• Clinical and Experimental Pediatrics
• /
• v.52 no.11
• /
• pp.1249-1259
• /
• 2009

Purpose:From a societal perspective, we evaluated the cost-effectiveness of a novel sustained-release injection of recombinant human growth hormone (GH) administered on a weekly basis compared with that of the present daily GH injection for the treatment of children with GH deficiency. Methods:Health-related utility for GH therapy was measured based on the visual analogue scale. During July 2008, caregivers of 149 children receiving GH therapy form 2 study sites participated in a web-based questionnaire survey. The survey required the caregivers to rate their current subjective utility with daily GH injections or expected utility of weekly GH injections. Because there was no difference in the costs of the daily and weekly therapies, for the purposes of this study, only drug acquisition costs were considered. Results:Switching from daily to weekly injection of GH increased the utility from 0.584 to 0.784 and incurred an extra cost of 4,060,811 Korean won (KW) per year. The incremental cost-utility ratio (ICUR) for a base case was 20,305,055 KW per quality-adjusted life year (QALY) gained. Scenario analyses showed that the ICUR ranged from 15,751,198 to 25,489,929 KW per QALY. Conclusion:The ICUR for a base case and worst case scenario analyses ranged from 0.85 to 1.37-times per capita gross domestic product of Korea, which is considered to be within the generally accepted willingness-to-pay threshold. Thus, it is concluded that switching from daily to weekly injection of GH would be cost-effective.

• The Journal of the Korea Contents Association
• /
• v.13 no.11
• /
• pp.187-197
• /
• 2013

Objectives : The purpose of this study was to analyze the effect of outpatient cost sharing reduction on health care utilization of children under 6 years old. Methods : The data in this analysis was the health insurance claims data between August 2006 and July 2008. The study group was divided into two age groups, namely 0-5 years old and 6-10 years old. This study evaluated the impact of policy change on office visits per person and expenditure per visit. In order to do so, the double difference analysis is used. Results: The results showed that outpatient cost-sharing reduction has never really had a huge impact on office visits per person and expenditure per visit. Conclusions: This study showed that the outpatient cost sharing reduction for children under 6 years old policy is not working. Therefore, cost sharing of National Health Insurance by income class is needed.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.10
• /
• pp.490-498
• /
• 2017

The purpose of this study was to investigate how many kindergarten parents use after-school programs and specialization activities and to suggest effective policy improvement plans based on the results. After 693 parents were interviewed by the investigators, the collected data were presented by calculating the percentages, averages, and standard deviations. First of all, the results of after-school are presented. First, about 38.2% of the surveyed parents spent additional expenses to use after - school program, and the average of additional costs was about 62,850 won. When the cost burden and satisfaction were evaluated as 5 points, it was rated as normal. Second, the main reason for participating in the after-school program was both parents were working, followed by the parents' wishes for their children to spend time with their friends. Next, the results for specialization activities at kindergartens are presented. First, the proportion of children using after-school specialization activities was 68.2%, of which 79% were expenditures, the number of activities was 2.69, and the average cost was 83,540 won. Second, the most preferred after-school specialization activity by age group was English, and the most common reason for this was that the children liked to participate. Improvement of the educational contents suggested as the most important thing to improve after-school specialization activities. Lastly, the results showed that after-school specialization activities reduced parents' spending on private education. On the basis of the results, some discussions are presented included the development after-school programs focusing on the different needs of children and parents accordingly.

• Journal of Families and Better Life
• /
• v.29 no.4
• /
• pp.205-216
• /
• 2011

Unequal distribution of shares among children during intergenerational transference of assets has been prevalent in Korea. This study intends to examine whether parental contribution, in the form of a cash gift, is differentiated between the bride's side and the bridegroom's side at marriage and by age group. This pattern may also change according to the generation. Questionnaires were equally distributed to members of three previously delineated age groups: 20' s-30' s, 40's -50's, and 60's and above who are married or have been married at least once and reside in Seoul or Gyeonggi province. A total of 700 questionnaires were analyzed using SPSS and the data were sorted by age group. The results indicate an apparent difference between the husband's side and the wife's side in providing funding for housing at marriage in that a large portion of the funding is provided by the husband's side. Among various funding sources, a cash gift from the couple's parents appears to fund the largest portion of the total cost for housing and marriage. Results show that a cash gift from the couple's parents funds a larger portion of housing expenses for younger generations, a phenomenon that becomes more severe and apparent the younger the couple is.

