The study was performed to investigate the effect of corn bran as a fiber source on the utilization of thiamin niacin and pantothenic acid in human subjects for 8 weeks. Four different corn bran diets were fed : dry milled fine(DF) dry milled coarse(DC) wet milled fine(WF) and wet milled coarse(WC) Basal diet no corn bran bread added was employed as a control Apparent recovery of each B complex vitamin in urine was estimated to evaluate the vitamin and compared. The utilziation of three B vitamins was affected by the corn bran treatment. Dry milled corn bran had a higher recovery rate of thiamin(dry milled : 233% wet milled : 1.70%) than those receiving wet milled corn bran. Similar recovery pattern of niacin(dry milled : 1.94% wet milled : 1.50%) to that of thiamin was also observed. Particle size seemed to affect the vitamin utilization regardless of type of corn bran. Coarse bran gave a lower recovery value than fine corn bran in genreral. For pantothenic acid the recovery of the vitamin was affected to a greater extent by particle size of corn bran than by type of corn bran milling(fine: 60.22% coarse : 51.51%) Groups consuming wet milled corn bran\ulcorner(5`.57%) excreted more NDF than those fed dry milled corn bran(42.29%) Dry milled corn bran showed little or no water holding capacity poor fecal bulking properties and increased fecal transit time. The results suggest that corn bran supplementation exerts an negative effect on three B vitamin utilization.
Background & Object: Ankylosing spondylitis (AS) is a chronic inflammatory disease that causes ankylosis and deformation of axial joints. Since current medicine cannot cure the disease yet, alleviating pain and preventing deformation with medications are the main therapy for patients with AS. The key medications for these purposes include nonsteroidal anti-inflammatory drugs (NSAIDs), and tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$) inhibitors. This study aims to analyze prescribing patterns of AS patients in South Korea. Method: National Patients Sample data compiled by the Health Insurance Review and Assessment Service from 2013 was analyzed. Patients with AS were identified with Korean Standard Classification of Diseases code-6, which was M45. The rates of prescription, discontinuation, and switching ingredients were calculated for each medication during 2013. Results: Total number of patients was 655, and most of them were male (n = 514, 78.5%). Of all age groups, the proportion of 30-40 year old patients was the greatest (35.1%). The most utilized drug class was NSAIDs (82.4%). Less than half of patients were prescribed $TNF-{\alpha}$ inhibitors (n = 212, 32.4%). Meloxicam, aceclofenac, and celecoxib were the most frequently prescribed NSAIDs. In case of $TNF-{\alpha}$ inhibitors, adalimumab, etanercept and infliximab were the top three most prescribed drugs. Although not recommended by the current practice guideline, significant proportions of patients were identified using disease modifying anti-rheumatic drugs (DMARDs). Conclusion: Considering the current practice guideline and previous studies about the efficacy, the use of DMARDs should be reduced and medical insurance term in South Korea should be re-examined.
Therapeutic duplication (TD) is a serious problem that frequently occurring primarily in the ambulatory setting in Korea. Implementation of concurrent drug utilization review (DUR) is a promising way to reduce inappropriate prescription and dispensing, and improve patient safety. This study was aimed to develop the process of DUR module of TD. Sixty-five drug ingredients classified into the drug category of the antipyretic, analgesic, and anti-inflammatory drug approved in Korea (The KFDA-dess nated classification codes of 114 or 264) were reviewed for this purpose. The drug ingredients (and products) were reclassified based on WHO's Anatomical, Therapeutic and Chemical (ATC) classification system. The clinical practice guidelines, textbooks and product labels on therapeutic uses of these drugs in Korea and several fores n countries were reviewed. If the drugs were categorized into the same therapeutically duplicable class, they were defined not to be used concurrently because the concurrent use was "therapeutically duplicated (unnecessary or even harmful)". Among the studied drug products, the following 5 drug classes were considto beas "therapeutic duplication": (1), on-t tooid DURnti-inflammatory drugs (NSAIDs, including s Dicylates), (2),Anilidts, (3),Opioids, (4) Ergot Dk Doids and (5) 5-$HT_1$ receptor agonot s. Therefore, concurrent prescribing or dispensing of more than 2 drug ingredients any in the above same classes should be considered as TD and needed to be warrant for careful review by pharmacists before dispensing.
This study intended to establish a direction for the revitalization of youth culture centers by examining the current status of youth centers operated in Daejeon and how they have been used. Four youth centers in Daejeon were visited and a survey was conducted targeting 180 people using the centers. Frequency, Mean, and ${\chi}^2$ analysis were performed by using SPSS statistics package, and major research outcomes are as follows; There were 6 youth culture centers in Daejeon and showed a lower construction rate of 7.4% on the basis of 81 up, myun and dong. Most youth centers were small, around $300-500m^2$ in total floor area, and accommodated 100-200 people, and the space comprised multipurpose hall, cafeteria, open space, club space, multimedia space, information service room, and guide booth. There were no sports spaces among the target facilities. So, it has created the need for physical activity space to promote health & development. Most users visited centers with their friends and simply to use the facilities, and the satisfaction with the facilities was relatively high at 4.32. The role of the local community and financial support of the government is required to activate the youth culture. Also, for the role of youth culture center, it was suggested that the youth culture center should develop program which corresponds with the level of the youth and boast the interest of the youth.
