The Korean government operates a fee-for-service system, as well as a diagnosis-related group (DRG) payment system that only applies to 7 different specific disease groups. To control rapidly increasing health expenditures, the Korean government adopted a compulsory DRG payment system for 7 disease groups in 2013. However, the current Korean DRG (K-DRG) system does not address the cost of new medical technologies and accompanying services, whereas the United States and European countries have implemented incentive systems within the DRG payment system to promote technological innovations. The Korean government is expanding the accessibility of new medical technologies to strengthen the coverage of 4 major conditions with a selective reimbursement system, but the K-DRG system is inconsistent with the selective reimbursement system in terms of adopting new medical technology. Such inconsistency is clearly shown in the case of advanced energy devices that are essential for surgical procedures. Despite their clinical usefulness and the high demand for such instruments, there is little space for compensation for advanced energy devices in DRG groups. Neither healthcare providers nor patients can choose selectively reimbursed medical devices under the current DRG system, leading to unequal healthcare benefits among patient groups. This paper proposes additional payments for new medical technology that is costly but clinically effective to ensure patient access to new medical technology under the K-DRG system, and suggests that a fair and consistent policy would be to apply the selective reimbursement of medical services in K-DRG.
Compensation and Redress ; Delivery of Health Care ; Diagnosis-Related Groups* ; Health Expenditures ; Health Personnel ; Humans ; Inventions ; Korea* ; Motivation ; United States

The Korean government operates a fee-for-service system, as well as a diagnosis-related group (DRG) payment system that only applies to 7 different specific disease groups. To control rapidly increasing health expenditures, the Korean government adopted a compulsory DRG payment system for 7 disease groups in 2013. However, the current Korean DRG (K-DRG) system does not address the cost of new medical technologies and accompanying services, whereas the United States and European countries have implemented incentive systems within the DRG payment system to promote technological innovations. The Korean government is expanding the accessibility of new medical technologies to strengthen the coverage of 4 major conditions with a selective reimbursement system, but the K-DRG system is inconsistent with the selective reimbursement system in terms of adopting new medical technology. Such inconsistency is clearly shown in the case of advanced energy devices that are essential for surgical procedures. Despite their clinical usefulness and the high demand for such instruments, there is little space for compensation for advanced energy devices in DRG groups. Neither healthcare providers nor patients can choose selectively reimbursed medical devices under the current DRG system, leading to unequal healthcare benefits among patient groups. This paper proposes additional payments for new medical technology that is costly but clinically effective to ensure patient access to new medical technology under the K-DRG system, and suggests that a fair and consistent policy would be to apply the selective reimbursement of medical services in K-DRG.
Compensation and Redress ; Delivery of Health Care ; Diagnosis-Related Groups* ; Health Expenditures ; Health Personnel ; Humans ; Inventions ; Korea* ; Motivation ; United States

PURPOSE: This study was conducted to examine the effect of oral care with an aroma solution on oral status and oral cavity microorganism growth in elderly patients with stroke. METHODS: A non-equivalent control group, with a pretest-posttest design was used in this study. The participants were assigned to the experimental group (n=30) that received oral care with an aroma solution or the control group (n=31) that received 0.9% saline solution. To identify the effect of the experimental treatments, objective/subjective assessments of oral status and oral cavity microorganism growth were performed using the oral assessment guide, oral perception guide, and oral swab culture. Data were analyzed using Chi-square test, Fisher's exact test, and t-test with the SPSS version 21.0 program. RESULTS: The objective oral status was significantly lower in the experimental group than in the control group (t= -3.64, p<.001). There was no significant difference between the subjective oral status of the experimental group and control groups (t= -1.24, p=.109). Oral microorganism growth was significantly lower in the experimental group than in the control group (t= -7.39, p<.001). CONCLUSION: These findings indicate that special mouth care using an aroma solution could be an effective oral health nursing intervention for elderly patients with stroke.
Aged ; Aged, 80 and over ; *Aromatherapy ; Bacteria/growth & development/isolation & purification ; Chi-Square Distribution ; Female ; Humans ; Male ; Mouth/*microbiology ; Mouth Diseases/microbiology ; *Oral Health/statistics & numerical data ; Stroke/*pathology

