• 보건행정학회지
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• 제23권2호
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• pp.112-123
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• 2013

Background: Under the risk of financial sustainability of National Health Insurance, Korean government attempted a series of regulations over pharmaceutical prices. The first price-cut was implemented to the hyperlipidemial treatments, and the prices of statins were reduced on 15th, April in 2009. The purposes of this study are 1) to investigate the impact of this price-cut on pharmaceutical expenditure, and 2) to identify the factors associated with drug-switch among statins. Methods: Using the national patients sample data, this study conducted time series analysis on the expenditures, prices, and volumes of statin drugs. To understand the factors associated with drug-switch, the multinomial logit model was analyzed at the patients level. Results: The results of time series analysis demonstrated that the price-cut of hyperlipidemic medicines did not lead to the reduced expenditure, suggesting the increased volume was the major cause. The multinomial logit analysis identified the switch of healthcare provider as the significant factor that was highly associated with drug-switch, implying the physicians' preference was the major motivation of drug-switch. Conclusion: Without control of utilization, price regulation itself could not reduce pharmaceutical expenditure. This suggests that the pharmaceutical regulations should be implemented on the basis of understanding of provider behaviors. The findings of this study will form the first step for further empirical studies.

• 한국임상약학회지
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• 제26권4호
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• pp.341-347
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• 2016

Background: Liver cirrhosis causes substantial socio-economic burden and is one of the major severe liver diseases in Korea. Nonetheless, there is only a few studies that analyzes disease burden of liver cirrhosis in Korea. Such study must be carried out due to its increasing need from the invention of new drugs for chronic hepatitis and demand for cost-effectiveness analyses. Methods: Patient sample data with ensured representativeness was analyzed retrospectively to compare the medical costs and uses for patients with compensated cirrhosis and decompensated cirrhosis. Patient claims data that include K74 and K703 from the year of 2014 were selected. Within the selected data, decompensated cirrhosis patient was identified if complications such as ascites (R18), encephalopathy (B190), hepatic failure (K72), peritonitis (K65), or esophageal varices (I85) were included, and they were compared to compensated cirrhosis patients. Results: 6,565 patients were included in the analysis. The average cost per patient was 6,471,020 (SD 8,848,899) KRW and 2,173,203 (4,220,942) KRW for decompensated cirrhosis and compensated cirrhosis, respectively. For inpatients, the average hospitalized days was 38.0 (56.4) days and 27.2 (57.2) days for decompensated cirrhosis and compensated cirrhosis, respectively. For outpatients, the average number of visits was 8.7 (9.1) days and 5.3 (7.5) days for compensated cirrhosis and decompensated cirrhosis, respectively. Conclusion: Compared to compensated cirrhosis patients, decompensated cirrhosis patients had higher costs, especially for hospitalization, injection, examination, and drugs administrated within medical institutions.

• 대한소아치과학회지
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• 제48권2호
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• pp.129-139
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• 2021

이 연구의 목적은 치면열구전색의 급여화 이후 치면열구전색 처치를 받은 소아청소년 환자들의 성별, 나이, 보험종류, 지역, 의료기관 등의 특성을 알아보는 것이다. 건강보험심사평가원의 환자표본자료를 이용하였으며 2010년부터 2017년까지 총 8,454,636명의 환자의 정보를 얻을 수 있었고 이중 치면열구전색 처치가 포함된 환자는 114,680명이었다. 여자에서 남자보다 치면열구전색 처치를 받은 비율이 더 높았고, 5 - 9세 집단이 다른 연령에 비하여 가장 많은 치면열구전색 환자 및 진료 비율을 보였다. 보험의 경우 건강보험을 가진 경우가 의료급여에 해당하는 환자에 비해 치면열구전색 진료를 받은 비율이 높았고 진료기관은 치과의원, 치과병원, 보건소 순으로 나타났다. 지역별 비교에서는 경기도가 가장 많은 치면열구전색 환자를 보였으나, 환자 비율의 경우 전북이 가장 높게 나타났다.

