• 한국임상약학회지
• /
• 제31권4호
• /
• pp.268-277
• /
• 2021

Background: Most antipsychotic drugs studies have been mainly conducted on side effects, randomized clinical trials, utilization rates, and trends. But there have been few studies on the influencing factors in elderly patients. The purpose of this study was to analyze the influencing factors on the outpatient prescription of antipsychotic drugs in the elderly patients. Methods: Active ingredients of antipsychotic drugs in Korea were selected according to the Korean Pharmaceutical Information Center (KPIC)'s classification. Data source was Korean Health Insurance Review and Assessment Service (HIRA) claims data in 2020 and target patient group was the elderly patient group. We extracted patients who have been prescribed one or more antipsychotic drugs and visited only one medical institution. Data were analyzed using descriptive statistics, chi-square, t-test, negative binomial regression. Results: A number of outpatients were 245,197 and prescriptions were 1,379,092. Most characteristics of patients were 75-85 year's old, female, health insurance type, no disease (dementia, schizophrenia), atypical drugs, cci score (>2) and characteristics of medical institution were neurology in specialty, rural region, general hospitals. Results of regression showed that patient's characteristics and medical center characteristics had significant effect on the outpatient prescription of antipsychotic drugs in the elderly patients. Conclusion: This study suggests that national policy of antipsychotic drugs in the elderly patients, with the consideration of the patients' and medical institutions' characteristics, is needed.

• 동서간호학연구지
• /
• 제28권2호
• /
• pp.179-189
• /
• 2022

Purpose: Based on the results of Grandey's Emotion Regulation Process Model and previous studies, this study was conducted to identify the relationship between emotional labor, communication competency, emotional intelligence, social support, and burnout, and to identify factors affecting burnout of nurses in outpatient department. Method: The participants were 190 nurses with more than six months of experience working at the outpatient department of a general hospital in Seoul. Data were collected from April 5 to May 28, 2021, and analyzed using SPSS/WIN 25.0. Results: Significant variables affecting burnout were emotional labor, communication competency, emotional intelligence, education, and total clinical experience. Social support showed a statistically significant negative correlation with burnout, but did not affect burnout. Burnout showed a statistically significant a positive correlation with emotional labor, and showed a negative correlation with communication competency, emotional intelligence and social support. We found a negative correlation between burnout and subjective health status. Emotional labor had a positive effect on burnout. Emotional intelligence, clinical experience for more than 10 years, communication competency, and education for masters or higher negatively affected burnout, respectively. They accounted for 49.2% of the total variance of burnout. Conclusion: Based on the results of this study, it is necessary to reduce emotional labor, one of the major predictors of burnout for outpatient care. In order to prevent emotional labor that results in burnout, an integrated program that improves emotional intelligence and communication competency should be developed.

• Clinical and Experimental Reproductive Medicine
• /
• 제50권1호
• /
• pp.53-62
• /
• 2023

Objective: The aim of this study was to investigate the relationships of serum folate (vitamin B9), cobalamin (vitamin B12) levels and diet with semen parameters (semen standard parameters [SSP] and DNA fragmentation index [DFI]) in infertile men. Methods: Sperm samples were assessed for SSP and DFI (using the sperm chromatin dispersion test). Serum vitamin concentrations were measured with an immuno-electrochemiluminescence assay, and men completed a semi-quantitative food frequency questionnaire (FFQ). Results: Serum folate levels were positively correlated with sperm progressive motility and DFI. A comparison of SSP between two groups of patients according to serum folate concentration (B9 <4.840 ng/mL and B9 ≥4.840 ng/mL) showed significantly higher sperm concentration and sperm progressive motility in the latter group. However, there was no difference between these groups regarding DFI. Interestingly, serum folate levels were significantly higher in patients with a high DFI (using the cut-offs of 30% or 18%). FFQ data showed that the consumption of fruits and egg yolk correlated positively with sperm concentration and sperm motility, respectively. Conclusion: Serum folate levels showed significant associations with sperm concentration and sperm progressive motility. However, the positive association of serum folate with DFI raises the need for careful prescription of folate supplements.

