1.Comparative study on medical fees: caesarean section, cataract, and appendectomy surgeries among OECD countries.
Changwoo LEE ; Hae Jong LEE ; So Jung PARK
Journal of the Korean Medical Association 2013;56(6):523-532
The question has been raised whether the medical fee schedule is very low in Korea. However, studies that empirically address this matter on a national scale are rare. This study attempted to determine the level of Korea's medical fees for caesarean section (C-section), cataract, and appendectomy surgeries by comparing and analyzing them with other Organization for Economic Cooperation and Development (OECD) countries' medical cost data obtained from other studies. There are two ways to compare the level of medical fees: one is a direct comparison, which obtains each country's medical fee schedule and compares them with each other. Another is indirect comparison, a method which compares data such as physician income. For direct comparison, fees were calculated using data provided by the OECD and Health Insurance Review and Assessment. For indirect comparison by physician income, data obtained from Korea Employment Information Services were used to represent Korean physician income. When compared with other OECD countries, the results suggest that, overall, the Korean fee schedule could be low, based on the fees for C-section, cataract, and appendectomy surgeries. The study results also confirm that Korean physicians' average earnings ranked relatively low among OECD countries. These results are meaningful in that they empirically support the contention that Korean medical fees could be low. In addition, under what is known as national health insurance, in which the medical fee schedule is determined by a single payer, an empirical analysis on medical fee levels, as in this study, has substantial political implications because it may be utilized for medical fee schedule negotiation in the near future. An attempt to directly research fees and the range of services of OECD countries is still needed in order to provide more established data.
Appendectomy
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Appointments and Schedules
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Cataract
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Cesarean Section
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Employment
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Fee Schedules
;
Fees and Charges
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Fees, Medical
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Female
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Information Services
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Insurance, Health
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Korea
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National Health Programs
;
Negotiating
;
Pregnancy
2.Patient satisfaction versus political support: Korea's drug-dispensing law revisited.
Euichul SHIN ; Changwoo LEE ; Jinkyung KIM ; Kwang Jum KIM
Journal of the Korean Medical Association 2012;55(7):676-684
In 2000, Korea enacted a controversial law prohibiting doctors from dispensing drugs. Doctors have opposed this law, and in theory, the law inconveniences patients. We assessed the relationship between patients' satisfaction with drug dispensation and their overall support for the law by using a logit model to determine the effects of the law on patients and which patients are likely to support the law. We employed random digit dialing and obtained a sample of 540 adults who had used drugs since the law was enacted. We collected the data through phone interviews. The results indicate that the respondents were generally dissatisfied with the law regardless of sociodemographic or regional characteristics. However, with other factors controlled for, those respondents from the same region as the ruling political party were significantly more likely to support the law. This implies that regional politics influenced the policymaking process through which the law was crafted and enacted.
Adult
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Health Policy
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Humans
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Jurisprudence
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Korea
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Logistic Models
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Patient Satisfaction
;
Politics
;
Surveys and Questionnaires
3.The Difference of the 2nd to 4th Digit Length Ratio betweenType I and Type II Alcoholism.
Changwoo HAN ; Yu Sang LEE ; Woong HAHM ; Sung Doo WON
Journal of the Korean Society of Biological Psychiatry 2011;18(4):260-266
OBJECTIVES: The second to fourth digit ratio (2D : 4D) is known to reflect testosterone level during intrauterine period. Testosterone is essential for masculinization of brain. Cloninger's type II alcoholism is characterized by early age at onset and largely limited to males. Compared with type I alcoholism, type II alcoholism is thought to be masculine. There is a possibility that the digit ratio of type II alcoholism is low compared with type I. We examined digit length ratio in Cloninger's type I and II alcoholism to understand the effects of intrauterine testosterone on the development of alcoholism. METHODS: The participants were 87 alcohol dependent patients. We divided two subtypes of patients by Irwin's symptom list, based on Cloninger's concept. We captured the images of both palms by the scanner and measured the lengths of digits by the graphic program. Then we analyzed the digit ratios by independent-sample t-test. RESULTS: The mean 2D : 4D of type I was 0.942 (right), 0.952 (left). The mean 2D : 4D of type II was 0.927 (right), 0.940 (left). In both hands, 2D : 4D of type II was significantly lower than type I. CONCLUSIONS: Type II alcoholism showed masculine type of digit length ratio compared with type I. It suggests the exposure of testosterone during intrauterine period might play an important role in determining the course and feature of alcoholism.
