• 한국병원경영학회지
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• 제24권3호
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• pp.1-10
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• 2019

Purpose: The purpose of this study was to investigate determinants of purchasing indemnity private health insurance and its impact on the healthcare utilization among outpatients with chronic disease. Methods: The study analyzed 4,997 chronic ill patients using 2015 Korean Health Panel data. Logistic regression analysis was conducted to analyze the factors affecting the purchase of indemnity private health insurance and multiple regression analysis was conducted to analyze the effect of private health insurance on the number of outpatient visits and outpatient expenditures. Findings: The age, education level, and number of chronic diseases were significant factors affecting the purchasing of indemnity private health insurance among chronic patients. As a result of analyzing the impact of indemnity private health insurance on healthcare utilization, the number of outpatient visits for those who enrolled in the indemnity private health insurance was higher than the number of outpatient visits for those who did not. But there was no statistically significant difference in outpatient medical expenses. Practical Implications: The results of this study shows that indemnity private health insurance may cause inequality in the healthcare utilization of the socially vulnerable. It is necessary to seek ways to strengthen the health security of chronic disease patients and high-risk elderly people who need more healthcare.

• Nutrition Research and Practice
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• 제13권3호
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• pp.256-262
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• 2019

BACKGROUND/OBJECTIVES: The objectives of this study were to evaluate the accuracy of the Dietary Reference Intakes (DRI) for estimating the energy requirements of older adults, and to develop and validate new equations for predicting the energy requirements of this population group. MATERIALS/METHODS: The study subjects were 25 men and 23 women with a mean age of $72.2{\pm}3.9\;years$ and $70.0{\pm}3.3\;years$, and mean BMI of $24.0{\pm}2.1$ and $23.9{\pm}2.7$, respectively. The total energy expenditure (TEE) was measured by using the doubly labeled water (DLW) method, and used to validate the DRI predictive equations for estimated energy requirements (EER) and to develop new EER predictive equations. These developed equations were cross-validated by using the leave-one-out technique. RESULTS: In men, the DRI equation had a -7.2% bias and accurately predicted the EER (meaning EER values within ${\pm}10%$ of the measured TEE) for 64% of the subjects, whereas our developed equation had a bias of -0.1% and an accuracy rate of 84%. In women, the bias was -6.6% for the DRI equation and 0.2% for our developed equation, and the accuracy rate was 74% and 83%, respectively. The predicted EER was strongly correlated with the measured TEE, for both the DRI equations and our developed equations (Pearson's r = 0.915 and 0.908, respectively). CONCLUSIONS: The DRI equations provided an acceptable prediction of EER in older adults and these study results therefore support the use of these equations in this population group. Our developed equations had a better predictive accuracy than the DRI equations, but more studies need to be performed to assess the performance of these new equations when applied to an independent sample of older adults.

• 대한간호학회지
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• 제49권2호
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• pp.203-214
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• 2019

Purpose: The purpose of this study to develop a fringed fall prevention program based on King's goal attainment theory and education. This study is applied to the personal, interpersonal, and social systems of fall high-risk patients to test its effects. Methods: This study was a nonequivalent control group pre- and post-test design. There were 52 fall high-risk patients in the experimental group and 45 in the control group. The experimental group received six sessions, with the group sessions lasting 60 minutes and the individual sessions lasting 20~30 minutes. Data were analyzed using descriptive statistics, an ${\chi}^2-test$, a paired sample t-test, and a Wilcoxon signed-ranks test utilizing IBM SPSS software. Results: For the 3-month intervention period, the fall prevention program was found to be particularly effective for patients in the experimental group (from 3.38 to 1.69 per 1000 patient days; p=.044), as opposed to the control group (from 1.94 to 1.49 per 1000 patient days; p=.300). For the 6-month follow up period, the fall prevention program was again found to be effective for patients in the experimental group (from 3.26 to 0.76 per 1000 patient days; p=.049) compared to the control group (from 1.98 to 1.01 per 1000 patient days; p=.368). Conclusion: These results indicate that the fringed fall prevention program is very effective in reducing falls, not only during the intervention period, but also after the intervention period has ended. We can therefore recommend this program for use concerning fall high-risk patients in long-term care hospitals.