• Quality Improvement in Health Care
• /
• v.5 no.1
• /
• pp.58-75
• /
• 1998

Background : In Korea, the rational use of antibiotics are rarely controlled, and their patterns of utilization are not understood. In order to reduce the excessive use and to improve the appropriate use of antibiotics, it is necessary to accurately determine present uses of antibiotics in hospitals. Methods : Analysis of the use of prescription drugs was performed on NFMI(National Federation of Medical Insurance) 1994 medical expense claim data. A stratified sampling by types of hospitals, departments, and diseases was obtained from 1994 August data. Patients with secondary diseases were excluded. In this study, 2,697 adults with URI, 6,397 children with URI, 704 adults with bronchitis, and 1,838 children with bronchitis were included. Results : Most patients were prescribed medication (95.2-99.6%). Of the patients prescribed medication, more than 85% of URI patients and more than 91% of bronchitis patients were prescribed antibiotics. Antibiotics expenses accounted for 14% of total medical expenses in adults and 9% of total medical expenses in children. In adults with URI, antibiotics expenses accounted for 52% of drug expenses. Of the patients prescribed antibiotics, average number of antibiotics used was 1.6-1.7. For patients who are prescribed antibiotics, drug expenses were 62-97% greater than patients not prescribed antibiotics. When children were prescribed antibiotics, the highest price of drugs prescribed were 3.4-fold greater. In addition, the number of drugs prescribed also increased by more than one. Elderly patients, more than 60 years, were prescribed antibiotics less frequently. Children less than 10 years and elderly patients greater than 60 years old were prescribed fewer antibiotics than other patients. And they were prescribed medications for longer days than other patients. Conclusion : This study demonstrated that the average rate of prescribing antibiotics was higher in Korea than other countries. Measures to reduce overuse of antibiotics and to improve the appropriate prescription of antibiotics must be considered for cost effective treatment and overall health of people.

• Journal of the Korean Dietetic Association
• /
• v.5 no.2
• /
• pp.117-127
• /
• 1999

This study was carried out to provide the improvable way of foodservice management to dietitian in the elementary schools. For this purpose the serving pattern of food, menu planning, nutrition education, leftover management and difficulties in foodservice were investigated. The survey was conducted through questionnaires, which were collected from 249 dietitions randomly selected in Taejon and Chung Nam. Data were analyzed by SAS program. The main results of this study are as follows. The children in Taejon took foods in the class room(65.7%) and those in Chung Nam in the dinning hall(89.9%)(p<0.01). In menu planning the balance of nutrition(42.6%) was mainly considered and then food preference(19.7%), variety of menus(16.1%), food cost(16.1%), composition of food color, taste and texture(3.2%), skills of food making(1.6%) and the number of students(0.8%). They referred cooking magazines(47.7%), the previous menu(42.2%), children's opinion(7.2%) for planning menu. The insufficiency of implements and devices for food(24.1%) and lack of season's food(20.4%) were indicated as difficulties in their job. 34.5% of dietitians used a standard menu, 79.5% investigated food preference of children, 74.3% evaluated taste of foods before serving, and 80.7% regularly checked leftover. The major reason for leftover was careless of the teacher in charge in Taejon and bad taste of foods nutrition in Chung Nam(p<0.001). 98.5% of them answered that they had the responsibility for nutrition education in elementary school. They had a hard time in relationship with the staffs in school(40.6%) and employees for food(39.8%), and lack of market information(38.2%). To efficiency of dietitian's work can be enhanced by reflecting the results of children's food preference and leftover, by using standard cooking method and proper cooking utensil, and by performing nutrition education for children by themselves.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.19 no.3
• /
• pp.143-149
• /
• 2019

Background: Uncooperative behavior of children due to dental anxiety may interfere with the effective delivery of dental care and compromise the quality of treatment provided. Injection of local anesthesia is one of the most anxiety-inducing stimuli in pediatric dentistry. This study aimed to compare the efficacy of a child-friendly device, having a combined effect of vibration and distraction, with the conventional method of injection on pain, anxiety, and behavior of pediatric patients aged 6-11 years. Methods: This randomized, crossover, split-mouth study included 30 children requiring a bilateral inferior alveolar nerve block. The children were equally divided into two groups: group 1, aged 6-8 and group 2, aged 9-11 years. All children were injected with anesthesia using the conventional and device method in two separate sessions. They were assessed for anxiety by measuring the pulse rate before and during the administration of local anesthesia. Behavior was assessed using Faces, Legs, Activity, Cry, Consolability (FLACC) scale, and the child's experience while receiving anesthesia was assessed using the Wong Bakers Pain Rating Scale. Results: Results showed that the children who received local anesthesia using the device method had a lower mean pulse rate, FLACC scores, and pain rating scores than those who received local anesthesia using the conventional method. Conclusion: The device method was more effective than the conventional method in managing pain, anxiety, and behavior of patients aged 6-11 years. The device is a cost effective, simple, and child-friendly product for administrating local anesthesia in pediatric patients.

