• Korean Journal of Clinical Pharmacy
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• 제25권3호
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• pp.151-158
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• 2015

Objective: This study was designed to compare pegfilgrastim and filgrastim in diffuse large B-cell lymphoma (DLBCL) patients treated with a rituximab with cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone (R-CHOP) regimen in terms of clinical efficacy and cost-effectiveness. Method: Clinical efficacy was measured by trough level of absolute neutrophil count (ANC), days of ANC under 50% of baseline value, days of ANC under 90% of baseline value, duration of ANC recovery to baseline value, days of ANC less than $0.5{\times}10^9cells/L$, and difference of peak and trough level of ANC during 1 cycle of R-CHOP regimen. To evaluate cost-effectiveness, total prices of used filgrastim and pegfilgrastim within 1 cycle of R-CHOP were analyzed. Results: In terms of clinical efficacy, trough level of ANC and days to ANC recovery showed statistical significance. The median trough levels of ANC with administration of filgrastim and pegfilgrastim were 0.18 and 1.94 (p = 0.021), respectively, and the median durations of ANC recovery to baseline value were 5.5 days and 2 days (p = 0.023), respectively. For the median days of ANC under 50% of baseline value, days of ANC under 90% of baseline value, days of ANC less than $0.5{\times}10^9cells/L$, and difference of peak and trough level of ANC during 1 cycle of R-CHOP, the pegfilgrastim group performed better than the filgrastim group. However the difference was not statistically significant. In terms of overall expense during 1 cycle of R-CHOP, pegfilgrastim is about 3.43 times more expensive than filgrastim. Conclusion: Pegfilgrastim is more efficient than filgrastim in terms of clinical efficacy. In terms of prices, pegfilgrastim is more expensive than filgrastim for patients, but it is more convenient in clinical use. Therefore, pegfilgrastim should be the preferred choice of G-CSF for neutropenic patients. Further comparative study of pegfilgrastim and filgrastim is needed.

• Journal of Preventive Medicine and Public Health
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• 제14권1호
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• pp.65-74
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• 1981

This survey was made to determine the overall health situation on (1) the status of sickness; (2) the medical care utilization; (3) the medical cost in Mi-Kum Myun, Nam Yang Ju Gun, Kyung-Gi Do. The survey with questionnaire was carried out with 2,840 peoples in 560 households from August 9th to 16th, 1979. The findings from the survey were as follows; 1. Annual morbidity rate of the prolonged ill cases was 97.2 per 1,000 population (male 94.7, female 99.6), The highest age specific morbidity rate was 274.5 of the 45-to 64-year group and the lowest was 21.9 of the 5-to 14-year group. 2. Annual morbidity rate of the new patients was 777.5 per 1,000 population(male 644.5, female 909.5). 3. The chief complaints distribution of the prolonged ill cases was: local pain 36.6%, indigestion 22.4%, and coughing 7.3%, respectively, In terms of age and sex distribution, a large number of female of the 45-to 64-year group complained of local pain or general pain and a large number of both sexes of the 25-to 44-year group complaned of indigestion. 4. The major diseases of the new patients which classified with International Classfication of Diseases (I.C.D.) were disease of the respiratory system, disease of the digestive system, and disease of the musculo-skeletal system and connective tissue for male, disease of the respiratory system, disease of the digestive system, and accident, poisoning, violence for female. 5. Total ill days of the 92 new patients were 536 days and average ill days per case were $6{\pm}38.3$ days. 6. The rate of receiving treatment in the prolonged ill cases was 82.2%(medical facilities 46.4%, drug stores 27.5%, herb medicine 8.3%). 7. The rate of receiving treatment by first choice of the new patients was 88.0% (drug stores 57.%, medical facilities 28.2%, and herb medicine 2.2%), and the rate of receiving treatment by second choice was 30.9% of first treatment cases (medical facilities 44.0%, drug store 44.0% and herb meicine 12.0%). 8. Annual hospitalization rate per 1,000 population was 12.0 (male 12.0, female 11.9). 9. The locations of medical facilities utilized by out-patients were: in the prolonged ill cases Seoul or other places 66.4%, Nam Yang Ju Gun 33.6%, in cases of the new patients Seoul or other places 35.1% and Nam Yang Ju Gun 64.9% respectively. 10. The satisfaction rate of the new patients by mode of receiving treatment was: in cases of primary utilization by first choice herb medicine 100.0%, medical facilities 88.5%, and drug stores 69.8%, in cases of secondary utilization medical facilities 100.0%, herb medicine 100.0%, and drug stores 72.7% respectively. 11. The medical cost per utilized facilities was as follows; in average medical fee per case out-patient 8.947 won, in-patient 266,000 won, drug stores 1,532 won, and herb medicine 15,607 won, in average medical fee per day out-patient 4,829 won, in patient 14,178 won, drug stores 891 won, and herb medicine 4,906 won respectively. 12. The sources of the hospital charges paid out were: there own expense 50.0%, debt 35.3%, and security of medical care 14.7% respectively.

