• Title/Summary/Keyword: outpatient diseases

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Correlation between Outpatient's Medical Adherence and National Insurance Types in the Type 2 Diabetes Mellitus (제2형 당뇨병의 외래환자 복약순응도와 보험유형과의 관계)

  • Lee, Mi-Joon;Kang, Hee-Kyung;Seo, Bum-Jeun
    • Journal of Convergence for Information Technology
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    • v.8 no.4
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    • pp.9-14
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    • 2018
  • The purpose of this study was to analyse the relationship between the characteristics of the patients who received oral antihyperglycemic drugs and their medical adherence in Korea. The study method was a cross-sectional study using the patient sample data of the Health Insurance Review and Assessment Service for 2016, and it was analyzed with 109 major components of diabetes drug. The medical adherence was slightly higher in male than female. The patriots & veterans(free) type had the highest medication adherence because they have low self burden to access medical institutions compared to other insurance types. It is expect that this study result will be used as a basic data to understand the burden of outpatients with health insurance and establish a policy to reduce of the self outpatients' burden with chronic diseases such as type 2 diabetes.

Comparison of the characteristics of patient who cancel after presentation to an emergency department by 119 ambulance (119 구급차를 통해 응급의료센터에 내원한 접수취소 환자들의 특성 비교)

  • Yong-Joon Kim;Kyoung-Youl Lee
    • The Korean Journal of Emergency Medical Services
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    • v.27 no.3
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    • pp.47-58
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    • 2023
  • Purpose: The purpose of this study was to analyze the characteristics of patients who canceled their ED visits and to determine the factors that influence ED cancellation. Methods: Retrospective study that analyzed data from the electronic medical records(EMR) and Prehospital Care Reports(PCRs) of 305 patients who cancelled their appointments at a single emergency medical center over a six-month period from October 12, 2022, to April 12, 2023. Results: ED cancellations were 2.287 times higher if the patient presented to the ambulance after outpatient hours(09:00~17:00) (p=.007), and ED cancellations were 3.712 times higher if the patient presented to the ambulance under the influence of alcohol(p=.011). For patients' symptoms, medical diseases were associated with a 1.965 times increase in cancelled ED visits compared to other modes of transport (p=.005), while mental and chronic diseases were associated with a 67.3% decrease in cancelled ED visits compared to other modes of transport (OR=0.327, CI=[0.130-0.822], p=.018). symptomatic improvement was associated with a 2.482 times increase in presentations to a 119 ambulance compared to delayed waiting time(p=.022). Conclusion: Emergency medical centers should consider improving the legal system, such as increasing emergency medical care fees, to reduce the number of patients who cancel their appointments.

The Efficacy of Epidural Blockade on Acute Herpes Zoster (대상포진 급성기에 시행한 경막외 차단술의 효과)

  • Lee, Young-Bok;Park, Jong-Taek;Han, Jong-Won;Yoon, Kyung-Bong
    • The Korean Journal of Pain
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    • v.12 no.2
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    • pp.183-187
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    • 1999
  • Background: The efficacy of nerve block on the progression of herpes zoster still remains controversy. The purpose of this study was to evaluate the efficacy of epidural blockade on the pain course of acute herpes zoster. Methods: Among 75 patients admitted with acute herpes zoster, 40 patients were treated with acyclovir and epidural block (epidural group), 35 patients were treated with acyclovir only (no block group). Follow up with patients was done for up to 3 months, either at the outpatient department or by telephone. The days required for pain relief were compared. We also investigated the factors associated with outcome. Results: Though statistically insignificant, patients in the epidural group tended to have faster pain relief. Patients with shorter symptom duration experienced significantly faster pain relief. But other factors such as sex, age, involved dermatome and other coexisting diseases (cancer, diabetes mellitus) were not associated with the outcome in this study. Conclusions: Though patients with epidural block leaded to have taster pair relief, more studies with larger patient population may be needed to confirm the efficacy of epidural block on herpes zoster.

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Comorbidity Adjustment in Health Insurance Claim Database (건강보험청구자료에서 동반질환 보정방법)

  • Kim, Kyoung Hoon
    • Health Policy and Management
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    • v.26 no.1
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    • pp.71-78
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    • 2016
  • The value of using health insurance claim database is continuously rising in healthcare research. In studies where comorbidities act as a confounder, comorbidity adjustment holds importance. Yet researchers are faced with a myriad of options without sufficient information on how to appropriately adjust comorbidity. The purpose of this study is to assist in selecting an appropriate index, look back period, and data range for comorbidity adjustment. No consensus has been formed regarding the appropriate index, look back period and data range in comorbidity adjustment. This study recommends the Charlson comorbidity index be selected when predicting the outcome such as mortality, and the Elixhauser's comorbidity measures be selected when analyzing the relations between various comorbidities and outcomes. A longer look back period and inclusion of all diagnoses of both inpatient and outpatient data led to increased prevalence of comorbidities, but contributed little to model performance. Limited data range, such as the inclusion of primary diagnoses only, may complement limitations of the health insurance claim database, but could miss important comorbidities. This study suggests that all diagnoses of both inpatients and outpatients data, excluding rule-out diagnosis, be observed for at least 1 year look back period prior to the index date. The comorbidity index, look back period, and data range must be considered for comorbidity adjustment. To provide better guidance to researchers, follow-up studies should be conducted using the three factors based on specific diseases and surgeries.

