• Health Policy and Management
• /
• v.33 no.1
• /
• pp.3-18
• /
• 2023

Background: A chronic disease management program including patient education, recall and remind service, and reduction of out-of-pocket payment was implemented in Korea through a chronic care model. This study aimed to assess the effect of a community-based intervention program for improving medication adherence of patients with diabetes mellitus in rural areas of Korea. Methods: We applied a non-equivalent control group design using Korean National Health Insurance Big Data. Hongcheon County has been continuously adopting this program since 2012 as an intervention region. Hoengseong County did not adopt such program. It was used as a control region. Subjects were a cohort of patients with diabetes mellitus aged more than 65 years but less than 85 years among residents for 11 years from 2010 to 2020. After 1:1 matching, there were 368 subjects in the intervention region and 368 in the control region. Indirect indicators were analyzed using the difference-in-difference regression according to Andersen's medical use model. Results: The increasing percent point of diabetic patients who continuously received insurance benefits for more than 240 days from 2010 to 2014 and from 2010 to 2020 were 2.6%p and 2.7%p in the intervention region and 3.0%p and 3.9%p in the control region, respectively. The number of dispensations per prescription of diabetic patient in the intervention region increased by approximately 4.61% by month compared to that in the control region. Conclusion: The intervention program encouraged older people with diabetes mellitus to receive continuous care for overcoming the rule of halves in the community. More research is needed to determine whether further improvement in the continuity of comprehensive care can prevent the progression of cardiovascular diseases.

• Journal of Periodontal and Implant Science
• /
• v.44 no.4
• /
• pp.158-168
• /
• 2014

Purpose: The present study was conducted to evaluate the impact of scaling and root planing (SRP) on the C-reactive protein (CRP) levels of gingival crevicular fluid (GCF) and serum in chronic periodontitis patients with type 2 diabetes mellitus (T2DM-CP) or without type 2 diabetes mellitus (NDM-CP). Methods: Forty-eight human participants were divided into two groups: an experimental (T2DM-CP) group (group I, n=24) comprising chronic periodontitis patients with random blood sugar ${\geq}200mg/dL$ and type 2 diabetes mellitus, and control (NDM-CP) group (group II, n=24) of those with chronic periodontitis and random blood sugar <200 without T2DM for the study. All subjects underwent nonsurgical periodontal therapy (NSPT) including complete SRP and subgingival debridement. Periodontal health parameters, plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), GCF volume (GCF vol), GCF-CRP, random blood glucose (RBS), glycated hemoglobin, and systemic inflammatory markers, serum CRP, total leukocyte count (TLC), neutrophil count (Neutr) and lymphocyte count (Lymph), were evaluated at baseline, 1 month, and 3 months after SRP. Results: NSPT resulted in statistically significant improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum as well as GCF of both groups I and II. The mean improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum and GCF was greater in group I than group II after NSPT. There was nonsignificant increase in GCF-CRP, TLC, Lymph, and RBS, and a significant increase in Neutr and Serum CRP in group II at 1 month. The Serum CRP level of 20 out of 24 group II patients had also increased at 1 month. Conclusions: The CRP levels in both GCF and serum were higher in T2DM-CP patients than in NDM-CP patients. Although there was a significant improvement in both the groups, greater improvement was observed in both GCF and serum samples of T2DM-CP patients.

• The Journal of the Korea Contents Association
• /
• v.10 no.3
• /
• pp.222-231
• /
• 2010

This study surveyed on the actual condition for food habits of high-school students in some of Gangwon region, and on the oral-health knowledge level according to the food habits. Its findings are as follows. 1. As a result of students' eating a light meal, the students, who eat a light meal once a day, were the largest with 46.5%. In consequence of examining about the time of eating 46.5% in students, the students, who eat a light meal irregularly, were the largest with 39.0%. 2. As a result of examining about food that students eat as a light meal, the students, who eat pizzas much as a light meal, were the largest with 40.1%. There was significant difference by gender(p<001), by division(p<.05), by parents' monthly income(p<.05) and by monthly pocket money(p<.001) 3. As a result of examining about students' food habit, the total average out of 10-point perfection was 5.03. Thus, students were indicated to be not so good in food habits. As a result of examining students' recognition on a light meal, which has influence upon dental caries, the students, who recognize that candy and chocolate have influence upon dental caries, were the largest with 49.2%. As a result of examining about oral health knowledge according to the actual condition for students' food habits, by frequency of eating a light meal, the students, who eat a light meal once per 3~4 days, had the highest oral-health knowledge. The students, who eat a light meal under once per week, had the low oral-health knowledge, and showed significant difference according to frequency of eating a light meal.

