• Journal of Preventive Medicine and Public Health
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• v.39 no.5
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• pp.397-403
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• 2006

Objectives: We estimated the asthma-related health care utilization and costs in Korea from the insurer's and societal perspective. Methods: We extracted the insurance claims records from the Korea National Health Insurance claims database for determining the health care services provided to patients with asthma in 2003. Patients were defined as having asthma if they had ${\geq}$2 medical claims with diagnosis of asthma and they had been prescribed anti-asthma medicines, Annual claims records were aggeregated for each patient to produce patient-specific information on the total utilization and costs. The total asthma-related cost was the sum of the direct healthcare costs, the transportation costs for visits to health care providers and the patient's or caregivers' costs for the time spent on hospital or outpatient visits. Results: A total of 699,603people were identified as asthma patients, yielding an asthma prevalence of 1.47%. Each asthma patient had 7.56 outpatient visits, 0.01 ED visits and 0.02 admissions per year to treat asthma. The per-capita insurance-covered costs increased with age, from 128,276 Won for children aged 1 to 14 years to 270,729 Won for those aged 75 or older. The total cost in the nation varied from 121,865 million to 174,949 million Won depending on the perspectives. From a societal perspective, direct health care costs accounted for 84.9%, transportation costs for 15.1 % and time costs for 9.2% of the total costs. Conclusions: Hospitalizations and ED visits represented only a small portion of the asthma-related costs. Most of the societal burden was attributed to direct medical expenditures, with outpatient visits and medications emerging as the single largest cost components.

• Journal of Biomedical Engineering Research
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• v.33 no.3
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• pp.155-162
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• 2012

Devices to measure the blood pressure of patients are being used without any calibration in a hospital. It is an important to show consistent values when any medical devices measure the same patients regardless they are sphygmomanometer or fully automatic electronic blood pressure meter. We compared sphygmomanometer and fully automatic electronic blood pressure meters with standard digital blood pressure monitor (SDBPM) to evaluate the consistency of the small healthy subjects. We measured the blood pressure from six healthy subjects (three of 20~40 years and three of 40~60 years old). Two sphygmomanometer and two fully automatic electronic blood pressure meters were used and compared with the SDBPM. Blood pressures measured from right and left arms each and were compared. All six healthy subjects showed normal blood pressure values. In general, left blood pressure values showed higher values than right side. Comparing SDBPM, with the other monitors, the systolic pressure showed ${\pm}$ 34.8% difference and ${\pm}$ 33.3% for the diastolic pressure. Correlation between SDBPM and Sphygmomanometer was 0.59~0.71, and 0.50~0.70 for fully automated digital BP monitors. It fell in grade-D when we apply the BHS(British hypertension society). AAMI(American association for the advancement of medical instrumentation) also showed unsatisfactory results for the mean value (${\leq}$ 5 mmHg) and standard deviation (${\leq}$ 8 mmHg). We tested sphygmomanometer and fully automatic electronic blood pressure meters and compared with a standard digital blood pressure monitor. All devices showed inconsistent blood pressures. A reliable calibration system is highly needed for all devices in all hospitals.

• Journal of Environmental Science International
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• v.25 no.6
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• pp.839-851
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• 2016

The effect of weather on disease was investigated based on results reported in academic papers. Weather-sensitive disease was selected by analyzing the frequency distributions of diseases and correlations between diseases and meteorological factors (e.g., temperature, humidity, pressure, and wind speed). Correlations between disease and meteorological factors were most frequently reported for myocardial infarction (MI) (28%) followed by chronic ischemic heart disease (CHR) (12%), stroke (STR) (10%), and angina pectoris (ANG) (5%). These four diseases had significant correlations with temperature (meaningful correlation for MI and negative correlations for CHR, STR, and ANG). Selecting MI, as a representative weather-sensitive disease, and summarizing the quantitative correlations with meteorological factors revealed that, daily hospital admissions for MI increased approximately 1.7%-2.2% with each $1^{\circ}C$ decrease in physiologically equivalent temperature. On the days when MI occurred in three or more patients larger daily temperature ranges ($2.3^{\circ}C$ increase) were reported compared with the days when MI occurred in fewer than three patients. In addition, variations in pressure (10 mbar, 1016 mbar standard) and relative humidity (10%) contributed to an 11%-12% increase in deaths from MI and an approximately 10% increase in the incidence of MI, respectively.

