• The Korean journal of helicobacter and upper gastrointestinal research
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• v.18 no.4
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• pp.225-230
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• 2018

Upper gastrointestinal (GI) bleeding (UGIB) is the most common GI emergency, and it is associated with significant morbidity and mortality. Early identification of low-risk patients suitable for outpatient management has the potential to reduce unnecessary costs, and prompt triage of high-risk patients could allow appropriate intervention and minimize morbidity and mortality. Several risk-scoring systems have been developed to predict the outcomes of UGIB. As each scoring system measures different primary outcome variables, appropriate risk scores must be implemented in clinical practice. The Glasgow-Blatchford score (GBS) should be used to predict the need for interventions such as blood transfusion or endoscopic or surgical treatment. Patients with GBS ${\leq}1$ have a low likelihood of adverse outcomes and can be considered for early discharge. The Rockall score was externally validated and is widely used for prediction of mortality. The recently developed AIMS65 score is easy to calculate and was proposed to predict in-hospital mortality. The Forrest classification is based on endoscopic findings and can be used to stratify patients into high- and low-risk categories in terms of rebleeding and thus is useful in predicting the need for endoscopic hemostasis. Early risk stratification is critical in the management of UGIB and may improve patient outcome and reduce unnecessary health care costs through standardization of care.

• Journal of Digital Convergence
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• v.11 no.4
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• pp.351-359
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• 2013

This study was conducted to investigate the factors that affect the length of stay in hospital for schizophrenic patients. Of the data from the in-depth injury patient surveillance system, the final subject included 2,239 patients with schizophrenia in their final diagnosis. Using SPSS 18.0, a hierarchical regression analysis was performed by sequentially entering the explanatory variables by setting sociodemographic characteristics, discharge characteristics and hospital characteristics as explanatory variables and the length of stay in hospital as a dependent variable. The findings showed that the sociodemographic characteristics had the highest explanatory power and the explanatory power changed when the explanatory variable of the hospital characteristics was added, as opposed to the discharge characteristics. Male, type-1 medicaid, Chungcheong-do and the number of beds were found to be the factors that mostly affect the length of stay. Since this study used the secondary data, it has a limitation in terms of additional variables that could better explain the length of stay for schizophrenic patients. Nevertheless, it has an implication in that it investigated a large scale of data on a national level. For the effort of reducing the length of stay, it is suggested that an effort should be made at the national level, by focusing more on the hospital characteristics as well as the individual characteristics of patients.

• Health Policy and Management
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• v.28 no.2
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• pp.178-185
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• 2018

Background: We investigated association between introduction of the diagnosis-related groups (DRG) system for anal operation and length of stay. Also, we investigated how it is different among hospitals with longer length of stay and among hospitals with shorter length of stay before introduction of the DRG system. Methods: We used data from Health Insurance Review and Assessment which were national health insurance claim data. Total 13,111 cases of anal surgery cases were included which were claimed by hospitals since July 2012 to June 2014. Two-level multivariable regression was conducted to analysis the association between length of stay and characteristics of hospital and patient. Results: Before introducing DRGs, the average length of stay was 5.41 days. After introducing DRGs, average length of stay was decreased to 3.92 days. After introducing DRGs, length of stay has decreased (${\beta}=-1.0450$, p<0.0001) and it was statistically significant. Among hospitals which had short length of stay (shorter than mean of length of stay) before introducing DRGs, effect of introducing DRGs was smaller (${\beta}=-0.4282$, p<0.0001). On contrary, among hospitals which had long length of stay (longer than mean of length of stay) before introducing DRGs, effect of introducing DRGs was bigger (${\beta}=-1.8280$, p<0.0001). Conclusion: Introducing DRGs was more effective to hospitals which had long length of stay before introducing DRGs.

• Journal of Digital Convergence
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• v.11 no.6
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• pp.159-167
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• 2013

Development of infusion pumps enabled injecting medical substances continuously and automatically to patients in hospitals. However, in cases when patients encountered emergent situations when moving to other areas, no clear measures were taken. The problem is that even the lightest error in injecting medical substances could be critical to the patient. That is why we proposes a remote infusion monitoring system using wireless network and RFID technology in this paper. When a problem occurs in the infusion pump, the medical personnel are informed of their patients' emergent situation and location information via wireless network so not only can they swiftly and accurately provide medical services but also can prevent safety accidents due to infusion pumps.