Alcoholism
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Brain
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Hand
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Humans
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Male
;
Testosterone
4.Factors Influencing the COVID-19 Infection Control Practice of Physical Therapists
Journal of Korean Physical Therapy 2022;34(6):304-311
Purpose:
The purpose of this study was to investigate the knowledge, awareness and performance of COVID-19 infection control among physical therapists and to identify the impact factors on performance Methods: Data were collected from March 16th to March 24th in 2022 from the physical therapist’s in Busan. Data analysis was conducted on 170 surveys, after excluding 27 surveys that were found to be unsuitable for data analysis.
Results
When correlating the study variables, knowledge and awareness were found to have a positive, meaningful correlation with performance. Performance of COVID-19 personal infection control regression analysis showed that the working department (clinic and long-term care hospital), clinical experience, the more knowledgeable, the awareness (personal), and the more clinical experience had significant positive impacts on the performance of COVID-19 infection control. Performance of COVID-19 treatment room infection control regression analysis showed that the working department (long-term care hospital), educational experience, the awareness (treatment room) had significant positive impacts on the performance of COVID-19 infection control Conclusion: The results of this study may be used as basic data for educating physical therapist’s working at the COVID-19 response department. This study suggests that physical therapist’s need educational programs to improve their knowledge and awareness and performance of infection control against infectious diseases such as COVID-19. Differentiated physical therapists practice education curricula must be developed and provided after understanding the varying characteristic of physical therapist’s with different levels of work experience.
5.The Development of the Mission · Vision · Core Values for Korean NeuroPsychiatric Association.
Changwoo HAN ; Kounseok LEE ; Han Yong JUNG ; Kang Joon LEE ; Chul Eung KIM
Journal of Korean Neuropsychiatric Association 2017;56(4):139-145
Awareness of public mental health has increased due to drastic changes in society, and issues concerning the rights of mentally ill patients have emerged. The Korean NeuroPsychiatric Association (KNPA) has examined the current environment and proposed directions for improvement of this field. As the step for the implementation of the development of the mission · vision · core values for KNPA, KNPA have gone on the effort to improve public mental health letting people realize of the work that KNPA have carried out and help members work together. The committee of special mission of KNPA began in 2016 and held its first meeting on March 25 with professional consultants. They researched and collected information, carried out interviews, surveys, analyzed various opinions, and examined information and materials throughout 7 meetings. The special members of KNPA submitted agendas to the board of directors on September 9th, and the provisional board committee debated and decided the final agendas on September 24th. They announced the mission · vision · core values for KNPA on October 28th at the great autumn congregation held in Kimdaejung Convention Center in Kwangju. The event has proved that all members of KNPA have cooperated for the rights and interest of the committee, and will lead the public mental health of our society. This will provide the basis for the better life of our society.
Consultants
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Gwangju
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Humans
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Linear Energy Transfer
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Mental Health
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Mentally Ill Persons
6.Utilization of Hospitals Located Outside Patients' Residential Areas among Those with Acute Cerebral Infarction
Sae Young LEE ; Stella Jung Hyun KIM ; Keun Young PARK ; Ji Man KIM ; Han Joon KIM ; Changwoo LEE ; Euichul SHIN
Health Policy and Management 2018;28(1):48-52
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.
Cerebral Infarction
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Delivery of Health Care
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Emergency Service, Hospital
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Gangwon-do
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Humans
;
Logistic Models
;
Seoul
7.Reliability and Validity of the Appropriateness Evaluation Protocol for Public Hospitals in Korea
Clara LEE ; Stella Jung Hyun KIM ; Changwoo LEE ; Euichul SHIN
Korean Journal of Preventive Medicine 2019;52(5):316-322
OBJECTIVES: This study was conducted to assess the applicability of the Appropriateness Evaluation Protocol (AEP) for public hospitals in Korea. METHODS: In May 2016, 1500 admission claims were collected from Korean public district hospitals using stratified random sampling. Of these claims, 560 admissions to 37 hospitals were retrieved for analysis. Medical records administrators determined the appropriateness of admission using the criteria detailed in the AEP, and a physician separately assessed the appropriateness of admission based on her clinical judgment. To examine the applicability of the AEP, the concordance of the decisions made between a pair of AEP reviewers and between an AEP reviewer and a physician reviewer was compared. RESULTS: The results showed an almost perfect inter-rater agreement between the AEP reviewers and a moderate agreement between the AEP reviewers and the physician. The sensitivity and specificity of the AEP were calculated as 0.86 and 0.56, respectively. CONCLUSIONS: Our findings suggest that the AEP could potentially be applied to Korean public hospitals as a reliable and valid instrument for assessing the appropriateness of admissions.