Evaluation of Azithromycin Prescriptions for Pediatric Patients (소아환자에서 아지스로마이신 처방 분석)

  • Oh, Eun Kyoung;Rhew, Ki Yon
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.2
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    • pp.115-120
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    • 2016
  • Background: Azithromycin has broad spectrum and is effective to treat several bacterial respiratory tract infection. It is also relatively safe and tolerable to pediatric patient. Careful use of azithromycin is also required for the prescribers because it could cause cardiovascular toxicity (QTc prolongation) and ototoxicity. There has been no study on duration of azithromycin use in pediatric patients in Korea. Methods: The outpatient sample data on the azithromycin prescription was obtained from Korean health insurance review and assessment service. The characteristics of azithromycin prescription were analyzed with two different years (2011 and 2014). Results: Total 4,215 cases were analyzed. The azithromycin was prescribed the most frequently in the children (73.2% in 2011 and 62.5% in 2014) and for the condition of bronchopneumonia (28.7% in 2011 and 21.7% in 2014) in both years. The duration of prescribed for azithromycin has significantly different between 2011 and 2014. In 2014, 94.3% of prescription were indicated less than 5 days, but 86.6% were in 2011. Acute bronchiolitis and bronchopneumonia prescriptions more longer duration of treatment compared with acute bronchitis and others. Conclusion: The pattern of prescribing azithromycin has been changed for the treatment of several infectious diseases in pediatric patients. The rate of appropriate duration of azithromycin treatment has increased.

Development of m-Health Application based on Medical Informatics Standards (의료정보 표준에 기반 한 m-Health 어플리케이션 개발)

  • Park, Hyun Sang;Kim, Hwa Sun;Jung, Hyun Jung;Cho, Hune
    • Journal of Korea Multimedia Society
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    • v.17 no.5
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    • pp.640-653
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    • 2014
  • Recently medical consumers pursue high leveled quality of life through active promotion, prevention, management activity of health as the importance of health during home life is emerged to meet the aging society and chronic diseases. In addition, people are directed to the m-Health for managing yourself their health by using smartphone and various personal health devices, if necessary transmits health data to the physician himself. In the previous studies, m-Health Application were developed and applied in the real clinical environment by adopting the medical information standards was rarely conducted. Therefore, in this study, the m-Health application platform was developed. Developed application was communicate with IEEE 11073 standard protocol using the Bluetooth Health Device Profile in personal health device via smart phone to process blood pressure information, and it converted to HL7 V2.6 ORU_R01 message for send to remote medical server. In addition, we tested the interoperability and safety of the developed application for 23 inpatient and 17 outpatient at D University Hospital. As a result, the blood pressure information has been transmitted without error.

Identification of Unmet Healthcare Needs: A National Survey in Thailand

  • Chongthawonsatid, Sukanya
    • Journal of Preventive Medicine and Public Health
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    • v.54 no.2
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    • pp.129-136
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    • 2021
  • Objectives: This study examined demographic factors hampering access to healthcare at hospitals and suggests policy approaches to improve healthcare management in Thailand. Methods: The data for the study were drawn from a health and welfare survey conducted by the National Statistical Office of Thailand in 2017. The population-based health and welfare survey was systematically carried out by skilled interviewers, who polled 21 519 384 individuals. The independent variables related to demographic data (age, sex, religion, marital status, education, occupation, and area of residence), chronic diseases, and health insurance coverage. The dependent variable was the degree of access to healthcare. Multiple logistic regression analysis was subsequently performed on the variables found to be significant in the univariate analysis. Results: Only 2.5% of the population did not visit a hospital when necessary for outpatient-department treatment, hospitalization, or the provision of oral care. The primary reasons people gave for not availing themselves of the services offered by government hospitals when they were ill were-in descending order of frequency-insufficient time to seek care, long hospital queues, travel inconvenience, a lack of hospital beds, unavailability of a dentist, not having someone to accompany them, and being unable to pay for the transportation costs. Multiple logistic regression analysis showed that failure to access the health services provided at hospitals was associated with demographic, educational, occupational, health welfare, and geographic factors. Conclusions: Accessibility depends not only on health and welfare benefit coverage, but also on socioeconomic factors and the degree of convenience associated with visiting a hospital.

