• Korean Journal of Clinical Pharmacy
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• v.28 no.2
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• pp.107-116
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• 2018

Objective: This study analyzed the national claims data of veterans to generate scientific evidence of the trends and appropriateness of their drug utilization in an outpatient setting. Methods: The claims data were provided by the Health Insurance Review & Assessment (HIRA). Through sampling and matching data, we selected two comparable groups; Veterans vs. National Health Insurance (NHI) patients and Veterans vs. Medical Aid (MAID) patients. Drug use and costs were compared between groups by using multivariate gamma regression models to account for the skewed distribution, and therapeutic duplication was analyzed by using multivariate logistic regression models. Results: In equivalent conditions, veteran patients made fewer visits to medical institutions (0.88 vs. 1), had 1.86 times more drug use, and paid 1.4 times more drug costs than NHI patients (p<0.05); similarly, veteran patients made fewer visits to medical institutions (0.96 vs. 1), had 1.11 times more drug use, and paid 0.95 times less drug costs than MAID patients (p<0.05). The risk of therapeutic duplication was 1.7 times higher (OR=1.657) in veteran patients than in NHI patients and 1.3 times higher (OR=1.311) than in MAID patients (p<0.0001). Conclusion: Similar patterns of drug use were found in veteran patients and MAID patients. There were greater concerns about the drug use behavior in veteran patients, with longer prescribing days and a higher rate of therapeutic duplication, than in MAID patients. Efforts should be made to measure if any inefficiency exists in veterans' drug use behavior.

• Journal of The Korea Institute of Healthcare Architecture
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• v.13 no.2
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• pp.27-36
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• 2007

Recently, hospital patients experience anxiety, confusion, and stress about wayfinding as the spacial layout and treatment circulatory system of hospitals have become complicated due to their oversized and complex structure. As part of finding a solution to the problem, this study seeks to examine what are the essential elements of the wayfinding planning of O.P.D. in general hospitals, to develop the model of wayfinding, and to suggest the methods of improving the wayfinding system. The research methods of this study adopted were literature review in wayfinding cognition, plan analysis of ten general hospitals, space analysis of these hospitals through space syntax, analysis of the system of visual-perceptual information through a field study, and analysis of surveys and follow-up surveys conducted to support the results. Based on these results, the proposals for finding decision points, providing the information, and developing a model planning are listed as follows. 1) The comprehensive understanding of O.P.D. spacial layout and the visual-perceptual information system is necessary to find the essential elements of wayfinding. 2) The decision points are found through the full understanding of spacial functions, circulation systems, and facility configuration, considering the spacial layout, the bound of the visual-perceptual information system, and the circulatory system. Furthermore, the information decision points could be confined by space syntax. 3) The checklist and color compound & color codes, developed through the planning of signage system and color system could be applied to the methods of providing the information. 4) The planning of wayfinding system according to the whole process of practices for outpatients was mentioned above. The system of visual-perceptual information developed through the process of this study should be integrated in the spacial layout of the whole O.P.D.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.12 no.2
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• pp.53-62
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• 2017

Objectives : The purpose of this study is to report the effect of foot orthosis and Korean Medicine therapy including Chuna on symptom that accompany scoliosis by observing one clinical case study. Methods : One patient suffer sole pain and numbness that accompany scoliosis who received outpatient treatment was investigated for the changes in numerical rating scale(NRS), pelvic height and pelvic angle. Pelvic height and angle were checked by using Whole spine X-ray. During outpatient treatment, patient treated by foot orthosis and Korean Medicine therapy including Chuna. Results : After 7 times treatment, NRS showed a remarkable difference, which decreased from 7 to 1. Pelvic height decreased from 11.16mm to 8.58mm and pelvic angle decreased from $5.03^{\circ}$ to $3.16^{\circ}$. They showed a slight difference. Conclusions : Foot orthosis and Korean Medicine therapy including Chuna might be effective in the patient that showed symptoms which is caused by scoliosis.

