Background: Primary rhinoplasty outcomes may not meet individual expectations. Consequently, reoperation may be advocated to improve results. This study examines the prevalence of individuals considering revision rhinoplasty, while identifying the main cosmetic and functional complaints and factors associated. Methodology: This is a cross-sectional study conducted in Saudi Arabia using a self-reported online questionnaire distributed through social media channels. The sample included 1370 participants who were all Saudi nationals over the age of 16 who had undergone primary rhinoplasty at least 1 year prior. Results: The prevalence of individuals considering revision rhinoplasty was 44.7%. The primary reason for considering it was the desire for further esthetic improvement in an already acceptable result (50.16%). The most common cosmetic complaints subjectively reported were poorly defined nasal tip (32.35%). The most prevalent nasal function symptom was nasal obstruction (56.9%). Significant factors associated with considering revision rhinoplasty included the physician not understanding the patient's complaints, short consultation time, low monthly income, inadequate information about the expected results, not using computer imaging to predict outcomes, lack of rapport with the surgeon, and inadequate information about the risks and complications. Conclusions: A thorough understanding of patient concerns and expectations, as well as thoughtful consideration of risk factors, may help surgeons achieve more successful outcomes and potentially reduce the incidence of revision rhinoplasties. Level of evidence: III.
Background: The use of health functional food (HFF) is increasing and will continue to rise worldwide. Concerns about HFF-drug interactions are increasing as HFF are becoming more widely used. Therefore, awareness of consumers' perceptions and behaviors associated with HFF use may help health care providers improve their communications with patients. Purpose: The aim of this study was to assess the characteristics, perceptions, and behaviors associated with HFF use in South Korea. Method: The online survey was conducted from September 21th to October 7th, 2013. With the aid of Social Network Service (SNS) and google, the questionnaire was posted online on internet website targeting people aged 15 years or older so that self-reported data covering 4 domains were collected from 257 Koreans. Results: A total of 257 people responded the questionnaire. Among them, 81.3% reported experiences of HFF use. Female were more likely than male to use HFFs. There were no differences in demographic characteristics between HFF users and non-users in relation to age, education, and household income. Higher level of education was associated with high-level perception of HFF function (OR 3.9, 95% CI 1.48, 10.1) and a positive relationship was observed between the maximum number of HFFs used concurrently and age of the respondents. Among the HFF users, 42.6% reported concurrent HFF-medication use. However 73.3% of them did not disclose their use to physician or pharmacist and only 30.2% were informed about potential drug-HFF interactions. Pharmacy was most commonly reported as the source from which the respondents were informed about potential interactions. Conclusion: Many people had used HFF and medications concurrently while not being informed about potential HFF-drug interactions. Pharmacists and physicians should be vigilant for risk of the interactions and actively determine whether the patient is using an HFF before prescribing and administrating medications.
Chung, Seol Hee;Lee, Hye Jin;Oh, Ju-yeon;Woo, Kyung suk;Kim, Han sang
Health Policy and Management
/
v.25
no.2
/
pp.107-117
/
2015
Background: The purpose of this study is to analyze the cost for the denture treatment in accordance with the government's plan to expand the National Health Insurance coverage for dental prothesis from July 1, 2012. Methods: We developed the draft of classification of the treatment activities based on the existing researches and expert's review and finalized the standard procedures through confirming by Korean Dental Association. We also made the list of input at each stage of treatments. We conducted survey of 100 dental clinics via post from April 4 to May 20 in 2011 and 37 clinics took part in the survey. The unit of cost calculation is the process from the first visit for denture treatment to setting of denture and adjustment. The manufacturing process performed by dental technician was not included in the cost analysis. Results: The process for the complete denture treatment was classified with 10 stages. The partial denture treatment was classified with 8 stages. The treatment time per each denture is about 5.6 hours for complete dentures and about 6.6 hours for partial dentures. The treatment cost were from 591,108 won to 643,913 won for complete denture and from 670,219 won to 738,840 won for partial denture in 2011, depending on the location, type of the clinics and the types of physician's income. Conclusion: This study shows the example of cost analysis for the treatment to set the fee schedule. Measures to get representative and accurate information need to be made.
