• Health Policy and Management
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• v.25 no.4
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• pp.323-332
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• 2015

Background: Antibiotic resistance has been becoming serious challenge to human beings. Overuse of antibiotics, especially, for infants is concerned, but studies are very few for the prescribing pattern of antibiotic use for infants. This study analyzes prescribing patterns of antibiotics in outpatients of preschool children with acute respiratory tract infections in South Korea. Methods: Data are used from 2011 Health Insurance Review & Assessment Services-pediatric patients sample. Inclusion criteria is outpatient children (0 to 5 years) with top five frequent diseases. Prescription rates are analyzed by types of disease, provider, specialty, region, and ages. Binary or multinomial logit models are used to analyze determinants of providers' prescription pattern. Results: The main findings are as follows. First, distributions of prescription rates are shown as L-shape or M-shape depending on the types of disease. Second, the prescription variation is so large among providers, where providers are polarized as a group with low prescription rates and the other group with high prescription rates, though the shapes are shown diversified across types of disease. Third, prescription rates appear to be lower in pediatrics and higher in ENT (ear-nose-throat). Fourth, broad spectrum antibiotics are widely used among children. Finally, the logit analysis shows similar results with descriptive statistics, but partly different results across types of disease. Conclusion: Antibiotics for respiratory tract infections of infants are used excessively with a large variation among providers, and especially broad spectrum antibiotics are used. The prescription guideline for antibiotics should be provided for each specific disease to reduce antibiotic resistance in the future.

• Quality Improvement in Health Care
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• v.4 no.2
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• pp.184-195
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• 1997

Background : The purpose of this research was to evaluate the appropriateness of preoperative hospital days in a tertiary care hospital and to examine the reasons of the inappropriateness, so as to provide basic information and policy for enhancing appropriateness of preoperative hospitalization and benefit of patients and hospital. Methods : The subjects of the research were the 344 patients who received operation among discharged patients during January, 1996 in surgical departments including general surgery, neurosurgery, orthopedic surgery, plastic surgery and ophthalmology. Their medical records were reviewed and appropriateness of hospital days was evaluated by the Appropriateness Evaluation Protocol. Result : The results of evaluating the appropriateness of preoperative hospitalization showed that inappropriate hospital days were 80.8%. The reasons of inappropriate hospital stays were the tests or preparation which could be done in outpatient basis' followed by 'possible tests or preparation on the operation day' and 'cancelation of operation'. Conclusion : In order to shorten the inappropriate preoperative length of stay, it is recommended that lengthening of laboratory running time and doing most of tests necessary for operations on the outpatient basis prior to admission should be considered. In addition, the operation at the same day of hospitalization and usage of day surgery should be encouraged. Finally there should be changes in the inpatient management system and attitudes and behaviors of surgeons to shorten unnecessary preoperative and maximize the benefit for patients and hospital.

• Journal of Korea Society of Industrial Information Systems
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• v.20 no.4
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• pp.55-65
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• 2015

An increase in patients' medical expenses for their injury. accident and intoxication is a major challenge to improve the sustain-ability of a national health security system, and increasing medical expenses need be suppressed through improving relevant systems and/or efficiently operating and managing the health insurance. At this juncture, in Korea which has a high rate of injury incidence and mortality, it is necessary to estimate social and/or economic costs for injuries with a focus on their social effects. This research has examined the results of a Korea medical panel investigation conducted in 2008, which largely surveyed of the actual conditions of outpatients' medical use for their injury, accident and/or intoxication and investigated relevant medical expenses, with a view to estimating the directly incurred costs when the patients use medical services and the production loss costs caused by an production decline and others, so that social and/or economic costs for injuries may be ultimately aggregated.

• Health Policy and Management
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• v.22 no.4
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• pp.561-578
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• 2012

This study was performed in order to compare a change in pharmaceutical expenditures per outpatient of clinic and to analyze factors relevant to a systems as part of evaluating policies for the incentive scheme to reduce total prescribed drug expenditure and for the drug utilization review system("DUR system" hereafter). For this, it had finally analytical subjects as 21,320 clinics nationwide without a change in location, clinics symbol and signed subject during both terms of the first half of 2010 and the first half of 2011. As a result, the odds ratio with reduction in pharmaceutical expenditures of clinic was statistically higher significantly in the shorter year number of opening clinic, in the larger number of doctors, when the classification of establishment is other, not individual, and when the signed subject is surgical division. Also, the odds ratio was significantly higher in the less patient number of clinic and in the lower ratio of patients aged over 65. Finally, the odds ratio was significantly high when a clinic had been located in DUR system demonstrative project area. Through this, a case of policy for improvement in doctor's autonomous prescription behavior like DUR system can be known to be effective for reduction in pharmaceutical expenditures. A future research on evaluation of policy for pharmaceutical expenditure management system will need to be performed in-depth analysis in consideration of diverse characteristics on the participatory entities.

