• Journal of Preventive Medicine and Public Health
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• v.40 no.3
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• pp.249-258
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• 2007

Objectives : The aims of this study were to estimate the antihypertensive medication adherence in people with a disability and a history of taking antihypertensive medication, and to identify the factors affecting medication adherence. Methods : The National Health Insurance claims data were linked with the National Disability Registry. People with a disability, who received a prescription of antihypertensives, were identified from a total of 85,098 cases. Cumulative medication adherence (CMA) was used as an indicator of medication adherence. A CMA > 80% was defined as appropriate medication adherence. Multiple logistic regression analysis was used to identify the factors affecting medication adherence. Results : The average CMA in a total of 85,098 patients was 79.5%. The appropriate adherence $(CMA{\geq}80%)$ rate was 54.5% and 20.5% of patients had a CMA < 50%. Multiple logistic regression analysis revealed that the probability of appropriate adherence decreased with decreasing number of prescription days per visit, increasing number of providers, the patients' residential area moving from urban to rural areas, and when patients have an internal organ disability, auditory impairment, mobility impairment. Conclusions : The adherence to antihypertensive medication in people with a disability is influenced by various socio-economic, clinical and regional factors. In particular, the disabled who have locomotive and communication disabilities and internal organ impairments have a higher probability of under-adherence to antihypertensive medication adherence in Korea.

• Journal of Digital Convergence
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• v.13 no.9
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• pp.323-332
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• 2015

This paper examines the level of the primary care continuity for patients with high blood pressure and the effects of the primary care continuity on their convergence health outcomes. We conducted a retrospective cohort study. A total of 315,791 patients who had received new diagnoses of hypertension. We determined standard indices of continuity of care-MFPC, MMCI, and COC and evaluated their association with study outcomes over three years of follow-up. Outcome measures included hospitalization and emergency room visits. The result of the primary care continuity levels and hazard ratios of health outcome showed that, comparing continuity group, non-continuity group had higher rates of hospitalization by 1.655(95% CI: 1.547-1.771) and emergency room visits by 1.669(95% CI: 1.465-1.903). This paper argues that medical costs of chronic diseases will reduce if low continuity of care turns into high continuity of care.

• Interdisciplinary Bio Central
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• v.1 no.2
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• pp.6.1-6.4
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• 2009

We stand at the brink of a fundamental change in how medicine will be practiced. Over the next 5-20 years medicine will move from being largely reactive to being predictive, personalized, preventive and participatory (P4). Technology and new scientific strategies have always been the drivers of revolutions and this is certainly the case for P4 medicine, where a systems approach to disease, new and emerging technologies and powerful computational tools will open new windows for the investigation of disease. Systems approaches are driving the emergence of fascinating new technologies that will permit billions of measurements on each individual patient. The challenge for health information technology will be how to reduce this enormous amount of data to simple hypotheses about health and disease. We predict that emerging technologies, together with the systems approaches to diagnosis, therapy and prevention will lead to a down turn in the escalating costs of healthcare. In time we will be able to export P4 medicine to the developing world and it will become the foundation of global medicine. The "democratization" of healthcare will come from P4 medicine. Its first real emergence will require the unprecedented integration of biology, medicine, technology and computation. as well as societal issues of major importance: ethical, regulatory, public policy, economic, and others. In order to effectively move the P4 scientific agenda forward new strategic partnerships are now being created with the large-scale integration of complementary skills, technologies, computational tools, patient records and samples and analysis of societal issues. It is evident that the business plans of every sector of the healthcare industry will need to be entirely transformed over the next 10 years.and the extent to which this will be done by existing companies as opposed to newly created companies is a fascinating question.

• Journal of Preventive Medicine and Public Health
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• v.34 no.1
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• pp.21-27
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• 2001

Objectives : To develop a model that will predict the mortality of patients undergoing Coronary Artery Bypass Graft (CABG) and evaluate the perfermance of hospitals. Methods : Data from 564 CABGs peformed in six general hospitals were collected through medical record abstraction by registered nurses. Variables studied involved risk factors determined by severity measures. Risk modeling was performed through logistic repression and validated with cross-validation. The statistical performance of the developed model was evaluated using c-statistic, $R^2$, and Hosmer-Lemeshow statistic. Hospital performance was assessed by severity-adjusted mortalities. Results : The developed model included age, sex, BUN, EKG rhythm, Congestive Heart Failure at admission. acute mental change within 24 hours, and previous angina pectoris history. The c-statistic and $R^2$ were 0.791 and 0.001, respectively. Hosmer-Lemeshow statistic was 10.3(p value=0.2415). One hospital had a significantly higher mortality rate than the average mortality rate, while others were net significantly different. Conclusion : Comparing the quality of service by severity adjusted mortality rates, there were significant differences in hospital performance. The severity adjusted mortality rate of CABG surgery may He an indicator for evaluating hospital performance in Korea.