The objectives of this study were to analyze the socio-economical factors related to smoking and drinking behaviors using the Korea Welfare Panel data. The key variables were sex, age, frequency of health and medical facilities visit, subjective health level, smoking level, drinking level, depression symptoms, and low income level. Since the health variables in the Welfare Panel data were limited, the analysis was exploratory. In male population of those older than 30 years old, low income group people were more likely to smoke cigarettes than the general income population. In the result of the Chi square analysis, the smoking rate showed significantly different relationships with the different age groups, gender and income level. According to the descriptive analysis, persons with low income level were more likely to experience health risk behaviors and showed more medical service utilization. The utilization of the local public health centers was 4.6% for the Bow income level and 1% for the general level. The higher smoking rate was associated with the younger age, and the lower income. The smoking rate in the age category from 20 to 29 was 23.3% for the general level and 25% for the low income level. On the other hand, the drinking rate was even higher in the general families. The rates of non use of alcohol was 36.7% in the general families and 58.4% for the low income families. For both smoking and high risk drinking issues, demographic and sociological variables such as sex, age, education levels and income levels were analyzed, and there wer significant relationships. Health risk factors were serious for males, with age groups of 20's and 30's, lower education level, and in a low income family. In general, females were more unhealthy. The rates of smoking and drinking were higher in the low income level. Even in the health and nutrition survey results in 2005, persons in the low income class were experiencing poorer health in health level or the degree of action restriction. Since the effects of the health promotion could not be measured in a short period of time, it has not been easy to create the basis for the substantial effects. Factors related to health risks needs to be continuously studied using data from diverse field.
Objectives: People who have chronic diseases, as well as gait imbalance or psychiatric drug use, may be susceptible to injuries from falls and slips. The purpose of this study was to evaluate the effect of musculoskeletal diseases on incidental fall-related injuries among adults in Korea. Methods: We analyzed data from the 4th Korea National Health and Nutrition Examination Survey (2007-2009), which are national data obtained by a rolling survey sampling method. The 1-year incidence of fall-related injuries was defined by health service utilization within the last year due to injury occurring after a slip and fall, and musculoskeletal diseases included osteoarthritis, rheumatoid arthritis, osteoporosis, and back pain. To evaluate the effects of preexisting musculoskeletal diseases, adults diagnosed before the last year were considered the exposed group, and adults who had never been diagnosed were the unexposed group. Results: The weighted lifetime prevalence of musculoskeletal disease was 32 540 per 100 000 persons. Musculoskeletal diseases were associated with a higher risk of fall-related injury after adjustment for sex, age, residence, household income, education, occupation, visual disturbance, paralysis due to stroke, and medication for depression (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.03 to 1.93). As the number of comorbid musculoskeletal diseases increased, the risk of fall-induced injuries increased (p-value for trend <0.001). In particular, patients who had any musculoskeletal condition were at much higher risk of recurrent fall-related injuries (OR, 6.20; 95% CI, 1.06 to 36.08). Conclusions: One must take into account the risk of fall-related injuries and provide prevention strategies among adults who have musculoskeletal diseases.
Objectives : This study was conducted to evaluate the effect of fixed critical pathway with emr (electronic medical record) on the length of hospital stay, the cost and quality of care provided to gastrectomy patients in a university hospital and to develop flexible critical pathway with emr which can be used excluded or drop-out patients. Methods : Thirty-eight patients with gastrectomy were included as case group and Thirty-four patients included as control group. The comparison between control and case with using fixed critical pathway were done. To develop and to evaluate usefulness of flexible critical pathway with flexible data base, simulation was done for flexible critical pathway with drop-out patients. Result : The major results of this study were as follows: There were no significant differences in patient clinical conditions and no sign of deterioration of quality from critical pathway. The length of hospital stay was 11 days in control group, 8 days in path group(P<0.01). The total costs during the hospital stay were reduced in path group. However the cost per day was significantly increased from reduction of hospital stay(554,352 won in control, 645,669 won in path group). One hundred percentage of drop out patients(60) in the simulation of flexible critical pathway was successful. Conclusion : Computerized critical pathway reduced the length of hospital stay, total hospital costs and resource utilization without harming quality of patient care. The flexible critical pathway program can be used as one of the powerful management tools for reducing the practice variations and increasing the efficiency of care process and decreasing the workload of doctors and nurses in Korean hospital settings.