• 성인간호학회지
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• 제28권2호
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• pp.226-236
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• 2016

Purpose: The aim of this study was to evaluate the nutritional status and to identify factors affecting malnutrition in hemodialysis patients. Methods: Data were collected from a convenience sample of 125 hemodialysis patients who agreed to participate in the study, between August 1 and October 4, 2014. Five structured questionnaires were used: Patient-generated Subjective Global Assessment, Simplified Nutritional Appetite Questionnaire, Self-rating Depression Scale, Fatigue Scale, and Family Support Scale. Data were analyzed by descriptive statistics, t-test, Mann-Whitney U test, ${\chi}^2$-test, and stepwise multiple regression analysis by using SPSS/WIN 22.0 program. Results: Of 125 patients, 30.4% were found to be malnourished. Malnutrition was related to age, family household income, depression, fatigue, social support, appetite, and levels of C-reactive protein and serum albumin. Stepwise multiple regression analysis showed that appetite, C-reactive protein level, fatigue, and albumin level were significant factors affecting malnutrition in hemodialysis patients. Conclusion: Regular and consistent nutritional assessment is essential in hemodialysis patients. Nurses who care for hemodialysis patients need to consider the factors identified from these findings when assessing their patients' nutritional status and needs.

• 한국치위생학회지
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• 제11권4호
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• pp.489-497
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• 2011

Objectives : Based on data collected from patients who suffered from dental caries during the period between 1990 and 2008, the number of patients and their trends were analyzed as a source of evidence to conduct the oral health plan. Methods : A population of sample design for patient survey data was derived from computerized data saved at medical institutions accredited by National Health Insurance Corporation. Large institutions such as dental hospitals were included for the complete enumeration test, while the rest of medical institutions, for example, dental clinic, relatively small institutions, were used for the sample survey. Most of patients with dental caries were outpatients and their disease was treated at the dental hospital or dental clinic in general, therefore, main analysis was carried out at those institutions. Results : The rate of patients who suffered the dental caries has decreased to 56.8% in 2008 from 78.5% in 1990. The rate of patients who visited the dental hospital for treatment has increased to 4.8% in 2008 from 0.5% in 1990, whereas the percentage of those who visited the dental clinic has fallen to 97.9% from 99.5% during the same period. The ratio by age, in the meantime, it showed that patients aged 40s has increased to 13.5% in 2008 from 7.2% in 1990, and the number also has risen in 50s from 5.6% in 1990 to 9.9% in 2008. However, the number of children aged 0 to 9 who visited hospital for treatment of dental caries has fallen to 17.0% in 2008 from 33.9% in 1990. Conclusions : By figuring out the trends of patients with the dental caries during the period between 1990 and 2008, fundamental data for the oral health policy have been collected. As a result, the necessity of a new medical treatment system for managing the dental caries in terms of patient ages as well as the oral health policy and campaign was taken into consideration.

• 대한치과교정학회지
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• 제19권1호
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• pp.219-243
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• 1989

The purpose of this study was to evaluate the effects of the chincap therapy on the craniofacial structure in persons with skeletal Class III malocclusion. The patients selected for this study were treated with extra-oral chincap therapy only. Both control and treatment samples were obtained from Seoul National University Hospital where these longitudinal data were gathered. 55 treated patients and 14 control patients were studied. The mean ages at the 1st evaluation was 8 years 3 months in the treatment sample and 9 years 4 months in the control sample. The duration of chincap therapy was variable but averaged 2 years of treatment. Post-treatment observation procedeeded for 1 year 2 months. Active treatment and post treatment effects were evaluated. The results were as follows: 1. Neither significant restraint nor acceleration of growth was found in the cranial base and maxilla during treatment. 2. A distal rotation of the mandibular complex was seen. 3. Some amount of restraint of growth was found in mandibular body length, ramus height, mandibular length during treatment. 4. The genial angle was reduced. 5. After removal of the chin-cap, forward displacement of the mandible took place.

• Journal of Korean Neurosurgical Society
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• 제62권1호
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• pp.71-82
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• 2019

Objective : To determine the prevalence of osteoporosis (OP) and osteoporotic vertebral fracture (OVF) in people with Parkinson's disease (PD) in Korea and its association with socioeconomic status. Methods : Using Health Insurance Review and Assessment Service-National Inpatient Sample (HIRA-NIS) data from 2009 to 2013, we estimated the annual prevalence of PD, OP, and OVF and investigated its association with socioeconomic status using data from National Health Insurance (NHI) beneficiaries and Medical Aid (MA) recipients. This study was supported by research funding from Korean Society for Bone and Mineral Research 2015. There were no study-specific biases related to conflicts of interest. Results : The number of PD patients in the HIRA-NIS increased each year from 2009 to 2013. Among patients with PD, the standardized prevalence rates of OP and OVF increased from 2009 to 2013; from 23.2 to 27.8 and from 2.8 to 4.2, respectively. Among patients with PD with OP, the prevalence of OVF were 12.2% and 15.1% in 2009 and 2013, respectively. The standardized prevalence rates of PD with OP and PD with OVF were significantly higher in MA recipients than in NHI beneficiaries. Conclusion : The prevalence of PD both with OP and with OVF increased and the prevalence was higher in MA recipients than in NHI beneficiaries. These findings may suggest that age over 65 years, female and low income may be a significant factor related to PD occurring with OP and OVF.