• Journal of Digital Convergence
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• v.15 no.2
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• pp.273-283
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• 2017

This study aims to develop a convergence optimized LOS(Length of Stay) management system that can provide efficient by predicting LOS on outpatient information for inducing the LOS to manage their own activities. web program has been implemented to comput in real-time predicting LOS by using the predicted LOS model of outpatient information. The predict model was derived management targets of long term predicted patient group and intensive care patient group. The optimized LOS(Length of Stay) management system was confirmed efficient for optimizing management of LOS that can provide by the long-term predicting alarm and over LOS alarm service for long term predicted patient group and intensive care patient group. Therefore the trial operating policy alternative on extension of predicted LOS is needed to utilized convergence optimizing system on LOS.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.2
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• pp.158-168
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• 1999

This study was carried out to know the main defense mechanisms used by adolescent victims of school violence. Subjects of this study are composed of 41 adolescent victims(clinical group) and 40 normal adolescents(control group). Clinical group is divided into four subgroups of inpatient, outpatient, day hospital, and school groups. Used scales are Ewha Defense Mechanisms Test(EDMT) and Staittrait anger scale. Several important results are found. Adoescent victims use neurotic defense mechanisms of neurotic and mature level less frequently than normal adolescents. In clinical group day hospital adolescents use more mature defense mechanisms than outpatient adolescents. Displacement and acting out are correlated with trait and sate anger. Somatization is correlated with trait anger, and regression is correlated with state anger significantly.

• Journal of Korea Society of Industrial Information Systems
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• v.20 no.4
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• pp.55-65
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• 2015

An increase in patients' medical expenses for their injury. accident and intoxication is a major challenge to improve the sustain-ability of a national health security system, and increasing medical expenses need be suppressed through improving relevant systems and/or efficiently operating and managing the health insurance. At this juncture, in Korea which has a high rate of injury incidence and mortality, it is necessary to estimate social and/or economic costs for injuries with a focus on their social effects. This research has examined the results of a Korea medical panel investigation conducted in 2008, which largely surveyed of the actual conditions of outpatients' medical use for their injury, accident and/or intoxication and investigated relevant medical expenses, with a view to estimating the directly incurred costs when the patients use medical services and the production loss costs caused by an production decline and others, so that social and/or economic costs for injuries may be ultimately aggregated.

• Korea Journal of Hospital Management
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• v.8 no.2
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• pp.93-110
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• 2003

Fiscal crisis in the medical insurance has put the pressure upon hospitals by increasing the rate of curtailment, since the implementation of the separation between prescription and dispensing of Drug. The purpose of this study is to analyze the curtailment for antibiotics, injected drug and other drugs expenditure before and after the system of separation between prescribing and dispensing. Data were gathered from 13 general hospitals and used for analysis of trends on antibiotics and injected drug expenditure, and curtailment in 2000-2001 at three months intervals. The results were as follows; The curtailment rate of antibiotics expenditure has been increased in outpatient and inpatient since 2000. The curtailed antibiotics cost and injected drug cost in outpatient under the prescription within the hospital and in inpatient increased. The ratios of curtailment versus expenditure had increased in antibiotics, injected drugs, anticancer drugs, antiulcer drugs, albumine, antiinflammatory drugs. These results suggest that claim review system in social health insurance were over-focused mainly to control the cost and it might to impede the validity of claim review function in health insurance system. Therefore, it's needed to develope the scientific and reasonable parameter & criteria for claim review of drug expenditure.

