• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.3
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• pp.165-175
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• 2015

Objectives : The purpose of this study was to investigate changes in child and adolescent outpatients at a university hospital in Daegu from 2004 to 2013. Methods : The subjects were first-visit patients under 18 years old, who visited Dongsan Medical Center, Keimyung University, from January 1, 2004 to December 31, 2013. Computerized medical records of 2,738 patients (male 1,906, female 832) were reviewed. Results : The ratio of male to female was 2.3 : 1 in the period of study. The most prevalent age category was 7-9 years. The mean age was $10.12{\pm}4.68$ years ($9.84{\pm}4.59$ years in males, $10.76{\pm}4.81$ years in females). The ratio of child and adolescent patients to total outpatients was 27.0%. The most common diagnostic category was the attention-deficit hyperactivity disorder (ADHD) group, followed by the mental retardation (MR) group. In males, the ADHD, MR, communication disorder groups were more prevalent, but in females, the MR, ADHD, depressive disorder groups were more prevalent. Conclusion : The female to male ratio and total mean age were on the rise. The ADHD group was the most prevalent and the depressive disorder group was also on the rise in this period.

• Journal of Preventive Medicine and Public Health
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• v.34 no.1
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• pp.28-34
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• 2001

Objectives : To investigate the changing pattern of medical utilization claims following the economic crisis in Korea. Methods : The original data consisted of the claims of the 'Medical insurance program of self-employees' between 1997 and 1998. The data was selected by medical treatment day ranging between 8 January and 30 June. Medical utilizations were calculated each year by the frequency of claims, visit days for outpatients, length of stay for inpatients, total days of medication, and the sum of expenses. Results : The length of stay as an inpatient in 1998 was decreased 4.7 percent in comparison to 1997. However, inpatient expenses in 1998 increased 10.8 percent as compared to 1997. Inpatient hospital claims in 1998 increased 6.2 percent over 1997, although general hospital inpatient claims in 1998 decreased 3.3 percent in comparison to 1997. The outpatient claim frequency decreased 7.3 in 1998 percent as compared to 1997 Outpatient visit days of in 1998 were decreased 8.5 percent in comparison to that recorded in 1997. Outpatient claim frequencies of 'gu region' in 1998 decreased 10.5 percent comparison to that in 1997, but 'city and gun region' decreased less than 'gu region'. Conclusions : Medical utilization in 1998 deceased in relation to 1997 Medical utilization by outpatients decreased more than that of inpatients. Medical utilization by 'gu region' decreased mere than the other regions.

• The Korea Journal of Herbology
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• v.34 no.1
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• pp.13-21
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• 2019

Objectives : This clinical trial is performed to investigate the effect of improving the hypersensitivity reaction and the safety of powdered ethanol extract Codonopsis lanceolata (S. et Z.) Trautv. for allergic patients. Methods : This study was randomized, double blinded, placebo-controlled clinical trial. 60 allergic rhinitis subjects were randomly assigned to Treatment group(n=30) and Control group(n=30). They were received the test substance or placebo in their $1^{st}$ and $2^{nd}$ visit, and took it once a day, 1 powder bag per 1 time, for 8 weeks. The freeze dried powder of Codonopsis lanceolata (S. et Z.) Trautv. was mixed with 30% ethanol and the filtrate was collected thrice with constant stirring of the mixture. The placebo was prepared in the same form as the test substance by replacing with corn starch. Total Nasal Symptom Score(TNSS) questionnaires and laboratory tests were performed at the screening and last visit to evaluate the efficacy. And to assess safety, vital signs and adverse events were confirmed at every visit. Statistical analysis about the result was performed using SAS 9.4. Results : In treatment group, there was a significant decrease in B cell after taking the test substance(p<0.005). And there was a statistically significant difference between groups(p<0.005). Changes in nasal symptoms were not statistically significant between groups, and both groups showed statistically significant differences before and after the test(p<0.0001). Also there were no adverse events associated with the clinical trial product. Conclusions : This clinical trial showed that Codonopsis lanceolata (S. et Z.) Trautv. extract was helpful in improving the hypersensitivity reaction in allergic patients without significant side effects.

