• Title/Summary/Keyword: interrupted time series

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The Effect of Public Report on Antibiotics Prescribing Rate (급성상기도감염 항생제 처방률 공개 효과 분석)

  • Kim, Su-Kyeong;Kim, Hee-Eun;Back, Mi-Sook;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.3
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    • pp.242-247
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    • 2010
  • Controlling inappropriate antibiotics prescribing for acute upper respiratory infections(URI) is a very important for prudent use of antibiotics and resistance control. Health Insurance Review and Assessment Service (HIRA) introduced Prescribing Evaluation Program and publicly reported antibiotics prescribing rate for URI of each health institution. We performed segmented regression analysis of interrupted time series to estimate the effect of public report on antibiotics prescribing rate using national health insurance claims data. The results indicate that just before the public report period, clinics' monthly antibiotics prescribing rate for URI was 66.7%. Right after the public report, the estimated antibiotics prescribing rate dropped abruptly by 12.3%p. There was no significant changes in month-to-month trend in the prescribing rate before and after the intervention.

Wavelet-based detection and classification of roof-corner pressure transients

  • Pettit, Chris L.;Jones, Nicholas P.;Ghanem, Roger
    • Wind and Structures
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    • v.3 no.3
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    • pp.159-175
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    • 2000
  • Many practical time series, including pressure signals measured on roof-corners of low-rise buildings in quartering winds, consist of relatively quiescent periods interrupted by intermittent transients. The dyadic wavelet transform is used to detect these transients in pressure time series and a relatively simple pattern classification scheme is used to detect underlying structure in these transients. Statistical analysis of the resulting pattern classes yields a library of signal "building blocks", which are useful for detailed characterization of transients inherent to the signals being analyzed.

Effects of Response Cost on the Charging for Directory Assistance in Taegu - An Interrupted Time Series Analysis - (간여시계열분석을 이용한 대구시 114유료화정책에 대한 응답비용효과)

  • JaeGal, Don;Song, Keun-Sup
    • Journal of the Korean Data and Information Science Society
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    • v.9 no.2
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    • pp.139-147
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    • 1998
  • An interrupted time series analysis of local directory assistance calls in the Taegu area from November 1, 1996 to February 28, 1997 revealed a gradual/permanent reduction in daily frequency of calls after charges were introduced in January 1, 1997. Even though the results cannot attest to the sbrupt/permanent reduction effect of response cost we expected, the reduction after charging may contribute to the efficacy of work and the improvement of service quality.

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Analysis of Drug Utilization after the Mandatory Application of the DRG Payment System in Korea (포괄수가제 당연적용 후 의약품 사용현황 분석)

  • Kang, Hee-Jeong;Kim, Ji Man;Lim, Jae-Young;Lee, Sang Gyu;Shin, Euichul
    • Korea Journal of Hospital Management
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    • v.23 no.2
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    • pp.18-27
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    • 2018
  • Purposes: This study aims to investigate the policy effect of mandatory application of DRG for 7 disease groups in general and tertiary hospitals. Methodology: As DRG was fully implemented in July 2013, this study compares two periods before and after the change(from July 2012 to June 2013, and from July 2013 to June 2014). The benefit claim data of the National Health Insurance Service was used for the comparison. Target patients were those who visited general or tertiary hospitals between July 2012 to June 2014. For pharmaceutical consumption, Interrupted Time Series (ITS) analysis was used to see the effect of DRG mandatory application. Findings: The number of drugs prescribed per patient and pharmaceutical expenditure both showed significant reduction compared to before the DRG implementation. Practical Implications: This study used 2 sets of 1 year period data from before and after the full implementation of DRG to analyze pharmaceutical consumption. When the comparison data accumulates further, it would be possible to conduct more diverse analysis to assess policy effect and to provide way forward for the future.

