• Title/Summary/Keyword: 건강보험심사평가

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Factors affecting the Length of Stay in Patients with Total Knee Arthroplasty (슬관절 전치환술 환자의 재원일수에 영향을 주는 요인)

  • Lee, Hye-Seung;Kim, Hwan-Hui
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.6
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    • pp.201-208
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    • 2020
  • The purpose of this study was to analyze the claim data of Health Insurance Review & Assessment Service to determine what factors affected the length of stay in patients aged 65 and older and undergoing total knee arthroplasty due to the principal diagnosis of gonarthrosis by the type of medical institutions. As a result of making an analysis, gender, age, medical security type, severity, residential area and the number of sickbeds were identified as the factors that influenced the length of stay in each type of medical institutions. At this point in time when an increase in the elderly population triggered by population aging and another subsequent increase in medical expenses put a heavy strain on household and national economy, it's necessary to consider how to shorten the length of stay and how to ensure the efficient management of sickbeds based on the findings of this study. In addition, this study is of significance in that it could be used as basic data on quality life-care for elderly patients by the introduction of a systematic management system geared toward lessening patient burden for medical expenses.

An Exploratory Health Outcome Analysis of Lumbar Surgery Patients Utilizing Korean Medical Services: Using Health Insurance Review and Assessment Service-National Patients Sample (HIRA-NPS 2019) Data (건강보험심사평가원 환자표본 데이터 분석을 통한 한의 의료 이용 요추 수술 환자의 탐색적 성과 분석)

  • Hye-Yoon Lee;Namkwen Kim;Yun-kyung Song
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.17 no.2
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    • pp.131-139
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    • 2022
  • Objectives This study aimed to analyze the medical utilization of low back pain (LBP) patients after back surgery and estimate the medical costs of Korean and Western medicine collaborative treatment, odds ratio, and hazard ratio between the two groups using the 2019 Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS-2019). Methods Data management and descriptive analysis, logistic regression, and survival analysis were conducted for defining and estimating the LBP patients after back surgery in the NPS 2019 dataset. Results A total of 216,424 patients out of 991,189 were identified as having LBP. Among the patients with LBP, 1,734 were treated with surgery while 214,690 were not. Among those who had surgery, 937 were treated with conventional treatments only and 797 underwent Korean medicine treatments. The odds ratio of the logistic regression analysis was 0.7129, suggesting that Korean medical treatment experience group had a 28.7% lower risk of reoperation than the Western medical treatments only group. The hazard ratio of the survival analysis was 0.9145; thus, the risk probability of reoperation was estimated to be approximately 8.55% lower. The 50% risk of reoperation was 69 days (0.5044) for the conventional group, and 97 days (0.5008) for the Korean medical group in the survival analysis using the Kaplan-Meier graph. Conclusions These results could be utilized in future studies in conducting economic evaluation for estimating cost-effectiveness of Western medicine and Korean medicine treatment compared to Western medicine alone in LBP patients after back surgery in a South Korean perspective. mended and should be applied while taking the necessary precautions.

Convergence Research on Periodic Changes in the Quality Assessment of Surgical Prophylactic Antibiotics (수술 예방항생제 적정성 평가의 주기별 융합 변화 연구)

  • Yang, Sae-Yie;Kim, Kwang-Hwan
    • Journal of Digital Convergence
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    • v.14 no.6
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    • pp.325-333
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    • 2016
  • This study was conducted to provide the base line for the use of prophylactic antibiotics and the standard of antibiotic use and the evaluation based on analysis of current use, quality assessment and periodic changes of prophylactic antibiotics in a university hospital. We chose the year 2008, 2009, 2010, 2012, and 2014 as the study periods since the primary evaluation on the first year of implementation in 2007. For this study, healthcare benefit quality assessment data from the Health Insurance Review and Assessment Service was used. We analyzed the differences each year of treatment period; one category for initial treatment timing, three categories for selecting antibiotics, and two categories for the length of treatment from multiple evaluation indices of gastric surgeries, colorectal surgeries, and cholecystectomy. The analysis revealed the followings: Regarding length of antibiotics treatment, total days of treatment decreased down to 1.5, 1.5, and 0.6 days in the year 2014, from 13.5, 12.8, and 6.9 days in the year 2007, for gastric surgeries, colorectal surgeries, and cholecystectomy. Based on these outcomes, the efforts to devise efficient delivery and distribution of the recommendations or indices which medical staff could adhere for quality improvement of the prophylactic antibiotics would be necessary. Also implementing monitoring system to help the hospitals to acknowledge their own faults may be helpful.

Survey of CT Practice and Collective Effective Dose Estimation (CT검사건수 및 CT검사에 의한 집단 실효선량의 추정)

  • Lee, Man-Koo;Lim, Cheong-Hwan
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.231-237
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    • 2010
  • Computed tomography (CT) has been established as an important diagnostic tool in clinical medicine and has become a major source of medical exposure. A nationwide survey regarding CT examinations was carried out in 2007. Thanks to the appeasement policy regulating the import of CT scanners, there are 1,825 CT scanners across the country as of the end of March 2010, which means that we have 36.8 CT scanners per one million people. The annual number of examinations was 3.29 million, the number of examinations per 1000 population was 68. The most part of examinations was abdomen and pelvis. and the collective effective dose was in these parts. The effective dose per one population was evaluated as 0.952 mSv.

