• Title/Summary/Keyword: pattern of care

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Prevalence and Treatment Pattern of Korean Patients with Temporomandibular Disorders (한국인 턱관절장애 환자의 유병률과 진료 양태)

  • Yang, Hee-Young;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.34 no.1
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    • pp.63-79
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    • 2009
  • While previous epidemiological studies on temporomandibular disorders (TMD) have been based on a given health center or population sample, no study has been performed on general population of Korea, especially concerning about treatment pattern such as clinician’s specialty involved in TMD treatment, types and amount of prescription medication and cost. This study aimed to investigate magnitude of health visits and treatment patterns for Korean patients with TMD through the computerized database of Health Insurance Review and Assessment Service (HIRAS). Inclusion criteria were all patients registered on the HIRAS database over 3 years' period from 2003 to 2005 and the medical records of patients with TMD as a main diagnosis were extracted. Information collected was as follows; distribution related to gender, age and region and type of hospital the patients visited, treatment duration, clinicians' specialty involved in treatment, cost, types of prescription medication and surgical treatment. The results of this study indicated that 0.15% of the population yearly sought TMD treatment, presenting with increase of incidence over the three years. Most of TMD patients were women (99.8%) and the biggest age group was second and third decades and decreased with age. Seoul and Kyeonggi province presented with higher incidence of TMD compared to the other regions of Korea, which seems to be related with magnitude of population. 56% of TMD patients visited primary care sector and the numbers of treatment visits was the highest in dental clinic (38.4%), followed by orthopedics (28%) and ENT (13.6%) clinics in order. Duration of prescription medication was the longest for anti-inflammatory analgesics, followed by antipsychotic drugs and muscle relaxants. Inpatient care related to TMD was primarily performed in dental hospital compared to medical hospital. Medical database of HIRAS provided comprehensive and vast information on epidemiologic characteristics and treatment patterns for patients seeking TMD treatment, which can be more reliable data to expect medical demand for TMD in condition that accurate diagnosis and standardized treatment is delivered in clinical settings.

A Clinical study on the Treatment of Pruritus (피부소양증(皮膚瘙痒症) 치료(治療)에 관(關)한 임상적(臨床的) 연구(硏究))

  • Park, Seong-sik
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.2
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    • pp.361-376
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    • 1999
  • 1. Backgrounds and Purpose : Pruritus, one of the most common dermatological symptoms, was clinically examined with a view to a better understanding of its characteristics for more accurate treatment. 2. Method : For 22 months from November in 1997 to September in 1999 we selected outpatients who had consulted for itchiness more than twice in the department of Sasang Constitution of the Pundang Oriental medical hospital, Dongkook University, and 59 of those (35 males and 24 females) were confirmed of their course of treatment. From their medical records and history, we learned the general characteristics and patterns of pruritus, and the qualities and effects of its various treatments. 3. Result and Conclusion : Pruritus was more complained by men than by women and the largest age groups were 20's and 30's. For its suffering period, the duration of 1 month to less than 1 year was the greatest, and most patients had already experienced western medical care. Itchiness affected them almost day and night. In addition, many patients had abnormal bowel habits as a general symptom. According to Sasang Constitution, the Soeumin gave sleep disturbance and indigestion; the Soyangin showed a different pattern in their tongue coatings and bowel habits; the Taeumin had different tongue coatings and sweating pattern. The commonly prescribed herbal formula for pruritus was Gakhangjungisan, Yangkyuksanhwatang, Chungsimyonjatang. As for their efficiency, 61.0 % of patients improved, whereas 39.0 percent did not. Patients aged over 30 showed a more significant improvement than those of 20 years or under, and the duration of less than 1 year was more significantly improved than that of 1 year or more. Those who had no experience in western medical care or had been continuously treated showed a more significant improvement than those with intermittent treatments, and severe pruritus was more significantly improved than mild pruritus.

