• Korean Journal of Schizophrenia Research
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• v.24 no.2
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• pp.52-59
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• 2021

Objectives: Recent studies have reported that delayed initiation of clozapine can affect clinical response in patients with treatment-resistant schizophrenia (TRS). This study aimed to explore the relationship between delayed initiation of clozapine and acute treatment response. Methods: Sixty-five inpatients with TRS who started clozapine for the first time were included through a retrospective chart review. Acute treatment response was defined as a 30% reduction in the Positive and Negative Syndrome Scale score or a Clinical Global Impression of Improvement score of 1 (very much improved) or 2 (much improved) at 4 weeks after initiating clozapine. Results: After meeting the TRS criteria, the mean delay for initiating clozapine was approximately 13.8 months. The delay was shorter in patients who showed a better response to clozapine in logistic regression analysis (p=0.037). Conclusion: Our findings suggest that reducing the delay in initiating clozapine increases the effectiveness of clozapine in patients with TRS.

• Journal of East-West Nursing Research
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• v.16 no.2
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• pp.172-178
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• 2010

Purpose: We examined the relationship between the health-related issues of elderly women and bone density and identified specific factors that affect the prevalence of osteoporosis to provide basic data for developing a health care program on osteoporosis prevention. Methods: This study is a secondary data analysis of 118,903 66-yr-old women who received a health examination conducted by the National Health Insurance Corporation in 2008. Multiple logistic regression analysis was used to identify factors affecting the prevalence of osteoporosis. Results: The prevalence of osteoporosis was 46.8%, whereas the prevalence of osteopenia was 38.4% among elderly women in this study. Statistically significant differences were observed between the osteoporosis and non-osteoporosis group in terms of smoking (p<.001), exercise (p<.001), obesity (p<.001), waist circumference (p<.001), depression (p<.001), falling experience (p<.05), and the cognitive function risk (p<.05). Based on the multiple logistic regression results, the risk for osteoporosis was high in those who were under-weight, smoked, or were depressed. In contrast, moderate or high level obesity showed a negative relationship with osteoporosis. Conclusion: The prevalence of osteopenia and osteoporosis was 85.2%. Therefore, there is a need to develop health care programs pertaining to osteoporosis intervention and prevention for elderly women. Because smoking, non-exercise, and obesity are main osteoporosis risk factors, it is highly recommended that some sound practical life programs and psychological support programs be considered for this population.

• Journal of Preventive Medicine and Public Health
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• v.53 no.4
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• pp.285-288
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• 2020

The health insurance system in Korea is well-established and provides benefits for the entire national population. In Korea, when patients are treated at a hospital, the hospital receives a partial payment for the treatment from the patient, and the remaining amount is provided by the health insurance service. The Health Insurance Review and Assessment Service (HIRA) assesses whether the treatment was appropriate. If HIRA deems the treatment appropriate, the doctor can receive payment from the health insurance service. However, this system has several drawbacks. In this study, we aimed to provide examples of the problems that can occur in relation to HIRA assessments in Korea through actual clinical cases.

• Journal of Society of Preventive Korean Medicine
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• v.11 no.2
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• pp.175-188
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• 2007

The purpose of this study was to confirm the reasons why the medical institutes avoid the traffic accident victims covered by the automobile insurance. For this purpose, a university hospital was sampled to comparatively analyze days of hospitalization, average medical cost per day, ratio of optional medical cost, average cost by injury/age group/department, distribution of MRI photographing, etc., between health insurance and automobile insurance patients. Accordingly, in order to assure automobile patients of a reasonable rights of medical services, it is deemed necessary to arrange a fair system encouraging them reduce the days of their hospitalization as well as a complementary mechanism preventing unnecessary expensive medical services due to the hazard.

• Journal of Information Technology and Architecture
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• v.10 no.3
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• pp.379-386
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• 2013

This study is about the suggestion of reduction method for social insurance cost of startup SMEs based on the study abroad. We suggest several methods (direct and indirect support, exemption, deferment or loan) based on the pros and cons, government's financial situation, the ease of implementation and effectiveness of mitigation methods, creating conditions for the implementation of social insurance mitigation.

• The Korean Journal of Applied Statistics
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• v.28 no.4
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• pp.663-683
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• 2015

The change of the population pyramid due to low fertility and rapid aging threatens the financial sustainability of National Health Insurance. We construct statistical models for prevalence rates and medical expenses using National Health Insurance Service (NHIS) sample cohort data from 2002-2013. We then project yearly expenditures and income of national health insurance until 2060 that considers various assumptions in regards to future population structure and economic conditions. We adopt a VECM-LC model for prevalence rates and the double exponentially smoothing method for the per capita co-payment of healthcare expense (in which the two models are institution-disease-sex-age specific) to project of national health insurance expenditures. We accommodate various assumptions of economic situations provided by the national assembly and government to produce a financial projection for national health insurance. Two assumptions of dependents ratios are used for the projection of national health insurance income to conduct two future population structures by the two assumptions of aging progresses and various assumptions on economic circumstances as in the expenditure projection. The health care deficit is projected to be 20-30 trillion won by 2030 and 40-70 trillion won by 2060 in 2015 constant price.

