• Title/Summary/Keyword: Musculoskeletal model

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Determinants analysis of uninsured herbal medicine utilization in the Korean Medicine outpatient service (한의 외래에서 첩약을 포함한 비급여 조제 한약 이용결정요인 분석)

  • Kim, Dongsu;Kim, Hyunmin;Lim, Byungmook
    • Journal of Society of Preventive Korean Medicine
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    • v.22 no.1
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    • pp.1-14
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    • 2018
  • Objectives : This study aimed to analyze the characteristics of uninsured herbal medicine(UHM) users and the economic and social barriers of UHM utilization. Methods : We used the Korea Health Panel Data, representative national survey on medical utilization and cost, provided by National Health Insurance Service and Korea Institiute of Health and Social Affairs. The frequency analysis was used to identify the characteristics of the respondents, and the cross-analysis (${\chi}^2-test$) was used to verify the relationship between their characteristics and the usage of UHM. In order to analyze the determinants of using the UHM considering the individual's characteristics, logistic regression analysis and multiple regression analysis were conducted for those who used the Korean medicine (KM) outpatient service in 2015. Results : The usage of UHM was significantly lower for those (1) who's age of 20 to 65; (2) who have the university or higher education degree; (3) who live in Jeju province, and (4) who bought the herbal medicine for other health related purposes. On the other hand, the usage of UHM for those (1) who have the first quintile of household income; (2) who have the chronic respiratory disease; (3) who have been taking the medicine for health promotion purpose for more than 3 months and (4) who have purchased the food which has health promotion function was significantly higher than others. The patients who have chronic musculoskeletal diseases accounted the most among the UHM users. Conclusions : There was the considerable inequality in the usage of UHM among household income groups, which provides policy rationale for UHM to be covered by national health insurance. To facilitate the coverage expansion, restrictive covering model can be considered for children and adolescents, or for patients with muskuloskeletal diseases who have the high demand for UHM.

The Impacts of General Coordination Manipulation Approach Models on the University Student's Gait, Which is Based on the Flexion or Extension Types of Upper and Lower Body (상.하체의 굽힘.폄 양상에 따른 전신조정술 접근 모형이 대학생의 보행에 미치는 영향)

  • Moon, Sang-Eun;Kim, Mi-Hwa;Ju, Wang-Suck;Lee, Su-Hong;Oh, Chang-Sun;Choi, Min-Ho;Jung, Woong-Chae
    • Journal of Korean Physical Therapy Science
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    • v.16 no.2
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    • pp.27-37
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    • 2009
  • Background: The musculoskeletal disorders with asymmetrical gait on the whole body are the most common. This study was designed to analyze that General Coordinative Manipulation Intervention Models would affect the balanced restoration of asymmetrical gait. Methods: 68 healthy volunteers(1st hypothesis: 46, 2nd hypothesis 22) participated in the two GCM intervention models, which have performed 2 times a week for 3 weeks. Digital Camera was used to measure the gait, and measurements were performed before and after the application of the each intervention model. Repeated measured ANOVA was used to determine a statistical significance. Results: The outcome of examining hypothesis is as follows: 1. The 1st hypothesis : GCM Intervention based on the coordinating the flexion type of upper body and the extension type of lower body will improve in the balanced restoration of asymmetrical gait because it offers a clear direction for treatment(p<.05). 2. The 2nd hypothesis: GCM Intervention based on the coordinating the flexion type of lower body and the extension type of upper body will improve in the balanced restoration of asymmetrical gait because it offers a clear direction for treatment(p<.05). Conclusion: GCM intervention programs on the two hypothesis groups have effects on the balanced restoration of asymmetrical gait(p<.05).

