• 보건행정학회지
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• 제24권3호
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• pp.283-290
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• 2014

Background: This study aimed to examine the relationship between home-visit nursing services and health care utilization under the public long-term care insurance program in Korea. Methods: We analyzed the long-term care need assessment database and the long-term care and the health insurance claim databases of National Health Insurance Service between July 2011 and June 2012. The sample includes a total of 20,065 home-visit nursing recommended-older beneficiaries who use home-visit nursing and/or home-visit care, based on a standard benefit model developed by the Health Insurance Policy Institute of National Health Insurance Service. The beneficiaries were categorized into home-visit nursing use and non-use groups, and the home-visit nursing use group was again divided into high-use and low-use groups home-visit nursing, based on their total annual home-visit nursing expenditure. Two-part models and negative-binomial regression models were used for the statistical analysis. Results: The home-visit nursing use was negatively associated with the number of outpatient visit and cost, while adjusting for all covariates. The home-visit nursing use was also negatively associated with the inpatient cost among the high home-visit nursing use group. Conclusion: The findings implies home-visit nursing use prevents health care utilization. Further studies and policy strategies that can promote and strengthen home-visit nursing services under the public long-term care insurance are necessary in Korea.

• 대한영양사협회학술지
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• 제9권1호
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• pp.32-39
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• 2003

Although medical nutrition therapy (MNT) is considered as a cornerstone of medical treatment for hypercholesterolemia, few studies have evaluated medical and economical outcome of MNT. This study was conducted to identify whether MNT administered by registered dieticians could lead to a beneficial clinical and cost outcome in persons with hypercholesterolemia. A prospective clinical trial was carried out at outpatient clinics, which involved an initial visit with a dietitian followed by another visit at first 4 weeks during the 6 weeks study periods. Thirty-nine subjects took part in a 6 weeks nutrition intervention program. Clinical and economical outcomes were compared before and after MNT. Medical nutrition therapy lowered total serum cholesterol level 6.1% (P<0.05), low-density lipoprotein cholesterol (LDL-C) 9.4% (P<0.05) and high-density lipoprotein cholesterol (HDL-C) 3.0% (P<0.05). The cost-effective ratio was ￦ 1,520/cholesterol mg/dl and ￦ 1,441/LDL-cholesterol mg/dl, respectively. After dietitian's intervention, lipid drug eligibility was obviated in 16 of 39(41%) subjects. The cost savings from the avoidance of lipid medications was ￦ 151,107 per patient annually. In conclusion, it is suggested that provision of systemic intensive nutritional care for persons with hypercholesterolemia has significant effects on serum cholesterol reduction and clinical cost savings.

• 대한안전경영과학회지
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• 제19권3호
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• pp.71-79
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• 2017

The purpose of this study was to identify the observable symptoms of musculoskeletal disease from electronic components manufacturing workers who involved in many repetitive tasks and to provide the basic data for the prevention and management. The survey was conducted on 721 people from 15 April, 2013 to 17 May, 2013 by self­recording type. The results of the study are as follows. First, symptom complaints based on different body parts are in following order, waist was 12.9%, shoulder was 10.5%, neck was 7.4%, hand/wrist/finger was 7.4%, leg/foot was 4.4%, arm/elbow was 2.8%, and 21.9% of the respondents showed symptoms in more than one body part. Sex, age, marital status, work experience, work intensity, and past accident experience were statistically significant. Second, in the job stress evaluation, all male and female workers were below the median of Korean workers in all of 8 categories. the higher the scores for lack of job autonomy, the higher the symptom complaints of musculoskeletal disease. In the case of patients complain observable symptoms of musculorskeletal disease, they should receive proper outpatient treatment, various programs such as stretching by body parts, setting up a desirable working posture, switching to cyclical work, should b developed as much as possible.

• 임상간호연구
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• 제20권1호
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• pp.53-63
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• 2014

Purpose: This study was conducted to investigate the relationship between drug-related knowledge, sick role behavior and quality of life of patients on wafarin therapy in an outpatient unit. Methods: The participants were 122 patients. Data were collected using a questionnaire and analyzed using t-test, ANOVA and Pearson correlation. Results: The Duration of wafarin averaged $28.80{\pm}32.99$ months, and 78.7% of participants remembered their blood coagulation value. The mean score for drug-related knowledge was 11.32 points out of a possible 13 points. Sick role behavior of the patients showed a moderate value with a mean of 49.83 points out of 68 points. The mean score for quality of life was rather low at 104.43 out of 175. Drug-related knowledge was significantly correlated to sick role behavior (r=0.39, p<.001), but the relationship between sick role behavior and quality of life was not significant. Also drug-related knowledge was not significantly correlated with quality of life. Conclusion: The resultsindicate that there is a need to enhance the level of drug-related knowledge in order to increase positive behavior as part of the sick role of these patients and thus improve quality of life.