• Journal of Nutrition and Health
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• 제30권10호
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• pp.1203-1210
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• 1997

This study was performed from March to June 1994 in ANsung Medical Center. We investigated serum components of 78 diabetics in the center, in addition to the nutrient intake status and anthrophometric status of 60 diabetics among them. We separated the latter into 2 groups(ⅰ) less tan 5 years of diabetic duration and ⅱ) more than 6 years of diabetic duration) and analyzed the clinical characteristics of each group. The results are as follows : \circled1 The average ages of male and female subjects were 57.1 and 58.9 years, respectively. The average diabetic duration of male subjects was 4.8 years and that of female subjects was 5.9 . The major occupational field of both male and female subjects was agriculture(33.3%, 36.1%). 50% of male and 75% of female subject's monthly incomes were less than 600, 000 won and 75% of male and 94.4% of female subjects had weekly food expense less than 40, 000 won. The nutrient intake status of the subjects was lower than RDA on the whole. There was no big differences between 2 the male groups of different diabetic duration , but calorie, protein , fat carbohydrate, phosphorus, iron and Vit B$_1$intakes of the above 6 year female group were appearently higher than those of the under 5 year female group (p<0.05). There were different intake tendencies between male and female subjects . For females. the longer the diabetic duration, the less intakes of calorie, protein , fat carbohydrate, phosphorus, iron Vit B$_1$, Vit B$_2$, and niacin were observed. Furthermore, the longer the diabetic duration in females , the more intakes of energy and nutrients, except Vit C were observed. Fasting blood glucose levels were 155mg/dl and 164mg/dl and Postprandial glucose levels were 242mg/dl and 247mg/dl for males and females respectively. Hb of both males and females , and Ht of males met the lower limit of normal status, The serum TG level was higher than normal , so that they seemed to suffer from hyperlipidemia ; their high HbAIC status indicated that the management of diabetes mellitus was poor. The total protein level of female subject was higher when compared with that of males(p<0.05). All subjects blood pressure were higher than normal , and the longer the diabetic duration, the higher was the blood pressure. The serum HDL-cholesterol levels of the above 6 year group male subjects were lower(p<0.05) than those of the under 5 year male group subjects, and the former group's systolic and diastolic blood pressures were higher than those of the latter(p<0.05). Levels of serum total protein, albumin and TG of the above 6 year female group were lower than those of the under 5 year female group(p<0.05). As the diabetic duration was extended, HDL-cholesterol and LDL-cholesterol levels showed a tendency to increase, while Hb, Ht, total protein, albumin, and A/G, which represent the nutrients state of iron and protein, were inclined to decrease. This result showed that serum lipid components went bad. To summarize the results, the longer the diabetic duration, the worse were the male subjects nutrient intake status, but those of the female subjects were good. With respect to serum components and serum lipid subjects Fe, protein, nutrition status and serum lipid component got worse as the diabetic duration was extended , implying the possibility of diabetes mellitus complication grows.