• 우울조울병
• /
• 제9권2호
• /
• pp.126-132
• /
• 2011

Background and Objectives : This study aims to identify sociodemographic and disease-related variables which predicts continuity of outpatient treatment after discharge among bipolar patients. Materials and Method : The medical records of patients who discharged with the diagnosis of bipolar disorder from Department of Psychiatry, St. Mary's hospital from 2005 to 2009 were reviewed. Data on sociodemographic and disease-related variables were analyzed. Results : It showed older age, higher rate of male and higher rate of being married in 1-year follow-up group than in non-follow-up group. And it showed longer duration of index hospitalization, higher rate of previous psychiatric outpatient treatment within 3 months before index hospitalization, higher rate of involuntary admission in 1-year follow-up group than in non-follow-up group. The univariate logistic regression analysis revealed that older age, being male, previous psychiatric treatment and longer duration of index hospitalization were significantly related to an increased likelihood of 1-year follow-up visits. Conclusion : Age, sex, history of previous psychiatric treatment, and duration of hospitalization seems to have influence on continuity of outpatient treatment after discharge.

• 보건행정학회지
• /
• 제33권3호
• /
• pp.325-337
• /
• 2023

Background: While there are many studies estimating the effects of private health insurance on various types of health care utilization, few have examined how such effects change in conjunction with important policy reforms in national health insurance (NHI). This study examined how the effect of private health insurance (supplemental and fixed cash benefit) on high-cost outpatient imaging test utilization changed following the expansion of magnetic resonance imaging (MRI) coverage in 2018, which is a key example of the NHI benefit expansion policy in recent years. Methods: Data from the 2017 and 2019 Korea Health Panel Survey, which contained information about healthcare utilization before and after the expansion of MRI coverage in 2018, were used. The incremental effect of private health insurance on high-cost outpatient imaging test utilization for each period were quantified and compared, with special attention given to the type of private health insurance. Results: While people with supplemental private health insurance were more likely to use high-cost outpatient imaging tests than those without, both before and after the expansion of MRI coverage, the incremental effect increased from 1.6% points in 2017 to 2.5% points in 2019. Conclusion: Benefit expansion in NHI does not necessarily reduce disparities in the use of health care between private health insurance subscribers and non-subscribers. The results of our study also suggest that the path through which private health insurance affects healthcare utilization may not be limited to the price mechanism alone but can be more complex.

• 한국병원경영학회지
• /
• 제24권4호
• /
• pp.43-56
• /
• 2019

Purpose: Importance of patient satisfaction related to patient-centeredness has been emphasized, and it is known to have effect on various health outcomes including health resource utilization. However, the effect of patient satisfaction has been discussed mostly in terms of hospital marketing in Korea. This study aims to examine the effect of patient satisfaction in patient-physician communication on healthcare utilization in a nationally representative adult population of South Korea. Method: Patient satisfaction with physician communication is assessed using 4 items in the 2011 Korea Health Panel Survey. Generalized linear regression analysis is conducted using 9,325 adults' healthcare utilization in 2012. Findings: Adjusting for the socio-demographic, economic factors, individual health status, health behaviors and healthcare utilization in 2011, more satisfied individuals, more likely to utilize the outpatient service, especially in clinical setting. Practical Implications: The study findings suggests that in context of South Korea healthcare system such as insufficient medical consultation time and the absence of health delivery system, patient satisfaction as a subjective healthcare quality indicator would have effect on the individual's outpatient visit. This study contributes to stimulate patient satisfaction research and discussion in South Korea to further explore its relationship with potential and various health related outcomes. Further implications of the study are discussed.

