• Title/Summary/Keyword: ACSC

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Hospital Admission Rates for Ambulatory Care Sensitive Conditions in South Korea: Could It Be Used as an Indicator for Measuring Efficiency of Healthcare Utilization? (한국의 의료기관 외래진료 민감질환 입원율: 의료이용 효율성 지표로의 활용 가능성?)

  • Jeong, Keon-Jak;Kim, Jinkyung;Kang, Hye-Young;Shin, Euichul
    • Health Policy and Management
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    • v.26 no.1
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    • pp.4-11
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    • 2016
  • Background: Hospital admissions for ambulatory care sensitive conditions (ACSCs), which are widely used as an indicator of poor access to primary care, can be used as an efficiency indicator of healthcare use in countries providing good access to health care. Korea, which has a national health insurance (NHI) system and a good supply of health care resources, is one such country. To quantify admission rates of ACSC and identify characteristics influencing variation in Korean health care institutions. Methods: By using NHI claims data, we computed the mean ACSC admission rate for all institutions with ACSC admissions. Results: The average ACSC admission rate for 4,461 institutions was 1.45%. Hospitals and clinics with inpatient beds showed larger variations in the ACSC admission rate (0%-87.9% and 0%-99.6%, respectively) and a higher coefficient of variation (7.96 and 2.29) than general/tertiary care hospitals (0%-19.1%, 0.85). The regression analysis results indicate that the ACSC admission rate was significantly higher for hospitals than for clinics (${\beta}=0.986$, p<0.05), and for private corporate institutions than public institutions (${\beta}=0.271$, p<0.05). Conclusion: Substantial variations in ACSC admission rates could suggest the potential problem of inefficient use of healthcare resources. Since hospitals and private corporate institutions tend to increase ACSC admission rates, future health policy should focus on these types of institutions.

The Empirical Ambulatory Care Sensitive Conditions Study & its Potential Health Insurance Applicability in Korea (한국형 ACSC에 대한 실증분석 및 건강보험 적용 가능성에 관한 연구)

  • Kim, Yang Yun;Sung, Joo Ho
    • Health Policy and Management
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    • v.15 no.3
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    • pp.79-93
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    • 2005
  • The purpose of the study is to identify Ambulatory Care Sensitive Conditions (ACSC) and their potential health insurance applicability in Korea, using the correlation and regression analysis with the empirical data provided by Korean Health Insurance Review Agency(KHIRA). Here, ACSC would be thought of as conditions that when timely and effectively treated in the outpatient medical services can help reduce the risk of hospitalizations. As for ACSC, reducing accessibility for outpatient visit results in increasing hospitalization. In this respect, the ACSC concept is popularly adopted as one of the performance indicators of the national health system. As one of main results, fortifying the accessibility to necessary health care in a way of sharing appropriately the role with private health insurance can lead to the efficiency of national health care delivery systems in view of total health care expense, in particular in a case of ACSC children. Lastly, we would like to strongly suggest that the disease treatment data set reported to KHIRA needs to be opened to private insurance companies only for illness experience investigation.

Current Status of Repeated Hospitalization in South Korea: Focused on Ambulatory Care Sensitive Conditions (국내 반복입원의 현황과 환자 특성: 외래진료 민감질환을 중심으로)

  • Jung, Hyemin;Kim, Hyun Joo;Lee, Jin Yong
    • Quality Improvement in Health Care
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    • v.27 no.2
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    • pp.45-56
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    • 2021
  • Purpose: Repeated hospitalization could be a proxy of unnecessary or preventive admission in South Korea where barriers to hospitalization are relatively low. This study aimed to estimate the current status of repeated hospitalization due to ambulatory care sensitive conditions (ACSC) in South Korea. Methods: Using the National Health Information Database, repeated hospitalization databases were constructed in units of episodes for patients who had been admitted more than twice between January 2017 and December 2018. The number of hospitalizations, total in-hospital days, and total medical expenditure were calculated and compared by patient characteristics in both of the entire patient group and the ACSC patient group. Results: Of total hospitalization episodes, 26.6% reported repeated admission, and 6.7% of repeated hospitalization was due to ACSC. A total of 183,110 patients with ACSC had been admitted an average of 2.9 times and spent an average of KRW5,630,118. In other words, KRW1,309 billion had been spent for repeated hospitalization due to ACSC. The scale of medical expenditure was relatively large in the highest and lowest socioeconomic status. Conclusion: Repeated hospitalization for ACSC can be considered a simple and intuitive indicator when assessing unnecessary hospitalizations or evaluating healthcare policy.

