Background: Difficult-to-treat asthma afflicts a small percentage of the asthma population. However, these patients remain refractory to treat, and account for 40% to 50% of the health costs of asthma treatment, incurring significant morbidity. We conducted a multi-center cross-sectional study to characterize difficult-to-treat asthma in Korea. Methods: Subjects with difficult-to-treat asthma and subjects with controlled asthma were recruited from 5 outpatient clinics of referral hospitals. We reviewed medical records of previous 6 months and obtained patient-reported questionnaires composed of treatment compliance, asthma control, and instruments for stress, anxiety, and depression. Results: We recruited 21 subjects with difficult-to-treat asthma and 110 subjects with controlled asthma into the study. The subjects with difficult-to-treat asthma were associated with longer treatment periods, more increased health care utilization, more medication (oral corticosteroids, number of medication), and more anxiety disorder compared to those of well-controlled asthmatics. There was no difference in age, gender, history of allergy, serum IgE, blood eosinophil count, or body mass index between the 2 groups. Conclusion: Difficult-to-treat asthma is characterized by increased health care utilization and more co-morbidity of anxiety.
Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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2015.05a
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pp.600-602
/
2015
WHO(World Health Organization) as specified due to the global epidemic of obesity in the nation and the social costs associated with health increase. If treating diseases of the existing research targets the medical field with increasing interest in the welfare and well-being sector due to the improvement in earnings, and gradually change to advance the prevention and management. In this paper, we consider these social changes, we propose a personalized recommendation system fitness. This makes it possible that the recommendation is effective to the movement by the movement mechanism by which user. Mobile sensor is overcome by software and having hardware limitations for this purpose, proposes an optimized sensor control mechanism.
Choi, Kangrok;Kim, Daeho;Seo, Ho Jun;Huh, Hyu Jung;Lee, Dong-Woo;Chae, Jeong Ho
Anxiety and mood
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v.9
no.2
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pp.147-153
/
2013
Objective : Despite the chronic nature and high social costs, individuals with anxiety disorders seldom seek treatment. Thus, education for public awareness and screening for the illness is tremendously important for mental health professionals. This study summaries and presents the results from Anxiety Disorder Screening Program during the Mental Health Exposition held in Seoul in April, 2013. Methods : We analyzed the data from 116 participants who agreed and completed the screening questionnaires during their visits to two-day Anxiety Disorder Screening Program prepared by the Korean Academy of Anxiety Disorder. The questionnaire comprised of modified Mobility inventory for agoraphobia, Contents of worries, Penn State Worry Questionnaire, Life Events Checklist, and Abbreviated Posttraumatic Stress Disorder Checklist. Results : Participants demonstrated high rates of anxiety symptoms and possible anxiety disorders. Experience of panic attack was reported by 45%, lifetime and 16% in the past month by respondents. Phobia was reported by 46%. Participants had an average of 3.3 pathological worries and among those, social or interpersonal content was most common (46%). At least one lifetime traumatic event was reported by 64%. By the cut-off scores in the literature, 46% had possible generalized anxiety disorder and 58% possible posttraumatic stress disorder. Conclusion : Our results suggested that many visitors to Anxiety Disorder Screening Program were in fact treatment seeking after experiencing some forms of anxiety symptoms. Further efforts for delivery of medical information and increasing public awareness for anxiety disorders are needed.
Cho, Eun;Kang, Moon Hae;Choi, Kui Son;Suh, MiNa;Jun, Jae Kwan;Park, Eun-Cheol
Asian Pacific Journal of Cancer Prevention
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v.14
no.7
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pp.4329-4334
/
2013
Background: Cervical cancer, which is common in developing countries, is also a major health issue in Korea. Our aim was to evaluate the cost-effectiveness of Korea's National Cancer Screening Program (NCSP), implemented in 1999. Materials and Methods: The target population was Korean women 30 years or over who were invited to take part in the NCSP in 2002-2007. By merging NCSP records with Korean Central Cancer Registry data, patients diagnosed with cervical cancer who had been screened were assigned to a "screened group," while patients diagnosed elsewhere were assigned to a "non-screened group." Clinical outcomes were measured in terms of life-years saved (LYS), derived from 5-year mortality rates supplied by the Korean National Health Insurance Corporation and National Statistical Office. Direct and travel costs associated with screening were evaluated from the perspective of the payer, the NCSP. Results: A diagnosis via screening was associated with 2.30 LYS, and the incremental cost-effectiveness ratio (ICER) estimate for screening was 7,581,679 KW/LYS (6,727 USD/LYS). ICER estimates were lower for older patients (${\geq}$ 50 years) than younger patients (4,047,033 KW/LYS vs 5,680,793 KW/LYS). The proportion of early-stage cancers detected was 16.3% higher in the screened group. Conclusions: In light of Korea's per capita gross domestic product (32,272 USD in 2012), the current NCSP's incremental cost per LYS appears acceptable.
Energy use has been recognized worldwide as a main cause of global warming and it is at the center of climate change. In this study, problems and measures of zero-energy building construction are investigated and analyzed. Based on the results, evaluation criteria of the zero-energy building are suggested. Performance related factors(Q) representing the environmental grade were divided into three categories as outdoor, indoor environment and maintenance. Energy related factors(LR) representing the energy load were divided into an energy, materials & resources, water cycle management, land use and transportation. Detailed fifty three items are listed for the evaluation under the consideration of energy, water cycle management sections gave weight. Upon receiving the first in the environment friendly certification system, Seoul Central Post Office and Seoul Metropolitan Water Supply Center evaluated. The reason why this score difference is due to lack of use of new generation energy building construction is required expensive costs so need expansion of governmental support. This effort is successful zero energy building construction and copes with global warming and climate change.