• 한국치위생학회지
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• 제21권4호
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• pp.413-425
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• 2021

Objectives: This study aimed to provide basic data to lay the groundwork for the introduction of an advanced dental hygienist system by sampling dental hygienists' views about the system. Methods: A nationwide questionnaire survey was conducted targeting 857 dental hygienists working at dental hospitals and clinics, local health institutions, and educational institutions. The collected data were analyzed using frequency analysis, t-test, one-way analysis of variance (ANOVA) (Duncan as post-analysis), and crossover analysis. Results: The average interest level in the advanced dental hygienist system was 3.83±0.95 points. The necessity by field was confirmed to be the highest during dental hygiene for the elderly and persons with disabilities. The working experience necessary for becoming a specialized dental hygienist is 5.56±2.99 (years). The education period necessary for becoming a specialized dental hygienist is 77.30±77.61 (hours). The work authority level for an advanced dental hygienist was indicated to be 50 respondents (5.8%), who said they required direct guidance from a dentist, 313 respondents (48.2%) who said they needed indirect guidance from a dentist, 200 respondents (23.3%) who said OK when given an advanced dental hygienist's separate judgment, 194 respondents (22.6%), who said that the authority must be varied depending on the work. Conclusions: The interest and need of the advanced dental hygienist system were proven to be high and are expected to be applied to basic data for the introduction and settlement of the system.

• 한국치위생학회지
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• 제20권6호
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• pp.865-874
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• 2020

Objectives: This study aimed to analyze the current status and educational contents of the geriatric-related curriculum in dental hygiene departments at colleges across the country. Methods: To analyze the current status of geriatric curriculum, it was investigated by searching the websites of colleges across the country where dental hygiene (curriculum) department was available. Furthermore, a literature review of domestic and foreign textbooks related to geriatric dental hygiene was conducted to analyze the contents of geriatric dental hygiene curriculum. Results: Among colleges that offer dental hygiene (curriculum) department, 8 four-year and 12 three-year colleges (24.4%) offered geriatric dental hygiene courses. A comparison of the contents of the textbooks titled "Geriatric dental hygiene" published by Goonja, Daehan Narae, and Komoonsa showed that basic contents such as the characteristics, health problems, and oral health problems of elderly -people were described in the same context. However, there was a difference in the volume and importance of the concerned contents also. Conclusions: Universities and related organizations which offer dental hygiene curriculum should continue to conduct studies for the development of geriatric hygiene curricula. Moreover, heightened efforts are needed to ensure that geriatric dental hygiene education is more systematically offered.

• 대한통합의학회지
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• 제9권1호
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• pp.91-100
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• 2021

Purpose : This study aims to investigate the awareness of occupational therapists among managers and directors of adult day care centers in Korea to explore the cause of the low employment rate of these therapists and offer the results as basic data that can be used to expand occupational therapy at adult day care centers. Methods : This study collected data by conducting an online questionnaire with managers and directors of adult day care centers located in Seoul, Busan, Incheon, Daejeon, Gwangju, and Ulsan. A total of 70 completed questionnaires were divided into two groups a 'group with experience in occupational therapy information (OT experience)' and a 'group with no experience in occupational therapy information (OT inexperience)' and analyzed. Results : First, the 'OT experience' was found to have higher levels of awareness of the scope of work of occupational therapists than the 'OT inexperience'. Second, significant differences were found in the degree of awareness and necessity of occupational therapists and plans to employ occupational therapists later between the 'OT experience' and the 'OT inexperience'. Third, it was shown that there were significant correlations between whether the respondents were familiar with occupational therapy and the degree of awareness and necessity of occupational therapists and plans to employ occupational therapists later. Conclusion : Based on these findings, the following measures are recommended to expand the area of occupational therapy in adult day care centers, the need for occupational therapists should be mentioned in the health and welfare-related education for workers at these adult day care centers, policies such as a medical fee system for occupational therapy at these adult day care centers should be prepared.

• 대한통합의학회지
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• 제8권4호
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• pp.79-92
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• 2020

Purpose : The purpose of this study was to evaluate the prescription pattern of NSAIDs and GPAs in the arthritis patients over 65 years old to prevent the GI adverse events. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used agents to treat arthritis, can cause gastrointestinal (GI) adverse effects. Recent guidelines recommend that moderate risk patients who have one or two risk factors, should be prescribed either combination of non-selective NSAID (nsNSAIDs) and gastroprotective agent (GPAs) or selective NSAID alone. Methods : Study population was National Patient Sample of 2011. Number of drugs used were 138 for NSAIDs and 21 for GPAs. Chi-square test was used to compare prescribing patterns. Results : The appropriate prescription rate follows the guideline was 11.2%: co-prescription with nsNSAID and proton pump inhibitor (PPI) or misoprostol was 1.6% and selective NSAID alone was 9.6%. Inappropriate prescription rates were as follows: co-prescription with nsNSAID and Histamine-2 receptor antagonist (H2RA) or antiacid was 53.8% and nsNSAID alone was 35.0%. The appropriate prescription rate among the types of medical institute was 54.4% in tertiary hospital, 31.2% in secondary hospital, and 6.0% in primary hospital. The appropriate prescription rate among the regions was 19.4%, highest in Seoul and 4.2%, lowest in Jeju. The appropriate prescription rate among the medical departments was as follow: 12.2% in orthopaedic surgery, 11.0% in internal medicine, and 7.7% in other departments. Conclusion : This finding suggests the needs to revise the national medical insurance imbursement policy, provide continuing medical education about the guideline of medical doctors.

