• Title/Summary/Keyword: patient of the Aged

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Multilevel Analysis of Factors Related to Cost and Length of Stay in Acute Myocardial Infarction Patients with Coronary Stenting: Based on Korean National Health Insurance Service's Customized Database in 2010 and 2015 (관상동맥 스텐트를 삽입한 급성 심근경색 환자의 진료비 및 재원일수 관련 요인에 대한 다수준분석: 2010년과 2015년 국민건강보험공단 맞춤형 데이터베이스 자료를 바탕으로)

  • Choi, Boyoung;Lee, Hae-Jong
    • Health Policy and Management
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    • v.30 no.3
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    • pp.418-429
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    • 2020
  • Background: This study aims to analyze the cost and the length of stay (LOS) of acute myocardial infarction (AMI) patients with coronary artery stenting according to the characteristics of individuals and institutions. Methods: The data was collected from Korean National Health Insurance Service's customized database in 2010 and 2015. Chi-square test, t-test, analysis of variance, and multilevel analysis were performed. Results: The intraclass correlation coefficients for cost were 7.02% in 2010, 5.61% in 2015 and for LOS were 3.17%, 1.40%, respectively. The average costs were 9,067,000 won in 2010 and 9,889,000 won in 2015 (p<0.0001). However, the cost in 2015 was lower than the cost applying increased fee. The costs increased in aged 50-59 years, 60-69 years, and aged ≥70 years versus in aged under 49 years. The cost was higher in Charlson comorbidity index (CCI) 3 to 4 and ≥5 than in CCI 0. The costs were lower in male, medical aid recipients, metropolises, and local hospitals in other regions in 2010. LOS decreased from 8.1 days in 2010 to 7.4 days in 2015. It decreased in male, high income group, and the group of admission via emergency room. However, it increased in higher ages and medical aid recipients, and it also increased when CCI rose. The Internal Herfindahl Index was related to LOS in 2010. Conclusion: The variation of hospital level was small compared to the patient level. Therefore, it is important to implement applicable policies at the patient level in order to reduce cost and LOS of AMI patients.

Fertility preservation during cancer treatment: The Korean Society for Fertility Preservation clinical guidelines

  • Kim, Jayeon;Kim, Seul Ki;Hwang, Kyung Joo;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.4
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    • pp.171-174
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    • 2017
  • While many fertility preservation (FP) options now exist for reproductive-aged cancer patients, access to these services continues to be limited. A comprehensive FP program should be organized to serve oncofertility patients effectively. Also, much effort is needed from various individuals-patients, specialists from various fields, and consultants-to facilitate FP in a timely manner. Various challenges still exist in improving access to FP programs. To improve access to FP treatment, it is important to educate oncologists and patients via electronic tools and to actively navigate patients through the system. Reproductive endocrinology practices that receive oncofertility referrals must be equipped to provide a full range of options on short notice. A multidisciplinary team approach is required, involving physicians, nurses, mental health professionals, office staff, and laboratory personnel. The bottom line of FP patient care is to understand the true nature of each patient's specific situation and to develop a patient flow system that will help build a successful FP program. Expanding the patient flow system to all comprehensive cancer centers will ensure that all patients are provided with adequate information regarding their fertility, regardless of geography.

Gender differences in Factors Associated with the Severity of Depression in Middle-aged Adults: An Analysis of 2014 Korean National Health and Nutrition Examination Survey (중년 성인에서 우울 중증도 관련요인의 성별 차이 : 2014년 국민건강영양조사 자료 분석)

  • Lee, Young Joo
    • Journal of the Korea Convergence Society
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    • v.9 no.10
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    • pp.549-559
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    • 2018
  • The purpose of this study is to examine the prevalence of depression in Korean middle-aged adults and to identify the gender difference in factors associated with the severity of depression. The data of 2,241 individuals who participated in the Sixth Korea National Health and Nutrition Examination Survey in 2014 were used. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), and multivariate ordinal logistic regression analysis was performed. The prevalence rate of moderate to severe depression ($PHQ-9{\geq}10$) was identified at 5.2% (men 3.3%, women 7.0%). The factors associated with the severity of depression in men were younger age, living in metropolitan, unemployed, lower body mass index, and heavily drinking. On the other hand, women were affected by having no spouse, lower income, limited physical activity, and sleeping shorter hours.