The Evaluation of Image Correction Methods for SPECT/CT in Various Radioisotopes with Different Energy Levels (SPECT/CT에서 서로 다른 에너지의 방사성동위원소 사용시 영상보정기법의 유용성 평가)

  • Shin, Byung Ho;Kim, Seung Jeong;Yun, Seok Hwan;Kim, Tae Yeop;Lim, Jung Jin;Woo, Jae Ryong;Oh, So Won;Kim, Yu Kyeong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.53-58
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    • 2013
  • Purpose: To optimize correction method for SPECT/CT, image quality consisting of resolution and contrast was evaluated using three radioisotopes ($^{99m}Tc$, $^{201}Tl$ and $^{131}I$) and three different correction methods; attenuation correction (AC), scatter correction (SC) and both attenuation and scatter correction (ACSC). Materials and Methods: Images were acquired with a SPECT/CT scanner and a conventional CT protocol with an OESM reconstruction algorithm (2 iterations and 10 subsets). For resolution measurement, fixed radioactivity (2.22 kBq) was infused into a spatial resolution phantom and full width at half maximum (FWHM) was measured using a vendor-provided software. For contrast evaluation, radioactive source with a ratio of 1:8 to background was filled in a Flanged Jaszczak phantom and percent contrast (%) were calculated. All the parameters for image quality were compared with non-correction (NC) method. Results: As compared with NC, image resolution of all three isotopes were significantly improved by AC and ACSC, not by SC. In particular, ACSC showed better resolution than AC alone for $^{99m}Tc$ and $^{201}Tl$. Image contrast of all three radioisotopes in a sphere with the largest diameter were enhanced by all correction methods. ACSC showed the highest contrast in all three radioisotopes, which was the most accurate in $^{99m}Tc$ (85.9%). Conclusion: Image quality of SPECT/CT was improved in all the radioisotopes by CT-based attenuation correction methods, except SC alone. SC failed to improve resolution in any radioisotopes, but it was effective in contrast enhancement. ACSC would be the best correction method as it improved resolution in radioisotopes with low energy levels and contrast in radioisotope with low energy levels. However, in radioisotope with high energy level, AC would be better than ACSC for resolution improvement.

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Aspect-Based Sentiment Analysis Using BERT: Developing Aspect Category Sentiment Classification Models (BERT를 활용한 속성기반 감성분석: 속성카테고리 감성분류 모델 개발)