• The Korean Journal of Pain
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• v.21 no.2
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• pp.136-142
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• 2008

Background: A transforaminal epidural steroid injection (TFESI) is one of the methods for the conservative treatment of the lumbar spinal stenosis. As efforts to prolong the therapeutic duration and to predict the outcome of TFESI are very important, we analyzed factors considered to be associated with the therapeutic duration of a TFESI. Methods: Between August 2006 and March 2007, 69 patients (Group A: patients with no pain relief, Group B: patients with pain relief of less than 6 months, Group C: patients with pain relief of more than 6 months) who failed to the medical treatment were included to undertake a fluoroscopic-guided TFESI. Prior to treatment, the VAS (visual analogue scale), ODI (Oswestry disability index), BDI (Beck depression inventory), and BAI (Beck anxiety inventory) scores were determined to evaluate the degree of pain, disability, and psychological status. The VAS and ODI scores were used to assess the degree of pain relief. To identify the total duration of pain relief, regular outpatient visits for six months were conducted, and for the patients who were not able to visit the outpatient clinic regularly, outcome was assessed by telephone interviews after six months. Results: The dural sac cross-sectional area (DSCSA), ODI, pain duration, BDI, BAI, and age showed similar distribution for patients in the A, B, and C groups. Conclusions: The DSCSA, ODI, pain duration, BDI, BAI, and age were not associated with the therapeutic duration of TFESI in lumbar spinal stenosis patients.

• Journal of The Korea Institute of Healthcare Architecture
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• v.16 no.2
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• pp.7-15
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• 2010

An early stage of general hospital in Korea was the quantitative growth period. Remodeling has been required to meet the increasing medical demands. To accept the change of paradigm and management operation method, remodeling occurred from the 20th century. Remodeling plans are difficult to define the direction of the detailed plan due to various factors in the beginning of the construction, Therefore, it is necessary to analyze the possibility and limitation of a feasible remodeling plan of general hospitals through the comparison of existing hospital before remodeling and after the remodeling takes effect. A comparison of the researched hospital's blue prints before and after the remodeling and recently built hospital's blue print, analyzed characteristic of the space variation by the remodeling. The purpose of research is to confirm a possibility and limitation of remodeling of general hospitals comparing with merits and faults of extension, reconstruction, and construction. In conclusion, the area of remodeling hospitals increase mostly medical department(ward, outpatient department, inpatient department) and subsidiary facilities, but the area of ward and inpatient department are less than the new hospitals. Especially, public area is greatly increased by the diversification of corridor function. Also, remodeling hospitals represent a limitation to plan departments in need of equipment-intensive space. To address this problem, expansion space is used mainly with inpatient department and existing space is placed mainly with low-impact department by equipment ; outpatient department, administration department.

• Archives of Plastic Surgery
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• v.34 no.2
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• pp.222-228
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• 2007

Purpose: Report of the good results of breast reconstruction using Becker permanent tissue expander that showed a short operation time and a quick post-operation recovery time, little side effects and usually superb aesthetic results without the need for additional incisions or donor site morbidity. The authors, after carrying out breast reconstruction operations using Becker permanent tissue expander on patients with appropriate indications, attempted to analyze several factors such as complication rates and patient satisfaction measurements. Methods: 11 cases of breast reconstruction using Becker expander implants were carried out on a total of 10 patients between March 2000 and February 2003. The patients were followed up at outpatient visit for an average of 6 months. Results: The most common post-operation complication was pain resulting from saline injection into the expanders, complained by 5 patients(50%). rib fractures, skin necrosis, implant removal due to infection, and breast cancer recurrence each occurred in 1 patient (9.9%). There was no occurrence of skin contracture complications which occurs frequently in case of silicone implant insertion. Patient complacency was surveyed by patient interviews made right after the operations and during outpatient follow-up periods: 5(50%) patients out of 10 showed excellent, 3(30%) good, and 2(20%) showed fair, leaving no patients who were disappointed with operation results. On routine follow-up, 80% of patients expressed satisfaction with the cosmetic outcome of their post-mastectomy beast reconstruction. Conclusion: Breast reconstruction using the Becker expander is a reliable alternative to other reconstructive methods but good patient selection is essential for satisfactory results.