Does Age Influence the Poor Prognosis after Aneurysmal SAH Surgery in Elderly Patients?

  • Sim, Jong-Eun;Kim, Hyung-Dong;Song, Young-Jin;Noh, Seung-Jin
    • Journal of Korean Neurosurgical Society
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    • v.40 no.5
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    • pp.357-362
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    • 2006
  • Objective : The incidence of aneurysmal subarachnoid hemorrhage has been increasing. At the same time, surgical results for elderly patients are unsatisfactory and no guidelines of treatment are available. We carried out a study comparing variable factors and surgical results between young and old age groups to find ways to improve prognosis. Methods : A retrospective study was carried out on 754 patients who were operated on between 1990 and 2004 by the same surgeon in our hospital. The patients were divided into seven groups according to age : 93 patients below 40 years of age [Group I], 419 patients aged $40{\sim}59$ [Group II], 115 patients aged $60{\sim}64$ [Group III], 82 patients aged $65{\sim}69$ [Group IV], 28 patients aged $70{\sim}74$ [Group V], 12 patients aged $75{\sim}79$ [Group VI] and 5 patients over the age of 80 [Group VII]. We then checked their medical history, Fisher's grade, Hunt-Hess grade, postoperative complications, and Glasgow Outcome Scale. Results : Age was not a statistically significant factor among patients below 70 years of age [P $value{\ge}0.05$]. But for those aged 70 and older, the age factor had a statistical value [P $value{\le}0.001$]. In addition, there was a close correlation between Hunt-Hess grade IV and V patients, and those with vasospasm, and hydrocephalus after surgery, with poor prognosis in elderly patients as well as young patients [P $value{\le}0.001$]. Conclusion : Advanced age [under the age of 70] dose not precluded adequate surgical treatment in patient with AN SAH, and we should be also alert to preventable causes of delayed neurological deterioration for improving the outcome in all elderly groups.

A Study on the Oral Hygien Index Change according to Comprehensive Dental Hygiene Care Treatment (포괄 치위생처치에 따른 구강환경지수변화 연구)

  • Lee, Eun-Sook;Lee, Cheon-Hee
    • The Korean Journal of Health Service Management
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    • v.5 no.3
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    • pp.145-155
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    • 2011
  • This study is Dental Hygiene Department of G University for comprehensive dental hygiene control and treatment weekly for four weeks from September 16 to October 20, 2010, excluding those who visited for ambulatory treatment of systemic diseases. For the 90 subjects, we performed oral examination, measured Simplified Oral Hygiene Index (S-OHI), Modified Patient Hygiene Performance (PHP-M), and O' Leary Index, and applied comprehensive dental hygiene control. First, as to the change of OHI according to age, the index in the 1st measurement was 3.43 in those under 35 and 3.17 in those aged 35 or older, so it was higher in the younger group, but in the 2nd measurement it was 1.89 in those under 35 and 2.14 in those aged 35 or older, and in the 3rd measurement it was 1.22 in those aged 35 or older, so it was higher in the older group. Second, as to the change of PHP-M according to age, the index in the 1st measurement was 50.35 in those under 35 and 43.16 in those aged 35 or older, soit was higher in the younger group, but in the 2nd measurement it was 31.97 in those under 35 and 28.88 in those aged 35 or older, and in the 3rd measurement it was 21.31 in those aged 35 or older, so it was higher in the older group.