• Research in Community and Public Health Nursing
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• v.16 no.2
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• pp.115-126
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• 2005

Purpose: The aims of this study were to describe general characteristics and needs of home health care, and to find the differences between home health care needers and non-needers. Method: In this study, 642 subjects participated who lived in Muan, Jollanam-do. Data were collected in August 2001 using a self-reported questionnaire. The questionnaire was a revised and simplified form of the Organization of Community Health System Program at the Seoul National University. Collected data were analyzed through Kruskal-Wallis test. t-test. and Chi-squire for cross-sectional analysis. Result: The average age of the subjects was 52.6 years and 33.3% of them aged over 65 years. Twenty six percent of them had chronic degenerative diseases. The percentages of hypertension patients and D.M. patients were 6.4% and 2.5%, respectively. The number of family members was 2.95 on the average, 2.19 in cases of families with the elderly and 3.33 in cases of families without the elderly. The rate of disability of the elderly was 10.5%. Marital status (p=.000), the number of family members (p=.000), education (p=.000), job (p=.000) and health insurance (p=.027) were significantly different between home care needers and non-needers. Home care needers had less living expenses (p=.001), more frequent hospital admissions (p=.004), higher chronic disease rate (p=.000) and more frequent visits to public health center (p=.027) than non-needers. Home care needers who wanted free service were twice as many as non-needers. Conclusion: Home care need was very high in rural areas and the needers had worse characteristics (low educational level. low income, no job and no family). Therefore, it is necessary to develop cheaper and more accessible services for home care needers in rural areas.

• Korean Journal of Biological Psychiatry
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• v.20 no.3
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• pp.80-85
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• 2013

Objectives Research suggests that content of delusion and hallucination in schizophrenia is influenced by culture and social environment. However, few studies investigated chronological change of delusions and hallucinations within a society. To investigate changes in delusions and hallucinations of schizophrenia according to time, we compared contents of symptoms between inpatients with schizophrenia at two different time frames. Methods All admissions to a psychiatric unit of Hanyang University Guri Hospital with discharge diagnoses of schizophrenia at two different five-year time frames (1996-2000 and 2006-2010) were reviewed. Using a checklist, adapted from the Scale for Assessment of Positive Symptoms, we investigated delusions and hallucinations of 247 patients (104 in the 1990s and 143 in the 2000s). Results Delusions and hallucinations of patients did not differ at two time frames. In women, however, auditory and somato-tactile hallucinations were significantly more frequent in the 1990s (p < 0.05). Conclusions Our findings support the literature emphasizing that content and frequency of hallucination may differ according to cultural environment. We speculate that attitude toward sex and defensiveness toward disclosure of symptoms may have contributed to interval difference.

• Korean Journal of Adult Nursing
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• v.12 no.3
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• pp.384-395
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• 2000

This study examined burdens of primary family caregivers, and family functioning of patients with cancer. In addition, the relationship between two concepts was assessed to develop nursing intervention to reduce the burdens of caregiving, and to improve family functioning. Ninety-two primary family caregivers of patients with cancer at a general hospital in Seoul participated in this study. The patients with cancer aged from 19 to 84 years with a mean age of 51 years, and sixty-one percent were male. About 30 percent of the patients suffered liver and billiary tract cancer. Fifty-six percent of the primary family caregivers were spouses of the patients and 70.7 percent were women. Primary family caregivers' burdens were assessed by the Burden Scale originally developed by Zarit (1980) and Novak & Guest(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales: time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financial burden. Family functioning was assessed by the Family APGAR developed by Smilkstein(1978). The results were as follows: 1. The average burden score was 86.1, indicating a moderate level of burden. The time-dependent burden scored highest followed by developmental, physical, social, financial, and emotional burdens. The mean score of family APGAR was 9.71; among subjects 82.6% were included in dysfunctional families. 2. Of the characteristics of patients, age, gender, number of admissions, and job were found to be associated with the level of burden. There was no significant difference between patient characteristics and family functioning. Of the characteristics of primary family caregivers, caregiver's perception of patient prognosis was significantly related to the level of burden, and family functioning. Caregiver's sex and age were also related to family functioning. The quality of relationship between a patient and a caregiver was significant situational factors affecting the level of burden, and family functioning. In addition, the income of family, and help from other family members were related to the level of burden. Given the results, it is essential to develop nursing intervention to reduce burden and to improve family functioning, such as support groups.

• Progress in Superconductivity
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• v.8 no.1
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• pp.40-45
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• 2006

In emergency rooms, patients with acute chest pain should be diagnosed as quickly as possible with higher diagnostic accuracy for an appropriate therapy to the patients with acute coronary syndrome or for avoiding unnecessary hospital admissions. At present, electrocardiography(ECG) and biochemical markers are generally used to detect myocardial infarction and coronary angiography is used as a gold standard to reveal the degree of narrowing of coronary artery. Magnetocardiography(MCG) has been proposed as a novel and non-invasive diagnostic tool fur the detection of cardiac electrical abnormality associated with myocardial ischemia. In this study, we examined whether the MCG can be used fur the detection of coronary artery disease(CAD) in patients, who were admitted to the emergency room with acute chest pain. MCG was recorded from 36 patients admitted to the emergency room with suspected acute coronary syndrome. The MCG recordings were obtained using a 64-channel SQUID MCG system in a magnetically shielded room. In result, presence of CAD could be found with a sensitivity of 88.2 % in patients with acute chest pain without 57 elevation in ECG, demonstrating a possible use in the emergency room to screen CAD patients.