Improved Symptoms of Peripheral Facial Nerve Palsy in ChAdOx1 nCoV-19 Vaccine Recipients Following Complex Korean Medicine Treatment

  • Jang, Woo Seok;Jang, Jung Eun;Jung, Chan Yung;Kim, Kyung Ho
    • Journal of Acupuncture Research
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    • v.39 no.2
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    • pp.139-144
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    • 2022
  • Peripheral facial nerve palsy is a neurological condition/disease characterized by unilateral paralysis of the facial muscles. We report the effects of complex Korean medicine treatment in 2 patients diagnosed with Bell's palsy who developed symptoms 3-4 days following vaccination with ChAdOx1 nCoV-19 and who received oral steroids and antiviral medications. Complex Korean medicine treatments including acupuncture, electroacupuncture, bee venom acupuncture, cupping therapy, herbal medicine, and physical therapy were performed. Symptom improvement was evaluated daily using the Numerical Rating Scale, House-Brackmann Grade, and Yanagihara's Score. Patient 1 was hospitalized for 22 days and Patient 2 visited the outpatient clinic 20 times. In both cases, postauricular pain caused by Bell's palsy disappeared, and symptoms of facial paralysis improved following completion of treatment. These findings could suggest that combined Korean medicine treatment may improve symptoms of peripheral facial nerve palsy.

A case of vocal cord gnathostomiasis diagnosed with sectional morphologies in a histopathological specimen from a Chinese woman living in Korea

  • Doo Sik Park;Eun Hyun Cho;Kyung Hoon Park;Soo Min Jo;Bumjung Park;Sun Huh
    • Parasites, Hosts and Diseases
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    • v.61 no.3
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    • pp.298-303
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    • 2023
  • This study aimed to describe a rare case of gnathostomiasis in the vocal cord. A 54-yearold Chinese woman living in Korea visited with a chief complaint of voice change at the outpatient department of otorhinolaryngology in Hallym Sacred Heart Hospital, Hallym University on August 2, 2021. She had eaten raw conger a few weeks before the voice change developed, but her medical history and physical examinations demonstrated neither gastrointestinal symptoms nor other health problems. A round and red cystic lesion, recognized in the anterior part of the right vocal cord, was removed using forceps and scissors through laryngeal microsurgery. The histopathological specimen of the cyst revealed 3 cross-sections of a nematode larva in the lumen of the cyst wall composed of inflammatory cells and fibrotic tissues. They differ in diameter, from 190 ㎛ to 235 ㎛. They showed characteristic cuticular layers with tegumental spines, somatic muscle layers, and gastrointestinal tracts such as the esophagus and intestine. Notably, intestinal sections consisted of 27-28 lining cells containing 0-4 nuclei per cell. We tentatively identified the nematode larva recovered from the vocal cord cystic lesion as the thirdstage larva of Gnathostoma, probably G. nipponicum or G. hispidum, based on the sectional morphologies.

Factors associated with the prescription of probiotics in patients with inflammatory bowel disease: a cross-sectional study

  • Joo Kyung Kim;Jae Hee Cheon
    • Journal of Yeungnam Medical Science
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    • v.40 no.1
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    • pp.37-48
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    • 2023
  • Background: Commensal bacteria play an important role in the pathogenesis of inflammatory bowel disease (IBD) and probiotics have been used as treatment options. We aimed to explore the current use of probiotics and factors associated with their prescription in patients with IBD. Methods: This cross-sectional study was conducted on a single hospital-based cohort. Patients were eligible if they were ≥18 years old, visited the IBD clinic as an outpatient more than twice during the study period, and had a confirmed diagnosis of IBD. Patients were divided into two groups based on the prescription of probiotics. Clinical assessments were compared between the two groups. Results: In total, 217 patients were enrolled in this study. In patients with Crohn disease (CD), moderate or severe abdominal pain; prior use of methotrexate (MTX), iron, thiopurines, or biologics; history of IBD-related surgery; and stool frequency were independently associated with the prescription of probiotics. In patients with ulcerative colitis (UC), moderate or severe abdominal pain, hematochezia, stool frequency, and moderate or severe physician global assessment score were independently associated with the prescription of probiotics. Conclusion: Increased disease activity may be associated with fewer prescriptions of probiotics in patients with IBD. However, physicians prescribed probiotics to control symptoms, such as abdominal pain and increased stool frequency in patients with UC and CD, and hematochezia in patients with UC. Additionally, the use of MTX and iron, and a history of IBD-related surgeries were associated with more frequent probiotic prescriptions in patients with CD.