• Health Policy and Management
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• v.34 no.1
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• pp.48-58
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• 2024

Background: The purpose of this study was to investigate the association between external medical service use and the characteristics of Chungcheongnam-do patients. We aimed to provide evidence of external medical service use enhance the healthcare delivery system in Chungcheongnam-do. Methods: We used the Health Insurance Cohort DB 2.0 of 2016-2019, and 2,570,439 patients were included in the study. Multivariate logistic regression and multinomial logistic regression were used to identify the association between external medical service use and each patient characteristic. Generalized linear model was used to identify the association between medical costs and external medical service use area. Results: During the study period, 32.2% of inpatients and 12.5% of outpatients had external medical service use in Chungcheongnam-do. In comparison to patients living in Cheonan and Asan, the odds ratio (OR) for external medical services use was higher across all regions. Specifically, hospitalized patients from Gyeryong, Nonsan, and Geumsan (OR, 116.817) and Gongju, Buyeo, and Cheongyang (OR, 72.931) demonstrated extremely high likelihood of external medical service use in the Daejeon area. Furthermore, compared to medical expenses incurred within Chungcheongnam-do, patients with external medical service use in the capitol area (outpatient=17.01%, inpatients=22.11%) and Daejeon area (outpatient=16.63%, inpatients=15.41%) spent more on healthcare services. Conclusion: This study found the evidence of external medical service use among Chungcheongnam-do patients. Further study should be conducted taking into account variables including satisfaction of local medical services, different types of patient diseases, and others. The study's findings may serve as a foundation for policy proposals aimed at ensuring the financial stability of our health insurance system, ensuring the efficient delivery of medical care, and localization of medical care.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.2
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• pp.149-158
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• 2003

Objectives: The authors studied the anxiety, depression and psychological characteristics of medical out-patients, which are diagnosed as peptic ulcer disorder and essential hypertension. We also examined the state of psychiatric consultation. Methods: The subjects were composed of 56 patients with peptic ulcer disorder, 44 patients with essential hypertension and 116 controls. STAI, BDI and SCL-90R was administered to all subjects. Chart review, telephone interview and Self report questionnaire of etiology and severity of illness, drug compliance and so forth were performed in disease groups. Results: Considerable depression was noticed in 39.3% among the patients with peptic ulcer disorder, 27.7% in hypertension and 12.1% in control group by BDI. State anxiety was noticed in 44.6% among the patients with peptic ulcer disorder, 54.5% in hypertension and 18.1% in control group by State anxiety. Trait anxiety was noticed in 42.9% among the patients with peptic ulcer disorder, 34.1% in hypertension and 25.8% in control group by Trait anxiety. The higher SOM, BDI, STAI, the lower drug compliance and rapport. Psychological problems are considered of the most important etiology in 48.2% of peptic ulcer group and 45.7% of hypertensive group. But psychiatric consultation is made only in 1.8% of peptic ulcer group and 2.3% of hypertensive group. Conclusions: Anxiety and depression are common phenomena in medical outpatients. In comparison with the normal control group, peptic ulcer group showed significantly higher trait anxiety and depression and hypertensive group higher state anxiety. These characteristics are related to the drug compliance and doctor-patient relationship. These results suggested the needs of active psychiatric consultation.

• Proceedings of the KSLP Conference
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• 1997.11a
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• pp.255-255
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• 1997

서론 : 성대구증은 음성장애를 주소로 외래로 찾아오는 환자에서 드물지 않게 볼 수 있으나, 그 병인이 불명확하고 그간의 치료가 만족스럽지 못한 것으로 알려져 간과하기 쉬운 질환이다. 저자들은 이러한 성대구중 환자들의 음성기능 분석을 통하여 향후의 치료효과를 알아보는데 도움이 되고자 하였다. (중략)

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.19-25
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• 2004

Dentally disabled person means one who have difficulty in cooperating voluntarily with a dentist for routine dental care. Seoul National University Dental Hospital (SNUDH) Dental Clinic for Disabled has worked for them under outpatient anesthesia concept. The aim of this study was to determine the anesthetic characteristics of the patients attending for dental treatment at SNUDH Dental Clinic for Disabled in order to establish better future treatment plans. The data were drawn from the patients who visited SNUDH Dental Clinic for Disabled from January 1999 to October 2002. Total 93 dental treatments for 83 patients were enrolled in this study. Most patients had mental retardation and the conservative treatments were carried out under general anesthesia. Thiopental and vecuronium were mostly used for induction agent and neuromuscular blocker, respectively. Enflurane, with oxygen and nitrous oxide, was mostly used to maintain the anesthesia. Mean total anesthetic time was $164.4{\pm}57.2$ minutes and mean duration at the post-anesthetic care unit was $106.2{\pm}50.5$ min. Serious postoperative complications were not observed. These results showed our successful anesthetic outcomes without any severe side effect or complication and the needs of more outpatient centers for dental care for disabled.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1987.05a
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• pp.15.2-16
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• 1987

