• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.7
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• pp.3390-3399
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• 2013

The purpose of this study was to examine the incidence rates of pressure ulcers depending on the types of healthcare organizations and to determine whether the characteristics of patients and facilities influence on the incidence of pressure ulcers in long term facilities. We analyzed data on 796,857 patients of the 2009 National Patient Sample which was extracted from to claims for medical fees to Health Insurance Review & Assesment Service(HIRA). A total of 3.2% of patients(n=25,339) had at least 1 pressure ulcer during their hospitalization. The pressure ulcer rates were highest in long term care facilities(8.2%, n=11,895) following general hospital(2.7%, n=8,052), hospital(1.7%, n= 5,059). According to logistic regression analysis, urinary incontinence (Odds ratio(OR)=2.462, 95% confidence interval(CI)=2.038-2.974), hypertension(OR=1.456, CI=1.400-1.515), peripheral vessel diseases (OR=1.357, CI=1.200-1.534) were significant predictors of pressure ulcers. As the number of diagnoses, age, and the number of doctors per 100 beds increased, the incidence of pressure ulcers increased. In addition, more number of beds was associated with fewer pressure ulcers.

• Journal of Global Scholars of Marketing Science
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• v.12
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• pp.99-119
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• 2003

A model is proposed for the role of emotional intensity of a web site, and the moderating influence of product involvement, in the Integrative Framework of persuasion (Meyers-Levy and Malvaiya 1999). The model also appropriately operationalizes the constructs emotional intensity of a web site and product involvement The three routes to persuasion, Central, Peripheral, and Experiential correspond to high, moderate, and low involvement (Meyers-Levy and Malaviya 1999). The involvement construct is measured from message recipients using the Personal Product Inventory (Pill, which was developed to capture the concept of product involvement (Zaichkowsky 1985). The conceptualization of the Personal Product Inventory is a contextrree measure that also has robust psychometric properties when applied to advertisements (Zaichkowsky 1994). The propositions highlight the expected importance of emotional intensity of a web site. The moderating influence of product involvement is also proposed. Specifically, what this work proposes is that the emotional intensity of a product site has a larger impact on attitude change under low product involvement, as opposed to moderate product involvement. Support for this reasoning can be found in the persuasion literature (Petty et al 1986). The Petty et al (1986) frame work is a dual process descriptive and predictive frame work in the area of altitude formation and change. Recently, Myers Levy and Malaviya (1999) have proposed a tri-process framework. This is in tum based on the dual process model of Petty et al. (1986). The study outlined in this paper aims to deepen the Meyers Levy and Malaviya (1999) and frame work. The propositions outlined in the model are empirically tested using a repeated measures experimental design. The emotional intensity is measured using a scale that is based on experts judgments. Using a paired comparison t-test two sites are determined to be of high and low emotional intensity. The model is tested using a repeated measures experimental design. The first independent variable Emotional Intensity of the site is manipulated. The Second independent variable, Personal Product Inventory is measured. While, the dependent variable, product altitude change will also be measured. Utilizing Analysis of Variance (ANOVA) the data is analyzed using SPSS. The results suggest that besides the rational content of messages their emotional content can also influence attitude change. Specifically, it is proposed that the manipulation of emotional intensity of a product Web site has a greater impact on product altitudes under high and low product involvement conditions, rather than moderate product involvement. However, the results for product involvement as a continuous variable has a p value of 0.09. Further, the results for three levels of product involvement were far from significant. For two levels of product involvement also, the results were insignificant, the p value approached 0.20. This evidence indicates that it is premature to conclude that there are three routes to persuasion. A caveat, however, must be added, in that the manipulations may not have been strong enough to test the proposed hypotheses. Further, undoubtedly, there is unequivocal evidence the emotional intensity of a product Web site, as measured here, has a direct impact on product attitudes.

• Korean Journal of Clinical Pharmacy
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• v.21 no.2
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• pp.122-130
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• 2011

