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A Study on the Applicability of the Population-Based Health Care Model: Focusing on Social Cooperative-type Medical Clinics in a Local Area (인구집단 기반 건강관리모형의 적용가능성 검토: 한 지역의 의료복지사회적협동조합형 의료기관을 중심으로)

  • Lee, Keun-Jung;Oh, Ju-Yeon;Lee, Da-Hee;Hahm, Myung-Il;Lee, Jin-Yong
    • Quality Improvement in Health Care
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    • v.26 no.2
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    • pp.95-103
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    • 2020
  • Purpose: This study was to examine whether a health care model that provides comprehensive medical services based on population groups to members of the medical cooperative is applicable as a policy alternative in terms of medical use and cost. Methods: Data were derived from National Health Insurance claim data in 2019. We compared the medical volume and expenses of patients who visited social cooperative-type medical clinics with other patients, control group who visited other clinics in a local area. Results: The average number of visit days was 25.3 days in social cooperative-type medical clinics, more than 24.2 days in the control group (p=.004). However, the average medical cost per visit was KRW 46 thousand in social cooperative-type medical clinics, which was significantly lower than KRW 51 thousand in the control group (p<.001), and the total medical cost was also KRW 16.1 billion in social cooperative-type medical clinics and KRW 16.9 billion in the control group. Conclusion: We identified that a population-based health care model might change patients' behaviors to health care services and decrease total medical cost. Further population based experiment is needed to develop alternative healthcare model.

COMPUTED TOMOGRAPHIC STUDY OF MAXILLOFACIAL GUNSHOT INJURIES (악안면부 총상 환자의 전산화단층사진상의 연구)

  • Park In-Woo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.26 no.2
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    • pp.65-73
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    • 1996
  • The purpose of this study was to evaluate the clinical and computed tomographic features of 7 cases of maxillofacial gunshot injuries in the suicidal patients visited the emergency room, Capital Armed Forces General Hospital. The obtained results were as follows : 1. The gunshot wounds were directed from submental area to dorsum of nose(3 cases), frontal area(1 case), orbit(1 case), infraorbital area (1 case), and lateral to nasal wing(l case). The shape of inlet in gunshot wounds were round (diameter: l-3cm) and that of outlet were oval shape(size : inlet

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Mild Bradykinesia Due to an Injury of Corticofugal-Tract from Secondary Motor Area in a Patient with Traumatic Brain Injury

  • Lee, Han Do;Seo, Jeong Pyo
    • The Journal of Korean Physical Therapy
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    • v.33 no.6
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    • pp.304-306
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    • 2021
  • Objectives: We report on a patient who showed mild bradykinesia due to injury of the corticofugal tract (CFT) from the secondary motor area following direct head trauma, which was demonstrated on diffusion tensor tractography (DTT). Case summary: A 58-year-old male patient underwent conservative management for subarachnoid hemorrhages caused by direct head trauma resulting from a fall from six-meter height at the department of neurosurgery of a local hospital. His Glasgow Coma Scale score was 3. He developed mildly slow movements following the head trauma and visited the rehabilitation department of a university hospital at ten weeks after the fall. The patient exhibited mild bradykinesia during walking and arm movements with mild weakness in all four extremities (G/G-). Results: On ten-week DTT, narrowing of the right CFT from the supplementary motor area (SMA-CFT), and partial tearing of the left SMA-CFT, left CFTs from the dorsal premotor cortex (dPMC-CFT) and both corticospinal tracts (CSTs) at the subcortical white matter were observed. Conclusion: This case demonstrated abnormalities in both CSTs (partial tearing at the subcortical white matter and narrowing), both SMA-CFTs (narrowing and partial tearing) and left dPMC-CFT. We believe our findings suggest the necessity of assessment of the CFTs from the secondary motor area for patients with unexplained bradykinesia following direct head trauma.