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Sleep Quality and Sleep Patterns of Patients Treated by the Hemopoietic Stem Cell Transplantation (조혈모세포 이식환자의 입원 후 수면의 질과 수면양상의 변화)

  • Choi, So-Eun;Park, Hae-Ryung;Park, Ho-Ran
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.37-44
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    • 2005
  • Purpose: To provide the basic data in developing the nursing intervention for patients who have symptoms of insomnia after undergoing hemopoietic stem cell transplantation (HSCT). This was achieved through investigating sleep quality and sleep patterns according to admission time, and discharge time. Methods: Data was put together by studying 52 HSCT patients who have been admitted to the department of HSCT from August 2002 to August 2003, in a university hospital. Research instruments used were, PSQI for sleep quality and a specified questionnaire for sleep patterns. Results: The PSQI regarding the past mono which was measured at the last day of hospitalization, was 11.8. This was significantly higher than 5.3, which was a measurement for the past month before the hospitalization (t=11.41, P=0.000). Looking at it with 7 categories-quality of sleep, consistency of sleep, sleep period, effectiveness of sleep, sleeping disorder, usage of sleeping pills, impediment of daily life- the PSQI for a month after admission increased significantly compared to the rate measured for a month before admission. Comparing the subjects sleep pattern before and after admission, it showed a significant difference regarding time attending sleep, time it takes to sleep, wake-up time, total time of sleep, day time sleep, number of times waking up during sleep, number of usage of sleeping pills, actions that are taken during sleep disorder, reasons for insomnia. Conclusion: The PSQI score of patients who undergo hemopoietic stem cell transplantation have increased significantly after hospitalization. Compared to the change of sleep patterns when hospitalized, significant changes were observed. Therefore nursing interventions addressing sleep are needed.

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Dental Care Utilization pattern of City Residents (소도시(小都市) 주민(住民)의 치과의료(齒科醫療) 이용양상(利用樣相))

  • Park, Myung-Ja
    • Journal of Technologic Dentistry
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    • v.14 no.1
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    • pp.67-79
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    • 1992
  • This study was conducted to analyze the dental care utilization pattern of the city residents. An interview and questionnaire survey was carried for 1008 people who lived in Kimchun-city, Kyungsangpook-do, from february 1 to March 30, 1992. The summarized results are as follows : The rate of persons who experienced the oral disease was 32.7 per 100 persons during 1 year and it was highest in the age group of 20$\sim$29. During 1 year period, 90.3% of the cases had treated the perceived oral disease, 9.7% had done no action. 65.8% had treated experienced oral disease at dental clinics. The rate of person who dad experienced dental prosthesis during ten-year period was 37.5% among 18year and older, and it was higher in male as compared to female and it was highest in age group of 40$\sim$64 year old. The rate of person who had treated dental prosthetics by the unauthorized illegally was 27.0%, and the reason for it was cheap-price free(44.2%). Of the person who dad treated dental prosthetics by the unauthorized illegally, 64.3% had satisfied and 4.3% had done out of use, while each was 80.1%, 2.7% at dental clinics. The rate of persons with missing teeth was 18.0%. Of the persons with missing teeth, 57.6% did not treat the missing teeth due to economic reason and 89.6% hopped treating the dental prosthetics at dental clinics. In consideration of above finding, we may conclude that oral health community program to prevent oral diseases should be intensified, oral health education to raise oral health knowledge should be performed periodically and the control of unlicensed activities should be enforce at community health center and allows benefits for prosthetics.