• The Journal of the Korea Contents Association
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• 제15권3호
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• pp.303-317
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• 2015

Although the public health centers have been initiating health education recently, it is not extending as expected and the participation of the program is low. The reason is that the office workers have few opportunities to receive health education since there are few public health centers in relation to the population. Much time is required for travel and attendance of the classes. In order to solve this problem, the aim is to increase participation in health education, improve the overall public health awareness, expand the number of health education locations to reduce medical expenses, vitalize the lifelong educational health programs, and improve the national health insurance. In order to research about the health education expansion plan for public health improvement, a study focused on men and women above age 20 who need health education. The research sample was selected through random sampling that targeted people who participated in the health programs or the health education. The period of this survey was from September 1st to September 30th, 2014. A total of 509 participants completed the survey data for the actual analysis to propose the health education expansion plan for the public health improvement.

• Health Policy and Management
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• 제20권4호
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• pp.58-73
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• 2010

Background : Cancer is a disease that not only places a significant burden on patients clinically but also requires significant expense for diagnosis and treatment. Although the cancer coverage of health insurance has recently been expended, the need for financial assistance among cancer patients and their families is still expected to be significant. In this study, cancer patients' need for financial assistance in Korea was examined and its influence factors were analyzed. Methods : Target study subjects were those who are over 18 years of age and were diagnosed with cancer more than four months prior at the National Cancer Center and 9 Regional Cancer Centers in Korea during the period from July to August of 2008. Quarter sampling was conducted according to the ratio of the type of each cancer. A face to face interview survey was conducted. A total of 2,661 cancer patients finished the survey. Medical charts were reviewed in order to obtain the cancer type and SEER stage of cancer patients. An ordered logistic regression model was used to examine the level of need for financial assistance according to the demographical, clinical, and socio-economic variables of cancer patients. Result : The percentage of cancer patients who needed financial assistance was 69.0%, and 36.9% needed significant financial assistance. The need for financial assistance was perceived to be greater in males, younger age group, low income group, low education group, medical aid recipients, those who were diagnosed recently, those with a low level of quality of life measured through EQ5D, and those with decreased income after cancer diagnosis. Conclusion : In spite of the current policy to increase health insurance coverage, the majority of cancer patients and their families in Korea still need financial assistance due to cancer. In particular, there were more vulnerable groups, such as the low income, or low education group. In the future, policies that focus on the disadvantaged, which strengthen social security, should be considered for achievement of a substantially better quality of life for cancer patients and their families.

• Journal of Practical Agriculture & Fisheries Research
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• 제5권1호
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• pp.64-76
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• 2003

This study was conducted in order to find out the basic data and informations for the accidents for repairing of agricultural machines. This study was summarized as fellows : 1. Among the total repair work, the ratio of repair accident was 68.9% and the accident ratio with power tiller, tractor, and combine was 84.8%. The accident occurred frequently in April to May and September to October because of frequent use of machines during this months. The accidents occurred often of ten to eleven and two to three afternoon in a day. 2. The 36.3% of the accident types was farming machines and the 60.4% of the accident occurred in yard of repair shop. The 34.4% of accident was caused by people, 26.2% by machines, 24.9% by environmental factors, and 14.5% by others. 3. In accident damage, human damage was 98.4% and economic damage was 43.6%. There was only 40.2% in having agricultural machinery insurance and 22.5% of research applicant answered that they would not have insurance in the future. 4. The 58.2% of the injured parts occurred in fingers, hands, wrists, or arms and the 74.4% of the damage types were bruise, prick or abrasion. The damaged parts of machinery were belt of power transmission device, chains, sharpened knives, narrow mechanism or cultivating knives for rotary. 5. The average days of medical treatment for casualty was 15.5 days and the average expense of medical treatment per person was 189,200 won. The days of temporary rest and the economic damage per person due to accident were 12.8 days and 469,300 won.