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An actual utilization and development plan study of interdisciplinary medical care at the National Rehabilitation Center (국립재활원 협진의료 이용실태와 발전방안 제안)

  • Lim, Sung Min
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.18 no.1
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    • pp.25-31
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    • 2014
  • Objective This study aims to understand the actual utilization of the oriental rehabilitation medicine center of the initial interdisciplinary medical care at the National Rehabilitation Center and to arrange proper development plans for more effective interdisciplinary medical services for future activation of interdisciplinary medical care. Method: The interdisciplinary patient status, composition of patient care, and major disease-related status were studied and analyzed for oriental rehabilitation medication relating to interdisciplinary medical care at the National Rehabilitation Center. Furthermore, the interdisciplinary status and its operating conditions were evaluated to devise a development plan for the National Rehabilitation Center. Results: As a result of the analysis of oriental rehabilitation medical care diagnosing status utilization at the National Rehabilitation Center regarding interdisciplinary medical care, the ratio of the number of those receiving interdisciplinary oriental rehabilitation medical care was less than half of the total receiving interdisciplinary care. As the major disease status from the patients of interdisciplinary care, stroke patients covered the large majority, and musculoskeletal pain patients covered the majority of outpatients. The establishment of additional oriental medication departments and assigning of interdisciplinary coordinators were presented as the goals of a development plan for the manpower and structural side of interdisciplinary medical care at the National Rehabilitation Center. On the institutional and systematic side, improvement in the interdisciplinary hierarchy and interdisciplinary model development based on the number of patients per disease was proposed. In addition, operation on ward bedding and construction of interdisciplinary EMR medical care is necessary on the medical and administration service side. Conclusion: To understand the actual utilization and to arrange development plans aimed at constructing a safe and effective interdisciplinary hierarchy for interdisciplinary medical care at the National Rehabilitation Center, patient-centered care needs to be implemented.

Differences in Behaviors of Utilization on Western and Oriental Medical Care according to Korea National Health and Nutrition Examination Survey (양.한방 의료 이용 선택에 영향을 미치는 요인 - 국민건강영양조사 2기, 3기 자료 분석)

  • Yoo, Jong-Hyang;Kim, Yun-Jeong;Ku, Bon-Cho;Lee, Si-Woo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.3
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    • pp.582-588
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    • 2011
  • The objective of this study is to examine the difference about manner of utilization and satisfaction on western and oriental medical care. The data came from the National Health and Nutrition Examination Survey in 2001 and 2005. The Andersen model of health behavior was employed to make this analysis. The major statistical methods used in this analysis are chi-square test and logistic regression. The major findings are as follows; Medical care is totally increased in 2005 in comparison with 2001, but medical care in the oriental side is decreased. There is no significant variables in predisposing factors such as sex, age, education level and spouse. Of health behavior factors, the average persons in health state are more favorable in oriental care rather than western care. Oriental care is favorably taken in health insurance subscribers and residents in a large city of enabling factors. The patients with musculoskeletal disease are more dependent in oriental care than western medical care. In conclusion, the findings show that it is largely related to patients' health state, medical insurance, living area and disease types to take oriental medical care. These characteristics should be considered in establishing policies of the oriental medical care in the future.

Review on the Pharmacopuncture Patent in Korea (국내 약침 특허 현황에 대한 분석연구)

  • Woo, Seong-Cheon;Kang, Jun-Chul;Kim, Song-Yi;Park, Ji-Yeun
    • Korean Journal of Acupuncture
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    • v.34 no.4
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    • pp.191-208
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    • 2017
  • Objectives : The purpose of this study was to analyze the trend of pharmacopuncture in Korean patent in order to establish database for patent technology. Methods : Electronic literature searches for Korean patents related to pharmacopuncture were performed in two electronic databases (Korea Intellectual Property Right Information Service and National Digital Science Library) to June 2017. Patents that were not Korean ones, did not use medicinal herb, only described method of manufacture, or had nothing to do with pharmacopuncture were excluded in this study. The status and application date of patents, Medicinal herb, target diseases, International Patent Classification (IPC), model of experiment and extracting methods were analyzed. Results : A total of 379 patents were retrieved. Based on our inclusion/exclusion criteria, 297 patents were excluded. Of 82 included patents, 27 patents did not include experiments using pharmacopuncture, and 9 patents were invented for treating animals such as pig or calf. In IPC analysis, Bee Venom, Panax (ginseng), Angelica, and Paeoniaceae were used frequently. Musculoskeletal diseases were the most targeted diseases followed by nervous diseases. For extracting, hot water extraction, distillation extraction, and solvent extraction using alcohol, ethanol, or methanol for solvent were commonly used. Conclusions : These data are useful for inventing new patent and extending range of pharmacopuncture in clinical use, however, more systematically analyzed patent studies and pharmacopuncture-related studies for new application on various diseases are needed in further studies.

