• 보건행정학회지
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• 제2권1호
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• pp.66-79
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• 1992

The code of the International Classification of Disease(ICD) is seriously questioned on its effectiveness in identifing an independent disease entity from similar conditions at general practitioner's offices. This study has attempted to show individual coding variations in ICD for similar ambulatory care conditions. It has been assumed that a following outpatient visit is regarded as the sane kind of visit owing to the same disease if a visit to the different source of care would be mad within an interval of less than two days. The 'D' health insurance association was selected for this analysis. The 'D' association had 153,298 members and made claims of 642,605 outpatient care in 1990. Out of the total outpatient claims, 8.6%(55,102 claims) were counted as the same disease which could meet the above assumption. Percent of conditions classified as the 10 leading causes of frequent visits which were matched accurately to the subsequent ICD diagnostic code found to be 15.8% on the average. The URI was noted for the highest concurrence rate of 20.4%. This proportion was even decreased to 11.6% on the case of chronic disease. Despite the fact that the assumption underlying the definition of the above same disease is rather rough and inappropriate, this study reveals that the code of ICD currently in use has weaknesses in seperating a certain independent disease from similar conditions at the outpatient setting. Thus, efforts need to be elaborated to meet the need of a new system of classification for conditions and diseases encountering at ambulatory care.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권4호
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• pp.271-280
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• 2017

Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results: Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ${\geq}6$. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion: With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.

• 대한한방소아과학회지
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• 제32권1호
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• pp.54-74
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• 2018

Objectives The purpose of this study is to investigate recent trend of diseases in Korean pediatrics and adolescent patients treated with oriental medicine. Methods Using data from the Korean statistical information service and healthcare bigdata hub, top 500 diseases pediatrics and adolescents that were treated with oriental medicine from 2012 to 2016 in admission and outpatient department was collected. Results From the inpatient study, majority of the subjects were between 15 to 19 years old (62.74%), followed by 10 to 14 years old, 5 to 9 years old and under 5 years old. In the outpatient department study, majority was 15 to 19 years old (36.51%), followed by 10 to 14 years old, under 5 years old, 5 to 9 years old. In systemic division of admission part, the most common disease was musculoskeletal related which was 72.32%, followed by brain, nerve, respiratory, dermatology and digestive related diseases. In systemic division of outpatient department, respiratory disease was the most common (41.81%), followed by digestive, dermatology, brain and nerve diseases. For under 5 years old patient group, respiratory disease was the most common, 29.86%, followed by dermatology, musculoskeletal, digestive related diseases. For 5 to 19 years old group of patients, musculoskeletal disease was most common. For the 5 to 14 years old patient group, respiratory related disease was the most common followed by dermatology and digestive diseases. For 15 to 19 years old patient group, digestive disease was the most common followed by respiratory and dermatology related diseases. For under 5 to 9 years old outpatient group, respiratory disease was the most common, and for under 5-year-old group, digestive, growth development, and dermatology disease were common. For the 5 to 9 years old group of patients, musculoskeletal related disease was the most common followed by digestive and dermatology related diseases. For the 10 to 19 years old patient group, musculoskeletal was the most common. For the 10 to 14 years old patient group, respiratory related disease was the most common followed by digestive, dermatology disease. For the 15 to 19 years old patient group, digestive related disease was the most common followed by respiratory, dermatology diseases. Musculoskeletal disease increased every year, in both inpatient and outpatient. Respiratory, brain, nerve, digestive related diseases were generally decreased. In outpatient, respiratory diseases were increased every year but brain, nerve, digestive related diseases were generally decreased. Conclusions More studies about the oriental medicine in chronic disease, such as allergy, metabolic syndrome, in Korean pediatrics and adolescents are needed.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제12권2호
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• pp.31-39
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• 2006

Much has changed in the healthcare field since the beginning of the industrial age. In the healthcare field changes are occurring so rapidly and dramatically that yesterday's paradigm will not be tomorrow's paradigm, creating the need above all else to stay fluid and flexible as strategies(included healthcare architecture planning) for the future are developed. The purpose of this study is to analyze the latest architectural trends of general hospital outpatient department based on the healthcare environment changes in Korea. The major healthcare environment change is to change the object of hospital's healthcare services from inpatient to outpatient. In conclusion, the first, medical faculties of outpatient department are subdivided specialized small faculty. The second, clinic systems for medical examination and treatment of specific disease are activated in the most outpatient department. The third, specialized medical centers for chronical disease(Cancer, Cardiac etc.) control are arranged in existed outpatient department or freestanding facility. Specialized medical center for preventive medicine is regionally decentralized for corresponding with the healthcare paradigm shifts.

• 한국병원경영학회지
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• 제24권3호
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• pp.1-10
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• 2019

Purpose: The purpose of this study was to investigate determinants of purchasing indemnity private health insurance and its impact on the healthcare utilization among outpatients with chronic disease. Methods: The study analyzed 4,997 chronic ill patients using 2015 Korean Health Panel data. Logistic regression analysis was conducted to analyze the factors affecting the purchase of indemnity private health insurance and multiple regression analysis was conducted to analyze the effect of private health insurance on the number of outpatient visits and outpatient expenditures. Findings: The age, education level, and number of chronic diseases were significant factors affecting the purchasing of indemnity private health insurance among chronic patients. As a result of analyzing the impact of indemnity private health insurance on healthcare utilization, the number of outpatient visits for those who enrolled in the indemnity private health insurance was higher than the number of outpatient visits for those who did not. But there was no statistically significant difference in outpatient medical expenses. Practical Implications: The results of this study shows that indemnity private health insurance may cause inequality in the healthcare utilization of the socially vulnerable. It is necessary to seek ways to strengthen the health security of chronic disease patients and high-risk elderly people who need more healthcare.

