Determinants of Healthy Living Practice: County Approach / 보건행정학회지

Background@#The purpose of this study is to investigate the factors affecting the healthy living practice rate such as non-smoking, moderate drinking, walking, and low-salt diet by elementary municipality (so called, ‘si-gun-hu’). @*Methods@#The 2016 Korean Community Health Survey was used for the analysis. The theoretical model is founded upon the Anderson model, and both the multiple linear regression analysis and the beta regression analysis was performed for estimation. @*Results@#As a result of the beta regression analysis, healthy living practice rate was found to be significantly higher in the areas with a less number of cigarette retailers, participating in healthy city projects, a low proportion of people who perceive their body type as obesity, a higher proportion of women, and a lower proportion of spouses. @*Conclusion@#In order to improve healthy living practices, the regulations on health risk businesses, the spread of Healthy City project, and policy efforts awaring obesity are recommended.

Utilization of Hospitals Located Outside Patients' Residential Areas among Those with Acute Cerebral Infarction / 보건행정학회지

BACKGROUND: The current study evaluated the hospital utilization and characteristics of patients who received health care services for acute cerebral infarction outside their own residential area. METHODS: Using the 2014 national patient survey data, information on 2,982 patients diagnosed with acute cerebral infarction through emergency department were retrieved for the analyses. Multiple logistic regression was performed to investigate the characteristics associated with using hospitals outside residential area among patients diagnosed with acute cerebral infarction. RESULTS: Fifteen point nine percent of patients admitted for acute cerebral infarction utilized hospitals outside their residential area. Patients residing in a province were 7.7 times more likely to utilize hospitals located outside their residential areas compared to those living in Seoul metropolitan city. Patients living in Gangwon and Jeolla were 0.26 times and 0.48 times more likely to go to hospitals in different geographical areas. Also, patients within the age group of 80 years and over were 0.65 times less likely to be admitted to hospitals outside their residential area compared to those in their 40s–50s. CONCLUSION: The use of hospitals outside patient's residential area is shown to be substantial, given that the acute cerebral infarction requires immediate recognition and treatment. The findings on the geographical differences in the hospital utilization suggest further investigation.

Analysis of variations in anesthesia cost according to severity of physical status and cancer stage in colorectal cancer patients

BACKGROUND: Since the late 2000s, the number of anesthesia performed has increased yearly. However, there has not been research into the appropriate cost of anesthesia based on the difficulty of anesthesia performed, the number of medical personnel participated, and materials administered for anesthesia. The purpose of this study was to analyze the variations in anesthesia cost according to severity of their physical status and cancer stage in patients who had undertaken colorectal cancer surgeries. METHODS: In order to analyze the cost of anesthesia for colorectal cancer surgery, we used Electronic Data Interchange data from 2011 to 2012 of the three superior general hospitals in Seoul. Colorectal cancer codes were limited to seven codes included in the cancer screening statistics of the Health Insurance Review and Assessment Service. Based on these data, a frequency analysis and a multiple linear regression analysis were performed. RESULTS: There was no variation in the cost of anesthesia according to gender and age. However, the ASA physical status (PS) class and the cancer stage variables were confirmed to modify the anesthesia cost. CONCLUSIONS: These study imply that there is a difference in the technology used for anesthesia by medical personnel as well as the anesthesia related materials used according to the ASA PS and the cancer stage among patients having the same disease.