A Study on Correlation of the Results VFA Measured by CT Position with VFA Measured by InBody (CT 측정 위치에 따른 내장지방 면적과 Inbody로 측정한 내장지방 면적의 상관성 연구)

  • Lee, Sang Heon;Im, In Chul;Lee, Hyo-Yeong
    • Journal of the Korean Society of Radiology
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    • v.13 no.5
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    • pp.691-698
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    • 2019
  • The patients who visited the Health Promotion Center were compared between the visceral fat area according to CT fat measurement position and the visceral fat area measured by Inbody. In the CT measurement, the visceral fat area measured at the L4-5 and CT Umbilicus positions was not different regardless of gender. In addition, there was no difference between CT visceral fat area and Inbody visceral fat area in the correlation between visceral fat area according to CT measurement position and visceral fat area measured by Inbody. The highly correlated CT measurement position were male L4-5, L5-S1, female L3-4, L4-5, L5-S1, and Umbilicus. In addition, when studying the relationship between the inbody visceral fat area and CT visceral fat area regardless of gender, it is suggested to compare the visceral fat area at the CT L4-5 position.

A Survey of College Student Behaviors on Fast Food Restaurants in Seoul Area (서울지역 대학생들의 패스트푸드의 외식행동에 관한 실태조사)

  • Han, Myung-Joo
    • Journal of the Korean Society of Food Culture
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    • v.7 no.2
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    • pp.91-96
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    • 1992
  • Eight hundred college students in Seoul area were surveyed for consumer behaviors and opinions about fast food restaurants at library, student center and class room from August 26 to 30, 1991. The result of this study showed that 70% of college students preferred to eat hamberger or chicken and 49% of them visited to fast food restaurants 1-3 times per month. The reasons given by students for patronizing fast food restaurants were the following, from most to least frequence: 'convenient', 'pleasant atmosphere', 'nice place to stay with friends', 'taste of food', 'speed of service', 'to be able to stay as long as I want', 'hygiene', 'variety of food price', 'nutritious food'. Majority of college students(71%) selected their food by preference, but 22% of them done by price. They were least satisfied with price and quantity of fast food. Therefore, it is important to develop domestic brand fast food restaurants to lower the price of fast food.

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Visting Pattern in Odaesan National Park (오대산 국립공원의 이용객 행태)

  • 오구균;김갑태;임윤희
    • Korean Journal of Environment and Ecology
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    • v.9 no.2
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    • pp.182-186
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    • 1996
  • The annual increasing rate of visitors was 9.5% in Odaesan National Park from 1989 to 1995. Ninety three percent of total visitor of Odaesan National Park has visited Woljongsa and Sogumgang area in which a motorcar access is convenient. Climbing rate of Pirobong(peak) were less seven percent of total cisitors at Woljongsa in summer and less twelve point six percent in autumn. Visiting pattern showed difference by area, seasons and a day of the week. Using rate of motorcars was higher in summer than in autumn

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Cystic lymphangioma in the submandibular triangle in the adult (성인의 악하부에 발생한 낭성 림프관종)

  • Kim Eun-Kyung;Han Won-Jeong;Kim Sang-Joon
    • Imaging Science in Dentistry
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    • v.31 no.3
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    • pp.175-179
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    • 2001
  • Cystic lymphangioma is an uncommon benign developmental tumor of the lymphatic system, seen rarely in adults. A 23-year-old man visited DKUDH complaining of the painless swelling in the right submandibular area. It was reported that swelling had increased since 5 months ago. Clinically, fltriangle uctuant and mobile mass was palpated at the right submandibular area. CT scan showed a large, well-defined, homogenous low density mass, measuring 5.0 × 2.5 × 4.0 cm. T1W MRI scan demonstrated a large, multiseptated homogenous low signal mass with septum and rim enhancement. Proton-density and T2W MRI scan showed mass of high signal intensity. MRI scan was able to delineate better the enhanced multi septation and extent of the lesion. Histopathologically, a lobulated cystic mass lined by a layer of flattened endothelium was observed.

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Ultrasonographic Diagnosis of Left Gluteal Mass without Appreciable Cause - A Case Report - (특별한 원인 없이 좌측 둔부에 발생한 종괴의 초음파를 이용한 진단)

  • Han, Kye-Young;Won, Jong-Kyoung
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.1
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    • pp.27-30
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    • 2012
  • There are various diseases in soft tissue tumors that occur in subcutaneous tissue, and hematoma generally would be occurred in traumatic or coagulopathic condition. We report a case of hematoma on left gluteal area that was diagnosed by ultrasonography and was resected in 70 year old woman who visited the hospital because of left gluteal mass detected by chance two month ago and slowly growing.