• Journal of Korean society of Dental Hygiene
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• v.20 no.3
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• pp.243-256
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• 2020

Objectives: This study aimed to determine and facilitate provisions for the unmet dental needs of Koreans, stratified by time, influencing factors, and research trends, through a systematic review of related published studies since 2006. Methods: this review focused on previous studies published between January 2006 and November 2019 that analyzed influencing the factors underlying the unmet dental needs of koreans. We followed the guidelines set for each phase of research and selected the final 32 studies that met the selection criteria for the analysis. Results: The number of studies has rapidly increased since 2015 (22 studies, 68.7%). the were 68.9% in 2006, 25.9% in 2009, 41.3% in 2010- 2012, and 33.3% in 2013-2015 for adults and 27.9% in 2010, 24.6% in 2015, and 16.1% in 2017 for the rates of older adults. the rates of unmet dental needs related to economic factors, were 38.6% in 2006, 41.4% in 2007-2009, and 35.9% in 2013-2015 for adults and 50.5% in 2010 and 41.2% in 2015 for the older adults. There were common influencing factors for unmet dental needs. the rate of unmet dental needs was increased by with female gender, younger age, single marital status, low family income, low educational level, worsened subjective health condition, and the presence of chronic diseases. Conclusions: Standardized studies with more accurate definitions and assessment tools are required. however, our study emphasizes the need for a policy intervention that accounts for the characteristics of subjects to reduce unmet dental needs.

• Journal of Preventive Medicine and Public Health
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• v.35 no.2
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• pp.92-98
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• 2002

Objective : To estimate the burden of cardiovascular disease attributable to the total suspended particulates (TSP) and sulfur dioxide ($SO_2$) in Korea using the YLD (years lived with disability) measurement. Methods : Congestive heart failure(CHF) and myocardial infarction (MI) were chosen as the main cardiovascular diseases whose causes are attributable to the TSP and $SO_2$ levels. In order to calculate the YLD (years lived with a disability), the following parameters in the formula were estimated. : the incidence rate, the case fatality rate, The expected duration of a disability and the average age of onset were estimated. The expected duration of a disability and the average age of onset were calculated using the DISMOD method, as developed by the GBD researchers. The burden of cardiovascular disease due to TSP and $SO_2$ was estimated using the number of years that the patient lived with a disability. Results : The VLD of the CHF due to the TSP and $SO_2$ was attributed to the TSP (94.4 person-year) and $SO_2$ levels (35.0 person-year). The YLD of the ME due to the TSP and $SO_2$ was attributed to the TSP (148.4 person-year) and $SO_2$ levels(27.6 person-year). Conclusion : The YLD method employed in this study was appropriate for quantifying the burden of cardiovascular disease. Therefore, it would provide a rational basis for planning a national health policy regarding the disease burden of the risk factors in Korea.

• Journal of Preventive Medicine and Public Health
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• v.39 no.4
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• pp.365-370
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• 2006

Objectives: The purpose of this study was to investigate the differences in smoking rates according to the major occupational categories in South Korea. Methods: The study subjects were a weighted sample of 24,495 men and 26,121 women aged 25-64 from the 2003 Social Statistics Survey, which was conducted by the Korea National Statistical Office. Occupation was classified according to the Korean Standard Occupation Classification. We computed the age-standardized smoking rates according to gender and occupations after adjusting for the education level, marital status, and self-rated health. Results: For men, the smoking rate in elementary occupations was two times higher than that of clerks (OR=1.98, 95% CI=1.74-2.26). In general, a more prestigious job(professionals) correlated with lower smoking rates, and less prestigious jobs correlated with higher smoking rates, except for legislators, senior officials and managers. For women, smoking among service workers was 4.1 times higher than among clerical workers (OR=4.11, 95% CI=2.87-5.88). For women, their occupations, except elementary workers, and the unemployed, the retired and the armed forces, failed to show significant differences in smoking compared with the clerical workers. After adjusting for education, occupational differences in the smoking rate for men were attenuated in most occupations, except for legislators, professionals, and technicians. Further adjustment for marital status and self-rated health had a minimal effect on the occupational differences in the smoking rate for men. For women workers with service or elementary occupations, the ORs of smoking were attenuated with adjustment of the educational levels. However, the ORs of smoking were increased in workers with service, sales or elementary occupations, as well as for legislators, and the unemployed, the retired and the armed forces, after additionally adjusting for marital status. Conclusions: More prestigious jobs generally correlated with lower smoking rates in both sexes. The anti-tobacco policy should consider smoking rate differentials by occupations.