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The Changing Patterns and Predisposing Factors of Delirium at End of Life in Palliative Care Unit (완화 병동에서 임종기 섬망의 변화 양상과 선행 요인)

  • Rim, Mi-Roo;Kang, Sang-Gu;Choi, Seo-Hyeon;Cho, Jinhyun;Lee, Moon-Hee;Kim, Hye-Young;Bae, Jae-Nam;Lee, Jeong-Seop;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.94-101
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    • 2018
  • Objectives : The purpose of this study is to investigate the change pattern and the leading factors of delirium in the palliative ward from 2 weeks before to the end of life. Methods : From October 2015 to August 2017, a retrospective chart review was conducted on the final 180 patients of 207 patients with terminal cancer patients at the Inha University Hospital. Clinical records were collected during palliative care hospitalization. Patients were diagnosed with three subtypes of delirium through the Richmond Agitation Sedation Scale and the Nursing Delirium Screening Scale, which were evaluated daily. Results : The prevalence of delirium 13 days before death was 46%, of which 18.3% were hyperactive subtypes, 13.8% were hypoactive subtypes, and mixed subtypes were 13.8%. And hyperactive delirium gradually decreased with the approach to the end of the day, and the mixed subtype gradually increased until 4 days before the end of life. Of the patients, the day before death, 86.9% were diagnosed with delirium. In multivariate analysis, hematologic malignancy was associated with a lower rate of delirium at the end of life than gastrointestinal cancer. Overweight was associated with hyperactive, mixed, and hypoactive delirium. Conclusions : Most palliative care patients experienced delirium at the end of life. Overweight was considered as a protective factor that reduced the all subtypes of delirium at the end of life. Further prospective studies are needed to reveal the prevalence of terminal delirium, and their risk factors.

Evaluation of Food and Nutrient Intake of Preschool Children in Day -Care Centers (보육시설 유아들의 식품 및 영양소 섭취상태 평가)

  • Sin, Eun-Kyung;Lee, Yeon-Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.7
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    • pp.1008-1017
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    • 2005
  • The purpose of this study was to evaluate the Quantity and Quality of food and nutrient intake of preschool children. The subjects were 57 children aged 3 to 6 years in Gumi day-care centers. Total daily dietary intakes were calculated by weighing food consumed at the day-care centers taken together with dietary records by children's mothers for intakes at home. This survey was conducted during 3 days including week and weekend days. Diet Quality was assessed by NAR (Nutrient Adequacy Ratio), MAR (Mean Adequacy Ratio), food group pattern and DDS (Dietary Diversity Score). The daily food intake was 992.7g, the plant food intake $(68\%)$ was higher than animal food intake $(32\%)$. The daily energy intake was 1249.2 kcal $(85\%\;RDA)$ and protein 43.8g $(153.6\%\;RDA)$. Percentage of calcium, iron, and niacin consumed below $75\%$ of RDAs were $29.8\%,\;35.1\%\;and\;28.1\%$, respectively. Proportions of energy from carbohydrate, protein and fat were $61.0\%,\;14.1\%\;and\;25.5\%$, respectively. Calorie intake proportion of breakfast, lunch, dinner and snack were $15\%,\;20\%,\;19\%\;and\;46\%$, respectively. The NAR of Ca and Fe and MAR were 0.84, 0.85 and 0.92, respectively. Thirty-one point six percent of children consumed 5 food groups (GMFVDS=110111) per day. Persons who had higher DDSs correlated positively with NAR and MAR. As a result, dietary intake of preschool children partially showed a problem of over and under nutrition in Quantity or Quality. We hope that the result of this study could be helpful for developing the nutrition education program for the health and nutrition of preschool children.

Morbidity Pattern of Residents in Urban Poor Area by Health Screening (도시 영세지역 주민의 건강진단 결과)

