• Journal of Preventive Medicine and Public Health
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• v.35 no.4
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• pp.340-350
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• 2002

Objectives : To evaluate the annual visit days, the annual prescription days and the medical costs of hypertensive patients. Methods : The medical insurance records of 40,267 incident patients with the diagnostic code of hypertension from September 1998 through August 1999 in Daegu city were reviewed. Results : The proportion of the most proper medical care pattern group (Group VIII) who visited for 6-15 days with 240 prescription days or more a year was only 6.2%. The proper care group (Group IX) who visited for more than 16 days with 240 prescription days or more a year was 9.3%. The overall proper care group (Group VIII+IX) was therefore 15.5%. The proportion of the insufficient care group (Group I, IV) in both the number of visiting days and prescription days was 57.4%. The mean prescription day of the most proper group (Group VIII) was 29 days; the mean annual medical expenses,453,587won; the mean annual amount paid by patients, 218,013won; and mean medical expenses per prescription day, 1,483won. The proportion of the overall proper care group (Group VIII+IX) was significantly higher in adults aged 50-59, those who were enrolled in industrial workers health insurance as well as government employees and private school teachers health insurance, and those who made a higher contribution per month (p<0.01). According to the type of medical facilities, the proportion of the most proper medical care pattern group was highest in the general hospitals (9.3%) but the overall proper care group was higher in the public health centers (22.1%) and private clinics (17.1%). Conclusions : The management system of hypertension should be reinforced urgently. Therefore, it is necessary to develop guidelines including the number of visiting days per year and prescription days per visit day, and make the system provide medical facilities to more properly care for hypertensive patients.

• Journal of Climate Change Research
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• v.7 no.4
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• pp.451-463
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• 2016

We explore the impact of Chinese future air pollutant emissions on ozone air quality in Northeast Asia (NEA) and health in South-Korea using an assessment framework including ICAMS (The Integrated Climate and Air Quality Modeling System) and BenMAP (The Environmental Benefits Mapping and Analysis Program). The emissions data sets from the climate change scenarios, the Representative Concentration Pathways (RCPs) (emission scenarios, EMSO), are used to simulate ozone air quality in NEA in the current (1996~2005, 2000s), the near future (2016~2025, 2020s) and the distant future (2046~2055, 2050s). Furthermore, the simulated ozone changes in the 2050s are used to analyze ozone-related premature mortality and economic cost in South-Korea. While different EMSOs are applied to the China region, fixed EMSO are used for other country regions to isolate the impacts of the Chinese emissions. Predicted ozone changes in NEA are distinctively affected by large changes in NOx emission over most of China region. Comparing the 2020s with the 2000s situation, the largest increase in mean ozone concentrations in NEA is simulated under RCP 8.5 and similarly small increases are under other RCPs. In the 2050s in NEA, the largest increase in mean ozone concentrations is simulated under RCP 6.0 and leads to the occurrence of the highest premature mortalities and economic costs in South-Korea. Whereas, the largest decrease is simulated under RCP 4.5 leads to the highest avoided premature mortality numbers and economic costs. Our results suggest that continuous reduction of NOx emissions across the China region under an assertive climate change mitigation scenario like RCP 4.5 leads to improved future ozone air quality and health benefits in the NEA countries including South-Korea.

• Korean Journal of Radiology
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• v.24 no.12
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• pp.1249-1259
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• 2023