• Journal of radiological science and technology
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• v.43 no.5
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• pp.343-351
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• 2020

This study analyzed dose reduction and quality of images through dose reduction tools and shielding board to protect sensitive eye lens in radiation during orbit CT examinations for clinical data use. During CT scans of the phantom, surface dose (CT scanner dosimetry phantom, ion chamber-3 times) and quality of image (radiosurgery head phantom, visual assessment-2 times, HU standard deviation) were evaluated using X-care which is dose reduction tools and bismuth shielding board. The results of experiments of eight conditions showed a relatively reduced dose in all other conditions compared to when no conditions were set. In particular, the area corresponding to the ophthalmic part reduced the surface dose by up to 45.7 %. The visual evaluation of images by specialists and the quality evaluation of images analyzed by HU standard deviation were clinically closest to the use of X-care and shielding board (1 cm in height). Therefore, it is believed that the use of shielding board in a suitable location with dose reduction tools while investigating the optimal radiation dose will reduce the exposure dose of sensitive lens at radiation while maintaining the quality of the images with high diagnostic value.

• Health Policy and Management
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• v.22 no.3
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• pp.451-465
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• 2012

In order to strengthen assurance of National Health Insurance, co-payment should be reduced. This can happen with collaborative efforts of patients, medical institutes, and government altogether at the same time. This research applied Dutton(1986)'s medical service research model with high R-square, and analyzed 2008 Korea Health Panel Data (Beta Version 1), that was examined by Korea Institute for Health and Social Affairs and National Health Insurance, in order to figure out influential variables on co-payment. In result of Multiple Linear Regression Analysis, R-square was 46.7%, the older the age, the patients who had surgery, the longer days of hospital treatment are, the higher gross income of a household is, the more hospitalized in upper grade general hospitals, and the more upper grade rooms and selecting a doctor are used. The results have statistical significance. When conducting research applying medical service research model, there is a need to apply Dutton(1986)'s medical service research model with high R-square. In order to strengthen assurance of National Health Insurance, first conditions should be that patients are hospitalized in upper grade general hospital, and at the same time, are patients who had surgery with long stay of hospitalization. In addition, if proven that patients used upper grade rooms and selecting a doctor due to lack of regular treatment and rooms, for certain number of days of such hospitalization, it is suggested to be provided with health care insurance in upper grade rooms and selecting a doctor in calculating co-payment limit.

• Clinical and Experimental Pediatrics
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• v.63 no.6
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• pp.219-225
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• 2020

Background: There is increasing concern that moderate preterm (32-33 weeks' gestation) and late preterm (34-36 weeks' gestation) birth may be associated with minor neurodevelopmental problems affecting poor school performance. Purpose: We explored the cognitive function, cognitive visual function, executive function, and behavioral problems at school age in moderate to late preterm infants. Methods: Children aged 7-10 years who were born at 32⁺⁰ to 36⁺⁶ weeks of gestation and admitted to the neonatal intensive care unit from August 2006 to July 2011 at the National Health Insurance Service Ilsan Hospital were included. We excluded children with severe neurologic impairments, congenital malformations, or chromosomal abnormalities. Neuropsychological assessments consisted of 5 neuropsychological tests and 3 questionnaires. Results: A total of 37 children (mean age, 9.1±1.2 years) participated. The mean gestational age at birth was 34.6±7.5 weeks, while the mean birth weight was 2,229.2±472.8 g. The mean full-scale intelligence quotient was 92.89±11.90; 24.3% scored between 70 and 85 (borderline intelligence functioning). An abnormal score was noted for at least one of the variables on the attention deficit hyperactivity disorder diagnostic system for 65% of the children. Scores below borderline function for executive quotient and memory quotient were 32.4% and 24.3%, respectively. Borderline or clinically relevant internalizing problems were noted in 13.5% on the Child Behavior Check List. There were no significant associations between perinatal factors or socioeconomic status and cognitive, visual perception, executive function, or behavior outcomes. Conclusion: Moderate to late preterm infants are at risk of developing borderline intelligence functioning and attention problems at early school age. Cognitive and executive functions that are important for academic performance must be carefully monitored and continuously followed up in moderate to late preterm infants.

• Journal of Preventive Medicine and Public Health
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• v.42 no.1
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• pp.5-11
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• 2009

Objectives : This study was conducted to estimate the socioeconomic cost of injuries in South Korea. Methods : We matched claims data from national health insurance, automobile insurance and industrial accident compensation insurance(IACI), and mortality data obtained from the national statistical office from 2001 to 2003 by patients unique identifier. Socioeconomic cost included both direct cost and indirect cost: the direct cost was injury-related medical expenditure and the indirect cost included loss of productivity due to healthcare utilization and premature death. Results : The socioeconomic cost of injuries in Korea was approximately 1.9% of the GDP from 2001 to 2003. That is, 12.1 trillion KRW(Korean Won) in 2001, 12.3 trillion KRW in 2002, and 13.7 trillion KRW in 2003. In 2003, direct medical costs were 24.6%(3.4 trillion KRW), the costs for loss of productivity by healthcare utilization were 13.0%(1.8 trillion KRW), and the costs for loss of productivity by premature death were 62.4%(8.6 trillion KRW). Conclusions : In this study, the socioeconomic cost of injuries in Korea between 2001 and 2003 was estimated by using not only health insurance claims data, but also automobile insurance, IACI claims and mortality data. We conclude that social efforts are required to reduce the socioeconomic cost of injuries in Korea, which represented approximately 1.9% of the GDP for the time period specified.