• 치위생과학회지
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• 제21권4호
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• pp.275-281
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• 2021

Background: The aim of this study was to understand the importance of professional oral care for inpatients by examining the type and frequency of surgery and hospital discharge period at dental hospitals, and identify the types of professional oral care actually in progress. Methods: In this study, the type of surgery and length of hospitalization were investigated among patients admitted to the dental hospital for oral and maxillofacial surgery, and the professional oral care status of inpatients who had difficulty self-managing their oral care was retrospectively identified by collecting data on oral care before and after surgery, including the type and frequency. Results: The majority of inpatients at dental hospitals were male (57.6%), elderly patients over 60 years accounted for 20% of patients, and the average length of hospitalization was 4 days. In the 20s (aged 20~29 y), the number of orthognathic surgery patients (73.1%) was high, and the incidence of cysts was high in middle-aged patients. Regarding the oral care of hospitalized patients, scaling was performed once by a dentist before surgery. After surgery, surgical dressings using H₂O₂ balls were applied and oral care education was introduced before discharge. Conclusion: Based on the results of this study, professional oral care is essential to prevent infection and complications caused by oral bacteria among inpatients at dental hospitals. It is necessary to use various oral hygiene aids for inpatients and to conduct effective oral care instruction according to each patient's situation. In addition, it is necessary to raise awareness and the role of dental hygienists in professional oral care.

• 임상간호연구
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• 제28권1호
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• pp.13-22
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• 2022

Purpose: Extravasation of diagnostic and therapeutic materials might occur when the intravascular solution leaks into the surrounding tissues. Injury associated with extravasation depends on various factors. It may range from mild skin reaction to severe necrosis. However, the incidence rate for extravasation is largely unknown because of the limited reporting in Korea. Therefore, this study was conducted to identify the incidence of extravasation and nurses' attitude and knowledge of extravasation for providing high-quality nursing care. Methods: Three acute care hospitals were surveyed to estimate the occurrence of extravasation. Knowledge and attitude toward extravasation were investigated from 793 nurses working in six hospitals. Results: The incidence rate of extravasation was 0.5%. Extravasation commonly occurred in elderly patients aged 66 or older (59.9%) and internal medicine (48.2%), and it happened 13.73±20.68 days after hospitalization on average. It mostly occurred in the forearm site (52.9%) and was mainly caused by parenteral nutrition (33.6%). The mean scores of nurses' knowledge and attitude were 14.63±2.86 and 28.91±36.00, respectively. There was a significant negative correlation between the subjects' knowledge and attitude (r=-.11, p=.002). Conclusion: It is necessary to have a reporting system that can accurately monitor the occurrence of extravasation for patient safety management. In addition, it is necessary to develop a protocol that can be applied to clinical practice and a nurse education program.

• 대한예방한의학회지
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• 제27권2호
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• pp.49-59
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• 2023

Objectives : This study aimed to identify the factors that affect the utilization of Korean Medicine within the past year. Methods : I analyzed micro-data from the Korean Medicine Utilization Survey (2020), which surveyed the general public. "User (in last 1 year)" were defined as those who had used Korean Medicine within the past year, while "Non-user (in last 1 year)" were defined as those who had used it in their lifetime but not within the past year. I examined several factors, including general characteristics, perceptions of Korean Medicine, satisfaction with Korean Medicine, and intention for future utilization. I conducted the Rao-Scott chi-squared test and complex sample logistic regression analysis. Results : I analyzed a total of 3,762 respondents, of which 1,442 (36.3%) were User (in last 1 year) and 2,320 (63.7%) were Non-user (in last 1 year). User (in last 1 year) and Non-user (in last 1 year) differed significantly in terms of demographic characteristics, perceptions, and satisfaction with Korean Medicine. Women, the elderly, those with low education levels, non-married individuals, those with low-income, chronic diseases, and poor subjective health conditions were significant factors. Those who used Korean Medicine within the past year were more knowledgeable about Korean Medicine than those who had not used it recently, and recognized herbal medicine as safer. In terms of satisfaction, User (in last 1 year) were more satisfied than Non-user (in last 1 year). The more women, the older, the more aware of Korean Medicine, the safer they perceived herbal medicine, the more satisfied they were with its use, the better their subjective health condition, and the absence of chronic diseases, the less they experienced Korean Medicine. Conclusions : The study showed that positive experiences and perceptions of Korean Medicine increase the likelihood of its utilization. Individuals with better subjective health conditions and without chronic diseases have a lower possibility of using Korean Medicine.