• Korean Journal of Psychosomatic Medicine
• /
• v.26 no.1
• /
• pp.26-34
• /
• 2018

Objectives : This study tried to explore the prevalence of chronic physical diseases in patients with schizophrenia and its effects on total medical costs. Methods : The Health Insurance Review and Assessment Service data in 2014-2015 was employed. Only the injuries and diseases, identically diagnosed 3 times or more as a major or minor injury and disease, were classified into chronic physical diseases to improve data accuracy. Total medical costs included out-of-pocket and insurer's costs from health care system perspective. Results : It was shown that 24.5%, 17.3% and 23.4% of schizophrenia patients had one, two and three or more chronic physical diseases, respectively. There was a high prevalence of not only metabolic, but also musculoskeletal, diseases in those patients. The amount of 2015 total medical costs of patients with schizophrenia in 2014 was about 1.08 trillion won. The factors affecting the costs included sex, age, number of chronic physical diseases, and health insurance status. Conclusions : It is considered that clinical practice guidelines based on personal diseases may not sufficiently solve the problems for comorbidities in schizophrenia patients. Accordingly, it should be required to develop models for new types of medical systems capable of treating and caring varied illnesses at the same time.

• Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
• /
• v.9 no.7
• /
• pp.707-722
• /
• 2019

The concept of neighborhood parks has been used as the principle of forming a community in our society going through modern and contemporary times. The concept of neighborhood parks equipped with physical facilities has been discussed constantly regarding the roles and meanings of them. This study focuses on pocket parks which have been playing roles in improving environment through regeneration and forming regional communities based on that as neighborhood facilities. This author carried out field investigation on total 72 Hanpyeong Park and Hanpyeom Parks formed in the capital area and examined the significance of planning them and also their utility and residents and users' attachment to them through a survey. In this process, this researcher has been able to draw following conclusions. First, according to the demographic characteristics of users, there is significant difference found by groups in terms of their place attachment to the parks. This implies that difference in the major types of residences supplied these days influences their intention to experience ecological space. Second, according to their educational background, there is significant difference found by groups regarding their place attachment to the parks. Third, according to user behavior, there are differences found in their place attachment to the parks and also detailed differences found by groups in terms of the frequency of use and duration of stay.

• Journal of Chest Surgery
• /
• v.35 no.5
• /
• pp.329-335
• /
• 2002

Background: The surgical technique for biventricular assist device(BVAD) implantation has mainly consisted of cannulation procedures. A median sternotomy has been the technique of choice as it gives a surgeon an excellent exposure of the heart. However, considering that most patients require a future sternotomy or already have a previous sternotomy, sternotomy-related complication remains a major concern in BVAD implantation. Based on this consideration as well as the clinical experiences of conventional heart surgery, the authors have hypothesized that the cardiac chambers for BVAD cannulation can be approached from the right side of the heart. The purpose of this studs to develop a novel surgical technique of right thoracotomy for BVAD implantation in an animals study. Material and Method: For last two years, 16 (11 calves, 3 canines, and 2 sheep) out of 30 experimental animals with AnyHeart implantation underwent a right thoracotomy. The device was used as an implantable BVAD in 14 animals, a wearable BVAD in 1, and an implantable LVAD in 1. The chest cavity was entered through the 4th intercostal space or the 5th periosteal bed. As for the BVAD use, a right inflow cannula was inserted into the right atrial free wall and a right outflow cannula was grafted onto the main pulmonary artery. A left inflow cannula was inserted into the interatrial groove and a left outflow cannula was grafted on the innominate artery of the ascending aorta. The connecting tubes were brought out through the thoracotomy wound and connected to the pump located in the subcutaneous pocket at the right flank. Result: Except for the 5 animals for a lilting test or during the early learning curve, all recovered smoothly from the procedures. The inflow drainage allowed the pump output 6.5 L/min at the maximum with 3-3.5 L/min in an average. Of the survivors, there noted no procedure-related mortality or morbidity. Necropsy findings demonstrated the well-positioned cannula tips in the each cardiac chamber