Objective: This study aimed to evaluate the clinical outcomes and cost-effectiveness of dual-energy X-ray absorptiometry (DXA) for osteoporosis screening. Materials and Methods: Eligible patients who had and had not undergone DXA screening were identified from among those aged 50 years or older at Kaohsiung Veterans General Hospital, Taiwan. Age, sex, screening year (index year), and Charlson comorbidity index of the DXA and non-DXA groups were matched using inverse probability of treatment weighting (IPTW) for propensity score analysis. For cost-effectiveness analysis, a societal perspective, 1-year cycle length, 20-year time horizon, and discount rate of 2% per year for both effectiveness and costs were adopted in the incremental cost-effectiveness (ICER) model. Results: The outcome analysis included 10337 patients (female:male, 63.8%:36.2%) who were screened for osteoporosis in southern Taiwan between January 1, 2012, and December 31, 2021. The DXA group had significantly better outcomes than the non-DXA group in terms of fragility fractures (7.6% vs. 12.5%, P < 0.001) and mortality (0.6% vs. 4.3%, P < 0.001). The DXA screening strategy gained an ICER of US$ -2794 per quality-adjusted life year (QALY) relative to the non-DXA at the willingness-to-pay threshold of US$ 33004 (Taiwan's per capita gross domestic product). The ICER after stratifying by ages of 50-59, 60-69, 70-79, and ≥ 80 years were US$ -17815, US$ -26862, US$ -28981, and US$ -34816 per QALY, respectively. Conclusion: Using DXA to screen adults aged 50 years or older for osteoporosis resulted in a reduced incidence of fragility fractures, lower mortality rate, and reduced total costs. Screening for osteoporosis is a cost-saving strategy and its effectiveness increases with age. However, caution is needed when generalizing these cost-effectiveness results to all older populations because the study population consisted mainly of women.

• Korea Journal of Hospital Management
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• v.18 no.4
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• pp.78-96
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• 2013

The purpose of this study is to analyze the emergency health care utilization using status according to income class. The target was the 2011 data out Korea Health Panel's raw data. 2011 data composed of total 17,035 people from total 5,741 households. This study set total 1,101 adults over full-20-years old having used an emergency health care utilization as its analysis target. In order to find out the number of emergency health care utilization use according to income class and the influential factors on emergency health care utilization cost, this study conducted the multiple regression analysis. And in order to more accurately analyze the emergency health care utilization use status depending on the income class and the features of emergency health care utilization use status, this study developed Models. As the result, this study found following findings. First, as the income class was lower, the gender was male, the age was lower, and the user has spouse, the user was not a business owner or a paid worker, the user is a house owner, the emergency medical facility type was a clinic, the means of transportation was others rather than 119 ambulance, the reason visiting emergency medical facility was belonged to others rather than accidents or poisoning, then the number of emergency was increased. Second, as the user was in higher income class, received the health insurance benefits, the using medical facility was general hospital, used 119 ambulance more often, stay days in emergency was shorter, then health care utilization cost was increased. In this study investigating the data out of Korea Health Panel, it was found that while the number of emergency health care utilization use was increased in the lower income class, but the emergency health care utilization cost was increased for higher income class. It is considered that this finding was caused from the facts that lower income class was more often exposed to dangers for physical health, so the number of emergency health care utilization use was increased, but their health care utilization cost was decreased because of their economic burdens against various examinations and their difficulties to pay such costs, comparing to that of higher income class. Therefore, in order to solve unequal problem of emergency health care utilization use between lower and higher income classs, it is required to set suitable solutions like the disease prevention effort by facilitating national health check-up programs, the enhancement of public health services in quantity and quality, the emergency health care utilization securing policy at using medical facilities, the promotional, educational activities about emergency health care utilization delivery system, the enhanced accessibility of emergency health care utilizations and emergency medical facilities.