A Case Study of a Patient with Cancer Fatigue Syndrome and Cancer Metastases who Received Ortho-Cellular Nutrition Therapy (OCNT) (세포교정영양요법(OCNT)을 이용한 암피로증후군, 전이암 환자 사례 연구)

  • Choi, Yeon
    • CELLMED
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    • v.12 no.5
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    • pp.4.1-4.3
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    • 2022
  • Objective: A Case Study of a Patient with Cancer Fatigue Syndrome and Cancer Metastases who Received Ortho-Cellular Nutrition Therapy (OCNT) Methods: The patient is a Korean woman aged 61 years. 13 years ago, she was diagnosed with stage 1 breast cancer and underwent surgery, chemotherapy, and radiation therapy. owever, 13 years later, the disease spread to the lungs and brain. Results: Following nutritional therapy, cancer fatigue syndrome improved. Conclusion: Nutritional therapy can be beneficial for cancer fatigue syndrome, a condition that remains undiagnosed and untreated.

Factors affecting dental biofilm maturity assessed with Quantitative Light-induced Fluorescence-Digital in Korean older adults

  • Shin, Na-Ri;Choi, Jun-Seon
    • Journal of Korean society of Dental Hygiene
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    • v.19 no.3
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    • pp.351-362
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    • 2019
  • Objectives: The study aimed to analyze the factors affecting the maturity of dental biofilm, which was assessed with quantitative light-induced fluorescence-digital(QLF-D), in a sample of Korean older adults. Methods: This cross-sectional study included 67 participants, aged 65 years and older. All participants completed a questionnaire and tests to measure their manual dexterity and handgrip strength, which are parameters that indicate hand function abilities. To evaluate dental biofilm maturity, 804 surfaces of six index teeth were imaged using QLF-D and then quantified as ${\Delta}R$ values. All data were collected from May 25, 2017 to April 30, 2018. The independent t-test, one-way analysis of variance, and step-wise multiple linear regression were performed to analyze the factors associated with the maturity of dental biofilm (${\Delta}R$). Results: The multivariate linear regression analysis revealed that the factor most strongly related to dental biofilm maturity(${\Delta}R$) was manual dexterity (${\beta}=-0.326$), followed by handgrip strength (${\beta}=-0.303$) and use of interdental cleaning devices (${\beta}=-0.283$) (p<0.05). Conclusions: Manual dexterity, handgrip strength, and use of interdental cleaning devices are factors that can predict dental biofilm maturity in adults aged 65 years or older. Therefore, the hand function of a patient should be evaluated first, before assessing the oral hygiene status of the patient or providing him/her with oral health education, and the dental hygienist should provide differentiated oral hygiene care depending on the patient's hand function ability. Finally, dental hygienists should help older adults to recognize the importance of auxiliary oral hygiene devices such as interdental brushes and keep motivating them to use the devices more frequently.

Impact of Periodontal Treatment and Demographic and Socioeconomic Factors on Tooth Loss in Persons with Disabilities: An Analysis of Korean National Health Insurance Claims Data

  • Bo-Ra Kim
    • Journal of dental hygiene science
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    • v.23 no.3
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    • pp.225-235
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    • 2023
  • Background: This study aimed to analyze the effects of periodontal treatment and individual- and tooth-related factors on tooth extraction in people with disabilities. Methods: The Korea National Health Insurance claims data of individuals with disabilities aged 40~64 years with chronic periodontitis in 2008 were obtained. Of these, data on the disabled who underwent scaling/root plaining, subgingival curettage/periodontal surgery, or non-periodontal treatments, and data on their teeth were selected. The extraction of 716,688 teeth from 39,097 patients was tracked until 2018, and the patient- and tooth-level factors related to tooth loss were identified using a mixed-effect logistic regression analysis. Results: Data from approximately 17% of the teeth were extracted during a follow-up period of approximately 11 years. Among the tooth-level variables, scaling/root planing treatment at baseline and periodontal treatment during the follow-up period were associated with a lower risk of tooth loss (odds ratio=0.692 and 0.769, respectively, p<0.001). Non-vital teeth increased the risk of tooth loss by 3.159 times (p<0.001). Among the patient-level variables, females were less likely to have lost their teeth than males, and those with orthopedic impairment or brain lesions/mental disabilities, a higher age group, lower income level, or residents in medium/small cities or rural areas were more likely to have lost their teeth (p<0.001). Conclusion: Through approximately 11 years of follow-up, scaling or root planing, experience with periodontal treatment at least once, female sex, older age, lower income, smaller residential areas, type of disability, and pulp vitality were found to be associated with tooth loss in individuals with disabilities aged 40~64 years with chronic periodontitis. To prevent tooth loss in individuals with disabilities, it is necessary to establish a dental treatment plan that considers the timing of periodontal treatment and the characteristics of the patient and teeth.