• Journal of Korean Clinical Nursing Research
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• v.25 no.3
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• pp.275-284
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• 2019

Purpose: The purpose of this study was to analyze the current state of home health nursing (HHN) for elders and to provide basic data on policy alternatives for establishing home medical care in the advanced general hospital. Methods: This study was conducted as a secondary data analysis, using electronic medical record (EMR) data of older patients who received HHN more than once from the S advanced general hospital between January 2016 and December 2018. Results: A total of 1,790 patients received HHN visits, with 22,477 visits being made. The mean age was 76.8±7.3 years old, 96.0% of elders had health insurance and 24.6% had orthopedics problems. Of the 1,168 people who visited emergency rooms, the most frequent symptom was pain (23.4%) and all patients visited the hospital at least once and at most 163 times outpatient care during HHN. Causative diseases were degenerative knee joint osteoarthritis (0.6%), surgery for right knee replacement (4.0%), and for dressings (9.7%) in the HHN service content analysis. Conclusion: The progress towards an aging society and the introduction of community care are expected to further enhance the need for HHN which should be able to provide comprehensive and continuous visiting health care services to the older patients. The results of this study are expected to help doctors solve problems not solved by HHN, reduce unnecessary emergency room or outpatient visits, and readmission, while at the same time contributing to the improvement of patient quality of life through efficient patient health care.

• Proceedings of the Korean Information Science Society Conference
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• 2005.11a
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• pp.859-861
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• 2005

의료 환경이 점차 변화함에 따라 효율적인 건강관리와 의료사고를 룰이기 위한 새로운 병원정보시스템의 개발이 활발히 이루어지고 있다. 이에 본 논문에서는 지속적인 건강관리와 의료정보 공유를 위한 외래환자 Clinical Summary 시스템을 제안하였다. 환자진료에 필요한 core data set을 XML기반의 구조적 문서로 정의하고 이를 웹 서비스(Web Services)를 통해 여러 의료기관에서 활용할 수 있도록 함으로써 진료의 계속성을 높일 수 있도록 설계하였다.

• Korean Journal of Digital Imaging in Medicine
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• v.3 no.1
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• pp.20-23
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• 1997

The purpose of this paper is to describe the transition of a 1,100 beds teritary hospital from 50% softcopy operation to full PACS operation. For the past 2 years, radiologists and clinicians have been using PACS to provide softcopy services to the outpatient clinics and inpatient wards of orthopedics surgery, neurosurgery and neurology as well as emergency room, surgical intensive care unit, medical intensive unit, pediatrics intensive care unit and neonatal intensive care unit. The examinations requested by these departments account for about 50% of hospital's radiological exams. In September 1996, we began the second phase of PACS implementation and installed additional workstations (102) in the remaining wards and clinics, interfaced to PACS additional imaging modalites, and increased the capacity of both the image server (256 Gbytes) and optical juke boxes (3 Tbytes). As of January 1997, we are in the final phase of moving away from conventional film system to full PACS operation.

• Journal of the Korean Society of Food Science and Nutrition
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• v.25 no.3
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• pp.415-422
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• 1996

This study was conducted to evaluate the necessity of clinical nutrition education in the medical school curriculum. One hundred and eighty five medical school students, residents, nurses, and forty undergraduate students majoring in food science and nutrition were involved in this study. The survey included questions about nutritional knowledge, necessity of nutrition counseling, necessity of clinical nutrition and nutritional attitudes. The nutritional knowledge scores of the subjects in medical school and residents were significantly lower than those of the students majoring in food science and nutrition. Subjects of 91.3% strongly agreed to the necessity of nutrition counseling for patients ; 78.9% agreed that the present nutrition education in medical schools was inadequate. Most subjects (94.1%) agreed that clinical nutrition was an important field in the treatment of diseases. The medical profession is facing the challenges of the 1990s with the shift to outpatient care and preventative services. Clinical nutrition is an essential element in the process of curriculum change. The nutrition educator will be expected to take a leading role in integrating clinical nutrition into medical school curriculum.

• Journal of Society of Preventive Korean Medicine
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• v.8 no.2
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• pp.129-139
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• 2004

This paper analysed the RBRVS for a doctor's consultation by measuring the time consumed in outpatient consultation, and compared the time among medical doctors, dentist, and oriental medical doctors. The time used in consultation could be a proxy for measuring RBRVS for medical services because it is the only common factor we observe in three different clinical settings. The results show that the optimal RBRVS for consultation is 183.22 for medical doctor, 99.12 for dentist, and 236.17 for oriental medical doctor. This implies the current fee schedule for consultation should be revised as 10,740 Won for a visit to medical doctor, 5,808 Won for dentist, and 13,832 Won for oriental medical doctor.

• Journal of The Korea Institute of Healthcare Architecture
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• v.7 no.1
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• pp.23-31
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• 2001

In order to improve their hospital services in unlimited competitive situations, the general hospitals, particularly, have since the 1990s been concentrating more on hospital information processing systems and the automation of the patients' convenience. They also give priority to the advance of integrated hospital information systems centred around the patients. Introducing more progressive information technology to already established hospitals, the OPD has been most affected by HIS because there are a lot of patients and doctors. On this background, this study analyse the change of OPD and some related departments around the 1990s with the general hospitals as it's object. It investigates the way of building hospitals and presents some information about the planning of building hospitals.