• Health Policy and Management
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• v.30 no.1
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• pp.72-81
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• 2020

Background: The out-of-pocket maximum is one of the distinctive healthcare systems which sets a ceiling on co-payment in order to reduce the burden of households from the unpredictable medical expenditure. However, this leads to an increase in the demand for healthcare services especially in long-term care hospitals (LTCHs) in Korea. Methods: This study analyzed the influence factor of medical service overuse of 165,592 inpatients in LTCHs which out-of-pocket maximum is applied, by utilizing data from the National Health Insurance Service (2016). Based on Anderson Model, the medical service overuse, as a dependent variable, was defined as long-stay admission more than 180 days at the LTCHs. Independent variable was comprised of predisposing factors (gender, age), enabling factors (income level, types of out-of-pocket maximum) and need factors (illness level, patient use of tertiary hospital). Results: The most powerful factor of medical service overuse in LTCHs was availability of pre-payment for the out-of-maximum (odds ratio [OR], 191.66; p<0.001). This tendency was found in high income level status (p<0.001). Furthermore, mild inpatients (OR, 1.50; p<0.001) which had no experience with the tertiary hospitals (OR, 2.06; p<0.001) were more relevant to the medical service overuse in LTCHs, compared to the severe inpatients. Conclusion: It is suggested that a separate standard of out-of pocket maximum with regards to LTCHs is required to secure the beneficial functions of long-term hospitals and prevent unnecessary financial leakage to achieve sustainable and financially sound National Health Insurance.

• Environmental Analysis Health and Toxicology
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• v.21 no.1 s.52
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• pp.57-69
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• 2006

Lately human exposure to fine particles smaller than $2.5{\mu}m$ in aerodynamic diameter ($PM_{2.5}$) has become a great concern in Korea due to their possible cause of elevated mortality, lung function decrements, and more frequent hospital admissions for asthma. This study was conducted to investigate seasonal variations of human exposure to residential $PM_{2.5}$ and particle-associated polycyclic aromatic hydrocarbons (PAHs). Ten homes in Chuncheon, Korea were visited for continuous 72 hour sampling of $PM_{2.5}$ in the living rooms using a MiniVol Portable Sampler from December 22, 2002 to November 3, 2003. During the same period, outdoor $PM_{2.5}$ samples were collected on the top of the Natural Sciences Building of Kangwon National University which is located in the middle of the ten households. Samples were analyzed for $PM_{2.5}$ mass concentrations and six selected PAHs. In two smoking homes, the highest $PM_{2.5}$ concentrations were measured ranging from 51.1 to 69.7 {\mu}g/m^3$ on average in all seasons, indicating smoking is a very important contributor to the elevation of indoor particle concentrations. Seasonal comparison showed that indoor particle concentrations were higher than outdoor ones except winter. Total PAH concentrations in smoking homes were highest in winter among the seasons primarily due to low ventilation rate, followed by the outdoor site and nonsmoking homes. BaP toxic equivalents (TEQs) were calculated for five PAHs. The TEQ for smoking homes in winter was highest followed by the outdoor site in winter. It is concluded that smoking and ventilation rate are two important contributors to the elevation of indoor $PM_{2.5}$ and PAH concentrations.

• YAKHAK HOEJI
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• v.47 no.4
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• pp.244-251
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• 2003

Asthma is a chronic inflammatory disease of the airway and the prevalence rate is increasing. As the burden of asthma to the society is significant due to the increasing hospital admissions and emergency visits, National Heart, Lung and Blood Institute (NHLBI, USA) and World Health Organization (WHO) have developed comprehensive guidelines to help clinicians and patients make appropriate decisions about asthma care. The aim of study was to analyze the pattern of asthma prescriptions based on the national asthma guidelines for the patients visiting primary health care providers. Prescription data for asthma were obtained from the Korean National Health Insurance claims database of January 2002. Ten percent of the primary health care providers were sampled based on their specialty areas, and 20％ of the claim cases were randomly chosen. Study results showed that prescription rate for oral beta-2 agonists was 44.3％, and that for oral theophylline was 46.9％. Oral steroids were prescribed for the 28.2％ of the claims. Utilization of inhalers was low for both bronchodilators (20.3％, beta-2 agonists inhalers), and steroids (8.4％ steroids inhalers). Bronchodilators were more preferred to the longterm anti-inflammatory controllers among the primary health care providers. Prescription rate for antibiotics was 46.0％ for asthmatic patients. Also gastrointestinal drugs were prescribed for 59.0％, antitussives 65.3％, antihistamines 25.3％ and analgesics 29.4％, respectively. This study presented that the prescribing pattern of the primary health care providers for the asthma was quite different from the national and international guidelines. More efforts need to be made to reduce the gap between the present pattern of asthma prescription and the guidelines.