• Title/Summary/Keyword: healthcare policy

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Understanding the Current Status of Research on Traditional Korean Medicine Treatment for the People with Disability and Suggestions for Further Research: Scoping Review (장애인 한의치료 연구의 현황 파악과 후속 연구에 대한 제언을 위한 Scoping Review)

  • Kwon, Miri;Lee, Jungmin;Kang, Doyoung;Jeon, Hyonjun;Kim, Suna;Kim, Mihyun;Lee, Shinhee;Jun, Hyungsun;Kang, Heeseol;Cheong, Moonjoo;Leem, Jungtae
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.1
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    • pp.89-106
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    • 2022
  • Objectives In this study, a scoping review was conducted to inform decision-making related to traditional Korean medicine for people with disabilities in the future. Methods Seven databases were searched to find previous studies on traditional Korean medicine for people with disabilities. Studies published until August 2021 were considered. Using the methodology of scoping review, research on traditional Korean medicine for people with disabilities was reviewed with the following steps: 1) drawing research questions, 2) searching for related studies, 3) selecting studies, 4) extracting data, and 5) analyzing and reporting results. Results Out of 2,072 studies, 7 research papers and 10 reports were finally selected. The research papers included 5 cases studies, 1 survey study, and 1 chart review. Most studies used herbal medicine and acupuncture treatment, but the reports on the interventions were not detailed. The reports included policy studies, project performance guidelines, and project results reports, and most of the evaluation indicators tended to be standardized. Conclusions This study reviewed the literature on traditional Korean medicine for people with disabilities. It presents future directions for clinical research on traditional Korean medicine for people with disabilities and can be used to inform healthcare policies and clinical practice. In the future, quantitative research such as clinical trials, meta-analysis, and health insurance big data analysis is needed to understand the current status and effects of traditional Korean medicine for people with disabilities. In addition, qualitative research is necessary to identify unmet demands of traditional Korean medicine for people with disabilities.

Risk Analysis of All Types of Cancer among Firefighters and Police Officers Using National Health Insurance Claim Data (건강보험 청구 자료를 이용한 소방 및 경찰공무원의 암 종별 위험도 분석)

  • Lee, Woo-Ri;Yun, Byungyoon;Yoo, Ki-Bong;Yoon, Jin-Ha
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.32 no.3
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    • pp.242-252
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    • 2022
  • Objectives: Firefighters and police officers are exposed to various occupational hazards. No studies in Korea have investigated the occurrence of cancer by type of cancer for the two occupations. This study aims to investigate the risk of occurrences associated with types of cancers in firefighters and police officers. Methods: Utilizing National Health Insurance(NHI) Claims data from 2006-2015, the study included 8,871,468 general workers, 25,001 firefighters, and 102,274 police officers. Using general workers as a control group, we calculated the standardized incidence ratios(SIR) by types of cancer for firefighters and police officers. After calculating the SIR for all subjects, the SIR was calculated by stratifying according to gender. Results: SIR of colon cancer 1.38(95% CI, 1.11-1.69), cancer of the liver and intrahepatic bile ducts 1.27(95% CI, 1.04-1.54), and 1.88(95% CI, 1.28-2.65) bladder cancer were higher firefighters than general workers. SIR of Lip, oral cavity, and pharynx 1.26(95% CI, 1.07-1.47), Stomach 1.14(95% CI, 1.06-1.23), colon 1.33(95% CI, 1.21-1.46), liver and intrahepatic bile ducts 1.21(95% CI, 1.10-1.32), pancreas 1.24(95% CI, 1.02-1.49), other skin 1.60(95% CI, 1.26-2.00), bladder 1.27(95% CI, 1.04-1.54), other urinary tract 1.46(95% CI, 1.27-1.68), other parts of central nervous system 1.68(95% CI, 1.10-2.46) were higher police officers than general workers. Conclusions: Both firefighters and police officers are exposed to various cancer occurrence risks, necessitating the development of occupational medical protection measures to reduce risk exposure factors.

