Purpose: We aimed to analyze the trend in intensity-modulated radiation therapy (IMRT) use in Korea from 2011 to 2018. Materials and Methods: We collected data from the Health and Insurance Review and Assessment Service (HIRA) big data based on the National Health Insurance Service claims and reimbursements records using primary treatment planning codes (HD 041) for IMRT from 2011 to 2018. We analyzed the changing patterns in clinical application to specific tumor sites and regional differences in IMRT utilization. Results: The use of IMRT has exhibited an 18-fold steep rise from 1,921 patients in 2011 to 34,759 in 2018. With regard to IMRT in 2018, 70% of patients (24,248/34,759) were treated in metropolitan areas (Seoul, Incheon, and Gyeonggi Province). IMRT was most commonly used to treat breast, lung, and prostate cancers in 2018. Among these, the use of IMRT for breast cancer shows the most remarkable increase from 2016 when the National Health Insurance began to cover IMRT for all solid tumors. Conclusion: The use of IMRT is steadily increasing to treat cancer and is concentrated in metropolitan areas.
Objectives : The purpose of this study is to examine senior citizens' perception of medical welfare service in Daejeon, and to investigate the level of Korean Medicine University students' satisfaction about medical services that they have done. Methods : We visited Daejeon city hall and Dae jeon Seo-gu community health center, and interviewed them. After that we select two population and did two different surveys. First, to investigate the current state of medical services and medical welfare in Daejeon, we select neglected class senior citizens who were serviced at social welfare center. Second, we select Daejeon Korean Medicine University student to investigate the level of satisfaction about medical services and pre-education. In first population, we random select 25 of 34 senior citizen who visits mere social welfare center. In second population, we random select 78 of 115 Korean Medicine University student who belongs to medical welfare club. Results : We found some advantages and problems in medical services. A lot of senior citizen who were serviced at social welfare center showed high level of satisfaction about medical service. But there were few citizens who knows about health & medical welfare. And most Korean Medicine University student who services medical service to neglected class senior citizens showed high level of satisfaction. Conclusion : We concluded that medical welfare for senior citizen needs more publicizing. Because result of our survey, many senior citizens showed not only low level of recognition in medical welfare service, also showed low utilization rate in public health center. And most Korean Medicine University students were satisfied with themselves about medical service that they have done, it seemed medical service gives beneficial influence to not only senior citizen but also Korean Medicine University student.
Purpose: Tuberculosis(TB) care unit in public health center should be carefully considered to be re-designed as an infection safety environment for both patient and healthcare workers. So, for the enhancement, this study analyses the facility requirements for co-using the screening clinic as a TB and other respiratory disease care unit. Methods: Not only screening clinic facility guidelines from "A Study for Standard Triage Design and Construction Document" but also the guidelines of TB care and related medical facility are reviewed; KDCA, CDC, ECDC and WHO as a TB care, and FGI and NHS for facility. The facility requirements are summarized space, approach, and mechanical requirement in order. By comparing the summary and screening clinic facility guidelines, supplementations are proposed for TB care unit setting. Results: The result of this study shows that both the space program and mechanical requirement of the screening clinic and that of TB care unit are almost identical and could be share, which include direct airflow or negative air pressure in an exam room. To increase functional and economical efficiency, however, it is necessary to consider a multi-functional negative pressured room, So care process may be re-designed based on a room type; face-to-face room or glass wall inbetween. Implications: The facility guidelines for TB care unit of a public health center should be developed to build a safe environment for infection control by reflecting its medical plan and budget.
Seung-Hoon Kim;Yonghan Cha;Suk-Yong Jang;Bo-Yeon Kim;Hyo-Jung Lee;Gui-Ok Kim
Hip & pelvis
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제36권2호
/
pp.144-154
/
2024
Purpose: The objective of this study was to assess postoperative direct medical expenses and medical utilization of elderly patients who underwent either hemiarthroplasty (HA) or internal fixation (IF) for treatment of a femoral intertrochanteric fracture and to analyze differences according to surgical methods and age groups. Materials and Methods: Data from the 2011 to 2018 Korean National Health Insurance Review & Assessment Service database were used. Risk-set matching was performed for selection of controls representing patients with the same sex, age, and year of surgery. A comparative interrupted time series analysis was performed for evaluation of differences in medical expenses and utilization between the two groups. Results: A total of 10,405 patients who underwent IF surgery and 10,405 control patients who underwent HA surgery were included. Medical expenses were 18% lower in the IF group compared to the HA group during the first year after the fracture (difference-in-difference [DID] estimate ratio 0.82, 95% confidence interval [CI] 0.77-0.87, P<0.001), and 9% lower in the second year (DID estimate ratio 0.91, 95% CI 0.85-0.99, P=0.018). Length of hospital stay was significantly shorter in the IF group compared to the HA group during the first two years after time zero in the age ≥80 group. Conclusion: A noticeable increase in medical expenses was observed for patients who underwent HA for treatment of intertrochanteric fractures compared to those who underwent IF over a two-year period after surgery. Therefore, consideration of such findings is critical when designing healthcare policy support for management of intertrochanteric fractures.