• Korean Journal of Environmental Agriculture
• /
• v.35 no.4
• /
• pp.286-293
• /
• 2016

BACKGROUND: 18% of difenoconazole+iminoctadin triacetate microemulsion (3%+15%) formulation were mixed and sprayed as closely as possible to normal practice on the ten of farms located in the Youngju of South Korea. Patches, cotton gloves, socks, masks and XAD-2 resin were used to measure the potential exposure for applicators wearing standardized whole-body outer and inner dosimeter (WBD). This study has been carried out to determine the dermal and inhalation exposure to difenoconazole during preparation of spray suspension and application with a power sprayer on a grape orchard. METHODS AND RESULTS: A personal air monitor equipped with an air pump IOM sampler and cassette and glass fiber filter were used for inhalation exposure. The field studies were carried out in a grape orchard. The temperature and relative humidity were monitored with a thermometer and a hygrometer. Wind speed was measured using a pocket weather meter. All mean field fortification recoveries were between 97.3% and 119.6% in the level of 100 LOQ (limit of quantification) while the LOQ for difenoconazole was $0.025{\mu}g/mL$ using HPLC-UVD. The arms exposure to difenoconazole for the mixer/loader (0.0794 mg) was higher than other body parts (head, hands, upper body, legs). The exposure to difenoconazole in the legs for applicator (3.78 mg) was highest in the parts of body. The dermal exposure for mixer/loader and applicator were 0.02 and 2.28 mg on a grape orchard, respectively. The inhalation exposure during application was estimated as 0.02 mg. The ratio of inhalation exposure to dermal exposure was equivalent to 0.9% of the dermal exposure. CONCLUSION: The inhalation exposure for applicator indicated $18.8{\times}10^{-3}mg$, which was level of 0.9% of the dermal exposure (2.28 mg). Operator exposure (0.004 mg/kg bw/day) to difenoconazole during treatment for grape is calculated as 2.5% of the established AOEL (0.16 mg/kg bw/day).

• Korean Journal of Environmental Agriculture
• /
• v.37 no.4
• /
• pp.302-311
• /
• 2018

BACKGROUND: Dithianon (75%) formulation were mixed and sprayed as closely as possible by normal practice on the ten farms located in the Mungeong of South Korea. Patches, cotton gloves, socks, masks, and XAD-2 resin were used for measurement of the potential exposure of dithianon on the applicators wearing standardized whole-body outer and inner dosimeter (WBD). This study has been carried out to determine the dermal and inhalation exposure to dithianon during preparation of spray suspension and application with a power sprayer on a apple orchard. METHODS AND RESULTS: A personal air monitor equipped with an air pump, IOM sampler and cassette, and glass fiber filter was used for inhalation exposure. The field studies were carried out in a apple orchard. The temperature and relative humidity were monitored with a thermometer and a hygrometer. Wind speed was measured using a pocket weather meter. All mean field fortification recoveries were between 85.1% and 99.1% in the level of 100 LOQ (limit of quantification), while the LOQ for dithianon was $0.05{\mu}g/mL$ using HPLC-DAD. The exposure to dithianon on arms of the mixer/loader (0.0794 mg) was higher than other body parts (head, hands, upper body, or legs). The exposure to dithianon on the applicator's legs (3.78 mg) was highest in the body parts. The dermal exposures for mixer/loader and applicator were 10 and 8.10 mg, respectively, from a grape orchard. The inhalation exposure during application was estimated as 0.151 mg, and the ratio of inhalation exposure was 11.2% of the dermal exposure (inner clothes). CONCLUSION: The dermal and inhalation exposure on the applicator appeared to be 4.203 mg - 25.064 mg and $0.529{\mu}g-116.241{\mu}g$, respectively. The total exposures on the agricultural applicators were at the level of 2.596 mg - 25.069 mg to dithianon during treatment for apple orchard. The TER showed 3.421 (>1) when AOEL of dithianon was used as a reference dose for the purpose of risk assessment of the mixing/loading and application.