Objectives: This study was to examine the associations between obesity level and major chronic diseases in older population in Korea, using different obesity indicators. Methods: Data was from the 2008 KloSA Biomarker pilot, a nationwide sample of 514 non-institutionalized subjects (age $63.6{\pm}9.8$ years; women 57.2%). Anthropometric information was collected by home visiting nurses. Portable bioimpedence devices(Omran HBF359) were used for measuring fat mass. Obesity cut-offs used the Asian criteria of $BMI{\geq}25$, $WC{\geq}90/85cm$, and $fat%{\geq}25/35$ for men and women. Chronic disease prevalence was defined by physician-diagnosed history of 8 specified diseases. Results: Prevalence of chronic diseases significantly increased with increment of obesity level by BMI, WC and fat %. Odds ratios of acquiring chronic diseases remained significant in the obese group (BMI OR 2.76, 95%CI 1.82-4.19; WC OR 2.73, 95%CI 1.81-4.11; Fat OR 1.87 95%CI 1.26-2.78), after adjusting for age, sex, marital status, education, work participation, household income, smoking, drinking, and exercise. Conclusions: Obesity measured by all three indicators, BMI, WC, and fat mass cannot be disregarded, accentuating the significant effect on increases in disease risks among older population. BMI and WC measure appeared better to assess the risks of chronic diseases.
The rapid development and distribution of information communication industry facilitates the changes of hospital administration, introducing EMR(Electronic Medical Record) instead of paper-based medical record in the medical field. The developed countries such as U.S. have established EMR system after in the middle of 1970s because the primary advantages of EMR is to store and handle vast amounts of records efficiently and increase the quality of health care. Most of health organizations in Korea also apply medical record system to their administration. As the result, they have accomplished a scientific administration system through the use of medical record to handle a variety of patient's information including patient's confidentiality and privacy such as family history, social status, income level, and so on. However, access to and the misuse of EMR causes illegal infringement of patient's information and finally it becomes a very serious medical issue. Potential leakage and misuse of records may seriously infringe patient's privacy rights. In this respect, the related agencies in the public and private sector have been making efforts to prevent patient's records leakages. Especially, the revision bill of Medical Law in 2002 establishes the ways on the security and standards of electronic records. However, it does not provide the proper guidelines which is applied to the rapid changes of the medical environment. One of the most priorities in the hospital administration is the production and maintenance of an accurate medical records fulfilled by medical recorders. Therefore, it is very important for health care providers to hire ethical-based medical recorders. But, unfortunately most of hospitals overlook the importance of their roles. All parts including government, physician and patient must have more concerns on the problems related to EMR. Therefore, this study aims to propose the proper ways to resolve the problems coming from EMR.
Objectives: This study divided the factors that affect participation in health screenings into individual, household, and regional levels and conducted a multi-level analysis to identify the factors related to participation in health screenings. Methods: Participants from the 2017 Community Health Survey were classified into 2 groups (under 40 and 40 or older). A multi-level logistic regression analysis was conducted to identify the factors that affected participation in health screenings. Results: The screening rate of the participants was 69.7%, and it was higher among participants aged 40 and older (80.3%) than it was among participants younger than 40 (49.8%). At the individual level, the factors that influenced participation in health screenings included age, economic activity, smoking status, physician-diagnosed hypertension, and a moderate or high physical activity level. At the household level, the odds ratio of participation in health screenings was high for participants who lived in single-person households, lived with a spouse, earned a high monthly household income, and were not beneficiaries of national basic livelihood security. At the regional level, the odds ratio at the 95% confidence interval level of participation in health screenings was high for participants who had trust in the local community and lived in an area with a proportionally high social welfare budget. Conclusions: This study analyzed nationalwide data and confirmed that individual, household, and regional characteristics affected participation in health screenings. Therefore, policies that prioritize the improvement of regional level factors and especially household level factors are likely to be the most effective for improving the screening rate.
The purpose of this study is to examine the factors associated with the probability and levels of the health service utilization among the disabled elderly in Korea. The sample includes 2,111 people older than 65 who are extracted from the 2008 National Survey on People with Disabilities. More than half (54.3%) of the sample experienced at least 1 outpatient physician visit within two weeks and 26.7% were hospitalized within a year. The key factors associated with the outpatient visits were health insurance status, the existence of chronic disease, self-rated health, the Activities of Daily Living (ADLs), as well as renal impairment. Similarly, the utilization of inpatient care was related to health insurance status along with the existence of the internal organ disabilities such as cardiac or respiratory disorders. The study implies the need for the health care policies regarding the prevention of chronic diseases, dependency for daily activities of the elderly, and a management system that specifically targets those with internal organ disabilities. Moreover, the study suggests that financial supports for the low-income group would be helpful to increase their access to health service utilization.