• Korea Journal of Hospital Management
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• v.8 no.1
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• pp.1-23
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• 2003

General drug prices involve three stages: shipment stage, wholesaler stage and retail stage. Policies on drug price differ from country to country. Shipment stage prices are tightly regulated in countries like France and Netherlands. They are free in only a minority of advanced countries, even if these include some major players such as the US, Germany and, in a very limited sense, Japan. The situation in the UK is very complex with a semi-free system, where drug companies are free to set their own prices but cannot exceed a predetermined profit ceiling. Mark-up at both wholesaler and retail stages is formally admitted in most countries observed. Apart from the general drug prices, reimbursement price of insured drugs has been major policy concerns. Most countries reviewed in this study has exerted some control over reimbursement prices, but differ both in the way how and in the extent to which prices are admitted or fixed. Price fixing has been used in France and Japan. Some countries have transformed their system over time, particularly to move to reference pricing in the last decade. This mechanism has empowered the customer, and improved price competition on the market. Referring to the drug price policies in the advanced countries, this study makes some suggestions for the redirection of Korean price policy for reimbursement drug in health insurance as follows: to match appropriate policy tools to each policy goal; to maximize market mechanism through effective reimbursement price fixing which admits mark-ups in wholesaler and retail prices; to introduce reference pricing system in order to redirect patient's demand with a financial incentive to choose the best-priced drugs and to save the finance of health insurance; and to strengthen surveillance and monitoring mechanism in the drug market.

• Health Policy and Management
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• v.18 no.1
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• pp.63-84
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• 2008

The aim of this study was to analyze the correlation between professional autonomy and ideology among Korean physicians and to investigate how these factors affect job satisfaction like social status satisfaction and economic reward satisfaction. This study utilized a self-administered questionnaire survey and collected data nationwide between July and August, 2003. 211 responses were used for final analysis. SPSS 12.0 was used for a chi-square test, one-way ANOVA, Pearson correlation analysis, independent t-test and hierarchical multiple regression analysis. The results of this study were as follows. First, many variables of ideological factor were related to job satisfaction. Second, physicians expecting the change of political influence has patient-centered attitude. Third, there were many relationships between professional autonomy and ideology variables. Fourth, physicians expecting the change of political influence and customer-centered healthcare system showed more job satisfaction. In conclusion, professional autonomy is related to ideology, and in order to enhance job satisfaction, ideological factor needs more development. In addition, market-oriented healthcare system would contribute to enhance the job satisfaction of physicians expecting the change of political influence and customer-centered healthcare system.

• Health Policy and Management
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• v.8 no.1
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• pp.232-265
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• 1998

Taiwan has experienced rapid economic growth during the past two decades. As a result, the demand for health care in Taiwan has increased rapidly. To meet the rising demand, Taiwan implemented a National Health Insurance (NHI) program on March 1, 1995. This program now covers more than 96 percent of Taiwan's citizens. Implementation of the NHI in 1995 represents fulfillment of a primary social and health policy goals of Taiwan. The goals of the NHI program is to eliminate financial barriers of health care for the citizens, to improve the quality of care. To achieve these goals, the NHI was designed on the following principles: 1. All Taiwan citizens are compul내교 joined the NHI program by law; 2. The NHI program provides comprehensive services; 3. The NHI is run by one single govt' subsidy; 5. The NHI adopt fee-for-services scheme to pay medical expenses and copayment to avoid abouse of medical services. However, the scheme did not bring in the efficient use of health care C. National Health Council, 1986 NARC, Aging in Japan, International Publication Series 1991;2 Kahana EF. Kiyak HA. Attitude and behavior of staff in facilities for the aged, 1984 Naoki I, John CC. Health polic report japan's medical care system, New England Joumal of Medicine 1995; 333(19) National Economic Research Associates, The Health CAre System in Japan, NERA, 1993. National Federation of health Insurance Societies (KEMPOREM), Health Insurance and Health Insurance Societies in Japan, 1995. Owe Ahlund, Aging and housing in sweden, Paper presented at the International Symposium, Long term Care Facility, 1993. Statisitics Jahrbuch, Statistisches Bundesamt, 1992. Stein S. Linn, MIW. and Stein EM. Patient's anticipation of stress in nursing home care, 1985. U. S. Senate Special Committee on Aging, A Report of the special Committee on Aging, Washing D. C, 1992. U.S. Bureau of the Census, 1994.

