• Journal of the Korean Dietetic Association
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• v.19 no.4
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• pp.400-415
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• 2013

The purpose of the study was to examine the current status of nutritional management at elderly nursing homes. A survey was performed of 83 nursing homes from January 5, 2011 to January 21, 2011 via mail. A total of 34 nursing homes responded to the survey and 149 elderly subjects were analyzed according to the presence of a dietitian. Among the 34 nursing homes, 70.6% had a dietitian on duty. All of the facilities with a dietitian had the dietitian making the meal plan, whereas 70% of the facilities without dietitian served meals planned by a non-professional person. Overall, however, a low proportion of nursing homes implemented dietetic treatments for residents with diseases. For the nutritional assessment of these residents, a mini nutritional assessment (MNA) was performed. MNA scores were significantly associated with body mass index (BMI), mid-arm circumference (MAC), calf circumference (CC), ingestion problems, and weight loss during the last 3 months (P<0.001). Among the elderly studied, 5.4% were malnourished, and 36.9% were at risk for malnutrition by MNA score. The results of this survey show that the current management of nutrition at nursing homes is insufficient because the elderly who needed dietetic treatment did not receive proper care. Dietetic management is the most important service in all nursing homes. Therefore, to improve the nutritional status of elderly residents in nursing homes, systematic nutrition management by nutrition experts should be implemented.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.7
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• pp.2406-2419
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• 2010

This study aims to elevate the usefulness of the current annual Accreditation of Hospitals. To achieve this purpose, A modeling of an efficiency analysis based on DEA and AHP to the Accreditation of Hospitals Data from 2004 to 2008. By applying to AHP and DEA_AR to the scores derived from the various domains in data, An adequate prediction model about conversion factor in fee contract is made. By summarizing information derived from DEA, factor analysis and Generalized Linear Model, The linear functions combining conversion factor and efficiency index is successfully established. The factor analysis with AHP was used to merge diverse scores from the domains of evaluation. Not only the input and output initially introduced, AHP scores, dummy variables of hospital classification, geographical location are effective variables to forecast a conversion factor. If a predicted conversion factors from efficiency is used, It will be a great contributions to the annul doctor's fee contract.

• Journal of Preventive Medicine and Public Health
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• v.45 no.4
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• pp.211-218
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• 2012

Objectives: The objective of this study was to identify the differences in obesity rates among people with and without disabilities, and evaluate the relationship between obesity rates and the existence of disabilities or characteristics of disabilities. Methods: Mass screening data from 2008 from the National Disability Registry and National Health Insurance (NHI) are used. For analysis, we classified physical disability into three subtypes: upper limb disability, lower limb disability, and spinal cord injury. For a control group, we extracted people without disabilities by each subtype. To adjust for the participation rate in the NHI mass screening, we calculated and adopted the weight stratified by sex, age, and grade of disability. Differences in obesity rates between people with and without disabilities were examined by a chi-squared test. In addition, the effect of the existence of disabilities and grade of disabilities on obesity was examined by multiple logistic regression analysis. Results: People with disabilities were found to have a higher obesity rate than those without disabilities. The obesity rates were 35.2% and 35.0% (people with disabilities vs. without disabilities) in the upper limb disability, 44.5% and 34.8% in the lower limb disability, 43.4% and 34.6% in the spinal cord injury. The odds for existence of physical disability and grade of disability are higher than the nondisabilities. Conclusions: These results show that people with physical disability have a higher vulnerability to obesity.

• Women's Health Nursing
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• v.16 no.2
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• pp.157-165
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• 2010

Purpose: The purpose of this study was to identify differences in Health Locus of Control (HLOC), depression, wellbeing, and Health Promoting Lifestyle Profile II (HPLP) between middle aged Korean and Korean-American women. Methods: Data from 80 Korean-American women living in Los Angeles, USA and 82 Korean women living in W-city, Korea, were collected using a self administered questionnaire including items on HLOC, HPLP, a Wellbeing Index and Major Depression Inventory. Results: There were statistically significant differences between the middle aged Koreans and Korean-Americans on mean age, education, religion, and current health insurance. Significant differences were found on HLOC (F= 2.504, p=.033) and Wellbeing (F=2.451, p=.036). The results also showed significant differences on HPLP (total HPLP, F=4.655, p=.001; physical activity, F=2.967, p=.014; nutrition, F=4.250, p=.001; spiritual growth, F=4.398, p=.001; interpersonal relations, F=2.648, p=.025; and stress management, F=5.201, p<.001) using ANCOVA. However, there were no significant differences on depression, or health responsibility in HPLP between the groups. Conclusion: Understanding middle aged women's health adjustments based on their culture will enhance the ability of health professionals to provide culturally congruent care and enable middle aged women to develop healthy lifestyles.