A national animal health monitoring system(NAHMS) in Gyeongnam area was started from 1997 to develop statistically valid data for use in estimating disease frequencies in dairy cattle, and the associated costs. The objectives of this study were to : (1) discribe what was done to implement and maintain the system in Gyeongnam ; (2) present selected disease frequencies ; (3) discuss the epidemiological consideration of what was done and implications for the results obtained. Veterinary Medical Officers(VMOs-professors and graduate students from Gyeongsang National University, Faculty of Gyeongnam Livestock Promotion Institute, and Clinic veterinarians) served as data collectors. After training on current disease and management problems of dairy cattle, interview techniques, sampling methods, and data collection instruments, the VMOs participated in selection of the sample herds and data gathering. Forty of 167 dairy herds were selected randomly and the VMOs visited farms once a month for 12 months to collect data about management, disease, inventory, production, preventive treatment, financial and any other relevant data. Strict data quality control devices were used. Specific feed-back was developed for the producers and data collectors. Of the three age groups studied, cows had the greatest number of disease problems. The six disorders found most frequently were (from the highest to the lowest) breeding problems, clinical mastitis, birth problems, gastrointestinal problems. metabolic problems, and lameness. In young stock, respiratory, multiple system, breeding problems, and gastrointestinal problems were pre dominant, whereas in calves, gastrointestinal, respiratory, and integumental problems were major.
According to rapid increase of the population of senior citizens, there has been growing concern of Long-Tenn Care(LTC) services recently. Long-Tenn Care services, however, haven't been established systematically in Korea and the supply of LTC services is not sufficient despite the increase in the current social demand. This study aims to estimate the 'Willingness to Pay(WTP)' for LTC insurance which the government plans to introduce by means of social insurance, using Contingent Valuation Method(CYM). In addition, this study analyzes the factors affecting WTP for LTC insurance. An interview survey was carried out to derive WTP for LTC from 450 people who lived in Seoul aged 20 and above during the period from 16th to 21st of June 2003. Double-Bounded Dichotomous Choice Method was applied among several CVMs available to estimate both use value and no-use value of goods. There was pilot survey carried out prior to the main survey. The results show that the average monthly. WTP for LTC provided in home and residential setting is 18,192Won and 19,293Won, respectively. In the case of home care, WTP goes higher depending on reliability of LTC insurance policy and need for LTC insurance, as well as marital status, education and average monthly income. On the contrary, WTP is conversely affected by higher age and higher bids. In the case of institutional care, the factors affecting WTP are similar to those of home care, except age. This study followed NOAA's suggestions generally and the value derived through survey could be reliable. However, there can be the least bias in the process of survey because the CVM should be used under the supposed circumstances. Despite those limitations, it can be concluded that the amount the citizens are willing to pay for LTC is high enough to meet the costs needed to provide LTC.
Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.
The purpose of this study was to analyses the main factors of research papers for related with home physical therapy. This study was retrospective descriptive study, the period of data collection was from 1991 to 2011. The data was collected by the journal related in physical therapy, the dissertation of academic degree, National Assembly Library and the web-site for academic information. In the web-site, searched with the keyword 'home physical therapy' and 'after school voucher'. The results were as follows; 1. In the home physical therapy, visiting physical therapy, school physical therapy, there were different based on laws; home physical therapy was based on medical law, visiting physical therapy was based on law for community health and law for long term health insurance, school physical therapy was based on special education law. 2. The summary of research title/thema from 1991 to 2011 was as follows; for the home and visiting physical therapy 'the needs and necessity of home and visiting physical therapy' was 18 papers, 'the contents of service of home and visiting physical therapy' was 18 papers, 'program and skill development' was 16 papers, 'system developing and induction strategy of home and visiting physical therapy 'was 15 papers, 'costs of nome and visiting physical therapy' was 2 papers, 'perception and information of home and visiting physical therapy' was 9 papers, 'Recoding system and administration management' was 9 papers, 'the others 'was 14 papers, for the school physical therapy 'after school voucher system' was 9 papers, the others was 4 papers. The total papers was 114 papers. 3. Finally suggested 'Model of Educational Program for HomeVisiting and School Physical Therapy'.
Purpose: The objectives for this study are to produce the comprehensive management indexes and find their application strategies for appropriate medical care in primary care clinics under workers' compensation insurance. Method: Data of this study was workers' compensation insurance medical fees claim's data from July 2006 to June 2007. Data were analyzed using SAS 9.1 version by applying descriptive statistics and Pearson's correlation. The indexes such as costliness index(CI), standard medical fee were calculated based on the fourth revision of korean classification of diseases(KCD-4.). Results: The CI, visiting index(VI), outliers index(OI), and medical review adjustment percentage were positively correlated in the both inpatient and outpatient medical fees in primary care clinics under workers' compensation insurance. The major medical specialities were neurological surgery, general medicine, general surgery, rehabitational medicine, and orthopedic surgery. The CIs were slightly high in rehabitational medicine among major medical specialities. The CIs were mostly high in diagnosis, test, anesthesia, and rehabitational assistive device fees among major medical specialities. The CIs were slightly high in Kwangju, Daegu, Daejeon, and Busan districts among district management centers of Korea Workers' Compensation and Welfare Service. Conclusions: We suggest the continuous development of appropriate disease classification system and medical care quality indicators to successfully take root the comprehensive management for appropriate medical care under workers' compensation.
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