• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제2권1호
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• pp.21-29
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• 1999

목 적: 학동기 소아들의 반복성 복통의 발생빈도, 임상증상, 의료기관 이용양상, 선택기준 및 관련된 요인을 조사하여 반복성 복통 환아의 특징, 증상의 발현 및 유지에 영향을 줄 수 있는 요인을 알아보고, 반복성 복통 환아의 의료기관 이용양상과 문제점을 파악하여 향후 치료를 위한 기초 자료를 제공하고자 실시하였다. 방 법: 1998년 6월 광주시내 초등학교 학부모 1417명을 대상으로 반복성 복통의 발생빈도, 임상증상, 의료기관 이용양상을 알아보기 위하여 설문조사를 실시하였다. 결 과: 1) 총응답자는 1417명, 남자 715명, 여자 702명이었고, 남녀비 1.02:1 평균나이는 10.3세였다. 2) 반복성 복통증의 발생 빈도는 18.9%이었다. 남자는 18.4%, 여자는 19.2%였다. 복통의 지속시간은 10분 이내가 68.5%였다. 3) 정확한 진단을 받지 못한 경우가 62.5%였고, 66.3%가 치료를 받았고, 67.5%가 치료시 증상 호전을 보였다. 민간요법을 실시한 경우도 66%를 차지하였다. 4) 치료 의료기관은 소아과 35.2%로 많았으나, 약국 및 내과의 이용률도 30%정도를 차지하였다. 연령이 증가함에 따라 소아과 이용률이 감소하고 내과의 이용율이증가하였다. 의료기관의 선택기준은 거리의 근접성이 36.3%로 가장 많았고, 의료인의 친절도, 치료의 질 순이었다. 5) 동반증상은 55.5%에서 있었고, 두통이 30.9%로 가장 많았고, 흉통, 현기증, 구토 순이었고, 동반 증상이 없는 경우도 44.5%였다. 6) 반복성 복통의 발생시기는 하루 중 식후가 35.3%로 가장 많았고, 식사전, 수업중 순이었다. 주내 변동은 월요일이 21.4%로 가장 많았으며, 점차 감소하여 토요일이 가장 낮았다. 7) 복통의 발생부위는 배꼽주위가 38%로 가장 많았고, 심와부 등 중앙부에 위치하였으며, 통증의 성격은 작열통이 36.9%로 가장 많았다. 결 론: 반복성 복통 환아는 대부분 정확한 진단을 받지 못하고, 전문적인 치료없이 대증적인 치료 및 민간요법이 많이 시행되고 있었다. 연령이 증가함에 따라 소아과 이외의 타과의 이용률이 증가하였다. 반복성 복통에 대한 올바른 이해와 함께 정확한 진단 및 전문적인 의료기관의 선택이 필요하고 이에 대한 홍보 및 대응책이 필요하다.

• Journal of Preventive Medicine and Public Health
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• 제39권5호
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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.

• 보건행정학회지
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• 제33권1호
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• pp.19-28
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• 2023

Background: With the enactment of the Hospice, Palliative, Care, and Life-sustaining Treatment Decision-Making Act in February 2018, legal guidelines for physician orders for life-sustaining treatment (POLST) were presented. This study was conducted to analyze the association of writing POLST on the use of health care before death. Methods: The study analyzed the electronic medical records and POLSTs of 1,003 adult patients who died at a tertiary hospital located in Seoul from February 4, 2018 to February 4, 2019. Results: Of the deaths, 80% (n=804) completed POLST. Among patients who completed POLST before death, 51% (n=412) were written 1-7 days before death, and only 31% (n=246) were completed by patients themselves. 99% (n=799) decided to withdraw or withhold cardiopulmonary resuscitation. As a result of analyzing the effect of POLST on medical use before death, it was found that POLST and inpatient cost had a significant negative correlation, and POLST completion significantly reduced death in the intensive care unit (ICU). However, both inpatient costs and death at ICU increased when the POLST was completed by surrogate decision-makers rather than patients themselves. Conclusion: The enactment of the Hospice, Palliative, Care, and Life-sustaining Treatment Decision-Making Act provided a legal basis for withdrawing and withholding meaningless life-sustaining treatment. By specifying the treatment to be received at the end of one's life through the POLST, inpatient treatment costs and death at the ICU were decreased. However, the frequent decision-making by the surrogates and completion of POLST close to death may hinder the original purpose of the law.