Approaches to Digital Health Passport for Healthy Travel in the the Era of COVID-19 (COVID-19시대에 건강한 여행을 위한 Digital Health Passport에 대한 접근법)

  • Yim, Myung-Seong
    • Journal of Digital Convergence
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    • v.19 no.5
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    • pp.81-92
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    • 2021
  • The purpose of this study is to present an approach to the "Digital Health Passport" (DHP), which will be the most important in the change of the travel industry among the sudden environmental changes brought about by COVID-19. To this end, this study reviewed a variety of empirical literature on DHP, and proposed a framework for DHP based on literature review. The framework is composed of travel intention, health information provision intention, and new technology acceptance/adoption of tourists. First, in terms of travel intention, providing information to DHP should not undermine the travel intention of the travelers. It should be possible to facilitate the travelers' enjoyment by using the information provided by the traveler. In addition, there is a need to assure that the data provided by travelers is managed in a reliable way. Second, it is necessary to understand why the travelers want to provide additional personal information (information disclosure), rather than seeing healthcare information only in terms of mandatory information provision. Finally, from the perspective of new technology, it is necessary to understand the intention of travelers to use/adopt DHP. The key implication of this work is that it proposed a DHP framework for realizing the travel bubble to predict and respond to foreign travelers' behaviors.

Analysis of the Use of Insured Herbal Extracts and Korean Medicinal Treatments in Patients with Allergic Rhinitis : Data from Health Insurance Review and Assessment Service (알레르기 비염 환자의 보험 한약 제제 및 한의 처치 이용 현황 : 건강보험심사평가원 자료 분석)

  • Kim, Jeong-Hun;Ryu, Ji-In;Kang, Chae-Yeong;Hwang, Jin-Seub;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.2
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    • pp.38-52
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    • 2021
  • Objectives : The purpose of this study is to analyze the use of insured herbal extracts and Korean medicinal treatments, which are mainly used to treat allergic rhinitis in Korean medicine. Methods : Among all HIRA(Health Insurance Review and Assessment Service) claims data in 2016, we included all statements that included J30(vasomotor and allergic rhinitis) or a subcategory of J30(J30.0, J30.1, J30.2, J30.3, or J30.4) as the main disease, using the Korean Standard Classification of Diseases(KCD-7). This study analyzed the most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis in Korean medicine. We performed a frequency analysis on subgroups based on treatment type(inpatient or outpatient), sex, age, insurance type, and medical institution type. Results : The result shows the 10 most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis. The total number of insured herbal extracts prescriptions was 82,533, and the most commonly prescribed insured herbal extracts was socheongryong-tang(35,131 prescriptions), followed by hyeonggaeyeongyo-tang(18,157 prescriptions), samsoeum(6,257 prescriptions), and galgeun-tang(4,465 prescriptions). The total number of Korean medicinal treatments prescriptions was 1,878,541, of which the most common Korean medicinal treatments was acupuncture(922,977 prescriptions), followed by moxibustion(372,120 prescriptions), cupping(242,094 prescriptions), and segmental acupuncture(161,553 prescriptions). Conclusions : It is expected that the results of this study can be used as a basis for establishing the priorities of evidence-based clinical research topics in the field of Korean medicine and making health care policy decisions to strengthen coverage in the future.

Study on the Justifiable Reasons for Medical Refusal (의사의 진료거부의 정당한 사유에 관한 고찰 -최근 일본의 논의를 중심으로-)

  • Lee, Eol
    • The Korean Society of Law and Medicine
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    • v.21 no.3
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    • pp.117-144
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    • 2020
  • In accordance with Article 15 of the Medical Law, medical personnel in Korea cannot refuse treatment of a patient unless there is a justifiable reason, and violation of this obligations is subject to criminal penalties. Japan also stipulates the same content in the law. However, this violation of obligations in Japan is not subject to criminal penalties, and is used as a judgment element of the liability for damages of doctors only in the case of damage to the patient. However, in both countries, it is difficult to interpret and apply the law because the regulation is a little ambiguous. In particular, the key is to find out what is the justifiable reason for the doctor to refuse treatment of the patient. Recently, Japan has completed the work of re-examining the discussion on medical refusal from a modern perspective in terms of improving the excessive working environment of doctors. On the other hand, in Korea, it is not clear in what cases it is possible to refuse treatment. because there is a lack of systematic discussion on medical refusal. Rather, unnecessary misunderstandings and controversies have resulted in the loss of trust between patients and doctors. In Korea, there is already a legal right for a doctor to reject it according to his religious beliefs or conscience in the implementation of the suspension of life-sustaining treatment decisions. And in the case of an abortion, debates are underway that doctors should be given the right to refuse it. This study introduces the current state of discussion in Japan, and examines the issues surrounding medical refusal in Korea. It is hoped that this study will facilitate further discussions on the medical refusal.