Impact of Bridge Construction on County Population in Georgia

  • Jeong, M. Myung;Kang, Mingon;Jung, Younghan E.
    • International conference on construction engineering and project management
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    • 2022.06a
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    • pp.1017-1023
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    • 2022
  • Past research shows that the construction of new infrastructure accelerates economic growth in the region by attracting more people and commodities. However, the previous studies only considered large-scale infrastructures such as sea-cross bridges and channel tunnels. There is a paucity of literature on regional infrastructure and its impact on socio-economic indicators. This paper explores the impact of new bridge construction on the human population, particularly focusing on regional bridges constructed during the 2000s in the state of Georgia. The human population at a county level was selected as a single socio-economic factor to be evaluated. A total of 124 cases were investigated as to whether the emergence of a new bridge affected the population change. The interrupted time series analysis was used to statistically examine the significance of population change due to the construction by treating each new bridge as an intervention event. The results show that, out of the 124 cases, the population of 67 cases significantly increased after the bridge construction, while the population of 57 cases was not affected by the construction at a significance level of 0.05. The 124 cases were also analyzed by route type, functional class, and traffic volume, but the results revealed, unlike large-scale infrastructure, that no clear evidence was found that a new bridge would bring an increase in the human population at a county level.

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Trends in the utilization of dental outpatient services affected by the expansion of health care benefits in South Korea to include scaling: a 6-year interrupted time-series study

  • Park, Hee-Jung;Lee, Jun Hyup;Park, Sujin;Kim, Tae-Il
    • Journal of Periodontal and Implant Science
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    • v.48 no.1
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    • pp.3-11
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    • 2018
  • Purpose: This study utilized a strong quasi-experimental design to test the hypothesis that the implementation of a policy to expand dental care services resulted in an increase in the usage of dental outpatient services. Methods: A total of 45,650,000 subjects with diagnoses of gingivitis or advanced periodontitis who received dental scaling were selected and examined, utilizing National Health Insurance claims data from July 2010 through November 2015. We performed a segmented regression analysis of the interrupted time-series to analyze the time-series trend in dental costs before and after the policy implementation, and assessed immediate changes in dental costs. Results: After the policy change was implemented, a statistically significant 18% increase occurred in the observed total dental cost per patient, after adjustment for age, sex, and residence area. In addition, the dental costs of outpatient gingivitis treatment increased immediately by almost 47%, compared with a 15% increase in treatment costs for advanced periodontitis outpatients. This policy effect appears to be sustainable. Conclusions: The introduction of the new policy positively impacted the immediate and long-term outpatient utilization of dental scaling treatment in South Korea. While the policy was intended to entice patients to prevent periodontal disease, thus benefiting the insurance system, our results showed that the policy also increased treatment accessibility for potential periodontal disease patients and may improve long-term periodontal health in the South Korean population.

The Impact of Outpatient Coinsurance Rate Increase on Outpatient Healthcare Service Utilization in Tertiary and General Hospital (외래 본인부담률 인상이 상급종합병원과 종합병원 외래 의료이용에 미친 영향)

  • Kim, Hyo-Jeong;Kim, Young-Hoon;Kim, Han-Sung;Woo, Jung-Sik;Oh, Su-Jin
    • Health Policy and Management
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    • v.23 no.1
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    • pp.19-34
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    • 2013
  • Background: The study describes the changes resulted from imposition on tertiary hospital outpatient coinsurance rate rise policy and in tertiary or general hospital drug coverage rise policy on healthcare service utilization. Methods: Accordingly, the hypothesis about outpatient healthcare utilization after rise policy in outpatient coinsurance rate and drug coverage was established, using interrupted time-series analysis and segmented regression analysis to test the hypothesis. 5-year analysis period (2007. 3-2012. 3) from the outset year was designated, the data about most common 10 high-ranking of the main diseases targeting visiting patient from age of 6 to 64 were collected. Results: The summary on the major research is followed. First, the medical expense and duration of treatment tends to be increased in case of imposition about rise policy in outpatient coinsurance rate in the tertiary hospital under the interrupted time-series analysis. It showed temporary increase and slow down on account of influenza A even after the policy enforcement. In segmented regression analysis, duration of visit and medical expense in the tertiary hospital increased temporally right after the policy implementation and the decreased rapidly depends on period. Both rise and fall is statistically significant. The second, In case of tertiary or general hospital outpatient drug coverage rise policy, all of the tertiary hospital healthcare service utilization variables by the interrupted time-series analysis, drug coverage policy in the general hospital deeply declined according to decreasing trend before policy implementation. The third, in case of segmented regression analysis, the visit duration and medical expense statistically declined right after the policy implementation in both the tertiary and general hospital. Meanwhile, administration day was statistically meaningful only for the decrease right after the policy implementation. Otherwise, general hospital changes are not statistically meaningful. And the medicine cost was statistically, meaningfully decreased after the increase in drug coverage. Conclusion: Finally, the result demonstrated according to the analysis is only 1 hypothesis is denied, the other 2 are partially supported. Then, tertiary hospital outpatient coinsurance rate increase policy comparatively makes decrease effect on long-term healthcare utilization, and tertiary or general hospital outpatient drug coverage policy showed partially short-term effect is assured.

