicillin G and ampicillin as the first-line treatment.

• The Journal of the Korea Contents Association
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• v.17 no.4
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• pp.585-595
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• 2017

The purpose of this study is to analyze the difference of medical care between medical assistance and health insurance patients to evaluate the increase of medical care costs due to the moral hazard of medical care patients and to provide a basis for rational medical care policy decision. For this purpose, we compared health insurance benefit data for Seoul citizens by gender, age, and type of medical institutions. The results of the analysis are as follows. First, all of the hospitalized and outpatient use of the advanced general Hospitals, medical assistance patients were less than those of the health insurance patients, so that the medical assistance patients could not use the high cost medical services. Second, in general hospitals, patients with health insurance are often hospitalized. On the other hand, medical assistance patients use a lot of outpatient services because they are less burdened. Third, in hospitals and clinics, medical benefits patients often use inpatient and outpatient services. Therefore, medical assistance patients are likely to use unnecessary medical care of outpatient and hospitalization clinics and hospitals, outpatient of general hospitals. But, in hospitalization and outpatient use in advanced general hospitals and medical assistance patients can not use due to excessive medical burden. Therefore, the policy to reduce the burden of medical expenses for patients with severe illness will continue, and the medical care patients using clinics and hospitals should be careful not to use unnecessary medical services.

• 한국사회정책
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• v.25 no.1
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• pp.125-159
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• 2018

The purpose of this study is to analyze the factors affecting service use intention of long-term care among the disabled. This study conducts a longitudinal study using the modified Andersen model by the disabled age groups of the 50-64 group and the 65 over group. This study examined random effects panel logit analysis for the 50-64 group and the 65 over group by age variations. The results have shown that there are different factors Influencing factors for each specific age group of the disabled(50-64, 65 over). The results were as follows: there are differences of factors between the 50-64 group and the 65 over group. This study found that predisposing factors of the service use intention of long-term care were significantly related to age, residential area, education status, existence of spouses. Enabling factors of the service use intention of long-term care were significantly related to long-term care service recognition, saving, personal salary income level, housing status. Need factors of the service use intention of long-term care were significantly related to chronic diseases, psychological health, IADL. So, there are a need for a policy considerations such as service for the mid-old age disabled by age groups. Finally, implications and future research directions were discussed based on the finding of the study.

• Journal of Korean Public Health Nursing
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• v.24 no.2
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• pp.182-196
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• 2010

Purpose: This study examined potential determinants of gender differences in utilization of health care services among Korean adults. Methods: The study population was 21,647 adults ${\geq}$25-years-of-age who had responded to a health interview survey conducted as part of the 2005 National Health and Nutrition Surveys. Relative gender differences in the use of each health service were assessed using chi-square test and sex ratios. The contribution of potential factors of sex differences in the use of health services was evaluated by comparing the odds ratio and sex ratio before and after adjustment for such variables. Results & Conclusions: More females had visited a physician and been admitted to hospital, but hospitalization time was longer for males. Adjustment for poor self-rated health, number of chronic disease and limit of full term for ADL led to a reduction in the odds ratio of females compared to males for health service utilization. However, adjustment for socioeconomic factors (household income, education, occupation, and health insurance) magnified the gender difference concerning length of hospitalization. Factors that explain gender-related differences in utilization of health care services are concluded to be different health needs and socioeconomic status.