Objective : The present study is aimed at providing basic data to help oriental medical hospitals devise efficient operational plans by analyzing the medical expenses of in-patients in an oriental medical hospital and the factors affecting such expenses. Methods : PASW 18.0 was used to analyze the medical insurance program data of 929 patients who were discharged from a university oriental medical hospital(with 105 sick-beds) during the period from January 1 to December 31, 2010 after treatment under the coverage of health insurance and medical aid. Results : 1) Of all the patients hospitalized, 63.3% were females, their mean age was 52.73 years old, and 87.7% was covered by the health insurance program. The biggest number or 31.2% of the patients were treated by the department of acupuncture, 31.5% suffered mainly from the diseases of musculoskeletal system and connective tissues, and the average length of stay at the hospital was 19.49 days. 2) There were statistically significant differences in total medical expenses by age, clinical department in charge, principal diagnosis, and number of days hospitalized while daily average medical expenses differed depending on age, type of medical security, clinical department, principal diagnosis, and number of days staying at the hospital. 3) Total medical expenses were found significantly influenced by age, type of medical security, clinical department, principal diagnosis, and number of days hospitalized(explanatory power : 95.9%), whereas type of medical security, clinical department and principal diagnosis turned out to exercise significant influence on the daily average medical expenses(explanatory power : 26.9%). Conclusion : Oriental medical hospitals are suggested to make efforts to ensure geographical and economical accessibility for their main clients, the elderly and middle-aged, as well as to improve satisfaction of the clients with the medical service provided. They are also encouraged to work out systems to specialize in treatment with a focus on chronic degenerative and adult diseases. In addition, they are expected to try to enhance people's awareness of oriental medicine in an attempt to diversify the brackets of clients and increase frequency of their utilization.
Objective: To analyze osteoporosis treatment patterns and teriparatide prescription-associated factors in Korea by using a national health insurance claims database. Methods: We utilized the Health Insurance Review & Assessment Service National Patients Sample claims database to identify patients (aged ≥50 years) with at least one osteoporosis claim (International Classification of Disease 10th revision code: M80, M81, M82) and at least one prescription for osteoporosis medication (antiresorptive agents: bisphosphonates, selective estrogen receptor modulators, denosumab, and calcitonin; bone-forming agent: teriparatide) in 2018. Demographic characteristics and healthcare utilization patterns were analyzed. Factors associated with teriparatide prescriptions were assessed using a multivariate logistic regression model. Results: Records showed that 44,815 patients were prescribed osteoporosis medications in 2018; the percentage of patients prescribed each treatment was as follows: 86.6% bisphosphonates, 13.9% selective estrogen receptor modulators, 3.1% calcitonin, 2.1% denosumab, and 0.7% teriparatide. A greater proportion of patients prescribed teriparatide were ≥75 years (53.4% vs. 33.8%) and had fractures (63.9% vs. 12.8%) compared to the same for antiresorptives (p<0.001). Patients prescribed teriparatide had higher Charlson comorbidity index values (1.2±1.3 vs. 0.9±1.2) and were more frequently hospitalized (0.8±1.3 vs. 0.1±0.5) than those prescribed antiresorptives (p<0.001). Elderly patients (≥75 years old; adjusted OR=1.66; 95% CI 1.16-2.38) and those with fractures (adjusted OR=6.23; 95% CI 4.76-8.14) were more likely to be prescribed teriparatide than antiresorptives. Conclusion: Patients prescribed teriparatide were older and more likely to have severe osteoporosis than those prescribed antiresorptives.
Eun Young Lee;Hyung-Sun Won;Miyoung Yang;Hyungtae Kim;Yeon-Dong Kim
The Korean Journal of Pain
/
v.37
no.1
/
pp.51-58
/
2024
Background: The rise in national health care costs has emerged as a global problem given the ever-aging population and rapid development of medical technology. The utilization of interventional pain management has, similarly, shown a continued rise worldwide. This study evaluates the differences in the medical costs in the field of interventional pain treatment (IPT) between two countries: Korea and Japan. Methods: Korean medical insurance costs for 2019 related to pain management focused on IPT were compared to those of Japan. Purchasing power parity (PPP) was used to adjust the exchange rate differences and to compare prices in consideration of the respective societies' economic power. Results: The cost of trigger point injections in Japan was 1.06 times higher than that of Korea, whereas the perineural and intraarticular injection prices were lower in Japan. The cost of epidural blocks was higher in Japan compared to Korea in both cervical/thoracic and lumbar regions. As for blocks of peripheral branches of spinal nerves, the cost of scapular nerve blocks in Japan was lower than that in Korea, given a PPP ratio 0.09. For nerve blocks in which fluoroscopy guidance is mandatory, the costs of epidurography in Japan were greater than those in Korea, given a PPP ratio 1.04. Conclusions: This is the first comparative study focusing on the medical costs related to IPT between Korea and Japan, which reveals that the costs differed along various categories. Further comparisons reflecting more diverse countries and socio-economic aspects will be required.
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