Prioritizing Themes Using a Delphi Survey on Patient Safety Theme Reports (환자안전 주제별 보고서의 주제 우선순위 설정: 델파이 조사를 통한 분석)

  • Park, Jeong Yun;Shin, Eun-Jung;Kim, Rhieun;Kim, Sukyeong;Park, Choon-Seon;Park, Taezoon;Choi, Yun-Kyoung;Heo, Young-Hee
    • Quality Improvement in Health Care
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    • v.28 no.1
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    • pp.45-54
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    • 2022
  • Purpose: The study aims to identify the theme list and priority criteria of patient safety theme reports in South Korea. Methods: The survey was conducted twice, and the importance of each criterion and theme was measured on a nine-point scale using the Delphi technique by a panel of 19 patient safety experts. The criteria included severity, universality, preventability, and organizational-social impact. Descriptive statistics such as frequency, percentage, mean, standard deviation, median, and interval quartile range were used to analyze the data. Results: The parameters were assigned a weighted average of 35% for severity, 20% for universality, 30% for preventability, and 15% for organizational-social impact, respectively. The final top three rankings were surgery safety, blood transfusion safety, and medication safety. In addition to expert opinion, for the theme that is selected based on the priority ranking, one to five sub-topics can be derived from the theme based on the priority ranking, societal demands, or the yearly priority list of patient safety incidents. Conclusion: It is recommended that the official patient safety center distribute the report in the form of a summary that can be utilized nationwide at medical institutions, government institutions, and other places. Updates, as well as accumulated theme reports, will serve as the baseline data for the proposal of the system and for the policy designed to implement and improve institutions' safety practices as a standard of domestic patient safety practice guidelines.

Analysis of ROX Index, ROX-HR Index, and SpO2/FIO2 Ratio in Patients Who Received High-Flow Nasal Cannula Oxygen Therapy in Pediatric Intensive Care Unit (고유량 비강 캐뉼라 산소요법을 받은 소아중환자실 환아의 ROX Index와 ROX-HR Index 및 SpO2/FIO2 Ratio분석)

  • Choi, Sun Hee;Kim, Dong Yeon;Song, Byung Yun;Yoo, Yang Sook
    • Journal of Korean Academy of Nursing
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    • v.53 no.4
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    • pp.468-479
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    • 2023
  • Purpose: This study aimed to evaluate the use of the respiratory rate oxygenation (ROX) index, ROX-heart rate (ROX-HR) index, and saturation of percutaneous oxygen/fraction of inspired oxygen ratio (SF ratio) to predict weaning from high-flow nasal cannula (HFNC) in patients with respiratory distress in a pediatric intensive care unit. Methods: A total of 107 children admitted to the pediatric intensive care unit were enrolled in the study between January 1, 2017, and December 31, 2021. Data on clinical and personal information, ROX index, ROX-HR index, and SF ratio were collected from nursing records. The data were analyzed using an independent t-test, χ2 test, Mann-Whitney U test, and area under the curve (AUC). Results: Seventy-five (70.1%) patients were successfully weaned from HFNC, while 32 (29.9%) failed. Considering specificity and sensitivity, the optimal cut off points for predicting treatment success and failure of HFNC oxygen therapy were 6.88 and 10.16 (ROX index), 5.23 and 8.61 (ROX-HR index), and 198.75 and 353.15 (SF ratio), respectively. The measurement of time showed that the most significant AUC was 1 hour before HFNC interruption. Conclusion: The ROX index, ROX-HR index, and SF ratio appear to be promising tools for the early prediction of treatment success or failure in patients initiated on HFNC for acute hypoxemic respiratory failure. Nurses caring for critically ill pediatric patients should closely observe and periodically check their breathing patterns. It is important to continuously monitor three indexes to ensure that ventilation assistance therapy is started at the right time.