• Health Policy and Management
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• v.29 no.3
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• pp.262-276
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• 2019

Background: The most important thing to strengthen primary care is to prove that the continuity of primary care is an essential area for good health outcomes. The purpose of this study is to analyze the effect of outpatient continuity of primary care on the hospitalization experience of diabetes mellitus in new diabetic patients. Methods: Using the Korean National Health Insurance Service national sample cohort (NHIS-NSC 2011-2015) data, 3,391 new diabetic patients in 2012 were selected for the study. Multiple logistic regression was performed to investigate the effect of outpatient continuity of primary care on hospitalization in new diabetic patients. Results: The outpatient continuity of primary care in new diabetic patients was measured by the continuity of care index, which showed that 69.4% (n=2,352) were high level and 30.6% (n=1,039) were low level. Patients who had high continuity of primary care at the early stage of diabetes diagnosis showed 3.49 times more likely to maintain high continuity of primary care in the second year (95% confidence interval [CI], 2.72-4.49). Patients with low continuity of primary care for 2 years from the initial diagnosis of diabetes were 2.56 times more likely to be hospitalized due to diabetes than those who did not (95% CI, 1.55-4.25). Conclusion: This study identified the need for policies to increase the continuity of primary care for new diabetic patients and could contribute to lowering the admission rate of diabetic patients if the policy for this would work effectively.

• Journal of Obesity & Metabolic Syndrome
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• v.27 no.4
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• pp.238-247
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• 2018

Background: We aimed to estimate the proportion of patients with diabetes who achieved target glycemic control, to estimate diabetes-related costs attributable to poor control, and to identify factors associated with them in the United Arab Emirates. Methods: This retrospective cohort study used administrative claims data handled by Abu Dhabi Health Authority (January 2010 to June 2012) to determine glycemic control and diabetes-related treatment costs. A total of 4,058 patients were matched using propensity scores to eliminate selection bias between patients with glycosylated hemoglobin (HbA1c) <7% and HbA1c ${\geq}7%$. Diabetes-related costs attributable to poor control were estimated using a recycled prediction method. Factors associated with glycemic control were investigated using logistic regression and factors associated with these costs were identified using a generalized linear model. Results: During the 1-year follow-up period, 46.6% of the patients achieved HbA1c <7%. Older age, female sex, better insurance coverage, non-use of insulin in the index diagnosis month, and non-use of antidiabetic medications during the follow-up period were significantly associated with improved glycemic control. The mean diabetes-related annual costs were $2,282 and $2,667 for patients with and without glycemic control, respectively, and the cost attributable to poor glycemic control was $172 (95% confidence interval [CI], $164-180). The diabetes-related costs were lower with mean HbA1c levels <7% (cost ratio, 0.94; 95% CI, 0.88-0.99). The costs were significantly higher in patients aged ${\geq}65$ years than those aged ${\leq}44$ years (cost ratio, 1.45; 95% CI, 1.25-1.70). Conclusion: More than 50% of patients with diabetes had poorly controlled HbA1c. Poor glycemic control may increase diabetes-related costs.

• Korea Journal of Hospital Management
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• v.23 no.4
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• pp.15-25
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• 2018

Purposes: The objectives of this study present the direction of the criteria for the separately reimbursement of therapeutic medical device. Methodology: We summarized experts' opinion using Delphi survey and Analytic Hierarchy Process(AHP). 48 experts were gathered from Medical Insurance Review Nurses Association, medical device industry, academy and association, Medical Device Expert Evaluation Committee. Descriptive statistics, consistency index, content validity ratio were analyzed. Findings: Clinical utility, patient safety, infection control, cost-homogeneity, cost-effectiveness showed high feasibility and importance, but market contribution and functional utility showed low feasibility and importance in a relative sense. The results of functional utility differed between clinical and non-clinical experts. Measurability was low across the whole area. Among the criteria for the separately reimbursement of therapeutic medical device. Patient safety/infection control and clinical utility showed the highest relative importance values, analyzed using AHP. Practical Implications: Patient safety and infection control are needed to be considered as one of Value Assessment Criteria. It is important to find out how to improve the measurability of therapeutic medical device.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.650-657
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• 2018