사성이란 후두의 발생기능에 장애가 있을 때 생기는 후두질환의 가장 대표적인 주증상으로 인간 문화의 발달에 병행되어서 대화에 의한 전달수단이 중요시되고 또한 암에 대한 인식이 높아져 사성을 호소하는 환자들이 많아지는 경향이 있다. 이에 저자는 1980년 1월부터 1984년 12월까지 이화여자대학교 의과대학 부속병원 이비인후과 외래에 내원한 신외래환자 총 24,949명 중 사성을 주소로 한 800명의 환자에 대하여 병력지를 기준하여 각 질환을 통계적으로 분석 검토하여 다음과 같은 성적을 얻었다. 1) 이비인후과 외래환자 총 24,949명중 사성환자는 800명으로 약 3.2%이었다. 2) 외래사성환자 800명중 남자 336명, 여자 464명으로 남녀비는 약 1 : 1.4이었다. 3) 질환별로는 급성 후두염 248예(31.0%), 만성 후두염 186예(23.3%), 성대결절 160예(20.0%), 성대폴립 90예(11.3%), 성대마비 56예(7.0%), 후두 유두종 12예(1.5%), 후두암 9예(1.1%)이었다. 4) 연령별로는 30대가 213예(26.6%), 20대가 190예(23.8%), 40대가 179예(22.4%)의 순이었다. 5) 각 질환별 최다연령은 급성 후두염 30대 73예(29.4%), 만성 후두염 30대 53예(28.5%), 성대결절 30대 52예(32.5%), 성대폴립 40대 26예(28.9%), 성대마비 40대 14예(25.0%), 후두암 50대 6예(66.7%)이었다. 6) 발병부터 초진까지의 기간은 10일 이내가 153예(19.1%)로 제일 많았고 1개월∼3개월 138예(17.3%), 11일∼l개월 119예(14.9%)의 순이었다. 7) 각 질환에 따른 발병부터 초진까지의 기간의 최다분포는 급성 후두염은 10일 이내가 117예(47.2%), 만성 후두염은 3개월∼6개월이 44예(23.7%), 성대결절은 3개월∼6개월이 40예(25.0%), 성대폴립은 6개월∼1년이 20예(22.2%), 성대마비는 10일이내가 12예(21.4%)이었다. 8) 질환별 동반증상 분포는 사성만을 호소한 경우가 394예(41.4%)로 가장 많았고 동반증상으로는 인두통, 이물감, 객담, 기침, 연하장애, 호흡곤란의 순이었다. 9) 저자의 연도별 사성환자의 평균발생빈도(3.2%)를 문(1981)의 1975년 1월부터 1979년 12월(만 5년간)까지의 평균발생빈도(2.9%)와 비교할 때 증가하였다.

• Korean Journal of Psychosomatic Medicine
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• v.22 no.2
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• pp.93-103
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• 2014

Objectives : The aim of study was to examine the prevalence of night eating syndrome(NES) and its correlates in schizophrenic outpatients. Methods : The 14 items of self-reported night eating questionnaire(NEQ) was administered to 201 schizophrenic patients in psychiatric outpatient clinic. We examined demographic and clinical characteristics, body mass index(BMI), subjective measures of mood, sleep, binge eating, and weight-related quality of life using Beck's Depression Inventory(BDI), Pittsburgh Sleep Quality Index(PSQI), Binge Eating Scale(BES) and Korean version of Obesity-Related Quality of Life Scale(KOQoL), respectively. Results : The prevalence of night eaters in schizophrenic outpatients was 10.4%(21 of 201). Comparisons between NES group and non-NES group revealed no significant differences in sociodemographic characteristics, clinical status and BMI. Compared to non-NES, patients with NES reported significantly greater depressed mood and sleep disturbance, more binge eating pattern, and decreased weight-related quality of life. While 'morning anorexia' and 'delayed morning meal'(2 of 5 NES core components in NEQ) were not differed between groups, 'nocturnal ingestions', 'evening hyperphagia', and 'mood/sleep' were more impaired in NES group. Conclusions : These findings are the first to describe the prevalence and its correlates of night eaters in schizophrenic outpatients. These results suggest that NES has negative mental health implications, although it was not associated with obesity. Further study to generalize these results is required.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.2
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• pp.562-570
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• 2019