The Analysis of Hospital Characteristics affecting Blood Transfusion to the patients under Knee or Hip Total Replacement Arthroplasty (슬관절과 고관절 전치환술 환자의 수혈에 영향을 미치는 병원특성 요인 분석)

  • Oh, Ji-Young;Kim, Sang-Mi;Lee, Seong-A
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.6
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    • pp.4031-4039
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    • 2015
  • The problems related with blood supply shortage and the stability of blood transfusion are on the rise, as it is expected that the blood doners will decrease but the blood use amount for aged population will increase, owing to low birth and aged population increase. The purpose of this study is to analyze the hospital characteristics which affect patients receiving and non-receiving blood transfusion for the knee and hip total replacement arthroplasty. Data were collected from Health Insurance Review and Assessment Service's 2011 sample data, and 5,370 inpatients were abstracted from them. Logistic regression analysis was performed, using SPSS 20. Independent variables used are hospital characteristics variables and patient characteristics variables. Hospital characteristics variables are hospital type, ownership, residence and the number of usable beds, and patient characteristics variables are gender, age, severity, type of anesthesia, main diagnosis, whether or not of anemia and insurance class. At the result of this study, it was found that hospital type, region, gender, age, severity, main diagnosis and whether or not of anemia were the factors that mostly affected the blood transfusion for knee arthroplasty. And hospital type, residence, gender, age, severity, type of anesthesia and whether of not of anemia were the factors that mostly affected the blood transfusion for hip arthroplasty. In addition to that, it is expected that this research which analyzed the present state of blood transfusion and its influence factors are cost effective, and would make a good use of preliminary data for good quality of medical service.

Application of Molecular Diagnostics Technology in the Development of a Companion Diagnostics for Malignant Solid Tumors (악성 고형암의 항암제 동반진단 기술에서 분자진단기술의 적용)

  • Kim, Jin-Hee
    • The Journal of the Korea Contents Association
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    • v.19 no.3
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    • pp.365-374
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    • 2019
  • Unlike benign tumors, malignant tumors are capable of metastasis, easy to relapse, poor survival, and low quality of life. In Korea, here is a tendency to treat the tumors collectively according to the General Principles of Cancer Chemotherapy(GPCC) of the Health Insurance Review & Assessment Service (HIRA). But recently, companion diagnostics(CDx) is recommended rather than unilateral medication because biomarker-based molecular diagnostics is possible to predict the drug response of patients before drug treatment. Not only domestic but also overseas Food and Drug Administratio (FDA) recommends the development of the CDx system at the stage of drug development to ensure the responsiveness and safety of medicines. In this study, I focused on the necessity of CDx development direction as well as CDx development status through literature review. Furthermore I also discussed CDx types according to the molecular diagnostic technology such as immunohistochemistry (IHC), polymerase chain reaction (PCR), in situ hybridization (ISH), and next-generation sequencing (NGS) not only in the approved CDx but also in the developing one by US FDA. And I suggested the technology issue of CDx development process such as a selection of molecular diagnostics at the time of release, a clear understanding of the CDx mechanism, and a convergence of drug with CDx development. The necessity of social insurance system also was proposed for CDx development.

Analysis of the Use of Insured Herbal Extracts and Korean Medicinal Treatments in Patients with Allergic Rhinitis : Data from Health Insurance Review and Assessment Service (알레르기 비염 환자의 보험 한약 제제 및 한의 처치 이용 현황 : 건강보험심사평가원 자료 분석)

  • Kim, Jeong-Hun;Ryu, Ji-In;Kang, Chae-Yeong;Hwang, Jin-Seub;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.2
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    • pp.38-52
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    • 2021
  • Objectives : The purpose of this study is to analyze the use of insured herbal extracts and Korean medicinal treatments, which are mainly used to treat allergic rhinitis in Korean medicine. Methods : Among all HIRA(Health Insurance Review and Assessment Service) claims data in 2016, we included all statements that included J30(vasomotor and allergic rhinitis) or a subcategory of J30(J30.0, J30.1, J30.2, J30.3, or J30.4) as the main disease, using the Korean Standard Classification of Diseases(KCD-7). This study analyzed the most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis in Korean medicine. We performed a frequency analysis on subgroups based on treatment type(inpatient or outpatient), sex, age, insurance type, and medical institution type. Results : The result shows the 10 most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis. The total number of insured herbal extracts prescriptions was 82,533, and the most commonly prescribed insured herbal extracts was socheongryong-tang(35,131 prescriptions), followed by hyeonggaeyeongyo-tang(18,157 prescriptions), samsoeum(6,257 prescriptions), and galgeun-tang(4,465 prescriptions). The total number of Korean medicinal treatments prescriptions was 1,878,541, of which the most common Korean medicinal treatments was acupuncture(922,977 prescriptions), followed by moxibustion(372,120 prescriptions), cupping(242,094 prescriptions), and segmental acupuncture(161,553 prescriptions). Conclusions : It is expected that the results of this study can be used as a basis for establishing the priorities of evidence-based clinical research topics in the field of Korean medicine and making health care policy decisions to strengthen coverage in the future.