• Journal of Biomedical Engineering Research
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• 제25권4호
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• pp.269-275
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• 2004

Different biological tissues have different values of electrical resistivity. In EIT (electrical impedance tomography), we try to provide cross-sectional images of a resistivity distribution inside an electrically conducting subject such as the human body mainly for functional imaging. However, it is well known that the image reconstruction problem in EIT is ill-posed and the quality of a reconstructed image highly depends on the measurement error. This requires us to develop a high-performance EIT system. In this paper, we describe the development of a 16-channel digital EIT system including a single constant current source, 16 voltmeters, main controller, and PC. The system was designed and implemented using the FPGA-based digital technology. The current source injects 50KHz sinusoidal current with the THD (total harmonic distortion) of 0.0029% and amplitude stability of 0.022%. The single current source and switching circuit reduce the measurement error associated with imperfect matching of multiple current sources at the expense of a reduced data acquisition time. The digital voltmeter measuring the induced boundary voltage consists of a differential amplifier, ADC, and FPGA (field programmable gate array). The digital phase-sensitive demodulation technique was implemented in the voltmeter to maximize the SNR (signal-to-noise ratio). Experimental results of 16-channel digital voltmeters showed the SNR of 90dB. We used the developed EIT system to reconstruct resistivity images of a saline phantom containing banana objects. Based on the results, we suggest future improvements for a 64-channel muff-frequency EIT system for three-dimensional dynamic imaging of bio-impedance distributions inside the human body.

• Journal of agricultural medicine and community health
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• 제25권2호
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• pp.427-440
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• 2000

A comparative study was made about health resources, medical care service statistics and public health service statistics by health subcenters at Jangdong and Jangpyung townships, Jangheung County, Chollanamdo before and after the unification of two health subcenter to improve their function. 1. While two general physicians, one dentist, 4 nurse aids arid one oral hygienist were working at two health subcenters with simple facility with examination room and public health office in 1997 prior to the unification, in 1999 after the unification of two health subcenters 14 staff including a specialist physician, a general physician, a dentist, a herb hygienist, a radiology technician and a physical therapist were working in the new health subcenters equipped with appropriate facilities in two storey building. 2. In 1997 before the unification the yearly total income of two health subcenters was 78,815 thousand won(about 14,000 won per capita) and the amount was 140,376 thousand won(about 25,000 won per capita) in 1999 after the unification. And the income was used for operation of health subcenters excluding personnel expense. 3. While 90.5% of visitors to the health subcenters came for general medical care, and 91.6% came for the revisit before the unification, after the unification 71.2% came for general medical care, 10.8% for dental care, 16.5% for oriental physician's care, 29.7% for the first visit and 70.3% for revisit. Most common problem cared for was musculoskeletal disorder like arthralgia. Average treatment cost per person per month was 9,363 won before the unification and 8,309 won after the unification. 4. Through the comparison of execution rate of public health services before and after the unification. the practice rate of most health service among target population including visiting service for chronic illness, maternal and child health service and immunization service increased after the unification. The practice rate of tuberculosis control service, hypertension control and diabetes management was a little decreased. In conclusion, continuous effort to satisfy all persons in two townships and evaluation are necessary to coincide with the spirit of unification of two health subcenters.

• Korean Journal of Occupational Health Nursing
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• 제4권호
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• pp.5-29
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• 1995

Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

• Journal of Venture Innovation
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• 제2권1호
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• pp.57-79
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• 2019

We have been experiencing an lengthened life expectancy due to rapid industrialization, economic and medical development. In particular, the elderly population was only 5.1% of the total population in 1900s when the senior centers were established, but 30 years later, the elderly population aged 65 or older reached 6.54 million in 2015 and became 14% in 2017. There is a very meaningful correlation between service quality of the senior welfare center and the life satisfaction of the elderly, where the elderly spend their leisure time on a daily basis. Accordingly, this study tried to identify the desirable conditions that the elderly think and the difference from the desired status and the actual status to identify what information and services should be provided by senior welfare centers. Gwanak Senior Welfare Center has provided senior welfare service for local seniors for 30 years since its establishment and contributed to silver welfare policy establishment based on the accumulated experiences. In the coming era of GDP 30,000 dollars, National Pension era and average life span 100 years, the new creative silver welfare programs should be introduced such as qualitative programs rather than quantitative, programs for caring minorities, complimentary or actual expense programs, creative programs rather than passive ones, and diversity of the subjects. This study would like to present the future direction for the next 30 years.