The purpose of this study was to identify the factors influencing the quality of sleep in breast cancer patients receiving chemotherapy in the outpatient settings. The data were collected from 203 patients with breast cancer receiving chemotherapy in the outpatient settings at one tertiary hospital in B City. Stress, fatigue and depression were negatively correlated with quality of sleep (r=-.369, p=.001; r=-.565, p=.001; r=-.526, p=.001, respectively). Fatigue(${\beta}=-.387$, p<.001) was one of the biggest impact factors on quality of sleep which explained 31.6% of the variance of the sleep quality, followed by the experience of sleep disturbances prior to the diagnosis of breast cancer(${\beta}=-.178$, p<.002) and depression(${\beta}=-.231$, p<.004). In total, all of the antecedent variables explained significantly 37.4% of the variance of the sleep quality. Thus, in order to improve the quality of sleep, integrative nursing interventions need to be developed to reduce fatigue and depression among them, including an proactive system to screen out the patients with the experience of sleep disturbances prior to the diagnosis with breast cancer and to provide adequate pharmacological and/or non-pharmacological sleep interventions prior to the chemotherapy.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.7
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• pp.357-366
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• 2016

This study evaluated the standardization of the outpatient management process in several regions of South Korea. The hospital workers in the administration department of the different medical institutions that are registered with the Korean Hospital Association were surveyed. These institutions can be standard hospitals or hospitals greater in size. A summary of the research results are as follows. There was no significant correlation in their registration procedures in relation to the institution's founder, number of sickbeds, number of staff employed in the administration department, and average number of outpatients per day. On the other hand, the prepayment of medical fees occurred more frequently when the number of sickbeds was larger. In addition, there was no large difference in their appointment procedures in relation to those features. Nevertheless, the prepayment of medical fees accounted for 11.8 % of the entire payment in institutions with less than five hundred beds, while fifty percent of the payment was made in advance in larger institutions with five hundred or more beds. From this research, there was only a small difference among the institutions' outpatient management, but a notable difference was observed in their electronic data processing systems and facilities. Therefore, more financial support should be generated for the implementation of a more integrated process. As a follow-up study, to provide patients with quality medical services, it will be necessary to apply the standardized procedure to an actual medical institution and analyze the expected effect.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.497-501
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• 2009

Background: Prolonged air leakage and pleural fluid drainage from a chest tube may delay removing the chest tube after a patient undergoes video-assisted thoracoscopic wedge resection and the patient is otherwise ready for discharge. We reviewed 37 outpatients patients who were being managed with a postoperative chest tube (a Panda Pneumothorax set with a Heimlich valve). Material and Method: From January 2005 to December 2007, 294 patients underwent video-assisted thoracoscopic wedge resections & pleurodesis. Of them, 37 patients met the criteria for outpatient chest drainage management with using a Panda Pneumothorax set with a Heimlich valve. The patients received written instructions, and they demonstrated competence with using the Panda system. The patients returned for chest tube removal after satisfactory resolution of their air leak and pleural fluid drainage. Result: The patients discharged with a Panda pneumothorax set had a longer duration of hospital stay (mean: 10.3$\pm$1.7 days, range: 11 to 17 days) as compared with the patients without a Panda pneumothorax set (mean: 6.2$\pm$1.5 days, range: 4 to 7 days). The chest tube was removed successfully from the patients with a Panda pneumothorax set at an average of 9.8$\pm$1.6 days (range: 9$\sim$18 days) after discharge. There were no major complications. Four patients experienced minor complications. Thirty six patients (97.3%) experienced uneventful and successful outpatient chest tube management. Conclusion: Successful postoperative outpatient chest tube management with using the Panda set was accomplished in 36 selected patients. This program resulted in a substantially reduced hospital cost and enhanced patient satisfaction by allowing earlier discharge.

• Journal of Oral Medicine and Pain
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• v.20 no.2
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• pp.421-427
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• 1995

두개하악장애는 저작근, 측두하악관절 및 그와 관련된 구조물의 많은 임상적인 문제를 포함하는 포괄적인 용어이다. 두개하악장애의 원인은 다양하고 종종 다인성이며 위험을 증가시키는 여러가지 소인들이 존재한다. 이갈이나 이악물기 같은 이상기능습관은 흔하며 또한 임상적으로 많은 관련이 있는 것으로 사료된다. 그러나 이전의 연구에서는 연령증가에 따른 기능적 마모를 고려한 치아교모에 관한 연구가 시행되지 않고 단순한 교모도의 평가비교만이 시행되었다. 본 연구는 법치의학적 연령감정에서 널리 사용되고 있느 치아교모도를 이용한 연령감정법을 이용하여 두개하악장애환자의 치아교모도에 관한 연구를 시행하였다. 연령은 기능적마모에 따른 정도를 평가하기 위해서 고려되었다. 단국대학교 치과병원 구강내과에서 두개하악장애로 진단된 환자18명과 대조군으로 외래환자 14명을 대상으로 하였다. 연령차는 연령감정법의 추정연령과 환자의 실제나이의 차이를 구해서 비교분석하였다. 이상의 결과로 두개하악장애환자의 중절치, 측절치, 제1소구치, 제2소구치의 치아교모도가 정상군보다 유의성 있게 높았다.