A Comparative Study of Changes in Cognitive Function, Depression and Activities of Daily Living in Patients with Dementia, Mild Cognitive Impairment and Ischemic Stroke (치매, 경도인지장애, 허혈성 뇌졸중 환자에서 인지기능, 우울 및 일상생활수행능력의 변화 비교)

  • Jung, Mi-Sook;Oh, Eun-Young;Cha, Kyeong-In
    • Journal of Digital Convergence
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    • v.20 no.3
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    • pp.517-527
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    • 2022
  • This study aimed to compare changes in cognitive function, depression and ability to perform activity of daily living (ADL) in patients with dementia, mild cognitive impairment (MCI), and ischemic stroke (IS) and to identify factors associated with changes in instrumental ADL. A total of 86 patients (dementia=30, MCI=32, and IS=24) were included to analyse cognitive function, depression, and basic and instrumental ADL obtained at the time of diagnosis and 1 year after baseline. Repeated measures analysis of variance and multiple linear regression were used. A significant group by time interaction was found in executive function (p=.037) and instrumental ADL (p=.023) across groups. The MCI group has little change in executive function and instrumental ADL from the baseline to 1 year after diagnosis while other two groups showed changes with the dementia group showing declines and the group of IS having improvement in these factors over time. Changes in executive function(p=.030) and basic ADL (p<.001) explained 26.9% in the variance of changes in instrumental ADL. These findings showed a different changing pattern in executive function during the first year after diagnosis of dementia, MCI, and IS which have cognitive changes as their main symptoms, probably leading to a different changing pattern in instrumental ADL. Healthcare professionals should routinely assess for executive function and instrumental ADL problems and intervene to maintain and improve these functional outcomes immediately after disease.

Investigation of Self-Rated Health and Happiness, Physical Activity, and Mental Health by Smartphone Overuse using Korea Youth Risk Behavior Web-Based Survey 2017 (2017년 청소년 건강행태온라인조사를 활용한 청소년의 스마트폰 과사용으로 인한 주관적 건강과 행복, 신체활동 및 정신건강에 대한 연구)

  • Moon, Jong-Hoon;Song, E-Seul;Seong, Hyun-Yong
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.8
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    • pp.515-524
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    • 2019
  • The purpose of this study was to investigate the influences of adolescents on self-rated health and happiness, physical activity, and mental health according to time of smartphone use. The researcher used raw data from the Korea youth risk-behavior web-based survey(2017). A total of 64,991 adolescents were enrolled and 54,603 were analyzed in logistic regression analysis. The researcher set gender, self-rated health and happiness, physical activity, and mental health as independent variables and performed logistic regression analysis with smartphone overuse time as dependent variables. As a result, the female had a smartphone overuse of 1.49 to 1.67 times higher than male. Subjectively healthy people were 1.2 to 1.35 times more likely to use smartphones than those who did not(p<.001). People with higher physical activity were higher by 1.17 to 1.18 times than people without physical activity(p<.001). Subjective happiness did not predict smartphone usage(p>.05). People with subjective stress were higher 1.13 to 1.22 times than people without stress, and person with sadness and despair and suicide plan, 1.37 to 1.54 times, 1.17 to 1.24 times than those who did not(p<.001). Depression tended to become more serious as smartphone use increased. These investigation suggest that the self-rated health, physical activity, and mental health excluding self-rated happiness are related to overuse of smartphone.

Health Behavioral Factors Affecting Depression in Patients with Chronic Disease (만성질환자의 우울에 영향을 미치는 보건 행태 요인)

  • Sun-Mee Kim
    • Journal of the Health Care and Life Science
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    • v.10 no.2
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    • pp.305-314
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    • 2022
  • The purpose of this study is to investigate the effect of health behavioral factors such as general characteristics, lifestyle and disease characteristics on depression in patients with chronic diseases. To this end, among 7,359 people who participated in the 8th National Health and Nutrition Survey conducted from 2019 to 2020, chi-square test analysis between health behavior factors and depression for 1980 people aged 19 years or older with chronic diseases and no missing values in the basic survey items was performed. After that, binary logistic regression analysis was performed with the factors that were significant as independent variables. As a result of the analysis, depression was 1.49 times higher in women than men (CI: 1.086~2.044), and was 1.828 higher in smokers than in non-smokers (CI: 1.285~2.561). And the higher the income level, the lower the depression. In particular, the odds ratio was 28.034 (CI: 13.132~59.849) in 'not stressful' versus 'very stressed', which had the greatest effect when the intensity of stress was very high. And the influence of subjective health cognition and sleeping hours was also relatively high. This study is meaningful in that it identified the priority of health behavior factors that should be practiced to improve depression in patients with chronic diseases. And since the number of comorbidity was not significant in the occurrence of depression, it would be necessary to identify the extent to which each type of chronic disease affects depression and to suggest policy alternatives tailored to each patient group.