  • Kim, Chang-Yoon;SaKong, Jun;Kim, Seok-Beom;Kang, Pock-Soo;Chung, Jong-Hak
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.150-157
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    • 1991
  • The purpose of the this study was to assess the morbidity pattern of urban residents in the poor area by health screening for the community diagnosis. The items of health screening were history taking and physical examination by medical doctor and hearing test, check blood pressure, test for hematocrit, liver function(sGOT, sGPT), urine sugar and protein, and chest X-ray. The examinee in health screening were 437 persons and they occupied 16.9% of total residents in the poor area. Male examinee were 129 persons(9.9% of total residents) and female examinee were 308 persons(23.9% of total residents). Age group of above sixty years old, 42.0% of total residents in the poor area were participated, but only 5.9% were participated in age group of 10 to 19 years old. Among the 437 examinee, 191 persons(43.7%) had one or more abnormal findings in health screening. In male 38.7% had abnormal findings, and some what lower than that of female(45.8%). Age group of above sixty years had most high rate of abnormal findings(69.8%), in contrast to age group of 10 to 19 years old (10.9%). Diseases of the digestive system was the most common and which occupies 23.7% of total abnormal findings. And diseases of the circulatory system occupied 19.7%. Low hematocrit(14.6% of total participants of 437 persons) occupies the most common abnormal findings for screening test(hematocrit, blood pressure, hearing test, sGOT/sGPT, urine protein and urine sugar, chest X-ray) and high blood pressure(10.1%) occupied second, third; hearing impairment (5.5%), fourth ; abnormal liver function (4.1%), fifth ; sugar in urine (2.3%), sixth ; protein in urine(1.4%) and lastly abnormal chest X-ray (0.9%). The positive rate of abnormal findings in health screening was very high compared with morbidity rate by health interview. It is supposed that some portion of this high rate is by selection bias in examinee in health screening specially high participating rate in older age, and the other portion is due to the low socioecomic status and bad environment of the residents of the poor area. These findings will be good information for the research and development of health care system in the urban poor area.

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The Determinants of Consumption Characteristics and Patterns of Elderly Households (고령자 가구의 소비특성 및 소비패턴 결정요인)

  • Kim, Jinhun
    • 한국노년학
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    • v.36 no.3
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    • pp.905-926
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    • 2016
  • Although the concept of the elderly varies depending on scholars and laws, as consumption expenditure is deeply associated with income due to the nature of this study, 55 years old was set as the low limit standard for the elderly according to Prohibition of Discrimination on Age in Employment and Employment Promotion for the Aged Act and the elderly households were limited to single-elderly person household and an elderly couple family household for this study. It is considered consumption characteristics as a significant analysis subject in terms of social welfare because it could be understood as an expressed need which was a reflection of desire. Therefore, the present study aimed to investigate the consumption characteristics of the elderly households by stereotyping the consumption pattern of the elderly households, and find the determining factors for consumption patterns and thus contribute to the establishment of related policies through the expressed needs of the elderly households. K-means of cluster analysis was performed by putting the consumption expenditure of the elderly households to investigate inherent structural type of consumption pattern of the elderly households, which were the investigation subjects. As a result, four groups were stereotyped and named as below: 'health care-centered type', 'saving-centered type', 'livelihood-centered type', and 'food expenses-centered type' Binary Logistic Regression analysis was used to identify the factors that influence the decision of consumption pattern of the elderly households. The result of study showed that the elderly households faced all different needs and problems and thus there is a need for various approach plans to solve this situation. In particular, although the elderly have been viewed as economically poor people so far, the study showed that there were also kind of prepared households through saving. Overall, livelihoodcentered type accounted for the highest portion and, as a factor that influenced this, marital state and household income played an important role. Therefore, it is considered that more active efforts to increase the income of the elderly households are needed. In addition, age, owning of house and subjective health state were found to also have significant influence. Through these results of the study, the elderly's own improvement of awareness on health, presentation of overall standard for health state of the elderly, securement of the elderly's access to cultural life, and financial management coordination for improvement of quality of life, development and dissemination of jobs suitable for the elderly, and dissemination of communal life household, which is a cooperation residential type, were presented as institutional task in the conclusion.