The Relationship between Perceived Family Functioning and Depression in Patients with Chronic Low-Back Pain (만성요통환자가 지각하는 가족기능과 우울의 관계)

  • Son Jung-Tae;Park Hyun-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.316-331
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    • 2000
  • This study was conducted using a descriptive correlational survey design to identify how patients with chronic low-back pain perceived family function and to examine the relationship between family function and depression. The participants of the study were 116 patients with chronic low-back pain patient who were having follow-up treatment in a local pain clinic, located in Daegu. A structured questionnaire was filled out participants themselves and the structured interview was given during January and February, 2000. The data collection instrument were FACE II-Korean version and Beck's Depression Inventory(1983). The data collected were analysed using mean, standard deviation(SD), t-test, F-test, Duncan test and Pearson correlation coefficient, done with SAS. The results are as follows; 1. The mean of the respondents' perceived family function was 3.47, with emotional bonding at 3.61, acceptability and sharing at 3.61, participation at 3.23, negotiation and satisfaction at 3.24 and responsibility and expectation at 3.76. 2. The mean of the respondents' perceived depression was $17.53{\pm}8.76$. 3. There was significantly negative correlation between family function and depression(r=-0.4817, p=.0001). 4. Research variables included demographic characteristics and showed that subjects who were aged 65 years or older showed significantly lower scores in patient's perceived family function than those who were aged 45 years or below(p=.0502). Perceived family function of females respondents were significantly lower than males(p=.0026). The illiterate showed significantly lower scores than other groups(p=.0001). Respondents with spouse and extended family tended to show significantly higher scores than those who were living with spouse only or by themselves alone(p=.0091). Those who had higher income showed significantly higher scores than in the lower income group(p=.0001). 5. For family function regarding pain characteristics, those who reported severe pain-related daily activity impediments showed significantly lower scores in family function than others with less pain(p=.0357).

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Rectal perforation caused by a sharp pig backbone in a middle-aged patient with mild depression (경도의 우울증이 있는 중년 남자에서 날카로운 돼지 척추뼈에 의한 직장천공)

  • Sun, Hyeong Ju;Lee, Jeonghun;Kim, Dong Min;Chu, Myeong-Su;Park, Kyoung Sun;Choi, Dong Jin
    • Journal of Yeungnam Medical Science
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    • v.32 no.1
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    • pp.31-34
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    • 2015
  • In Korea, cases of direct insertion of foreign bodies into the rectum are rare in the literature. Most cases of rectal insertion of foreign bodies are associated with sexual acts and psychiatric disorder such as schizophrenia. Objects inserted into the anus are usually blunt and shaped like the male genitalia. The removal method can be varied depending on the size and shape of the foreign object, its anatomical location, and the accompanying complications. In cases wherein attempts to remove the object fail or there are rectal perforation and peritonitis complications, immediate laparotomy may be required in order to prevent serious complications such as sepsis. Here, we report on a case of rectal perforation and peritonitis due to insertion of a foreign body in a middle-aged patient, with a literature review. He inserted a sharp pig backbone in his rectum and he only had depression. The patient underwent a Hartmann's operation as well as psychiatric counseling and treatment. Thus, after removal of foreign bodies, psychiatric counseling and treatment should be carried out in order to prevent similar accidents and to minimize the need for trauma medicine.