• The Journal of Korean Medicine
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• v.42 no.1
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• pp.12-25
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• 2021

Objectives: The aim of this study was to investigate influencing factors of using Korean medicine services (KMS) using the 2017 Korean Medicine Utilization Survey (KMUS). Methods: Demographic statistics of the survey were summarized and influencing factors of the KMS experience and the intention to visit KMS were analyzed using logistic regression model with complex sample design. Influencing factors were specified based on Andersen's behavioral model of health care utilization and factors associated with individual recognitions of KMS. Additionally, using the ordinary logistic regression model without complex sample design, the survey data were analyzed to compare the results. Results: In the logistic regression analysis, sex, age, health condition, presence of chronic disease, a degree of knowledge about Korean Medicine, and a view about herbal medicine safety were statistically significant both in the KMS experience, and the intention to visit KMS. Marital status was statistically significant in the KMS experience, while family income, a view about the cost of KMS were statistically significant in the intention to visit KMS. Conclusion: Individual recognitions of KMS and enabling components should be considered when establishing KMS policies. In addition, future studies analyzing KMUS need to take into account the complex sample design features of the survey to avoid statistically misleading results.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.4
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• pp.264-270
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• 2018

Purpose: The aim of this study was to describe functional gastrointestinal disorders (FGID) presented in a tertiary medical center, characteristics of patients and results of the diagnostic work-up together with an outcome during the follow up. Methods: This was a retrospective, single center, observational study including all patients who were diagnosed with FGID based on Rome III criteria from January to December 2015 in tertiary medical center. Results: Overall 294 children were included (mean age, 8.9 years [range, 1-18 years]; 165 females). Majority had functional constipation (35.4%), followed by functional abdominal pain (30.6%), irritable bowel syndrome (17.0%), functional dyspepsia (12.6%), functional nausea (3.4%) and abdominal migraine (1.0%). Regression model found that only significant factor associated with improvement of symptoms is the establishment of the functional diagnosis at the first visit (hazard ratio, 2.163; 95% confidence inverval, 1.029-4.544). There was no association between improvement of symptoms and presence of alarm signs/symptoms (weight loss, nocturnal symptoms and severe vomiting) at diagnosis. Furthermore, in pain symptoms (functional abdominal pain, irritable bowel syndrome, dyspepsia) no treatment positively correlated with pain improvement. Conclusion: Regardless of the initial diagnosis of FGID, positive diagnosis at the first visit increases a chance for resolution of symptoms.

• Health Policy and Management
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• v.24 no.1
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• pp.13-23
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• 2014

Background: A need arises to efficiently control health expenditure for medical aid due to a sharp increase in medical aid expenditure. This study experimently analyzes the impact of physician behavior on medical use for medical aid beneficiaries using supplier induced demand (SID) theory. Methods: This study looks into analyze SID effect using expenditure factor analysis of medical aid for the years between 2003 and 2010 in comparison with health insurance. Moreover, this study analyzes the existence and scale of SID using econometrics modeling with panel data on 16 cities and provinces's health expenditure data for medical aid from 2003 1/4 to 2010 4/4. Results: This study finds that the growth rate of visit days per capita and treatment amount per visit days for medical aid is higher than health insurance. Furthermore, the result of econometrics modeling analysis shows the existence of SID in general hospital, hospital, clinic, oriental clinic. Conclusion: In order to efficiently control expenditure for medical aid, it is required to reinforce macro polices such as the introduction of 'target management' and micro policies such as the strengthen of management on medical institutes in the perspective of suppliers as well as regulations of demanders.

• Journal of Korean Critical Care Nursing
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• v.4 no.2
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• pp.47-60
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• 2011

Purpose: The purpose of this study was to develop a standardized education protocol for peritoneal dialysis patients. Methods: First, the demand for education was investigated from the 27 patients on peritoneal dialysis and 16 guardians, and later, the standardized nursing education protocol has been developed through the comprehensive literature review and the critical analysis of the related studies. Contents validity and applicability have been tested through the expert group survey. Results: The standardized peritoneal dialysis nursing education protocol with 9 areas and 20 items has been developed. The content validity for timing and duration, contents, method, and place of education proposed by the protocol were all above than 0.8. In terms of the applicability of the protocol, the experts scored between 4.20 to 4.93 for all items except one. The item on home visit education acquired the lowest applicability score, because there might exist potential restrictions in visiting patient's home. Conclusion: The standardized education protocol developed in this study turned out to be adequate by representing high content validity for all items and the applicability also was high except the item on home visit education. Further researches to test the effects of this education protocol should be done.