A Study on the Actual Conditions of Denture Prosthodontics used by the Elderly Aged 65 or Older in Seoul (시술장소에 따른 65세 이상 노인의 의치보철 실태 조사연구)

  • Jung, Jung-Ock
    • Journal of dental hygiene science
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    • v.7 no.3
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    • pp.113-119
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    • 2007
  • This study attempts to find factors contributing to the use pattern of prosthetics by investigating the current condition of prosthetics for the aged of over 65 years old by place of practice. Among those of over 65 years old who live in Gangnam-gu, Seocho-gu, Seongbuk-gu, and Gwanak-gu of Seoul and use the apartment senior's center, those having prosthetics were selected as subjects of this study, and this study was conducted in forms of interview and record. Findings of this study are summarized as follows: First, in regard of the state of prosthetics and relevant symptoms in the mouth according to the place of prosthetics practice, there was significant difference in the questions except the medical benefit of prosthetics between unlicensed facilities and dental clinics and hospitals. Second, regarding difference in satisfaction according to the place of prosthetics practice, dental clinics and hospitals showed a higher level of aesthetic satisfaction than unlicensed facilities. For difference in satisfaction at pronunciation, chewing, pain, a sense of foreign body, and holding power, dental clinics and hospitals showed a higher level than unlicensed facilities, Third, after factor analysis on the perception factors of unlicensed treatment and dental treatment, unlicensed facilities showed the highest level of reliability, and then convenience, word of mouth, and modernity in order. Dental clinics and hospitals also showed the highest level of reliability, however, and then convenience, modernity, and word of mouth in order. Fourth, as a consequence of analyzing the factors to influence the use pattern of prosthetics, regarding residential pattern, there were higher possibilities to use dental clinics and hospitals when the subjects lived together with their children and in Gangnam, and the more were the number of pyeong for the residence, pocket money, medical expense, and property in their name, compared to unlicensed facilities. In conclusion, economic factors appear to be the most important factors in selecting facilities for denture prosthodontics. Therefore, it is important to ensure the denture prosthodontics for the elderly are reimbursable so that they can enjoy a healthier life.

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Comparision of Medical Care Utilization Patterns between Beneficiaries of Medical Aid and Medical Insurance (의료보호대상자의 의료이용양상)

  • Kim, Bok-Youn;Kim, Seok-Beom;Kim, Chang-Yoon;Kang, Pock-Soo;Chung, Jong-Hak
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.185-201
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    • 1991
  • A household survey was conducted to compare the patterns of morbidity and medical care utilization between medical aid beneficiaries and medical insurance beneficiaries. The study population included 285 medical aid beneficiaries that were completely surveyed and 386 medical insurance benficiaries selected by simple random sampling from a Dong(Township) in Taegu. Well-trained surveyers mainly interviewed housewives with a structured questionnaire. The morbidity rates of acute illness during the 15-day period, were 63 per 1,000 medical aid beneficiaries and 62 per 1,000 medical insurance beneficiaries. The rates for chronic illness were 123 per 1,000 medical aid beneficiaries and 73 per 1,000 medical insurance beneficiaries. The most common type of acute illness in medical aid and medical insurance beneficiaries was respiratory disease. In medical aid beneficiaries, musculoskeletal disease was most common, but in medical insurance beneficiaries, gastrointestinal disease was most common. The mean duration of acute illness of medical aid beneficiaries was 3.8 days and that of medical insurance beneficiaries was 6.8 days. During the one year period, mean duration of medical aid beneficiaries chronic illnesses was 11.5 months which was almost twice as long compared to medical insurance beneficiaries. Pharmacy was most preferrable facility among the acute illness patient in medical aid beneficiaries, but acute cases of medical insurance beneficiaries visited the clinic most commonly. Chronic cases of both groups visited the clinic most frequently. There were some findings suggesting that much unmet need existed among the medical aid beneficiaries. In acute cases, the average number of days of medical aid users utilized medical facilities was less than medical insurance users. On the other hand, the length of medical care utilization of chronic cases was reversed. Geographical accessibility was the most important factors in utilization of medical facilities. Almost half of the study population answered the questions about source of funds on medical security correctly. Most respondents considered that the objective of medical security was afford ability. The chief complaint on hospital utilization was the complicated administrative procedures. These findings suggest that there were some problems in the medical aid system, especially in the referral system.

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