• 보건의료생명과학 논문지
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• 제8권2호
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• pp.135-142
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• 2020

본 연구는 강원도 영북지역에 주소를 둔 환자의 입원/외래 진료의 이용빈도를 분석하여 영북지역의 의료수요 및 의료이용 현황 파악을 하고자 국민건강보험공단 공공데이터포털(www.data.go.kr) 2003년 부터 2017년까지 건강보험 및 의료급여(입원/외래) 진료비 청구자료를 분석하였다. 다빈도 순위는 '진료건 및 %'에 따라 최빈도의 상병순으로 1-60순위까지의 순위를 선정하였다. 또한, 영북권 유일의 속초의료원 환자의 이용 추이를 병행 분석하였다. 분석결과 강원도 영북지역은 과거 급성기 질환에서 점차 만성인 비감염성 질환의 형태로 상병에 따른 외래 진료 이용과 입원환자의 이용이 증가하고 있다. 특히 조현병과 산과진료의 기능을 확충하고 지역사회의 건강관리에 필요한 구체적인 보건사업을 수행할 필요가 있으며 이를 통해 강원도 영북지역 주민의 삶의 질적 향상을 높여야 한다.

• 한국병원경영학회지
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• 제26권2호
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• pp.56-67
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• 2021

Background: Regular doctor visits are vital for hypertension patients, especially for who have never received hypertension medication or non-pharmacologic therapy. This study purposed to study factors affecting outpatient visits for patients diagnosed with hypertension. Methods: This study included 59,009 respondents with hypertension over 30 from 2019 Community Health Survey data. Outpatient visits were defined by having hypertension treatments such as medication or non-pharmacologic therapy. Logistic regression was used to examine the factors affecting outpatient visits using SAS ver. 9.3. Results: 57,081(96.73%) patients with hypertension were identified as those having a outpatient visit for hypertension treatments, whereas 1,928(3.27%) patients did not have visits. Patient's characteristics such as gender, age, periods of hypertension, education level, perception of the blood pressure, hypertension management education, place of living, body mass index, depression and diabetes were found to have statistically significant relationship with the outpatient visits. Practical Implications: There is a need to select patients with high blood pressure who are unlikely to visit for hypertension treatments based on the study results. For those, establishing a personalized management plan such as health education and counseling programs will be helpful for the successful implementation of national chronic disease management program.

• 한국농촌건축학회논문집
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• 제26권2호
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• pp.73-84
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• 2024

This study investigated the outpatient departments of Infectious Disease Hospitals by Region, which play an important role in establishing regional medical networking, to find a spatial structure that can provide a safe environment for efficient diagnosis and treatment, as well as a rational medical procedure in case of crisis. Department layout and adjacencies were derived by considering the access procedures according to patient classification, medical procedures by department, and connectivity with other departments. Based on the results derived by setting up zones according to infection control, activities, and objects, and analyzing the division of zones, the composition of areas by activities, movement flows by objects and treatment units, it can be used as basic data for the architectural plan of the Infectious Disease Hospital. Also, there are implications that can be used as basic data for planning related facilities by analyzing spatial relationships according to user behavior.

• 지역사회간호학회지
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• 제21권3호
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• pp.321-332
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• 2010

Purpose: This study examined change in healthcare utilization by disease severity after case management (CM) for Medicaid. Methods: Data were extracted from survey data on "Healthcare utilization and health status of Medicaid beneficiaries" conducted in 2007 and 2008 by the Ministry for Health, Welfare and Family Affairs. This study was designed to compare change in healthcare utilization between the CM group and the non-CM group. The subjects were 528 Type I Medicaid beneficiaries who utilized healthcare more than 365 days during 2006. Results: In beneficiaries having fewer than 3 among the 11 notified diseases, the CM group showed a significantly larger decrease in outpatient day, outpatient expense, medication day, and medication expense than the non-CM group. In beneficiaries having 3 or more among the 11 notified diseases, however, there was no significant difference in healthcare utilization between the CM group and the non-CM group. Conclusion: CM worked effectively on Medicaid beneficiaries outpatient healthcare utilization for mild diseases. However, its effects on hospitalization, which is a major cause increasing the total expense, were not observed. Therefore, a future study is needed to develope strategies to reduce hospitalization and care for Medicaid beneficiaries with severe diseases.

• 보건행정학회지
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• 제24권2호
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• pp.128-135
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• 2014

Background: With ageing and growing importance of disease management system, it is necessary to investigate the extent of regional difference in service utilization for chronic diseases among the elderly and to reflect it in designing the system. Methods: A multiple regression analysis and descriptive statistics analyses were employed using patient survey, which covers nationwide health facilities and their users. Results: While the differences in the rate of service utilization/utilization outside living area between urban and rural areas or between income levels are not large, considerable variations are observed within urban or rural areas and within income groups. Conclusion: This results suggest that it is important to subsidize economically disadvantaged segments of the population and residents of less-favored areas to be better-equipped for chronic disease management in order to prevent the development of severe ailments and the need for treatment at higher-level medical institutions. Improvements to the service infrastructure in vulnerable regions are essential.