The purpose of this study was to investigate the residents' opinions about community mental health in the Taegu-Kyungpuk area for the future development of a community mental health program and model appropriate for Korea, The subjects were 152 residents in the Taegu - Kyungpuk area. In July 1999, the data was collected using a convenience sample technique. Mental health status was significantly different for the level of occupational advantage(x$^2$=15.684, p<.05) and physical health(x$^2$=39.262, p<.000). Factor structure for mental health problems with the percentage of variance was as follows. optimistic view(27.518), dark view(10.758), mastery(6.200), discomfiture(6.101) and life style(5.641). Most of the respondents(92.1%) took the mental health problems seriously. The serious aspects of the mental health problem were found to be epilepsy, mental retardation, neurosis and schizophrenia respectively. Concerning about the view of community mental health, most of the respondents answered that the a C.M.H.C. was ‘useful and urgent’ concerning the need for C.M.H,(77.6%). They answered positively on the utilization of C.M.H.C(75.7% ) and preferred the separately new community mental heath center. A psychiatrist was preferred as the key person in charge(44.1%). If community mental health centers were established in a community health center, they answered that the expected major problem would be quality control of care(44.7%). They preferred the psychiatrist's office as the recommended agency for the insane(44.7%). Opinions of the asylum system were found very negative in respect to psychiatric therapy and humanitarianism. The results of this study will help establish a relevant model for this community as the primary site for a community-based mental health model.
Health of a nation is quite often represented by the statistics such as infant death rate and maternal mortality rate. It is indisputable that maternal child health(MCH) is the basis of health of a nation. MCH is also one of the cardinal component of primary health care. The importance of MCH is conspicuous especially in the developing countries. In Korea, People in the rural communities still have high access barrier to basic health care needs, including MCH services. Access to quality care during pregnancy and delivery seems to be the crucial factor in preventing deaths in women and children. The beneficial effects of prenatal and postnatal care on the outcome of pregnancy for mother and child, and those of health professional-attended institutional delivery on the health of mother and child have been well documented in many studies. Recognizing these effects, the government of Korea received IBRD loan of $30 million in 1979 for th purpose of constructing 89 rural MCH centers. The construction is complete now and all 89 MCH centers are under operation ti imporve primary health care for mothers and children in Korea. However, it has been observed over time that overall performance of public MCH centers is declining. The decline has been attributed partly to low quality services by public MCH centers, poor management by health center mangers, competition with for-profit private clinics, and to the development of national health insurance. This study investigates the utilization by rural communities in Korea of MCH services provided by public sector health centers deemed to be physically and financially accessible to the community but suboptimally used. It seeks also to determine the factors that influence people's utilizations. This study sets out to discover a desirable form of MCH center from among alternative forms of centers, thereby to construct a MCH model.
Purpose: This study was conducted to identify health problems and support received from the health and welfare service using MDS-HC(Minimun Data Set for Home Care) in the aged living at home. Method: Eighty-one elderly persons were selected from those listed in community-welfare service centers in Seoul and Kyunggi Province between December 2002 and January 2003. Result: Eleven health problems per elderly person on average were identified, and the frequent care needs were in order: preventive health measure, health promotion, visual function, depression & anxiety, communication disorders, social function, pain, environmental assessment, oral health, cognition and falls. The number of health problems by the level of ADL was ‘ADL 1(Independence)’ 9.87, ‘ADL 2(Partial independence)’ 12.78, ‘ADL 3(Dependence)’ 13.73. Utilization of formal health & welfare services among the elderly was ‘meals on wheels’ 40.7%, ‘home helper’ 38.2%, ‘visiting of social welfare worker’ 21.0%, ‘physical therapy’ 19.6%, ‘day care center’ 12.3%, ‘volunteer's service’ 9.9%, ‘home visiting care’ 3.7%, ‘occupational therapy’ 3.7%, and ‘speech therapy’ 2.5%. Conclusion: The results suggest that using the MDS-HC 2.0 is applicable to help decide criteria for both health and welfare service supplied to the elderly.