  • Park, Hyun-jung;Shin, Kyung-shik
    • Journal of Intelligence and Information Systems
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    • v.26 no.4
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    • pp.1-25
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    • 2020
  • Sentiment Analysis (SA) is a Natural Language Processing (NLP) task that analyzes the sentiments consumers or the public feel about an arbitrary object from written texts. Furthermore, Aspect-Based Sentiment Analysis (ABSA) is a fine-grained analysis of the sentiments towards each aspect of an object. Since having a more practical value in terms of business, ABSA is drawing attention from both academic and industrial organizations. When there is a review that says "The restaurant is expensive but the food is really fantastic", for example, the general SA evaluates the overall sentiment towards the 'restaurant' as 'positive', while ABSA identifies the restaurant's aspect 'price' as 'negative' and 'food' aspect as 'positive'. Thus, ABSA enables a more specific and effective marketing strategy. In order to perform ABSA, it is necessary to identify what are the aspect terms or aspect categories included in the text, and judge the sentiments towards them. Accordingly, there exist four main areas in ABSA; aspect term extraction, aspect category detection, Aspect Term Sentiment Classification (ATSC), and Aspect Category Sentiment Classification (ACSC). It is usually conducted by extracting aspect terms and then performing ATSC to analyze sentiments for the given aspect terms, or by extracting aspect categories and then performing ACSC to analyze sentiments for the given aspect category. Here, an aspect category is expressed in one or more aspect terms, or indirectly inferred by other words. In the preceding example sentence, 'price' and 'food' are both aspect categories, and the aspect category 'food' is expressed by the aspect term 'food' included in the review. If the review sentence includes 'pasta', 'steak', or 'grilled chicken special', these can all be aspect terms for the aspect category 'food'. As such, an aspect category referred to by one or more specific aspect terms is called an explicit aspect. On the other hand, the aspect category like 'price', which does not have any specific aspect terms but can be indirectly guessed with an emotional word 'expensive,' is called an implicit aspect. So far, the 'aspect category' has been used to avoid confusion about 'aspect term'. From now on, we will consider 'aspect category' and 'aspect' as the same concept and use the word 'aspect' more for convenience. And one thing to note is that ATSC analyzes the sentiment towards given aspect terms, so it deals only with explicit aspects, and ACSC treats not only explicit aspects but also implicit aspects. This study seeks to find answers to the following issues ignored in the previous studies when applying the BERT pre-trained language model to ACSC and derives superior ACSC models. First, is it more effective to reflect the output vector of tokens for aspect categories than to use only the final output vector of [CLS] token as a classification vector? Second, is there any performance difference between QA (Question Answering) and NLI (Natural Language Inference) types in the sentence-pair configuration of input data? Third, is there any performance difference according to the order of sentence including aspect category in the QA or NLI type sentence-pair configuration of input data? To achieve these research objectives, we implemented 12 ACSC models and conducted experiments on 4 English benchmark datasets. As a result, ACSC models that provide performance beyond the existing studies without expanding the training dataset were derived. In addition, it was found that it is more effective to reflect the output vector of the aspect category token than to use only the output vector for the [CLS] token as a classification vector. It was also found that QA type input generally provides better performance than NLI, and the order of the sentence with the aspect category in QA type is irrelevant with performance. There may be some differences depending on the characteristics of the dataset, but when using NLI type sentence-pair input, placing the sentence containing the aspect category second seems to provide better performance. The new methodology for designing the ACSC model used in this study could be similarly applied to other studies such as ATSC.

Analysis of the Characteristics of Ambulatory Care Sensitive Conditions in Patients Visiting the Emergency Departments: Focused on Health-care Delivery System (외래의료 민감 질환으로 응급실을 내원한 환자의 특성 분석: 의료전달체계 중심으로)

  • Huh, Young-Jin;Kim, Ji-Yeon;Lee, Myoung-Hwa;Lee, Sung-Min;Oh, Mi-Ra
    • Journal of Convergence for Information Technology
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    • v.10 no.10
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    • pp.253-258
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    • 2020
  • This study analyzed, the characteristics of ambulatory care sensitive conditions(ACSCs) in patients visiting emergency departments(EDs) and compared characteristics according to two age groups (adults aged 19-64 years and, elderly people aged ≥65 years). By accessing data from the National Emergency Department Information System(NEDIS) from January 1 to December 31, 2018, we examined the proportions of different ED types and ACSCs, length of stay(LOS) in the ED, LOS hospital, and hospital admission rates. Regarding the types of EDs, we found that the proportion of local emergency medical centers was high(P<0.001). Regarding the rates of different ACSCs, 31.7% of adults were treated for gastroenteritis, a high proportion of the elderly people(48.2%) were diagnosed with and treated for pneumonia(P<0.001). The LOS in the ED was longer in elderly people for all diseases categories, except for congestive heart failure and diabetes(P<0.001). The LOS in the hospital was also significantly longer in elderly people for all ACSCs(P<0.05), and the admission rate was significantly higher in elderly people for all diseases, except for diabetes(P<0.01). Thus, analyzing the ED visits made by patients with ACSCs will need to strengthen the health-care policy to induce treatment centered on outpatient.

The Effect of Residential Migration on the Utilization and Accessibility of Medical Care (거주지역 이동이 의료이용량과 의료접근성에 미치는 영향)

  • Lee, Woo Ri;Choi, Yong Seok;Lee, Gyeong Min;Kim, Li Hyen;Yoo, Ki-Bong
    • Health Policy and Management
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    • v.31 no.1
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    • pp.125-139
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    • 2021
  • Background: In Korea, the health gap widens due to the number of medical resources and access to medical services between metropolitan and rural. The purpose of this study is to identify the impact of residential migration on medical utilization and accessibility. Methods: This study extracted 528,516 claimed cases in the National Health Insurance Service-Cohort Sample Database from 2006 to 2015. Subjects were classified into two groups by the magnitude of the region, the metropolitan and the rural. The inversed probability weights were calculated for each group. And coefficients of the two-part model were estimated by generalized estimation equation. Results: Those who moved region from metropolitan to rural tend to increase the length of stay and inpatients with ambulatory care sensitive conditions (ACSC) disease. Contrariwise, those who moved areas from rural to metropolitan tend to decrease the total medical cost, the adjusted patient days, the number of outpatients and the number of outpatients and inpatients with ACSC disease. Conclusion: This study identified that between the residents who continued to reside in the region and the migrants, there were significant differences in the medical accessibility, quality of primary care, and unmet medical need.