This study suggests a model for continuing and comprehensive management of hypertension or Type 2 diabetes mellitus (T2DM) in Korea. Moreover, this paper computed the contribution cost of hypertension or T2DM management using the healthcare medical cost, which could have occurred from stroke, myocardial infarction (MI), and end-stage renal disease (ESRD) that were successfully prevented from the effective hypertension or T2DM management. Additionally, these costs were compared with the cost of implementing the hypertension or T2DM management model suggested in this study. This study used the medical fee summary of the health insurance claims submitted to National Health Insurance Corporation by medical facilities for services provided during the period from January 1st 1999 to December 31st 2006. The prevalence rate with treatment referred to cases in which patients submitted their medical claims at least once during the period, along with an accordant diagnosis. The incidence rate with treatment referred to cases in which patients who never submitted claims for the accordant disease during the five years from 1999 to 2003 submitted claims for the accordant disease in 2004 and 2005. The relative risk of the occurrence of stroke, MI and ESRD was 11.0, 13.6, and 30.3, respectively. The attributable risk of hypertension or T2DM for stroke was 0.730, and that for MI and ESRD were 0.773 and 0.888, respectively. Based on these, the contribution cost of hypertension or T2DM is estimated to be 986.3 billion Korean Won(KRW) for stroke patients, 330.5 billion KRW for MI patients, and 561.7 billion KRW for ESRD patients as in 2005. Hence, the total contribution cost of hypertension or T2DM to stroke, MI, and ESRD is 1.878 trillion KRW. The estimate for operational costs included an annual expenditure of 50,000 KRW per each recipient and an annual subsidy of 0.22 million KRW per person for the 1.6 million low.income individuals with hypertension or T2DM to cover their out.of.pocket medical expenses. Under this assumption, it took approximately 0.6 trillion KRW to manage 5 million high.risk patients in the low. and mid.income range, coverings up to 50% of costs. In conclusion, considering the potential benefits of preventing stroke, MI, and ESRD, the costs seems to be reasonable.
Atopic dermatitis (AD) is prevalent in preschoolers and schoolchildren. The utilization of complementary and alternative medicine (CAM) is increasing in patients with AD as well as the general population. This study is based on the utilization of CAM for children with AD. Subjects were children suffering from AD who participated in the project of 'Seoul Atopy Asthma Free School'. In 6,800, the number of subject available data to final analysis was 4,985 for children with AD. Independent variables were age, monthly income of households, sleep disturbance, and dependent variables were medical treatment (MT), oriental medicine clinic (OMC), home remedy (HR) use experience during the past 12 months. As a result, MT was 76.5%, OMC was 24.6%, and HR was 62.3%, while multiple treatment from OMC and HR was 34.2%, and MT with OMC and HR was 18.8%. And variables influenced on CAM were age, monthly income of households, and sleep disturbance. However, some parents, tended to recognize that home remedy was effective and safe than other treatments. Therefore, it is recommended to counsel with physician about the merits and demerits of CAM.
Island regions suffer from a shortage of health care in part because they are less developed, they cover a widespread area relative to the population, and due to transportation barriers. The purpose of this study was to assess the level of illness and the magnitude of medical care utilization, and to investigate the determinants of utilization in these area. The data were collected by means of a household survey conducted from February 16 to 25, 1987 on S islands which were selected in consideration of the size of the population, the distance from the main land, and the distribution of health care facilities. The household response rate was 89.1% (491 of 551 households), and 1971 persons were surveyed. The major findings of this study are as follows: 1) The morbidity rate of the island inhabitants was 27.7% during the two weeks, and 25.5 chronic illnesses and 9.1 acute illnesses per 100 persons, were noted. Differences in the magnitude of illness were statistically significant by sex, age, education, and family size. 2) The magnitude of total ambulatory carl utilization was 16.8 visits per 100 persons during the two weeks, which was less than that of other regions; and differences in the magnitude of total ambulatory care were statistically significant by sex, age, education, occupation, and family size. 3) Unmet needs were classified as 56.0% in chronic illnesses and 19.6% in acute illnesses; and differences in unmet needs were statistically significant by sex, age, education, occupation, income, and family size. 4) Statistically significant determinants in medical care utilization included the frequency of acute illness and chronic illness, and income in total utilization; the frequency of chronic illness and acute illness, and medical care insurance in physician visits. 5) According to the results of the path analysis, need factors had the greatest effect on utilization, and predisposing factors had more indirect effects through enabling or need factors than direct effects.
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