Purpose: The purpose of this study was to examine the effect of laughter therapy on the quality and quantity of sleep in elders with sleep disorders. Methods: This was a quasi-experimental study using a non-equivalent control group pretest-posttest design with 59 participants and included elders with sleep disorders, The Pittsburgh Sleep Quality Index (PSQI) scores of five or more points were: 29 in the experiment group and 30 in the control group. The experimental group participated in laughter therapy sixteen times, twice a week for 50 min per session for 8 weeks. Results: The results showed that laughter therapy was effective according to the PSQI (F=86.13, p<.001), total sleep time (F=9.34, p<.001), sleep efficiency (F=45.34, p<.001), sleep onset latency in the experimental group x2=13.77, p=.001, and in the control group x2=11.95, p=.003), number of awakenings (F=31.21, p<.001), light sleep (F=5.09, p=.008), deep sleep (F=15.13, p<.001), and serum melatonin levels (Z=-3.90, p<.001). but rapid eye movement sleep time did not differ significantly between the groups. Conclusion The results of the study indicate that laughter therapy may be an effective nursing intervention to improve quantity and quality of sleep in community-dwelling elderly.

Purpose: This study was done to examine the effects of auricular acupressure (AA) on blood pressure (BP) and stress responses in adults with prehypertension. Methods: This single-blind, randomized, placebo-controlled study was conducted from September 2019 to February 2020. Participants were recruited through bulletin board notices in D city. The experimental group (n=27) received 8 weeks of AA intervention on specific acupoints (shenmen, kidney, heart, occiput, adrenal gland) to reduce blood pressure and stress, whereas the control group (n=25) received AA unspecific acupoints (helix 1-5). The outcomes were measured using BP, perceived stress scale (PSS), cortisol, and heart rate variability (HRV). Collected data were analyzed using Fisher’s exact test, chi-square, Shapiro-Wilk normality test, paired t-test, independent t-test, Mann-Whitney U test, repeated measures ANOVA and Friedman test with the SPSS/WIN 24.0. Results: Statistical differences were found between the groups for systolic BP (x2=85.64, p<.001), diastolic BP (x2=27.76, p=.001), PSS (F=9.439, p=.003), low frequency (F=5.22, p=.027), heart rate (F=3.208, p=.045), and HRV index (F=3.579, p=.035). Cortisol did not differ significantly between the experimental group and control group. Conclusion The findings show that AA leads to improvements in BP and stress responses in adults with prehypertension. Therefore, AA can be used as an alternative nursing intervention for hypertension prevention and stress management.

PURPOSE: The purpose of this study was to investigate diabetic knowledge, self-care behaviors, and HbA1c of patients with diabetic mellitus in public hospitals. METHODS: Participants were 287 adult patients who had been diagnosed with diabetes in two public hospitals in Seoul. Collected data were analyzed using t-test, ANOVA, Pearson's correlation with the SPSS (PASW) 21.0 program. RESULTS: For general characteristics of the participants, there were significant differences in the level of diabetic knowledge according to age (F=11.28, p<.001), educational level (F=11.07, p<.001), type of health insurance (F=9.38, p<.001), and monthly income (t=-4.58, p<.001) and in the self-care behaviors according to age (F=8.61, p<.001) and in HbA1c according to age (F=6.72, p=.001). As for disease related characteristics of the participants, significant differences were found for self-care behaviors according to education about diabetes (t=3.90, p<.001) and in HbA1c according to education about diabetes (t=3.26, p=.001) and current diabetic therapy methods (F=13.51, p<.001). The study results showed that there was no correlation between diabetic knowledge and self-care behavior, or between self-care behavior and HbA1c. CONCLUSION: Results indicate that when developing preliminary data on nursing intervention education programs on diabetes, increasing diabetic knowledge and self-care behaviors would help to improve blood glucose levels.
Adult ; Blood Glucose ; Diabetes Mellitus ; Education ; Hemoglobin A ; Hospitals, Public* ; Humans ; Insurance, Health ; Nursing ; Self Care* ; Seoul