Study on the characteristics of magnetic field distribution in AC superconducting generator using normalized data

  • Jo, Young-Sik;Ahn, Ho-Jin;Hong, Jung-Pyo;Lee, Ju;Kwon, Young-Kil;Ryu, Kang-Sik
    • 한국초전도학회:학술대회논문집
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    • v.10
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    • pp.216-220
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    • 2000
  • AC Superconducting Generators (ACSG) are featured by 3D magnetic flux distribution, which decreases in the direction of axis. For this reason, when ACSG is optimal designed, 3D magnetic field analysis is required. This paper proposes 2D Finite Element Analysis (FEA) results normalized by 3D FEA according to the position of armature coil and the ratio of field coil width to axial length in order to reduce the analysis time. By using the proposed data, the reasonable 3D FEA results of ACSG can be only predicted by 2D FEA results. The validity of the 3D FEA results is verified by comparison with the experimental results of 30kVA superconducting synchronous generator.

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The Impact of Medicaid Expansion to include population with low income on the preventable hospitalizations (의료급여 수급권자 확대정책이 예방가능한 입원율에 미친 영향)

  • Shin, Hyun-Chul;Kim, Se-Ra
    • Health Policy and Management
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    • v.20 no.1
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    • pp.87-102
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    • 2010
  • The objective of this study were to examine the impact of medicaid coverage expansion policy aimed at improving access to primary care. The case-control study was conducted to compare preventable hospitalization(PH) rate in new medicaid recipients versus national health insurance(NHI) enrollees form 1996 to 2001. Rates of preventable hospitalization associated with ambulatory care sensitive conditions(ACSC) were calculated and standardized by age and sex. Multinomial logit regression model was used to control the confounding factors such as age, gender and charlson comorbidity index Annual PH rates in the new medicaid increased 1.64 times after medicaid expansion, with controling confounding factors. Meanwhile, annual PH rate in the NHI increased 1.68 times during the same period, with adjusting confounding factors. Current findings suggest that the new medicaid PH rate was less likely to rise than NHI PH rate after implementing medicaid expansion. This study is expected to provide policy-relevant evidence of medicaid expansion to include population with low income.

Empirical Analysis of Medical Accessibility for People with Disabilities using Health Insurance Big Data (건강보험빅데이터의 고혈압 입원율 분석을 통한 장애인의 의료접근성 실증 분석)

  • Jeon, HuiWon;Hong, MinJung;Jeong, JaeYeon;Kim, YeSoon;Lee, ChangWoo;Lee, HaeJong;Shin, EulChul
    • Korea Journal of Hospital Management
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    • v.27 no.1
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    • pp.1-10
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    • 2022
  • Background: This study aims to empirically compare and evaluate the current status of medical accessibility and health inequality between people with disabilities and without. We calculated the ACSC hospitalization rate, which is a medical accessibility index, for hypertension, a major risk factor for cardiovascular disease that accounts for more than 20% of deaths among people with disabilities using the 2016 National Health Insurance Big Data. Methods: The subjects of the study were a total of 601,520, including 64,018 people with disabilities and 537,501 people without. Logistic regression was performed to analyze the differences in hypertension hospitalization rates adjusted for demographic and sociological characteristics and disease characteristics using SAS 9.4 program. Results: Before adjusting for the characteristics, the hypertension hospitalization rate of people with disabilities was 1.55%, and the people without disabilities were 0.49%. After adjusting, it was found that people with disabilities were 2.11 times higher than people without disabilities, and it was statistically significant. Conclusion: The preventable hospitalization rate of people with disabilities is higher than that of people without, suggesting that the disabled have problems with access to medical care and health inequality. Therefore, the government's policy improvement is required to close the medical gap for the disabled.