• Clinical and Experimental Vaccine Research
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• 제12권4호
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• pp.313-318
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• 2023

Purpose: Globally, 25 million children were either unvaccinated or under-vaccinated in year 2021. Among them, India had the highest number of children unvaccinated. Studies have shown impact of coronavirus disease 2019 (COVID-19) pandemic on routine health-care services. Present study aimed to estimate the impact of COVID-19 on utilization of routine immunization services during years 2020 and 2021 in tertiary-care facility. Materials and Methods: Record based descriptive analytic study was conducted at pediatric tertiary-care hospital, Jaipur. Data of children vaccinated as per the National Immunization Schedule for the period January 2019 to December 2021 were retrieved from the immunization records. Doses administered were assessed as a proxy measure of vaccine coverage. The vaccination trends of 2020 and 2021 were compared assuming base year 2019. Unpaired t-test of significance and Pearson correlation was used for correlation analysis. Results: There was significant drop in the vaccine counts after emergence of COVID-19 pandemic. In year 2020 and 2021, mean monthly vaccine count was 2,190±715.1 and 2,305±393.2, respectively, in which maximum drop was in April 2020 (-79.12%) and May 2021 (-57.16%) when it was compared with matched month of base year. There was negative correlation between percent change in vaccine count and COVID-19 cases in 2020 (r=-0.057, p=0.861) and 2021 (r=-0.827, p=0.001) as compared to year 2019. Conclusion: Study concludes that there was a significant gap in utilization of routine immunization services during the COVID-19 pandemic. This necessitates planning and management of routine immunization services in-case of future pandemics to avoid resurgence of vaccine-preventable diseases in the Rajasthan.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1999년도 제51차 추계 학술대회 연제집
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• pp.169-170
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• 1999

• 대한한방소아과학회지
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• 제25권1호
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• pp.90-110
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• 2011

Objectives: The purpose of this study is to examine the parental recognition and utilizing patterns of oriental medical care in children who live in Seong-Dong district. Methods 802 day-care center children's parents participated in the survey on recognition and utilizing patterns of oriental medical care, and 702 of the surveys were analyzed. Results: 1. 38.33% has received previous oriental medical treatments and most were received at the children's age under 12-24 months. Majority of the treatments took place in the clinical settings. By recommendation, some also received their treatment at the medical centers. One of the reasons why they receive oriental medical treatments was that they prefer to balance their treatment with the orental medical treatments along with the western's. 2. 53.85% of those who received oriental medical treatments were satisfied with their treatments. The effective treatment results were the major reason for the satisfaction. 3. 49.56% of those who had oriental medical treatments chose specific oriental medical facilities for the children's ailment. Most specific oriental medical facilities were local oriental medical clinics. Reputation fame were the main reason in choosing the clinics. 4. In 2009, 55.26% had received care in the specific oriental medical clinics for the diseases, such as respiratory symptoms, systemic symptoms, gastrointestinal symptoms, skin problems, neurological and psychiatric disease for infants, and respiratory symptoms, gastrointestinal symptoms, systemic symptoms, skin problems, neurological and psychiatric symptoms, urinary symptoms and musculoskeletal symptoms for toddlers. 5. The average duration of herbal treatment were 7-14 days, preferably 4-6 days, and preferred number of medical visits were once a week on Saturdays and preferred day for night cares were on Friday nights. Average treatment fee per treatment was less than 10,000 won which coincided with the preferred treatment fee per visit. 6. The very first medical institutions chosen by parents once their children are ill are the following; Western medical institutions, western medical clinics, pharmacies, oriental medical clinics, health centers, and lastly, oriental medical institutions. The major concerns in receiving oriental medical cares include pesticides in herbs and hazardous substances in heavy metals. Preferred form of oriental medicine was decoction, the negative feedback of oriental medicine was mostly due to the bitter taste of the oriental herbal decoctions. Preferred frequency of intake was twice a day with less than 10cc~20cc per single intake. Conclusions: Taken all together, we conclude that the growing recognition of Oriental Pediatric medicine is needed among parents.

• 보건행정학회지
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• 제10권2호
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• pp.22-40
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• 2000

The purpose of the study was to discuss amrketing strategy for oriental hospital, by making a comparative analysis of how hospital user satifaction was affected by hospi시 choice motivation between oriental hospital users and western hospital. The data usel in this study was the Korea Isititute of oriental medicine(1999)'s study on utilization of oriental medical care. And and interview was hold with outpatients who visited around march to April, 1999, at each an oriental hospital and a westen hospital in Seoul and in Wonju city, Kongwon province. The collected data were analyzed by SPSS program. The factor analysis of hospital choice motivation was made by figuring out facor's mean value, and T-test and ANOVA were employed to find out what difference was made by sociodmographic charcteristics to the factors. Also, the multiple regression analysis was carried out to examine what gave an impact on hospital user satisfaction. The findings of this study were as follows; First as a result of making a factor analysis against hospital choice motivation to find out what kind of differenc there was between oriental hospital user motivation and western hospital and person factors. Among them, the hospital charcteristics, preception, personal and person factors. Among them, the hospital charcteristics appered to have the biggest effect of hospital choice motivation. Second, as a result of making comparison between oriental oriental hospital user satisfaction and werterm hospital user satisfaction, there was a singificant between their satisfaction at treatment time, kindness and relative kiness aginst the pther hospital. The oriental level combining 6 items. The geneal satisfaction level combining 6itmes tured out to have reliability of chronbach $\alpha$=0.7126. As a result of examining how mech the general satifaction level depended on sociodemographic characteristics, ther was found be significantly affected by age, marital status, educational background or hospital type. Those who a spouse or a lower educational background or the oriental hospital users got better score. Third, the multiple regression analysis was made to find out what factors affected western and oriental hospital user satisfaction, As a result, the waiting time, experience of other medical facilities and hospital characteristic variable were identified as a key factor on which westerm hospital user satisfaction depended. In conclusion, the oriental hhspital user expressed more staisfaction than the weshren hospital users. Then the characteristic factor played a singificant role in user satisfaction, which included hospital facilities, kindness of herb doctor and employees, or hospital reputation of credibility. in order to raise hospital user datisfaction, it seemed necessary to pay more attention to hospital characteristic factor rather than to perception factor.