• Parasites, Hosts and Diseases
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• 제51권1호
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• pp.75-84
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• 2013

Cutaneous leishmaniasis (CL) is an endemic parasitic infection in the Mediterranean region, including Libya and its Al-jabal Al-gharbi province. We aimed at studying the occupational relevance as well as other epidemiological aspects of CL. We investigated 140 CL cases who attended at Gharyan outpatient polyclinic during a period of 6 months in 2009. CL infection was clinically diagnosed and confirmed by demonstration of Leishmania parasites on smears from lesions. Our findings showed that males were more affected than females (P=0.04), and people above 10-years were more affected than younger ones (P=0.0001). A significant percent of CL cases belonged to Al-Kawasem subprovince (P=0.0001). Farm-related activities were the most frequent occupations among CL cases (P=0.04). In addition to farm workers, housewives and students are at risk groups since they are engaged at farm activities. Moreover, those who have occupations that require staying outdoors for a part of night, e.g., policemen, are also at risk. Compared to children, adult CL patients had multiple lesions (P=0.001) that were more prevalent in their upper and lower extremities than the face (P=0.0001). We conclude that CL is a major health problem in Al-jabal Al-gharbi province of Libya. The presence of rodents and sandflies makes it a suitable environment for Leishmania to spread in an endemic epidemiological pattern. Being engaged in farming activities or outdoor occupations increases the risk of infection. Various clinical patterns of CL suggest the presence of more than 1 species of Leishmania at Al-jabal Al-gharbi province. We propose that the 2 species responsible for CL in this area are L. major and L. tropica. Further investigations to identify the leishmanial species responsible for CL at Al-jabal Al-gharbi together with adoption of preventive and control programs are needed.

• Clinical Psychopharmacology and Neuroscience
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• 제16권4호
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• pp.415-421
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• 2018

Objective: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairment in social skills and communication with repetitive behaviors. Etiology is still unclear although it is thought to develop with interaction of genes and environmental factors. Oxytocin has extensive effects on intrauterine brain development. Vitamin D, affects neural development and differentiation and contributes to the regulation of around 900 genes including oxytocin receptor gene. In the present study, the contribution of D vitamin receptor and oxytocin receptor gene polymorphisms in the development of ASD in Turkish community was investigated. To our knowledge, this is the first study examining these two associated genes together in the literature. Methods: Eighty-five patients diagnosed with ASD according to DSM-5 who were referred to outpatient clinics of Child and Adolescent Psychiatry of Başkent University and Mersin University and 52 healthy, age and gender-matched controls were included in the present study. Vitamin D receptor gene rs731236 (Taq1), rs2228570 (Fok1), rs1544410 (Bsm1), rs7975232 (Apa1) polymorphisms and oxytocin receptor gene rs1042778 and rs2268493 polymorphisms were investigated using real time polymerase chain reaction method. Results: No significant difference between groups in terms of distribution of genotype and alleles in each of polymorphisms for these genes could be found. Conclusion: Knowledge of genes and polymorphisms associated with the development of ASD may be beneficial for early diagnosis and future treatment. Further studies with larger populations are required to demonstrate molecular pathways which may play part in the development of ASD in Turkey.

• 대한한의학회지
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• 제40권1호
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• pp.86-98
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• 2019

Objectives: This study analyzes the electronic medical record (EMR) data of the spine specialist oriental hospital and clinic in various regions, and reports the actual number and used cases of Chuna therapy. Methods: 2,470,772 data was extracted retrospectively from electronic medical records of all inpatients and outpatients who were treated chuna therapy at 21 Korean medicine hospitals and clinics from January 1, 2018 to December 31, 2018. The characteristics of medical treatment using chuna therapy reflect the minimum, maximum and average values of the number of hospitalized patients, length of hospitalization, frequency of hospitalization, number of outpatients, frequency of treatment and frequency of visit. Diseases were classified in the proportion of Chuna treatment according to the KCD, 7th edition. The chuna and blindness charts were derived accordingly from illness and disease of each part of the body. Results: During the study period, a total 1,342,022 inpatients and outpatients visited the study sites. The male proportion was a little higher than the females' (male: 53.7%, female: 46.3%). According to age, the 30s and 40s were more than half the total(30s: 33.0% and 40s: 20.1%). Chuna therapy was treated to more outpatients than hospitalized patients (outpatient: 83.6%, hospitalization: 16.4%), and most treatments were related to musculoskeletal illness(99.06%). Conclusions: As a result of this study, 1,342,389 chuna therapy was performed in 21 hospitals for one year. As highly demanded by the public, we look forward to ensuring national health care options and medical access when health insurance for chuna therapy is applied beginning March 2019.