The societal cost of rotavirus infection in South Korea (한국에서 로타바이러스 급성 위장관염의 질병 부담)

  • Yang, Bong Min;Jo, Dae Sun;Kim, Youn Hee;Hong, Ji Min;Kim, Jung Soo
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.977-986
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    • 2008
  • Purpose : This study aims to estimate the financial cost of rotavirus infection in Korea in the year of 2005. Methods : The incidence rates used were from the epidemiological profile at Jeoungeub District (5.8 cases/1,000 children <5 years old for inpatients, and 22.65 cases/1,000 children <5 years old for outpatients, per year). The health care cost per capita of rotavirus infection (ICD code: A08.0) was extracted from the Health Insurance Review and Assessment Service database in Korea. The patient survey was conducted to capture information about non-medical costs and associated productivity loss incurred by adult caregivers. Results : The number of annual national cases among children <5 years old with rotavirus infection was estimated to be 69,122 (i.e., 55,030 outpatients and 14,092 inpatients). The total cost of rotavirus infection was estimated at 13.3 billion Korean won, comprising 11 billion Korean won (82.7%) of direct medical costs, 1.6 billion Korean won (12.0%) of direct non-medical costs (e.g., transportation and supplies), and 0.68 billion Korean won (5.1%) of productivity lost by adult caregivers. Conclusion : Rotavirus infection carries not only medical costs but also non-medical and indirect costs; together, these costs incur a significant burden on South Korean society. The impact of rotavirus on quality of life and health among patient caregivers was not considered in this study, but it does merit further research.

Diagnostic Conundrum: Fever and Pyuria Preceding Diagnosis of Kawasaki Disease in Children

  • Jiseon Park;Young June Choe;Seung Ah Choe;Jue Seong Lee;Hyung Eun Yim;Yun-Kyung Kim
    • Pediatric Infection and Vaccine
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    • v.30 no.3
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    • pp.139-144
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    • 2023
  • Purpose: Children with incomplete Kawasaki disease (KD) and pyuria may be misdiagnosed with urinary tract infection (UTI) during the early phase of the prodrome. We investigated the percentage of UTI diagnoses preceding a KD diagnosis. Methods: Using the National Health Insurance data of South Korea, we assessed differences in UTI diagnoses made during the week preceding a KD diagnosis, according to demographic and geographic factors from November 2007-October 2019. Results: A total of 53,822 KD cases were identified, including 304 patients (0.56%) diagnosed with a UTI during the week preceding a KD diagnosis. The younger age group (0-11 months) showed the highest percentage of preceding UTI diagnoses (0.95%), with higher odds than 4-year-old children (3.12; 95% confidence interval, 2.05-4.77). Conclusions: These findings suggest a potentially misleading presentation of incomplete KD, a clinical conundrum requiring further investigation and validation, particularly in infants.

National Trends in Pediatric CT Scans in South Korea: A Nationwide Cohort Study (소아 전산화단층촬영의 국내 동향: 전국적 코호트 연구)

  • Nak Tscheol Kim;Soon-Sun Kwon;Moon Seok Park;Kyoung Min Lee;Ki Hyuk Sung
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.138-148
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    • 2022
  • Purpose This study evaluated the rates and annual trends of pediatric CT scans in South Korea using a nationwide population-based database. Materials and Methods Data regarding pediatric CT scan usage between 2012 and 2017 were retrieved from the health insurance review and assessment service. Data on the age, sex, diagnosis, and the anatomical area of involved patients were also extracted. Results A total of 576376 CT examinations were performed among 58527528 children aged below 18 years (9.8 scans/1000 children), and the number of CT examinations per 1000 children was noted to have increased by 23.2% from 9.0 in 2012 to 11.0 in 2017. Specifically, the number of CT examinations increased by 32.9% for the 6-12 years of age group (7.4/1000 to 9.8/1000) and by 34.0% for the 13-18 years of age group (11.4/1000 to 15.3/1000). Moreover, majority of the CT scans were limited to the head (39.1%), followed by the extremities (32.5%) and the abdomen (13.7%). Notably, the number of extremity CT scans increased by 83.6% (2.3/1000 to 4.2/1000), and its proportion as compared to other scans increased from 25.3% to 37.7%. Conclusion CT scans in the pediatric population increased continuously from 2012 to 2017 at an annual rate of 4.4%. Therefore, physicians should balance the benefits of CT with its potential harms from associated radiation exposure in pediatric patients.