• Journal of Hospice and Palliative Care
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• 제26권2호
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• pp.60-68
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• 2023

Purpose: For the dignity of patients nearing the end of their lives, it is essential to provide end-of-life (EoL) care in a separate, dedicated space. This study investigated the utilization of specialized rooms for dying patients within a hospice unit. Methods: This retrospective study examined patients who died in a single hospice unit between January 1, 2017, and December 31, 2021. Utilizing medical records, we analyzed the circumstances surrounding death, the employment of specialized rooms for terminally ill patients, and the characteristics of those who received EoL care in a shared room. Results: During the 1,825-day survey period, deaths occurred on 632 days, and 799 patients died. Of these patients, 496 (62.1%) received EoL care in a dedicated room. The average duration of using this dedicated space was 1.08 days. Meanwhile, 188 patients (23.5%) died in a shared room. Logistic regression analysis revealed that a longer stay in the hospice unit was associated with a lower risk of receiving EoL care in a shared room (odds ratio [OR]=0.98, 95% confidence interval [CI] 0.97~0.99; P=0.002). Furthermore, a higher number of deaths on the day a patient died was associated with a greater risk of receiving EoL care in a shared room (OR=1.66, 95% CI 1.33~2.08; P<0.001). Conclusion: To ensure that more patients receive EoL care for an adequate duration in a private setting, additional research is necessary to increase the number of dedicated rooms and incorporate them into the hospice unit at an early stage.

• 보건행정학회지
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• 제31권3호
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• pp.335-343
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• 2021

Background: The purpose of this study was to extract the major areas of interest in health insurance research in Korea, and infer policy agendas related to health insurance by analyzing research keywords. Methods: For this study, 2,590 articles were selected from among 7,459 academic papers related to health insurance published between January 1987 and December 2018, which were looked up using the Research Information Sharing Service (RISS). Keyword extraction and keyword network analysis were performed using the KrKwic, KrTitle, and UCINET software. Results: First, the number of studies in the area of health insurance continued to increase in all government terms, and it was not until after the 2000s that the subjects of health insurance researches were diversified. Second, degree centrality showed that 'medical expenditure' and 'medical utilization' were consistently high-ranking keywords regardless of the government in power. Aging and long-term care insurance-related keywords were ranked higher in the Lee Myung-bak government, Park Geun-hye government, and Moon Jae-in government. Third, betweenness centrality showed the same high ranking in key topics such as medical expenditure and medical utilization, while the ranking of key keywords differed depending on the interests and characteristics of each government policy. Conclusion: We confirm that health insurance as a research topic has been the main theme in Korean health care research fields. Research keywords extracted from articles also corresponded to the main health policies promoted during each government period. Efforts to systematically investigate policy megatrends are needed to plan adaptive future policies.

• 한방안이비인후피부과학회지
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• 제34권2호
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• pp.21-37
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• 2021

Objectives : Allergic rhinitis(AR) is a common chronic disease that accounts for 10-40% of the world's population. This study aims to analyze the status of claims, prevalence, and medical utilization of allergic rhinitis patients using representative patients sample data. Methods : This study used the National Patients Sample(HIRA-NPS) of the Health Insurance Review and Assessment Service for 7 years(2010-2016). And we defined AR patients as all statements including J30 or a subcategory of J30 as the main disease, using the Korean Standard Classification of Diseases(KCD-7). The trend of AR patients by year was divided into Western medicine(WM) and Korean medicine(KM), and analyzed by subgroup analysis such as inpatient/outpatient, gender, age, insurance type, and care institution. Results : Patients with AR were mainly claimed for first sub diagnosis in WM and major diagnosis in KM, and the number of claims increased about 1.3 times and 1.4 times compared to 2010 in WM and KM, respectively. In addition, the total annual medical expenses in 2016 increased 1.3 times and 1.7 times compared to 2010, respectively. Conclusions : Both WM and KM are showing a steadily increasing trend in medical use due to allergic rhinitis. Further research is needed by considering genetic and environmental factors and individual characteristics, and linking with additional data.