Exploring Study Designs for Evaluation of Interventions Aimed to Reduce Occupational Diseases and Injuries

  • van der Molen, Henk F.;Stocks, Susan J.;Frings-Dresen, Monique H.W.
    • Safety and Health at Work
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    • v.7 no.1
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    • pp.83-85
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    • 2016
  • Effective interventions to reduce work-related exposures are available for many types of work-related diseases or injuries. However, knowledge of the impact of these interventions on injury or disease outcomes is scarce due to practical and methodological reasons. Study designs are considered for the evaluation of occupational health interventions on occupational disease or injury. Latency and frequency of occurrence of the health outcomes are two important features when designing an evaluation study with occupational disease or occupational injury as an outcome measure. Controlled evaluation studies-giving strong indications for an intervention effect-seem more suitable for more frequently occurring injuries or diseases. Uncontrolled evaluation time or case series studies are an option for evaluating less frequently occurring injuries or diseases. Interrupted time series offer alternatives to experimental randomized controlled trials to give an insight into the effectiveness of preventive actions in the work setting to decision and policy makers.

Time series analysis for incidence of scarlet fever in children in Jeju Province, Korea, 2002~2016 (2002~2016년도 제주도 소아의 성홍열 발생의 시계열분석)

  • Shin, In-Hye;Bae, Jong-Myon
    • Journal of Medicine and Life Science
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    • v.16 no.3
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    • pp.90-95
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    • 2019
  • The Korea Centers for Diseases Control and Prevention interpreted that recent outbreaks of scarlet fever in Korea since 2011 was resulted from the expansion of scarlet fever notification criteria. To suggest a relevant hypothesis regarding this emerging outbreak, a time series analysis(TSA) of scarlet fever incidence between 2002 and 2016 was conducted. The raw data was the nationwide insurance claims database administered by the Korean National Health Insurance Service. The inclusion criteria were children aged ≤14 years residing in Jeju Province, Korea who received any form of healthcare for scarlet fever from 2002 to 2016. The season was defined as winter (December, January, February; Q1), spring (March, April, May; Q2), summer (June, July, August; Q3), and autumn (September, October, November; Q4). There were seasonal variations with showing peak season on Q1 and Q3. And three phases as 2002 Q2~2005 Q2, 2005 Q2~2009 Q4, and 2010 Q1~2016 Q4 were found between 2002 and 2016. The results from TSA suggested that the recent outbreak of scarlet fever among children in Jeju Province might be a phenomenon from 'unknown birth-related environmental factors' changed after 2010.

Do Fraud Investigations Impact Healthcare Expenditures of Medical Institutions?: An Interrupted Time Series Analysis of Healthcare Costs in Korea

  • Kim, Seung Ju;Jang, Sung-In;Han, Kyu-Tae;Park, Eun-Cheol
    • Health Policy and Management
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    • v.28 no.2
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    • pp.186-193
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    • 2018
  • Background: The aim of our study was to review the findings of health insurance fraud investigations and to evaluate their impacts on medical costs for target and non-target organizations. An interrupted time series study design using generalized estimation equations was used to evaluate changes in cost following fraud investigations. Methods: We used National Health Insurance claims data from 2009 to 2015, which included 20,625 medical institutions (1,614 target organizations and 19,011 non-target organizations). Outcome variable included cost change after fraud investigation. Results: Following the initiation of fraud investigations, we found statistically significant reductions in cost level for target organizations (-1.40%, p<0.001). In addition, a reduction in cost trend change per month was found for both target organizations and non-target organizations after fraud investigation (target organizations, -0.33%; non-target organizations of same region, -0.19%; non-target organizations of other regions, -0.17%). Conclusion: This study suggested that fraud investigations are associated with cost reduction in target organization. We also found similar effects of fraud investigations on health expenditure for non-target organizations located in the same region and in different regions. Our finding suggests that fraud investigations are important in controlling the growth of health expenditure. To maximize the effects of fraud investigation on the growth of health expenditure, more organizations needed to be considered as target organizations.