Background and Objectives The present study aimed to compare receptive and expressive language development in children who have undergone simultaneous bilateral cochlear implantation (SCI) and those who have undergone bimodal stimulation (unilateral CI+ hearing aid). Subjects and Method In a retrospective analysis of clinical data, 15 pediatric patients who have received SCI and nine patients who have received bimodal stimulation (BM group) were enrolled. CI was performed for all patients at 24 months of age. Category of Auditory Performance (CAP) scores, Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) scores, and developmental quotients (DQ) for expressive and receptive language were compared between the groups at 12 month of follow-up. The Percentage of Consonants Correct (PCC) of children evaluated at 4 years old was also compared. Results At 12 months of follow-up, significantly greater improvements in CAP scores (${\Delta}4.25{\pm}0.5$) were noted in the SCI group compared to the BM group (${\Delta}3.56{\pm}0.88$, p=0.041). Significantly greater improvements in IT-MAIS scores were also noted in the SCI group (${\Delta}36.17{\pm}4.09$) than in the BM group (${\Delta}30.17{\pm}2.91$, p=0.004). The DQ of receptive language was higher in the SCI group than in the BM group ($87.6{\pm}15.4%$ vs. $75.5{\pm}12.0%$, p=0.023) at 12 months of follow-up. Moreover, early SCI was associated with better receptive language skills. PCC index of children at 4 years old was higher in the SCI group than in the BM group ($88.5{\pm}13.2%$ vs. $62{\pm}15.8%$, p=0.014). Earlier SCI was associated with even greater improvements. Conclusion Bilateral SCI is associated with significant improvements in language development when compared with bimodal stimulation. Earlier SCI was associated with better outcomes.

• Journal of Gynecologic Oncology
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• v.29 no.6
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• pp.82.1-82.13
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• 2018

Objective: The impact of beta blockers (BBs) on survival outcomes in ovarian cancer was investigated. Methods: By using Korean National Health Insurance Service Data, Cox proportional hazards regression was performed to analyze hazard ratios (HRs) with 95% confidence intervals (CIs) adjusting for confounding factors. Results: Among 866 eligible patients, 206 (23.8%) were BB users and 660 (76.2%) were non-users. Among the 206 BB users, 151 (73.3%) were non-selective beta blocker (NSBB) users and 105 (51.0%) were selective beta blocker (SBB) users. BB use in patients aged ${\geq}60$ years, longer duration use (${\geq}1$ year), in patients with Charlson Comorbidity Index (CCI) ${\geq}3$, and in cardiovascular disease including hypertension was associated with better survival outcome. These findings were observed in both NSBB and SBB. When duration of medication was analyzed based on number of days, NSBB (${\geq}180$ days) was associated with improved overall survival (OS) with a relatively shorter period of use compared to SBB (${\geq}720$ days). In multivariate Cox proportional hazards model, longer duration of BB medication (${\geq}1$ year) was an independent favorable prognostic factor for both OS and disease-specific survival in ovarian cancer patients. Conclusion: In our nationwide population-based cohort study, BB use was associated with better survival outcomes in ovarian cancer in cases of long term duration of use, in older patients, and in cardiovascular and/or other underlying disease (CCI ${\geq}3$).

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.21 no.2
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• pp.85-100
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• 2022

Recently, with the widespread expansion of convergence based on digital connectivity, the transportation and mobility fields are rapidly changing, and research related to this is also diversifying. This study aims to analyze the research trends in the mobility field and identify key research areas and topics. Topic modeling analysis has been proved as a useful approach for analyzing the research trends. The abstracts of 142 research papers concerning mobility from the Korean academic citation index were analyzed, derived 9 research topics and linked to 6 key elements of research framework. The result showed that 'Advanced vehicle and transportaion technology' and 'Linkage and integrated services among means for mobility' were most actively studied research fields. It also found that research on insurance, law, regulation for securing user's safety and conflict-resolving with the existing industry has been conducted.