• The Korean Journal of Air & Space Law and Policy
• /
• v.32 no.1
• /
• pp.177-200
• /
• 2017

This writer have thus far reviewed the civil and criminal obligations of the directors of a parent company that sponsored financially troubled affiliates. What was discussed here applies to logistics companies in the same manner. Hanjin Shipping cannot expect its parent company, Korean Air to prop it up financially. If such financial aid is offered without any collateral, under Korean criminal law, the directors of the parent company bears the burden of civil and criminal responsibility. One way to get around this is to secure fairness in terms of the process and the content of aid. Fairness in terms of process refers to the board of directors making public all information and approving such aid. Fairness in terms of content refers to impartial transactions that block out any possibilities of the chairman of the corporate group acting in his private interest. In the case of Korean Air bailing out Hanjin, the meeting of board of directors were held five times and a thorough review was conducted on the risks involved in the loans being repaid or not. After the review, measures to guard against undesirable scenarios were established before finally deciding on bailing out Hanjin. As such, there are no issues. In terms of the fairness of content, too, there were practically no room for the majority shareholder or controlling shareholder to pocket profits at the expense of the company. This is because the continued aid offered to a financially troubled company (i.e. Hanjin Shipping) was a posing a burden to even the controlling shareholder. This writer argues that the concept of the interest of the entire corporate group needs to be recognized. That is, it must be recognized that the relationship of control and being controlled between parent company and affiliate company, or between affiliate companies serves a practical benefit to the ongoing concern and growth of the group and is therefore just. Moreover, the corporate group and its affiliates, as well as their directors and management must recognize that they have an obligation to prioritize the interests of the corporate group ahead of the interests of the company that they are directly associated with. As such, even if Korean Air offered a loan to Hanjin Shipping without collateral, the act cannot be treated as an offense to law, nor can the directors be accused of damages that they bear the responsibility of compensating under civil law.

• Korea Journal of Hospital Management
• /
• v.13 no.1
• /
• pp.24-41
• /
• 2008

This research is aimed at analyzing and understanding the perception and attitudes of inpatients in a general hospital in Seoul towards the activation of private health insurance. Survey was conducted against 231 inpatients, results of which were analyzed in the methods of frequency analysis, chi square test, and logistic regression. The results are summarized as follows; First, better-educated population who finished college education at least, higher-income population, and people who had more knowledge about private health insurance showed more perception about activation of private health insurance. Second, better-educated population who finished college education at least, higher-income population, those who are insured in existing private insurance, oncological patients, and people who had more knowledge about private health insurance showed more positive attitude towards private health insurance paying for actual damages, long-term care insurance, and income security insurance. Third, age and education were the factors affecting perception about activation of private health insurance. The older the age is, perception was 1.035 times positive towards activation of private health insurance, and those who finished college education or above showed 3.148 times positive perception towards the same. Forth, surgical patients showed 1.087 times more positive attitude towards private health insurance paying for actual damages than internal medicine patients, while oncological patients showed 2.314 times more positive attitude than internal medicine patients. Further, understanding on the activation of private health insurance was 6.014 times higher in the higher understanding group than in the lower understanding group. Intention to use long-term care insurance was 2.692 times stronger in the male group than in the female group, and 3.616 times stronger in the oncological patients group than in internal medicine patients group. Further, understanding on the activation of private health insurance was 3.881 times deeper in the higher understanding group than in the lower understanding group. Intention to use income security insurance was 3.185 times stronger in those who have academic background of under the high school than those over the college, and 4.175 times higher in the group those whose monthly average income is over 4 million won than those under 4 million won. Also, intention to use income security insurance was 4.323 times higher in the group those who are insured by existing private insurances than those who are not insured by those insurances and it was 5.234 times higher in the group of oncological patients than in the group of internal medicine patients. Further, intention to use income security insurance was 3.559 times higher in the group those who thought that out-of-pocket money of the National Health Insurance is too much to bear than those it is quite endurable. Understanding on the activation of private health insurance was 4.875 times deeper in the higher understanding group than in the lower understanding group. There were some suggestions could be made based on the results of this research. First, reinforced publicity and education is needed for the low-educated or low-income group, as there are gaps in the understanding on the activation of private health insurance depending on the degree of education and income. Second, government should prepare administrative complementary measures to solve the problem of adverse selection by the consumer which is foreseen when private health insurances are activated. Third, government should suggest the desirable course of development of private health insurance items to ensure efficient use of enormous fund of private insurance market for health security of the people. Further, institutional complementary measures are needed to convert existing cancer insurances or specific disease insurances to private health insurances paying for actual damages guaranteeing against every kind of disease. Forth, it judged that, not only private health insurances paying for actual damages, but also long-term care insurances and income security insurances are prospective as fields to create fresh demand for insurance industry.