PURPOSE: To examine the effects of auricular acupressure on symptoms of patients with allergic rhinitis and their quality of life. METHODS: A quasi experimental was used with a nonequivalent control group pretest-posttest method involving 56 adult outpatients who were seen in the Allergy & Asthma clinic at a tertiary referral hospital in Seoul, Korea. The experimental group (n=28) received 2 weeks of auricular acupressure to the Shenmen, wind stream, endocrine, adrenal, and lung acupuncture points; no acupressure was provided to the control group (n=28). Outcome measures included Total Nasal Symptom Score used to assess nasal symptoms, and the Rhinoconjunctivitis Quality of Life Questionnaire to assess the quality of life. Repeated measure ANOVA and independent t-test were used to calculate statistical significance. RESULTS: The experimental group showed significant improvements in terms of allergic rhinitis symptoms (p < .001) and on the Rhinoconjunctivitis Quality of Life Questionnaire (p < .001) compared to the control group. CONCLUSION: Finding in this study indicate that auricular acupressure can be used as a nursing intervention to alleviate nasal symptoms and improve rhinoconjuctivitis quality of life in allergic rhinitis patients.
Acupressure* ; Acupuncture Points ; Adult ; Asthma ; Humans ; Hypersensitivity ; Korea ; Lung ; Methods ; Nursing ; Outcome Assessment (Health Care) ; Outpatients ; Quality of Life* ; Rhinitis ; Rhinitis, Allergic* ; Rivers ; Seoul ; Tertiary Care Centers ; Wind

South Korea implemented interventions to curb the spread of the novel coronavirus disease 2019 (COVID-19) pandemic with discovery of the first case in early 2020. Mathematical modeling designed to reflect the dynamics of disease transmission has been shown to be an important tool for responding to COVID-19. This study aimed to review publications on the structure, method, and role of mathematical models focusing on COVID-19 transmission dynamics in Korea. In total, 42 papers published between August 7, 2020 and August 21, 2022 were studied and reviewed. This study highlights the construction and utilization of mathematical models to help craft strategies for predicting the course of an epidemic and evaluating the effectiveness of control strategies. Despite the limitations caused by a lack of available epidemiological and surveillance data, modeling studies could contribute to providing scientific evidence for policymaking by simulating various scenarios.

Airway management is challenging during general anesthesia particularly in small infants. Airway obstruction is prone to occur in premature infants during general anesthesia due to several reasons. We report a case of airway obstruction occurred during the induction of general anesthesia in a 2-month-old infant. Several attempts at endotracheal intubation with positive pressure ventilation resulted in repeated patterns of no end-tidal carbon dioxide output after each trial of endotracheal intubation, but it was reappeared after extubation. However, anesthetic induction with self-respiration and gentle assistance with manual bagging led to a successful intubation. This case was explained by hydromechanics in a collapsible premature airway.
Airway Management ; Airway Obstruction* ; Anesthesia, General* ; Bronchial Spasm* ; Carbon Dioxide ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Intubation ; Intubation, Intratracheal ; Positive-Pressure Respiration

Objective: To investigate a measles outbreak that spread to Japan and Taiwan, China during March–May 2018, exploring the characteristics of the super-spreading event. Methods: A contact investigation of the index case and reconstruction of the epidemiological dynamics of measles transmission were conducted. Employing a mathematical model, the effective reproduction number was estimated for each generation of cases. Results and discussion A single index case gave rise to a total of 38 secondary cases, 33 in Japan and five in Taiwan, China. Subsequent chains of transmission were observed in highly vaccinated populations in both Japan and Taiwan, China. The effective reproduction number of the second generation was >1 for both Japan and Taiwan, China. In Japan, the reproduction number was estimated to be <1 during the third generation. Vaccination of susceptible individuals is essential to prevent secondary and tertiary transmission events.