• Health Policy and Management
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• v.6 no.1
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• pp.110-143
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• 1996

The purpose of this study is to assess the extent of inequality in health outcomes and the distribution of health services according to health need under National Health Insurance System in Korea. For the empirical analysis, data were collected through an interview survey during one month of October, 1994. Interview were conducted with a total of 10, 875 of the employees and the self-employed selected through cluster, systematic sampling. The major findings of this research are as follows: 1. The analysis of the differentials in morbidity rates by socio-economic group showed that health inequality in the pro-higher groups existed in all self-reported morbidity indicators. 2. The findings of the conventional use measures showed that the lower socio-economic groups had more ambulatory and inpatient services than the higher groups. In contrast to the level of the medical care utilization, however, the higher socio-economic groups were more likely to use the high-quality source of care in terms of their treatment place compared to the lower groups. 3. By using the need-based use measures, the results were different from each use-disability ration indicator. Using the use-disability ration measured by physician visits per 100 restricted-activity days in the population, it was found that there was no evidence favoring the higher socio-economic groups. In contrast, the use-disability ration based on physician visits per a chronic patient in one year displayed that there was remarkable relative difference by income group as well as the evidence of the pro-higher income groups. 4. The results of logistic regression analysis and two-stage estimation method indicated that although the utilization is significantly affected by type and duration of insurance coverage, the use or nonuse of service and the volume of physician care consumed is determined by health need and demographic characteristics rater than economic status. In sum, these findings suggest that physician service is equitably distributed according to health need under national health insurance system in Korea. As there were some evidences of inequality including the differential in physician visits of chronic patients by income group, however, the government should strengthen the activities to guarantee the equity of health services utilization.

• Journal of the Korea Society of Computer and Information
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• v.19 no.11
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• pp.149-157
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• 2014

Diabetes is a chronic disease that requires continuous medical care and patient-self management education to prevent acute complications and reduce the risk of long-term complications. The worldwide prevalence and incidence of diabetes mellitus are reached epidemic proportions in most populations. Early detection of diabetes could help to prevent its onset by taking appropriate preventive measures and managing lifestyle. The major objective of this research is to develop an automated decision support system for detection of diabetes using mixture of experts model. The performance of the classification algorithms was compared on the Pima Indians diabetes dataset. The result of this study demonstrated that the mixture of expert model achieved diagnostic accuracies were higher than the other automated diagnostic systems.

• Journal of Korean Clinical Health Science
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• v.2 no.1
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• pp.59-71
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• 2014

Purpose. Medical tourism is recently becoming a new industry with great growth potential. The South Korean government is shifting medical tourism from simple cultural tourism to a high value-added industry with a new paradigm. Methods. The government has been providing positive support and marketing policies since the introduction of the article concerning foreign patient attraction to the medical law in 2009, and various types of medical institutions around the country has participated actively in medical tourism by themselves or in cooperation of government bodies and made increasingly greater performance. Results. This study obtained the following results. The medical institutions in Korea have been making efforts to see more development and profitability in diverse ways, including medical tourism for foreign patients and the advance of the Korean medical institutions into foreign markets. However, many local governing bodies and medical institutions participating in medical tourism around the country have primarily focused on examination and treatment on the basis of foreign patients' visit to South Korea and rarely built a medical network with other countries directly for medical tourism. This study presents a case of building a local medical network and a network for international medical tourism successfully on the basis of the local medical association, CMP, which has been formed naturally in Busan. The success factors for CMP included 1) enthusiasm of the official in charge; 2) the medical level, the service level, and open-mindedness of participant medical institutions; 3) cost efficiency due to executive office management with no costs, no conflicts, and constant partnership; 4) security of non-competitive expertise for participants; 5) local factors of CMP; 6) participation of good agencies; 7) reinforcement of participation networks; and 8) post facto management and local doctor management. Conclusions. Its positive effects included patient introduction and greater profitability on an internal basis as well as construction of the collaboration system with the institutions related to medical tourism and confidence. However, there are some limitations: it is still difficult to predict performance due to the short period of their activities, and it is necessary to continue to observe their constant activities since a single medical association was involved.