Discomfort Analysis in Computerized Numeric Control Machine Operations

  • Muthukumar, Krishnamoorthy;Sankaranarayanasamy, Krishnasamy;Ganguli, Anindya Kumar
    • Safety and Health at Work
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    • v.3 no.2
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    • pp.146-153
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    • 2012
  • Objectives: The introduction of computerized numeric control (CNC) technology in manufacturing industries has revolutionized the production process, but there are some health and safety problems associated with these machines. The present study aimed to investigate the extent of postural discomfort in CNC machine operators, and the relationship of this discomfort to the display and control panel height, with a view to validate the anthropometric recommendation for the location of the display and control panel in CNC machines. Methods: The postural discomforts associated with CNC machines were studied in 122 male operators using Corlett and Bishop's body part discomfort mapping, subject information, and discomfort level at various time intervals from starting to end of a shift. This information was collected using a questionnaire. Statistical analysis was carried out using ANOVA. Results: Neck discomfort due to the positioning of the machine displays, and shoulder and arm discomfort due to the positioning of controls were identified as common health issues in the operators of these machines. The study revealed that 45.9% of machine operators reported discomfort in the lower back, 41.8% in the neck, 22.1% in the upper-back, 53.3% in the shoulder and arm, and 21.3% of the operators reported discomfort in the leg. Conclusion: Discomfort increased with the progress of the day and was highest at the end of a shift; subject age had no effect on patient tendency to experience discomfort levels.

Survey of Korean Medicine Military Doctors for Establishing Clinical Evidence of Korean Medicine Treatment in Military Medical Service (군진 한의학 근거 기반 구축을 위한 한의군의관 진료 현황 및 인식 조사 연구)

  • Kwon, O-Jin;Kim, Eun-Jung;Eom, Yu-Sik;Park, Sang-Min;Kim, Dongsu;Park, Hyo-Ju;Kim, Joo-Hee
    • The Journal of Korean Medicine
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    • v.38 no.3
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    • pp.73-85
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    • 2017
  • Objectives: The purpose of this study was to investigate the status of Korean medicine treatment, and to analyze problems and demands to provide basic data on Korean medicine in military medical services. Methods: This survey was completed by 30 volunteer Korean medicine military doctors on service via a web-based questionnaire system. The questionnaire was developed through in-depth interviews with Korean medicine military doctors and consisted of general information on the subject, overall characteristics of the medical environment, current status of Korean medicine care in each workplace, problems and needs, and related clinical evidence and education. Results: Korean medicine military doctors administered acupuncture treatment most frequently in clinical practice. The most common complaints were related to musculoskeletal diseases, which accounted for 86.5% of all diseases, including those of the respiratory, digestive, and nervous systems. Most of the problems in Korean medicine care were pointed out as being due to a lack of awareness of Korean medicine in the military. Many doctors were aware that it is necessary to establish clinical evidence for Korean medicine in the military, and were also positive about the possibility of performing clinical research in the military, but the experience of actual participation in clinical research or related education was uncommon. Conclusions: Korean medicine military treatment differs from private medical care due to the specificity of each workplace and the military medical system. In the future, it will be necessary to establish an appropriate Korean medicine treatment model in the military suitable for these characteristics and strategic plans for clinical evidence.

Prognostic Factors of Soft Tissue Sarcomas - analysis of 205 cases - (연부 육종의 예후 인자 - 205례 분석 -)