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Correction of Frontal bone defect in Cleidocranial Dysostosis with Porous Polyethylene(Medpor®): A case report (쇄골두개이형성증(Cleidocranial Dysostosis)환자에서 Porous Polyethylene(Medpor®)를 이용한 두개골 함몰의 교정 1례)

  • Moh, Jae Seong;Na, Young Cheon
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.481-484
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    • 2009
  • Purpose: Cleidocranial dysostosis is a rare hereditary disorder affecting bones that develop by intramembranous formation. The typical features include excessive growth of transverse diameter of the skull, hypoplastic clavicles, low height and characteristic facial features. Methods: A 28 years old female patient visited by frontal area depression. The diagnosis was performed by computed tomographic study and radiographic imaging. The patient has widely opened anterior fontanelle, partial fused metopic suture, multiple wormian bone and supernumenary impacted teeth. Under the coronal incision, we exposed depressed frontal area and corrected with Medpor block carving. Results: Postoperatively, frontoparietal skull was aestheticlly improved and she was satisfied with the results. Conclusion: Authors report a case of cleiodocranial dysostosis who has been done correction of abnormal skull shape by Medpor$^{(R)}$ insertion.

The Difference in Attitude toward Medical Care between Patients and Physicians (환자와 의사의 의료에 대한 태도 차이 -한 중소도시의 대학병원과 한의과대학 부속 한방병원을 중심으로-)

  • Kang, Myung-Guen;Park, Jong-Ku;Kim, Han-Joong;Sohn, Myong-Sei;Kim, Dal-Rae
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.516-539
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    • 1998
  • The objective of this study is to identify the difference in attitude toward medical care between patients who visited a university hospital or an oriental medical hospital of oriental medical college, and physicians who engaged in the same hospitals. The subjects of this study were 397 cases who agreed to respond the prepared questionnaire, including 288 patients(146 university hospital utilizers and 142 utilzers for an oriental medical hospital) and 109 physicians(76 physicians and 33 oriental medical doctors). The attitude toward medical care was measured by the structured questionnaire developed for this study, which had high validity and reliability according to factor analysis, item discriminant validity, and Cronbach's $\alpha$ coefficients. On the criteria of mean value of care and cure score, the attitude toward medical care was classified into 4 groups encompassing a group with dependent attitude on medical care, a group with skeptical attitude toward it, a group with cure-oriented attitude, and a group with care-preferred attitude. The results of chi-square test, discriminant analysis, and logistic regression analysis were as follows; patients who visited a univisity hospital, patients who visited an oriental hospital, physicians, and oriental medical doctors included in the group with dependent attitude, the group with cure-oriented attitude, the group with skeptical attitude, and the group with care-preferred attitude, retrospectively. Among the subdomains of care and cure domains, which classified in reference to the result of factor analysis on pilot study, those that patients ranked more importantly than physicians were 'the importance of medical equipment for diagnosis and treatment', 'authority of physician, 'aggressiveness of treatment', 'information giving', 'personal interest' in the case of western medicine. In the case of oriental medicine, those were 'the importance of equipment for diagnosis and treatment', 'aggressiveness of treatment', 'amenities and accessibility', 'coordination of medical staff'. Both physicans and patients put the subdomain, 'physicians' medical knowledge and skillfulness' on the highest rank. The differences in ranking the important attributes of medical care between patients and physicians were apparent in the area of an 'importance of medical equipment for diagnosis and treatment' and so on. It meant that patient had over-expectation on medical care and suggested that the policy on demanad side such as the developement and dissemination of an evidence-based recommendation protocol for health care consumers might be important in Korea. In addition, regarding the attitude of physicians, during the medical education and training it may be neccessary to emphasize the aspect of 'care' of medical care rather than 'cure'. In planning on heath care delivery system, it should be considered that there is a difference in the attitude toward medical care between western medicine and oriental medicine as well as between health care providers and consumers. We expect that more valid measurement tool be developed in this area, which may be major limitation of this study and that this kind of research be expanded into the non-academic settings.

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