This study investigated the public use of Myeon Location in Jeollanam - do where the population is at risk of declining. And discussed the rational provision and coordination of public facilities as a guarantee of fundamental rights. As a result of the study, the rational supply and adjustment directions of public facilities are as follows. First, there are problems such as high availability of management, finance, shopping, and health facilities, lack of culture, leisure, community facilities, and weakening of center function. Therefore, in the continuing declining population situation, face management, safety and health facilities should be upgraded to multifunctional facilities, and utilization efficiency and integration should be promoted. In addition, town center rehabilitation should be centered on multifunctional facilities. In addition, elementary schools will have to utilize and preserve them to take advantage of local cultural values as nostalgia storing place that provide incentives for young people and elementary school children in the future. Second, in order to cope with population decline, public facilities need to strengthen public services through complexity and multifunctionality, wide-area operation with neighboring areas, and user-centered operation management.
Purpose: The purpose of this study was to identify the health status and request of community residents. This study is part of development of efficient health life enhancement programs. Methods: The subjects of this study were 586 households in a rural community and well-trained interviewers visited every household in the designated area and individually interviewed heads of households for general information and health service utilization. The data were collected using a questionnaire for seven months from March 25 to September 24, 2002. The data were analyzed using frequency. percentage by SPSSWIN (v 10.0). Results: 1. 58.9% of subjects were above sixty, and 60.8% of them were women. 2. The most serious problems they identified were health problems (45.6%), and the second was(##-was+were) economic problems(22.0%). 3. Almost half of the study population regarded themselves as healthy (46.2%). The types of illness they had were neuralgia, arthritis, hypertension, diabetes, and heart disease. 4. Most of the study population answered that they didn't do anything special for health enhancement. 5. Among medical facilities, hospitals or medical clinics (55.3%) were most commonly utilized when they were sick. 6. The highest request of the subjects was 'Home visiting service (45.4%)', and 'free treatment connected to the service of hospitals' was the second. What they needed most regarding health enhancement programs in health life enhancement centers was 'free health examination (58.2%), and heath education programs (57.7%). 7. As a result of investigating the subjects' demand for nursing services in health life enhancement center, 'the clinical examination' was the most requested, and next was 'blood pressure check', 'emergency treatment', and 'rehabilitation service', in that order.
Rapid industrialization has induced the migration of rural people to urban areas. Such migration has created enlarged the existing low income group. Residents of low income area have increased health risk owing to their poor living environment, low income. overwork and inappropriate health care. The general objective of this study was to group the pattern of medical care utilization of low income group. The specific objectives were to identify disease prevalence and medical care utilization of low income group. To meet the objectives of this study, household interview method was applied. A total of 1845 households in 5 areas such as Bongchon 5th Dong, Bongchon 2nd Dong, Sanggae 5th Dong, Sanggae 4th Dong, and Shinrim 7th Dong were visited and interviewed by field team during the period from April 19 to May 3. 1989. The major findings obtained from the information collected were as follows : The Number of room per household used was one to two rooms. The employment state of the head of household disclosed that 88.6% had a job and the remaining 11.4% were unemployed. The average monthly income was 502,770won. however, 30% of the total income was less than 300,000 won in Bongchon 5th dong area. and 34.5% in Shinrim 7th Dong area. 41.3% of households had debts, which was consisted of household expense(33.4%), income formulation(22.7%) and medical care cost(15.9%) etc. Prevalence rate of diseases during the preceding 30days before the date of the household interview was 387.7 per 1000 persons. The prevalence rate of female was higher than that of male. 8.9% of the sick persons wasn't receiving any medical treatment, and the main reasons of which were lack of economic availability(43.3%) and feeling of non treatment needed(33.7%). According to the study results it was found that the prevalence rate of chroic diseases and the disabled in low income resident areas was higher than that in the other areas. Therefore, the health status of this group should be improved through PHC approaches. In addition. in order to prevent the diseases and promote the health of those people, the health center as well as health subcenter should be strengthened.
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