• The Korean Journal of Health Service Management
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• v.5 no.2
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• pp.209-226
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• 2011

The purpose of this study is to analyze and find out key success factors and marketing strategies of Bumrungrad Hospital in Bangkok, Thailand. The major success factors of Bumrungrad Hospital are as follows; First, Bumrungrad Hospital had professional medical team and board of directors who had the international career. Second, Bumrungrad was supported by Thai government and they were in a cooperative relationship with each other for the development of the medical industry. Third, Bumrungrad appropriately handled the internal and external changes including Asia Financial Crises in 1997 and others. Fourth, Bumrungrad diversified and broaden its business field such as global medical investing and management, medical technology, anti-age medicine and wellness. Marketing strategies of Bumrungrad analyzed are the following four factors. First, Bumrungrad focused on the quality of services by employing professional medical staffs, who have the international certification, and by constructing IT system for hospital management. Second, Bumrungrad has maintained an equalized price policy to attract the customers bothin the domestic and foreign markets. The cost for care has appealed the foreign customers for its comparatively low price, but it focused mainly on the upper middle class in Thailand. Third, it established, managed, and consulted hospitals in the foreign countries including the Philippines and the Arab Emirates. Fourth, it adopted differentiated promotion strategies suitable for the special needs of domestic and foreign customers, and put emphasis on the buzz marketing.

• Korean Medical Education Review
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• v.21 no.3
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• pp.143-149
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• 2019

In 2018, The Ministry of Health and Welfare announced its first comprehensive plan for patient safety, which included the imperative to develop a patient safety curriculum for students studying to become health professionals. The aim of this study is to assess current patient safety education and points of consideration for introducing new curriculum. An online survey was used to understand the status of patient safety education in medical schools, and key informant interviews and focus group interviews were used to collect qualitative data on the experience of patient safety education. The results of the online survey from 16 out of 40 medical schools (40% response rate) and the qualitative data analysis were integrated and analyzed. Twelve schools (75%) had established courses related to patient safety. The qualitative responses suggest that patient safety education is appropriate both before and after clinical training through a variety of educational methods, and that the topics should be linked with clinical training. The challenge of securing lecture time to address patient safety was mentioned as a realistic obstacle. When patient safety education is integrated in future curriculum, it is necessary to consider it as a priority. Moreover, in the early stages of introducing patient safety education, a step-by-step, policy-based approach is required for seamless adoption and settlement.

• Quality Improvement in Health Care
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• v.28 no.1
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• pp.34-44
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• 2022

Purpose:We investigated physicians' responses to a series of clinical vignettes consisting of patient safety incidents, with and without disclosure of patient safety incidents (DPSI). Methods: An anonymous survey was conducted to investigate physicians' responses to the DPSI via online communities of physicians, and additional participants were recruited using a snowballing sampling method. We evaluated physicians' responses to the DPSI using eight hypothetical scenarios (HS) from the following perspectives: thoughts regarding medical errors, revisiting the physician, recommendation, lawsuit, criminal prosecution, trust score, and compensation amounts. We used the chi-square test to evaluate the overall differences in response rates among the scenarios. Statistical analyses were performed using the Student's t-test to compare the trust scores and compensation amounts. Results: A total of 910 physicians participated in this survey. An overall comparison of trust scores among HS showed that HS 1 (unclear medical errors, minor harm, and DPSI) had the highest trust score. In contrast, in the opposite scenario, HS 8 (clear medical errors, major harm, and DPSI not conducted) received the lowest scores. Cases with minor harm to patients (HS 1, 2, 5, and 6) showed lower compensation amounts than the others (HS 3, 4, 7, and 8). Physicians were more likely to think of situations with DPSI as not having medical errors (53.1% vs. 55.2%). In addition, the scenarios with DPSI were evaluated favorably in terms of intention to revisit, recommend, suit, and engage in criminal proceedings. Physicians showed higher trust scores (6.2 vs 5.4) and gave lower compensation amounts ($27.7 million vs $28.1 million), although there was no significant difference in terms of compensation amounts to the physician conducting DPSI. Conclusion: Our study showed overall positive perceptions regarding DPSI among Korean physicians.