  • Lee, Jong-Seok;Jeon, Dae-Geun;Lee, Soo-Yong;Kim, Sug-Jun;Jung, Dong-Whan;Park, Hyun-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.2
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    • pp.89-97
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    • 1997
  • Twenty hundred and five out of 266 patients who were registered in Korea Cancer Center Hospital from Mar. 1985 to Jan. 1994, were analyzed in the aspect of survival and local recurrence. Fifty one patients were excluded due to inadequate data and follow up. Prognostic factors for survival were evaluated statistically. One hundred and four cases were male, 101 female. Average age was 39.7(range 1 to 77) year with a peak incidence around 4th decade. The most frequent diagnosis was malignant fibrous histiocytoma(MFH)(24.1%). Liposarcoma, synovial sarcoma, rhabdomyosarcoma, malignant peripheral nerve sheath tumor and fibrosarcoma were relatively common diagnostic entities, in decreasing order. In location, extremity was 179(87.3%) and trunk 26(12.7%). Average follow up period was 7.5 years(6 months to 10 years). Actuarial 5 years and 10 years survival rate were 64.0% and 40.8% respectively. In univariate analysis with log-lank test, significant differences in survival rate were noted in histopathological diagnosis, size(10 cm), stage and metastasis. Age, sex, tumor location, tumor depth and local recurrence didn't affect the survival rate. Adjuvant chemotherapy and/or radiotherapy did not affect overall survival rate, but lowered the local recurrence rate when compared with surgery only. Surgical margin did not affect the survival rate, but local recurrence rate was different according to each margin; 5.7% in more than wide; 39.5% in marginal; and 60.0% in intralesional excision. In multivariate analysis for results of univariate analysis with Cox's propotional model, metastasis was a meaningful factor for survival of soft tissue sarcoma.

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The Comparison Study of Ankle Joint Mobilization and Elongation on the Difference of Weight-bearing Load, Low Back Pain and Flexibility in Flat-foots Subjects (편평족에 대한 관절가동술과 자가신장이 요부의 신장성, 요통과 하지 체중부하 차이에 대한 비교 연구)

  • Park, Sung-doo;Yu, Dal-yeong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.23 no.2
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    • pp.9-16
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    • 2017
  • Background: The purpose of this study was to investigate the relationship between the spine and the flat-foot, the stability and the alignment of the posture of the neck to prevent the alignment of the ankle joint operation and the lower back flexibility of the lumbar region according to the type of treatment using active stretching of the triceps, back pain, and to see how they affect weight bearing differences. Methods: The subjects of this study were 24 chronic low back pain patients. They were randomly divided into experimental group and control group. In the experimental group, ankle joint mobilization and active scraping of triceps were performed three times a week for a total of 6 weeks. The control group was performed in the same way without articulation. The range of flexion and extension motion of the lumbar spine and pain degree and difference of weight-bearing were measured before and after the experiment. Results: The model of ankle joint mobilization and calf muscle elongation of flat foot significantly improved the range of flexion and extension motion of the vertebrae (p<.05) and the VAS and distribution of weight-bearing were decreased in both of two groups (p<.05). In other words, the exercise and mobilization help to recover of the balance of the whole musculoskeletal, the vertebrae. Conclusions: The active exercise of the triceps muscle of the lower leg in this study It affects the flexibility of the lumbar spine, the pain and the difference in the weight support of the lower extremities, when we performed ankle joint mobilization for exercise and cramping, pain and the difference in weight support between the two lower limbs.

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Factors Influencing Readmission of Convalescent Rehabilitation Patients: Using Health Insurance Review and Assessment Service Claims Data (회복기 재활환자의 재입원에 영향을 미치는 요인: 건강보험 청구자료를 이용하여)

  • Shin, Yo Han;Jeong, Hyoung-Sun
    • Health Policy and Management
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    • v.31 no.4
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    • pp.451-461
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    • 2021
  • Background: Readmissions related to lack of quality care harm both patients and health insurance finances. If the factors affecting readmission are identified, the readmission can be managed by controlling those factors. This paper aims to identify factors that affect readmissions of convalescent rehabilitation patients. Methods: Health Insurance Review and Assessment Service claims data were used to identify readmissions of convalescent patients who were admitted in hospitals and long-term care hospitals nationwide in 2018. Based on prior research, the socio-demographics, clinical, medical institution, and staffing levels characteristics were included in the research model as independent variables. Readmissions for convalescent rehabilitation treatment within 30 days after discharge were analyzed using logistic regression and generalization estimation equation. Results: The average readmission rate of the study subjects was 24.4%, and the risk of readmission decreases as age, length of stay, and the number of patients per physical therapist increase. In the patient group, the risk of readmission is lower in the spinal cord injury group and the musculoskeletal system group than in the brain injury group. The risk of readmission increases as the severity of patients and the number of patients per rehabilitation medicine specialist increases. Besides, the readmission risk is higher in men than women and long-term care hospitals than hospitals. Conclusion: "Reducing the readmission rate" is consistent with the ultimate goal of the convalescent rehabilitation system. Thus, it is necessary to prepare a mechanism for policy management of readmission.