• Journal of Korean Neurosurgical Society
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• 제65권4호
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• pp.507-513
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• 2022

Objective : The goal of the following statewide age and gender-coordinated cohort study in Korea is to find out if there is a link between acute myocardial infarction (AMI) and Parkinson's disease (PD). Methods : Utilizing the National Health Insurance Sharing Service cohort, patient data were collected. Six thousand four hundred seventy-five individuals with PD were distinguished by utilizing the International Classification of Diseases 10 code G20 and have enrolled in the PD group. The number of participants decreased to 5259 after excluding 1039 patients who were hospitalized less than one time or who visited an outpatient clinic less than twice. Then, 26295 individuals were selected as part of the control group after case control matching was conducted through 1 : 5 age- and gender-coordinated matching. The Cox proportional hazard regression analysis and Kaplan-Meier method were utilized to analyze the likelihood of AMI in PD. Results : After controlling for age and gender, the hazard ratio of AMI in the PD group was 3.603 (95% confidence interval [CI], 2.837-4.577). After that, the following hazard ratio of AMI in the PD group was modified against for co-morbid medical disorders, resulting in 3.551 (95% CI, 2.795-4.511). According to a subgroup analysis, in males and females aged <65 and aged ≥65 and in the non-diabetes and diabetes, hypertension and non-hypertension, dyslipidemia and non-dyslipidemia subgroups, the AMI incidence rates were dramatically higher in the PD group compared to that of the control. Conclusion : Individuals with PD have a greater chance of AMI, according to this cross-national study.

• 산업진흥연구
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• 제8권4호
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• pp.209-220
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• 2023

본 연구는 일반적 질적 연구와 집단 포토보이스(G-Photovoice) 방법을 활용하여 정신과 환자의 낮병원 직업재활 프로그램 참여 경험을 연구하였다. 연구자는 낮병원 직업재활 프로그램 참여 경험이 있는 정신과 환자 5명을 대상으로 2회 이상 면담을 실시하였으며 낮병원 이용과 외래 진료 이후 추가 면담을 실시하였다. 더불어 사진을 활용한 반 구조화된 집단 면담을 진행하였다. 연구결과 연구 참여자들의 낮병원 직업재활 프로그램 참여 경험은 '직업 활동의 어려움을 경험함', '함께 일하는 것에 대한 즐거움', '안정감을 얻음', '자신이 성장했음을 느낌'으로 나타났다. 이러한 연구결과에 기반하여 본 연구에서는 낮병원 직업재활을 활성화하고 정신과 환자의 성장을 촉진시킬 수 있는 함의를 논의하였다.

• Korean Circulation Journal
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• 제53권11호
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• pp.727-743
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• 2023

Although cardiac rehabilitation (CR) has been shown to improve exercise tolerance and prognosis in patients with cardiovascular diseases, there remains low participation in outpatient CR. This may be attributed to the patients' busy schedules and difficulty in visiting the hospital due to distance, cost, avoidance of exercise, and severity of coronary disease. To overcome these challenges, many countries are exploring the possibility of remote CR. Specifically, there is increasing attention on the development of remote CR devices, which allow transmission of vital information to the hospital via a remote CR application linked to a wearable device for telemonitoring by dedicated hospital staff. In addition, remote CR programs can support return to work after hospitalization. Previous studies have demonstrated the effects of remote CR on exercise tolerance. However, the preventive effects of remote CR on cardiac events and mortality remain controversial. Thus, safe and effective remote CR requires exercise risk stratification for each patient, telenursing by skilled staff, and multidisciplinary interventions. Therefore, quality assurance of telenursing and multi-disciplinary interventions will be essential for remote CR. Remote CR may become an important part of cardiac management in the future. However, issues such as cost-effectiveness and insurance coverage still persist.