The State of Anesthetic Services in Korea: A National Survey of the Status of Anesthesia Provider in the 2011-2013 Period

Active involvement of anesthesiologists in perioperative management is important to ensure the patients' safety. This study aimed to investigate the state of anesthetic services in Korea by identifying anesthetic service providers. From the insurance claims data of National Health Insurance for 3 yr, the Korean state of anesthetic services was analyzed. The claims for anesthesia from the medical institutions which hire their own anesthesiologist or with an anesthesiologist invitation fee are assumed to be the anesthesia performed by anesthesiologists. The annual anesthetic data were similar during the study period. In 2013, total counts of 2,129,871 were composed with general anesthesia (55%), regional anesthesia (36%) and procedural sedation with intravenous anesthetics (9%). About 80% of total cases of general anesthesia were performed in general hospitals, while more than 60% of the regional anesthesia and sedation were performed in the clinics and hospitals under 100 beds. Non-anesthesiologists performed 273,006 cases of anesthesia (13% of total) including 36,008 of general anesthesia, 143,134 of regional anesthesia, and 93,864 of sedation, mainly in the clinics and hospitals under 100 beds. All procedural sedations in the institutions without direct employed anesthesiologist were performed by non-anesthesiologists. Significant numbers of anesthesia are performed by non-anesthesiologist in Korea. To promote anesthetic services that prioritize the safety of patients, the standard to qualify anesthetic service is required. Surgeons and patients need to enhance their perception of anesthesia, and the payment system should be revised in a way that advocates anesthesiologist-performed anesthetic services.

Current Status and Availability of Specialized Maternity Non-Standard Room for Delivering Mothers / 대한주산의학회잡지

PURPOSE: Demand of specialized maternity ward is increasing as national income level rises. However, the National Health Insurance limits the number of hospital's non-standard room to less than 50% of total hospital beds. Therefore, this research was performed to investigate the utilization rate of non-standard room among the Korean women who recently delivered baby in medical facilities in order to examine the factors affecting their selection. METHODS: One hundred sixty six medical facilities which deliver a minimum of ten cases in 2011 were selected and categorized by type, region, and size. A cross-sectional survey was done in November 2012 by a professional research survey company. Eight hundred and two pregnant women answered the questionnaire through a face-to-face interview. RESULTS: Of the 802 expecting mothers, 690 (86%) occupied non-standard room and 684 (85.2%) preferred non-standard room to the standard room. Satisfaction levels were significantly higher in mothers occupying non-standard room [5.9+/-1.0 vs. 5.4+/-1.2 (0-7 scale), P<0.01] and high-income families used non-standard room more often. Reasons for using non-standard room included adequate convalescence (78%), separate place for breastfeeding (6.1%), and convenience on receiving visitors (5.4%). Preference for non-standard room on next visit was higher in case of delivery compared to other cause of hospitalization (81.8% vs. 44.9%, P<0.001). CONCLUSIONS: Preference and actual use of non-standard room after delivery were significant. In spite of concrete preference, there was certain barrier in use of non-standard room according to the income and types of hospitals. Therefore, changes of policy such as insurance support for room charge may be needed in case of delivery.

Clinical study on therpeutic effects of Guided tissue regeneration by Nanogide-C(R) and Biomesh(R) in furcation defects / 대한치주과학회지

This study was designed to compare the effects of treatment using chitosan membrane (Nanogide-C(R)) resorbable barrier with control treated by polylactic acid/polylacticglycolic acid membrane(PLA/PLGA membrane, Biomesh(R)). 44 furcation defecs from 44 patients with class 2 furcation degree were used for this study, 22 sites of them were treated by chitosan membrane as experimental group and 22 site were treated by PLA/PLGA membrane as control group. Clinical parameters including probing depth, gingival recession, attachment level and radiographic examination were evlauated at base line, 1 month, 2 month and 3 month. after surgery. Statistical test used to analyze these data included paired t-test, one way ANOVA. The results are as follows : 1. Probing depth was significanlly decreased in the two group and there were significant differences between groups(p<0.05). 2. Gingival recession was not significanlly increased in the two group and there were no significant differences between groups(p<0.05). 3. Loss of attachment was statistically decreased in the two group and there were no significant differences between groups(p<0.05). 4. Horizontal bone level was significanlly increased in the two group and there were significant differences between groups(p<0.05). On the basis of these results, chitoans resorbable membrane has similar potential to PLA/PLGA membrane in GTR for furcation defect.