• Journal of Society of Preventive Korean Medicine
• /
• v.23 no.2
• /
• pp.25-42
• /
• 2019

Objectives : The purpose of this study was to identify factors that affect the utilization of Korean medicine (KM) among children with cerebral palsy (CP) and explore a processing model of decision-making by their parents. Methods : We conducted an individual in-depth interview with 21 mothers of children with CP who were recruited during the observational study. A grounded theory of Strauss and Corbin was used for qualitative analysis. Thus, collected data were classified into open coding including 121 concepts, 27 sub-categories and 7 categories. Results : The central phenomenon of the process of using KM for children with CP is 'KM as an optional treatment not essential'. Therefore there are many obstacles to starting KM treatment and it is easily interrupted for various reasons, unlike general rehabilitation treatment. However, if the patient experiences the therapeutic effect, the parents want to continue KM treatment. They try to provide treatment as much as possible if they can afford it. The parents give priority to general rehabilitation treatment and value the information and experience provided by the caregivers in similar situation as well as expert opinions. Conclusions : To expand and generalize KM treatment for children with CP, efforts to change interventional conditions such as treatment effect, treatment cost, treatment compliance, and convenience of treatment based on the understanding of the strategy used by the parents in KM utilization.

• Journal of the East Asian Society of Dietary Life
• /
• v.15 no.6
• /
• pp.644-654
• /
• 2005

The purpose of this study was to investigate the related factors to nutritional supplements intake of elementary school student aged 7 to 12 years in Incheon area. The subjects were 631 mothers of elementary school students and cross-sectional study was conducted by a self-administered questionnaire. In view of the relation with general circumstances, taking nutritional supplements was shown to be significantly associated with general and socio-demographic factors such as father's job, mothers concern about children's academic record, family's monthly income and food cost, and the experience of other family members' taking nutritional supplement. In view of the relation with anthropometric and health-related factors, taking nutritional supplement was associated with elementary school student' weight obesity index, mothers evaluation of children's height and weight mother's concern about health and growth of children, and ,disease of children. In view of the dietary behavior-related factors, taking nutritional supplements was associated with skipping breakfast, food habits, and mothers beliefs and attitude about nutrition and nutritional supplements. However, it was shown that mothers nutritional knowledge did not affect taking nutritional supplements. Therefore, it may be suggested that general and socio-demographic factors, anthropometric and health-related factors, dietary behavior-related factors, and mother's nutritional beliefs and attitude are important determinants in children's taking nutritional supplements.

• Nutrition Research and Practice
• /
• v.5 no.1
• /
• pp.40-45
• /
• 2011

Hemoglobin and zinc protoporphyrin (ZPP) tests are commonly used to screen for iron deficiency, but little research has been done to systematically evaluate the sensitivity and specificity of these two tests. The goal of this study was to evaluate the effectiveness of zinc protoporphyrin/heme (ZPP/H) ratio as a point-of-service screening test for iron deficiency among preschool-aged children by comparing the sensitivity and specificity of hemoglobin, ZPP/H ratio, and serum ferritin (SF). Also completed were assessments for the prevalence of anemia, iron deficiency (ID), and iron deficiency anemia (IDA) with indicators of ferritin models. This study was carried out with 95 children ages 3 to 6 y. Anthropometric measurements were assessed and blood samples were analyzed for hemoglobin, SF, transferrin saturation (TS), and ZPP. Anemia was common and the prevalences of anemia, ID, and IDA were 14.7%, 12.6%, and 5.2%, respectively. The ZPP/H ratio was strongly and significantly correlated with hemoglobin. And ZPP/H ratio was a more sensitive test for ID than hemoglobin or SF measurement, correctly identifying more than twice as many iron-deficient children (sensitivity of 91.7%, compared to 41.7% for hemoglobin and SF). However, ZPP/H ratio had lower specificity (60.2%, compared to 89.1% for hemoglobin or 96.4% for SF) and resulted in the false identification of more subjects who actually were not iron deficient than did hemoglobin or SF. Low hemoglobin concentration is a late-stage indicator of ID, but ZPP/H ratio can detect ID at early stages and can be performed easily at a relatively low cost. Therefore, ZPP/H ratio can serve as a potential screening test for pre-anemic iron deficiency in community pediatric practices.