• 지역사회간호학회지
• /
• 제21권4호
• /
• pp.375-385
• /
• 2010

Purpose: This study examined the effects of case management (CM) for Medicaid on healthcare utilization considering the Medicaid system. Methods: Data were extracted from survey data on "Healthcare utilization and health status of Medicaid beneficiaries" conducted in 2007 and 2008 by the Ministry for Health, Welfare and Family Affairs. This study was designed to compare the effects on healthcare utilization between the CM group and the non-CM group. The subjects were 535 Type I Medicaid beneficiaries who utilized healthcare more than 365 days during 2006. Results: The outpatient days and medication days of the CM group decreased significantly more than those of the non-CM group with the copayment system. There were no significant differences of healthcare utilization between the CM group and the non-CM group with the designated doctor system. Conclusion: CM worked effectively on Medicaid beneficiaries' outpatient healthcare utilization with the copayment system. However, its effects on hospitalization, which is a major cause increasing the total expense, were not observed. Therefore, future studies are needed to develop strategies to reduce hospitalization and Medicaid beneficiaries outpatient healthcare utilization with the designated doctor system.

• Journal of Preventive Medicine and Public Health
• /
• 제22권2호
• /
• pp.236-241
• /
• 1989

The purpose of this study was to introduce the methodology of intervention analysis with time series data and to investigate the influence of the patient referral system on medical care utilization in Kangwha county. The data were obtained at the Kangwha Medical Inurance Society and we analysed the material based on the outpatient care fee. The results were as fellows: 1. The average outpatient care utilization in the hospital decreased by 41.7% due to the patient referral system. 2. The utilization of the health instituation increased by 278.8 persons per month due to the patient referral system. 3. The patient referral system did not influence the total outpatient are utilization. The methodology of intervention analysis, which detected the effect of intervention, will be helpful to the study of public health area.

• 대한방사선기술학회지:방사선기술과학
• /
• 제41권3호
• /
• pp.255-260
• /
• 2018

Most patients and parents and guardians display frequent anxiety due to radiation exposure during outpatient, ward, and pediatric general radiographic examinations. This is a behavior that perceives only the harmfulness of radiation. For the recognition of medical radiation, we conduct surveys on outpatients, inpatients, and pediatric parents and guardians to identify their awareness, and then use the radiation dose promotional materials After providing accurate information on the use of radiation, the outpatient, inpatient, and pediatric parents and guardians were asked to explain the change in awareness. The questionnaire items were classified into five categories: repetitive radiation awareness for diagnosis, awareness of exposure dose, availability of exposure information, awareness of radiation risk, and awareness of health problems caused by radiation. There was a statistically significant difference in the items of recognition result of medical radiation, although there was a slight difference in the individual items in the pre and post-recognition results of providing information about the radiologists of the protector and the outpatient(p<0.05). Therefore, through the installation of these promotional materials, we will improve our awareness of medical radiation safety during general radiography surveillance in the Department of Radiology to provide better quality medical information and medical services, thereby contributing to strengthening the competitiveness of the hospital.

• 한국실내디자인학회논문집
• /
• 제15권5호
• /
• pp.183-192
• /
• 2006

This study analyzes the characteristics of special configuration for wayfinding in general hospitals. To that end, the study categorizes four different hospitals, according to the type of their wayfinding systems. It aims at utilizing the result of the analysis for wayfinding system in general hospitals by applying three elements of analysis methods', perpetual access, depth, and intelligibility. The study result shows as follows: First, there is no difference in special hierarchy when hospitals are analyzed and divided by halls and streets. It means that outpatient departments are located by spatial function and characteristics rather than form of spatial configuration. Second, we found that fewer direction changes are conducive to easier circulation in terms of wayfinding, when we analyzed spatial depth from the main entrances to the outpatient departments. Third, regarding intelligibility, intelligibility of Chungang University Hospital ranked highest. Kunkook University Hospital, Dongkook University Hospital and Seoul National University Hospital ranked 2nd, 3rd, and 4th respectively. It means that difficulty level of wayfinding is not decided by the characteristics of special configuration such as hospital hall and hospital streets but depends on location planning. The difficulty level of wayfinding mainly relies on location planning.