• Journal of Korean Biological Nursing Science
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• v.8 no.2
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• pp.73-92
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• 2006

Purpose: This study was to understand actual state of supportive behavior of parents and nurses during invasive procedure for children who visit emergency medical center. Method: The object group was children's parents who have from 0 to 7 aged children takes invasive procedure except neonates and nurses who take part in the invasive procedure. Among them, 80 children's parents and 31 nurses were selected. For data analysis, SPSS for Window 8.0 was used and especially content analysis was performed for concrete supportive behavior of parents and nurses by survey. Results: Supportive behavior of parents and nurses during children's invasive procedure gave negative influences to the children, because most parents supplied poor supportive behavior without preparation, nurses performed work-oriented and treatment-oriented nursing due to speciality and busy business in emergency medical center. Conclusion: To lead positive and affirmative supportive behavior of parents and nurses during children's invasive procedure, for parents, positive supportive behavior ability must be strengthen through the overall education about children's invasive procedure when they visit emergency medical center or go to hospital: for nurses, hospital must provide successive instruction and policy to make nurses perform not work-oriented but patient-oriented nursing and positive supportive behavior.

• Journal of Sasang Constitutional Medicine
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• v.34 no.4
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• pp.68-80
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• 2022

Objectives This study is to report a significant improvement in a Taeeumin patient with systemic contact dermatitis after eating urushiol chicken by herbal medicine treatment. Methods The patient had complaints of erythema, swelling, pruritus, scaly skin, and facial flushing. We treated the patient with an herbal medicine 'Galgeunhaegi-tang' for three months. We evaluated the treatment outcome of systemic contact dermatitis using the Three Item Severity(TIS) score every visit and facial flushing by Image color summarizer at the first and last visit. Results After the treatment, the severity of the patient's skin complaints lessened from moderate to mild. The Image color summarizer showed a minor decrease in the normalized red color level and a significant increase in the brightness level and facial color percentage. Conclusions The patient diagnosed with systemic contact dermatitis, treated with Galgeunhaegi-tang for three months, showed a significant improvement in skin complaints with brighter and even facial color.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.2
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• pp.222-232
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• 2004

The sample collection room(SCR) will have much more influence than all the other departments for the improvement of hospital image, if anyone coming to the SCR in the hospital goes back with the perfect complacency and because most clients who have much stresses and fatigues pay a final visit to the SCR via receipt-diagnosis- acceptance process. SCR has improved its image for the purpose of gratifying clients, in order for clients to visit the hospital again, the quality improvement(QI) team in the Diagnosis Inspection Medical Department has come to a conclusion as follows. The degree of client gratification before improvement marks 65.9 point, but the degree after improvement was 74.2 point. Therefore, satisfaction has increased by 8.3 points. The degree of client gratification in groups before improvement marks (1) service parts-89.2 points (2) facilities and environments-49.1 point (3) toilet facilities-46.3 point. But its gratification after improvement marks (1) 92.5 point (2) 60.1 point (3) 61.0 point. Therefore the degree of satisfaction has increased by (1) 3.3 point, (2) 11.0 point, (3) 14.7 point. The progress of facility improvement plans and the exclusion of improvement on the facility contents in the hospital have made facilities and environments of SCR and toilet facilities to be poorly improved. Although service parts have a good mark, and the facilities and environments are not scoring well, the whole degree clients' gratification of SCR couldn't be helped by the low grade. Therefore the bottom line for the clients' gratification of SCR in the future is to ameliorate the facilities and environments. SCR will take the clients' gratification survey every year and if any items get low marks, that is, below 90 point throughout the survey, SCR will immediately starts the improvement work for the clients' gratification with operating the programs of controlling quality continually, and SCR should induce the operation of services, participating in the kind campaign drive for clients. So SCR will adopt the incentive system for the best staff members who perform these kinds of services.