• Investigative and Clinical Urology
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• 제59권6호
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• pp.383-391
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• 2018

Purpose: We aimed to analyze the incidence and prevalence of urolithiasis in Korea over the last decade using the National Health Insurance (NHI) sample cohort data. Materials and Methods: From January 2002 to December 2013, we enrolled sample cohort data from the NHI. Patients diagnosed with international classification of diseases code N20 or N13.2 were included. The incidence and prevalence rate was counted from the same period and patients previously diagnosed with urolithiasis were excluded. We compared the incidence and prevalence of urolithiasis by region, age, and sex, and identified the changes. Results: Total 1,111,828 subjects were included. Of these subjects, 36,857 had urolithiasis. The male-to-female ratio was 1.57:1, and total incidence rate was 3.27 per 1,000 person-years (1,000p-yrs). The annual incidence was lowest in 2013 (3,138 patients) and highest in 2005 (3,751 patients). Incidence rate by diagnostic code was highest in ureter stone only (2.49 per 1,000p-yrs) and was lowest in kidney and ureter stone both (0.17 per 1,000p-yrs). Prevalence gradually increased from 3,172 in 2002 and 5,758 in 2013. Jeollanam-do had the highest incidence rate of 3.70 persons per 1,000p-yrs, and Jeju had the lowest rate of 2.84 persons per 1,000p-yrs. In gender analysis, Daegu had the highest incidence (4.56) in males, Jeollanam-do had the highest incidence (3.20) in females. Conclusions: Annual incidence remained stable, whereas prevalence gradually increased. The incidence in male was 1.57 times higher than female, and the peak incidence age was 45-49 years, with the highest incidence occurring in Jeollanam-do and the lowest in Jeju.

• 한국치위생학회지
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• 제18권5호
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• pp.653-664
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• 2018

Objectives: The purpose of this study was to examine the association between two major oral diseases and cardiovascular diseases. Methods: Data from the 6th Korean National Health and Nutrition Examination Survey (2013-2015) were used. The study included 12,754 adults, aged ${\geq}19years$, who participated in the questionnaire survey of health related to hypertension, stroke, myocardial infarction, and angina pectoris as well as completed blood tests, anthropometry, and oral examination. Statistical analyses included complex sample frequency, complex sample general linear, complex sample cross-tabulation, and complex sample logistic regression analyses. Results: With respect to the number of Decayed-Missing-Filled-Teeth(DMFT ), patients with hypertension (DMFT 8.05), stroke (DMFT 8.66), and angina pectoris (DMFT 8.24) showed a DMFT score of >2, compared with those who did not have these diseases (p<0.05). Patients with hypertension, stroke, myocardial infarction, and angina pectoris presented an approximately 2.7, 3.5, 4, and 3 times higher incidence of periodontal diseases, respectively, than those who did not (p<0.05). Based on the analysis of the relationship between the number of DMFT and cardiovascular diseases, patients with cardiovascular diseases had a risk of 1.033 higher DMFT than those who did not (p<0.05). As per the analysis of the relationship between periodontal diseases and cardiovascular diseases, patients with cardiovascular diseases had a 2.969 higher risk of periodontaldiseasesthanthosewithout them (p<0.05). Conclusions: Two major oral diseases were found to be associated with cardiovascular diseases. Therefore, to prevent these major oral diseases in patients with cardiovascular diseases, oral hygiene management must be actively performed.

• Asian Pacific Journal of Cancer Prevention
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• 제17권11호
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• pp.4831-4836
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• 2016

The study aimed to find out to what degree suicidal thoughts and associated factors affect the suicide risk of advanced cancer patients. The frequency of suicidal thoughts among patients with cancer, especially in the advanced stages, is about 3 times greater than the adult average in South Korea. We recruited 457 participants with four types of cancers (colon, breast, cervical, and lung) using stratified sampling. Data collection was carried out through one-on-one interviews by trained nurses using a structured questionnaire. Advanced cancer patients with high, vs. low, levels of anxiety and pain had a higher suicide risk. In contrast, having one's spouse as the primary care provider was associated with a low suicide risk. Overall, the three factors of anxiety, pain, and the primary caregiver being one's spouse explained 17.2% of the variance in suicide risk. In conclusion, we derived influencing factors of suicide risk using a sample of patients with various types of advanced cancer. The results provide systematic baseline data for preparing nurse-led interventions to prevent suicidal thoughts and suicide attempts among advanced cancer patients.