Administrative Personnel
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Hospitals, District
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Hospitals, Public
;
Humans
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Judgment
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Korea
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Medical Records
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Reproducibility of Results
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Sensitivity and Specificity
8.Reliability and Validity of the Appropriateness Evaluation Protocol for Public Hospitals in Korea
Clara LEE ; Stella Jung Hyun KIM ; Changwoo LEE ; Euichul SHIN
Journal of Preventive Medicine and Public Health 2019;52(5):316-322
OBJECTIVES:
This study was conducted to assess the applicability of the Appropriateness Evaluation Protocol (AEP) for public hospitals in Korea.
METHODS:
In May 2016, 1500 admission claims were collected from Korean public district hospitals using stratified random sampling. Of these claims, 560 admissions to 37 hospitals were retrieved for analysis. Medical records administrators determined the appropriateness of admission using the criteria detailed in the AEP, and a physician separately assessed the appropriateness of admission based on her clinical judgment. To examine the applicability of the AEP, the concordance of the decisions made between a pair of AEP reviewers and between an AEP reviewer and a physician reviewer was compared.
RESULTS:
The results showed an almost perfect inter-rater agreement between the AEP reviewers and a moderate agreement between the AEP reviewers and the physician. The sensitivity and specificity of the AEP were calculated as 0.86 and 0.56, respectively.
CONCLUSIONS
Our findings suggest that the AEP could potentially be applied to Korean public hospitals as a reliable and valid instrument for assessing the appropriateness of admissions.
9.The Ratio of 2nd to 4th Digit Length in Korean Alcohol-dependent Patients.
Changwoo HAN ; Hwallip BAE ; Yu Sang LEE ; Sung Doo WON ; Dai Jin KIM
Clinical Psychopharmacology and Neuroscience 2016;14(2):148-152
OBJECTIVE: The ratio of 2nd to 4th digit length (2D:4D) is a sexually dimorphic trait. Men have a relatively shorter second digit than fourth digit. This ratio is thought to be influenced by higher prenatal testosterone level or greater sensitivity to androgen. The purpose of this study is to investigate the relationship between alcohol dependence and 2D:4D in a Korean sample and whether 2D:4D can be a biologic marker in alcohol dependence. METHODS: In this study, we recruited 87 male patients with alcohol dependence from the alcohol center of one psychiatric hospital and 52 healthy male volunteers who were all employees in the same hospital as controls. We captured images of the right and left hands of patients and controls using a scanner and extracted data with a graphics program. We measured the 2D:4D of each hand and compared the alcohol dependence group with the control group. We analyzed these ratios using an independent-samples t-test. RESULTS: The mean 2D:4D of patients was 0.934 (right hand) and 0.942 (left hand), while the mean 2D:4D of controls was 0.956 (right hand) and 0.958 (left hand). Values for both hands were significantly lower for patients than controls (p<0.001, right hand; p=0.004, left hand). CONCLUSION: Patients who are alcohol dependent have a significantly lower 2D:4D than controls, similar to the results of previous studies, which suggest that a higher prenatal testosterone level in the gonadal period is related to alcoholism. Furthermore, 2D:4D is a possible predictive marker of alcohol dependence.
Alcoholism
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Biomarkers
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Epigenesis, Genetic
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Gonads
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Hand
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Hospitals, Psychiatric
;
Humans
;
Male
;
Testosterone
;
Volunteers
10.Clinical Correlates of Subtype and Severity in Patients with Delirium.
Taehyeon AN ; Youngsun RA ; Changwoo HAN ; Hyun Soo KIM ; Kye Seong LEE ; Hwallip BAE
Journal of Korean Neuropsychiatric Association 2015;54(4):489-494
OBJECTIVES: Delirium is commonly seen in clinical settings, and it can substantially influence the prognosis of patients. In this study, we investigated delirium with respect to its severity, classification and characteristics on each subtype. METHODS: Severity of delirium was examined in delirium patients, who were referred to the department of psychiatry in a general hospital for multidisciplinary treatment. After classification based on subtypes, factors influencing these aspects of delirium were examined. RESULTS: Among the 193 consultation-liaison patients referred to the department of psychiatry in a general hospital, 61 patients (31.6%) were diagnosed with delirium. Compared to patients in the non-delirium group, patients in the delirium group were older, had a shorter education period, and medical history of surgery. Among the delirium patients, the hyperactive subtype was found to be the most common (57.4%) and patients with the mixed subtype showed the highest severity score for delirium symptoms. In addition, the patient with the hypoactive subtype had a higher frequency of medical history of depression compared to those with the other subtypes. CONCLUSION: People with symptoms of hypoactive delirium can be misdiagnosed due to recurrence of depression, therefore, careful examination is required, particularly in patients with a history of depression.
Classification
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Delirium*
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Depression
;
Education
;
Hospitals, General
;
Humans
;
Prognosis
;
Recurrence