• Journal of Home Health Care Nursing
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• v.2
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• pp.5-18
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• 1995

While the socioeonomic status of Koreas has been dramatically increasing in recent years, chronic and geriatric diseases have also been on the rise, bringing about many changes in our health care system. The basic goals of the home health care are to reduce health care costs, to increase the attrition rate in general hospitals, and to care for patients effectively and conveniontly at home. The purpose of this paper is to review and examine the current status of the home health care in Korea throughout the reports, surveys, other informations and education system of home health nurse. We identified the various types of home health care services programs, such as hospital-based home health care operated in public sector(demonstration project) and community-based home health care in health centers or in private sector, that is, Korean Nurse Association. Hospital based home heatlh care model was established as an alternative to traditional in-patiet services. Quality assurance and client satisfaction is an important measure of care received and establishment of payment and reimbursement for home health care services is important in promotng the home health care. We found out a fee-per-visit system composed of three kinds of fees : a basic service fee(16,000 Won), a travel fee(5,000 Won), and per-service fees (variables). Like fees paid for in-patient care, insureds pay 20% and insurers pay 80% of the basic and per-service fee. The travel fee is borne totally by the insured. Home health care continues to be viewed as not only the most preferred way to provide care to clients, but also the most cost effective. Home health care is that component of a continuum of comprehensive health care whereby health services are provided to individuals and families in their places of residence for the purpose of promoting, maintaining, or restoring health, or of maximizing the level of independence, while minimizing illness. Services appropriate to the needs of the individual patient and family should be planned and provided, nursing is to be a force for positive change and enhanced the nursing professionalism. Whatever type of involvement of home health care, it is essential to remember that home health care is highly service-oriented and highly touch health car deilvery system.

• The Korean Journal of Health Service Management
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• v.9 no.3
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• pp.43-55
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• 2015

Objectives : This study analyzed the managerial efficiency of hospitals and identified the productivity trends for three years. Methods : Data were collected from 44 tertiary hospitals and 32 university hospitals from 2009 to 2011. Efficiency scores and productivity trends were evaluated with the DEA (Data Envelopment Analysis) method. The input variables were the numbers of beds, doctors, nurses, and health personnel, and the medical costs. The output variables were the numbers of outpatients, and inpatients, and the medical revenues. Along with the traditional input-oriented DEA analysis, the Malmquist Productivity Index(MPI) was calculated. Results : First, the mean values of the study variables showed gradual increases in all the variables for all the study years. Second, technical efficiency scores varied depending on the study year. Third, MPI decreased from 2009 to 2010 (MPI=0.986), and then increased from 2010 to 2011(MPI=1.011). The contributions of the Efficiency Change Index and Technical Change Index on the MPI varied depending on the study year. Conclusions : This study provides information to hospital managers about changes in hospital performances. External environments had more influence on hospital performances, and hospital managers will need to manage these influences from factors surrounding the hospitals.

• Journal of dental hygiene science
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• v.18 no.5
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• pp.319-326
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• 2018

Although scaling is the primary method for improving oral health, it is also associated with dental fear. The objective of this study was to empirically verify whether the use of gel anesthetic within the gingival sulcus during scaling relieves pain and improves other factors. A total of 128 patients scheduled to undergo scaling at a dental clinic of a general hospital located in the Gyeonggi Province, between July 2014 and July 2015, were enrolled in the study. The participants underwent scaling following the application of 20% benzocaine gel or placebo gel anesthetic within the gingival sulcus, and the data was collected using a questionnaire. There was a significant difference in the severity of pain, participant satisfaction, perceived sensitivity, overall discomfort, and fear of scaling between the two groups. The two groups were compared in terms of perceived need for gel anesthesia, willingness to pay for anesthesia costs, and willingness to receive scaling in the future. There were significant differences in all the three parameters depending on whether gel anesthesia was used or not. There were significant differences between the two groups in perceived sensitivity immediately after scaling and one day after scaling, with no difference seen one week after scaling. With regards to overall discomfort over time, there were significant differences between the two groups immediately after scaling. Based on these findings, we expect that application of gel anesthetic within the gingival sulcus during scaling will reduce pain, perceived sensitivity, overall discomfort, and fear of scaling with increased satisfaction.