Objective: Although recombinant human erythropoietin (rhEPO) has revolutionized the treatment of anemia in chronic kidney disease (CKD) receiving hemodialysis (HD) with no need of blood transfusion, some patients have a blunted or appear to be resistant to rhEPO. There is a controversy in the causes of rhEPO resistance in maintenance HD patients with anemia. This study is to examine current anemia treatment outcomes and the factors influencing the rhEPO responsiveness in HD patient with CKD. Methods: The clinical parameters or factors relating to erythrompoietin treatment outcomes and erythropoietin responsiveness were collected from the HD patients in two large dialysis centers for three months. The collected paramenters included serum iron, total iron biding capacity (TIBC), transferrin saturation rate, ferritin, albumin, intact PTH, C-reactive protein (CRP), nPCR and medications such as an angiotensin converting enzyme inhbitor, an angiotension II receptor blocker and an HMG-CoA reductase inhibitor (HMG-CoA RI). The data were analyzed to examine the degree of acheiveing the anemia treatment goal and factors relating to ERI. Results: Among total 111 patients, 42 (42.3%) and 47 (37.8%) patients achieved the target Hct and Hb based on the Health Insurance Review and Assessment Services (HIRA) reimbursement criteria. In the higher ERI group (upper quartile), the patients had higher CRP levels (0.5 mg/dl) (p=0.0096), and lower TIBC score (<$240{\mu}g/dl$) (p=0.0027), and less patients were taking HMG-CoA RI (p=0.0019). Male patients (p=0.0204), patients with high TIBC score ($R^2$=0.084, p=0.0021) and patients taking HMG-CoA RI (p=0.0052) required to administer less dose of rhEPO meaning higher erythropoietin responsiveness. Conclusion: Less than 50% of CKD patients were achieving the goals of anemia by erythropoietin administration in large hospitals in Korea even though the goals were lower than those of NKF-K/DOQI practice guideline. The factors influencing ERI were sex, TIBC and HMG-CoA RI administration status, and neither an ACEI nor an ARB did not influence ERI.

• The Journal of the Korea Contents Association
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• v.13 no.12
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• pp.900-909
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• 2013

This study purposed to analyze the determinants of length of stay for patients having alzheimer dementia in geriatric hospitals. Sample data was collected from the National Patient Sample (NPS) produced by the Health Insurance Review & Assessment Service (HIRA) in 2009. Total 538 alzheimer inpatients over 65 years were used in the analysis. Patients were classified into 5 risk groups to represent the case-mix differences of patients. Organizational characteristics of geriatric hospitals such as number of beds, doctors, and nurses were included in the analysis model. In multivariate regression analysis, hospital variables were not statistically significant in explaining the length of stay. Two risk group were statistically significant in analysis, However, their signs of relationship with the dependent variable were opposite to the expectations. These results suggest that the characteristics of patients and hospitals did not have impacts on the length of stay. There will be needs to test the effects of other factor such as social needs which represents the socio-economic status of the family for the patients.

• Journal of the Korean Data and Information Science Society
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• v.28 no.1
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• pp.75-86
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• 2017

The facial palsy is one of the most common illness in Western-Korean collaborative treatment (hereinafter "collaborative treatment"). The purpose of this study is to analyze facial palsy patients'collaborative treatment use patterns. By analysing the 2014 National Health Insurance Review and Assessment Patient Sample Data (NPS 2014) with the episode of care unit, we have found the following results. First, the collaborative treatment is preferred by patients over 50 years old and female. Second, western medicine mainly focuses on diagnosis and medical examination while korean medicine and collaborative treatment focus more on treatment activity. Third, western medicine showed the shortest treatment period, followed by korean medicine and collaborative treatment. However, the cost of medical treatment per day is highest in western medicine. The analysis of the use patterns of collaborative treatment shown in the study is expected to provide a direction for the development of clinical practice guidelines and the establishment of medical policies in the future.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.195-218
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• 2017

The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system.

• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.123-164
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• 2014

Under the new system of 'Separation of pharmaceutical prescription and dispensing' in Korea, which was implemented in 2000, physician could not dispense a medicine, and outpatient should have a physician's prescription filled at a drugstore. After pharmacist makes up outpatient's prescription, National Health Insurance Service(NHIS) pay for outpatient's medicine to pharmacist, except an outpatient's own medicine charge. And NHIS only pay for outpatient's prescription fee to physician and, physician doesn't derive profit from dispensing medicine in itself. Nevertheless, if physician writes out a prescription with violation of 'Criteria for the Medical Care Benefits', NHIS clawed back the payment of outpatient's prescription and medicine from the physician or the medical institution which the physician belongs to. In the past, NHIS's confiscation was in accordance with 'the National Health Care Insurance Act, Article 52, Clause 1'. But, since 2006 when the Supreme Court declared that there was no legal basis on the NHIS's confiscation of outpatient's medicine payment, NHIS had put in a claim for illegal prescriptions on the basis 'the Korean Civil law, Article 750(tort)'. So, Many medical institutions filed civil actions against NHIS. The key point of this actions was whether the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits constitute of the law of tort. On this point, the first trial and the second trial took different position. Finally the Supreme Court acknowledged the constitution of the law of tort in 2013. In this paper, the author will review critically the decision of the Supreme Court, and consider the relativeness between the legal effect of Criteria for the Medical Care Benefits and the constitution of the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits as the law of tort.

• Journal of Oral Medicine and Pain
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• v.33 no.4
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• pp.353-374
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• 2008

The descriptive epidemiology of specific neuropathic pain disorders has not been well-des-cribed, although the burden of neuropathic pain is well recognized. The true incidence of neuro-pathic pain disorder is unknown, but it is believed to be under diagnosed and treated inade-quately, despite the development of various diagnostic system. The purpose of this study was to report the epidemiology of specific neuropathic pain as managed by all kinds of hospital in Korea. A descriptive analysis of the epidemiology of prevalent trigeminal neuralgia(TN)(n-=77,053 27,6%), atypical facial pain(AFP)(n=12,382 4.4%), glossopharyngeal neuralgia(GN)-(n=1,319 0.5%), post-herpetic neuralgia(PHN)-(n=84,598 30.3%), diabetic neuropathy(DN)-(n=85,989 30.8%), atypical odontalgia(AO)-(n=16,001 5.7%) and glossodynia(GD)(n=2,133 0.8%) and treatment departments and treatment durations from computerized Health Insurance Review and Assessment Service(HIRA) of Korea: January 2003 to December 2005, are reported with rates increasing over time for PHN and DN and decreasing for the other neuropathic pain disorders. Most patients were treated at private clinic record for 57.6-72.8% of patients except OA for 10.3%. The percentage of Dept of dentistry for outpatients was 3.2% for TN, 34.7% for AO and 15.4% for GD. Other neuropathic pain patients visited nearly medical clinic.

• Tuberculosis and Respiratory Diseases
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• v.73 no.1
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• pp.48-55
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• 2012

Background: The epidemiology of tuberculosis (TB) has been assessed based on the data of the analysis of TB patients notified to the surveillance system in Korea. However, the national status of TB is not validated through this surveillance system. The objective is to determine the epidemiology of TB and to understand the accurate status of TB patients treated in private institutions. Methods: Medical records of 53,579 patients who had been diagnosed with TB in 2008 were analyzed. Results: Among 53,579 patients, the number of sputum smear positive cases was 15,639(29.2%) and the number of new cases was 39,191 (73.1%). The drug resistance rate of new cases was 5.3%, while the rate stood at 13.3% for TB patients with treatment history. The number of multi-drug resistant TB (MDR-TB) patients was 2,472 (4.6%), which consists of 2.9% of new cases and 9.3% of TB patients with prior treatment history. The number of extensively drug-resistant TB patients was 749 (1.4%), consisting of 1.1% of new cases and 2.2% of TB patients with prior treatment history. In terms of treatment outcomes, 66.4% of all TB patients, 70.5% of new cases, 64.4% of relapse cases, and 46.8% of MDR-TB cases were cured or completed. It was inferred that in 2008, the total number of TB patients reached 70,767, 145.6 per 100,000 people (95% confidence interval, 145.5~145.7). Conclusion: We conclude that the medical records review of the Health Insurance Review and Assessment Service (HIRA) data can be very effective in promoting the understanding of the current status of TB in private institutions.

• Korean Journal of Clinical Pharmacy
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• v.19 no.1
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• pp.1-17
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• 2009

Adverse drug reactions (ADR) caused by inappropriate prescription are responsible for major socioeconomic loss. Drug-drug interactions (DDI) has been recognized as a major part of ADRs and, therefore, healthcare professionals should prevent possible DDIs to minimize preventable ADRs. This study aimed to examine DDI information in drug information references and Korea Food & Drug Administration (KFDA) drug labeling information. Drug ingredients from the formulary of Health Insurance Review and Assessment Service in Korea (HIRA) were included for the study. DDI information source used for the study were Micromedex Drugdex and Drug Information Facts (DIF) with the DDI severity level of "moderate" or more. The DDI information in KFDA drug labeling were collected and compared. Drug ingredients were classified with KFDA Drug Classification and ATC Classification of WHO for the analysis. Among the total 1,355 drug ingredients satisfying inclusion criteria, 738 ingredients involved at least one DDI, which was described in Micromedex and/or DIF. Drug Ingredients of 176 involved DDI only described in KFDA drug labeling, but not Micromedex nor DIF. Drug ingredients of 35 which DDIs were described in Micromedex or DIF did not have DDI based on KFDA drug labeling. Micromedex and DIF retrieved 7,582 and 3,071 DDIs, respectively 57.6% and 58.5% of DDIs were also described in KFDA drug labeling. Central nervous system (CNS) drugs, cardiovascular system (CVS) drugs and the antiinfectives appeared to have higher frequency of DDIs among all drug classes. The highest number of DDIs with high severity level ("contraindicated" or "major") were the DDIs of CNS drugs. The antiinfectives are the second drug group having serious DDIs. The DDI pairs of the CNS drug and the antiinfective had the highest contraindication risk (13.6%). DDI information from Micromedex and DIF were not consistent with the result that only 465 ingredients' DDIs are common in both literature (total DDI numbers were 715 vs 488, respectively). And 1,652 DDI information are common in both references among 7,582 vs 3,071 DDIs, respectively. Only 55.2% of DDI information in the database contained in the KFDA drug labeling. Prescribers and pharmacists should pay attention to the drugs for CV system, CNS and infections because of higher risk of possible DDIs compared to other drug classes. KFDA drug labeling is not likely to be recommended as a good information source for DDI due to significant inconsistency of information. Drug information providers should be aware that DDI information from different sources are not consistent and therefore multiple references should be used.