• Korean Journal of Health Education and Promotion
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• v.21 no.1
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• pp.243-257
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• 2004

Alcohol consumption is a major source of health problems, for example, alchol consumption is related to liver diseases. In addition, the social and economic costs related to alcohol consumption are enormous. This study was conducted to evaluate the current status and influencing factors related to the recognition and behavioral intention for both drinking and alcohol-reduction programs. Three effective alcohol-reduction programs of clinic program, mass education, and alliance were considered. To explain the health behavior for drinking and alcohol-reduction programs, a five-stage behavioral intention model was built and 500 questionnaires were completed through a telephone survey. Stages of the model composed of recognition of the programs, past experiences, present drinking status, intention for drinking, and behavioral intention for alcohol-reduction programs. As a result, recognition rates of the programs were low in general, therefore the strategies of education, public relations, and advertisement need to be pursued. The alcohol dependency resulted in the fact that success rate was 30％ although trial rate of alcohol-reducing was 23％. The necessity of alcohol-reduction programs were suggested. In addition, significant factors related to the intention for alcohol-reducing were individual attitude and reluctancy to pay their time and money. An insignificant factor was the attitude to their alcohol-reduction by other people. Behavioral intention rates for alcohol-reducing clinics were 4％, and those for mass education were 8％. There were very low purchase rates for clinic program, mass education, and alliance. In conclusion, evidenced-based and effective alcohol-reduction programs need to be encouraged to drinkers by medical doctors, and the strategies of education, public relations, and advertisement are also recommended. In addition, continuing legal and systematic support for alcohol-reducing would lower the drinking rate and ultimately contribute to the nation's health promotion.

• Journal of the Korean Society of Food Culture
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• v.33 no.4
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• pp.299-306
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• 2018

Pork is a popular meat consumed in Korea. However, the consumption pattern has typically focused on preferred parts, like pork belly, which is usually broiled. This consumption pattern has increased both stocks of low fat parts and medical costs, and has thereby disturbed pork industry growth and the national health welfare. Changing the consumption patterns of preferred parts and encouraging consumption of low fat parts will improve consumers' quality of life and also increase their benefits. Thus, this study estimated WTP (Willingness To Pay) for health funds among consumers who eat pork meat, considering the health benefits gained by consuming low fat parts and changes in preferred part consumption. The results of this study show that WTP is higher when consumers have a smaller family and a higher income; these consumers plan to increase intake of pork meat in the future and think that the promotion of low fat pork meat consumption is more important. The WTP for health funds is estimated to be 49won to 287won through Logit Model. The health benefits of low fat consumption were estimated to be 92 billion won to 539 billion won per year. Therefore, reforming low fat pork consumption not only changes the traditional consumption pattern focused on preferred parts but also leads to a variety of benefits for consumers, including health benefits.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.20 no.2
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• pp.76-81
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• 2009

Ovjectives: As the attention devoted to children's mental health increases, medical costs and burdens mount as well. In the present study, we evaluated the association between socioeconomic status(SES) and major child psychiatric symptoms. Methods: The subjects of this study were children of recruited from a mental health screening program in the Seoul Sungbuk mental health center over the course of 3 months. To establish the SES of each child, we collected data about each child's medical insurance, years of parental education, household income, family structure and housing. 149 children & parents completed questionnaires including the Childhood Depression Inventory(CDI) and the Korean Attention Deficit Hyperactivity Disorder Rating Scale(K-ARS). Results: The mean K-ARS-P score was $12.1{\pm}11.1$ and the suspected prevalence of ADHD was 20.8%(n=31). The mean cm score was $12.9{\pm}7.9$, and the prevalence of suspected depression was 16.8%(25). Depressive symptoms and ADHD symptoms were both more severe than those observed in a previous epidemiologic study in Korea. Depressive symptoms were more closely associated with family SES status. Conclusion: SES status is one of the most important risk factors in the development of major child psychiatric symptoms. In our study we found that depressive symptoms in particular were most tightly associated with psychosocial factors. Evaluation of the risk factors, early screening and intervention for low SES children would be valuable mental health management tactics to implement in a community mental health system.