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 descriptive correlation study was done to identify the hardiness, coping behavior, and organizational commitment of general hospital employees and show how these variables affect increases in role performance and problem solving ability to have a positive influence on organizational harmony. METHODS: A quantitative, descriptive research design was used with a sample of 368 employees working in general hospitals in M and C cities. A survey was used to collect the data. RESULTS: The score for perception of hardiness of general hospital employees was 2.85, and coping behavior was 2.40, both out of a possible 4 points, and organizational commitment, 3.03 out of a possible 5 points. There were statistically significant positive correlations between hardiness and coping behavior (r=.33, p<.001), also between hardiness and organizational commitment (r=.51, p<.001), and also between coping behavior and organizational commitment (r=.22, p<.001). CONCLUSION: The results of the study indicate that hardiness, coping behavior, and organizational commitment in general hospital employees have positive correlations, and thus hospital administrators should explore ways of increase individual employee hardiness and coping behavior, and make efforts to harmonize their organizations by enhancing organizational commitment.
Adaptation, Psychological ; Hospital Administrators ; Hospitals, General ; Humans ; Problem Solving ; Research Design ; Statistics as Topic

Tetanus is a neurologic disease which features the muscle spasm as the hallmark. It is an infectious disease with high mortality rate triggered by tetanospasmin produced by Clostridium tetani. This report concerns incidence of tetanus consequent to oriental medical care such as acupuncture and moxibustion. Although the tetanus occurrence has shown a remarkable decline since nationwide vaccinations in some of the developed countries, including Korea, it still remains to be an important issue, to be dealt within Korea, as the majority of the patients are old aged and Korean population is rapidly becoming an aging society. Furthermore, since more elders are coming to rely on Oriental medicine in Korea, the Korean elders are at a higher risk than elsewhere. The lack of medical experiences, including those in oriental medical field, has been hindering early diagnosis of Tetanus. This study aims to encourage rapid and accurate decisions in diagnosis and treatment through reviewing symptoms particularly specific to tetanus, and also to arouse attention to the riskiness of invasive procedures involving skin puncture.
Acupuncture ; Aged ; Aging ; Clostridium tetani ; Communicable Diseases ; Developed Countries ; Early Diagnosis ; Humans ; Incidence ; Korea ; Medicine, East Asian Traditional ; Metalloendopeptidases ; Moxibustion ; Punctures ; Skin ; Spasm ; Tetanus ; Tetanus Toxin ; Vaccination

PURPOSE: The purpose of this study was to identify muscle atrophy in critically ill patients on ventilators. A comparison was made between limb circumferences and muscle areas on the day of admission to an intensive care unit (ICU) and on the 8th day after admission. METHODS: The data were collected from 30 critically ill patients using ventilators at S hospital ICU in Seoul during the period from October 2005 to April 2006. Limb circumferences and skinfold thickness were measured on the day of admission and on the 8th day after admission to the ICU. Limb circumferences and skinfold thickness were measured on the right mid-arm, right mid-thigh, and right mid-calf using a measuring tape and a skinfold calipers. Limb muscle areas were calculated by an equation after measuring limb circumferences and skinfold thickness. The data were analyzed by paired t-test and independent t-test. RESULTS: 1) Mid-arm circumference, mid-thigh circumference and mid-calf circumference on the 8th day after admission to the ICU were significantly less than those on the day of admission to the ICU, 2) Mid-arm muscle area, mid-thigh muscle area and mid-calf muscle area on the 8th day after admission to the ICU were significantly less than those on the day of admission to the ICU, 3) Steroid and vecuronium medication didn't affect changes in limb circumferences (mid-arm, mid-thigh, mid-calf) and muscle areas (mid-arm, mid-thigh, mid-calf) on the 8th day after admission to the ICU compared to the day of admission. CONCLUSION: Limb muscle atrophy may occur on the 8th day after admission to the ICU in critically ill patients using ventilator.
Adult ; Aged ; Critical Illness ; Data Interpretation, Statistical ; Extremities/physiology ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Muscle, Skeletal/pathology ; Muscular Atrophy/*diagnosis/etiology/therapy ; Skinfold Thickness ; Steroids/administration & dosage ; *Ventilators, Mechanical

PURPOSE: This study was to develop and evaluate an individualized education program based on self-efficacy for patients with kidney transplantation in Korea. METHODS: A nonequivalent control group pretest-posttest design was used. The participants consisted of 43 patients who underwent kidney transplants at one hospital in Seoul, from July 2012 to April 2013. The experimental group received an individualized education based on self-efficacy in the hospital and follow-up telephone consultation in the 2nd and 3rd week after discharge. The control group received a routine discharge education. Knowledge, self-efficacy, and compliance related to kidney transplant were measured and analyzed by frequency, average, Mann-Whitney U test, Fisher's exact test, independent t-test, and chi2-test using SPSS Win 20.0. RESULTS: Significant differences were found in self-efficacy between the experimental group and the control group. But no significant differences were found in knowledge and compliance between two groups. The scores of several items on monitoring health status in compliance were higher in the experimental group than those of the control group. CONCLUSION: The results of this study demonstrate the fact that an education program based in self-efficacy for patients with kidney transplant would be effective in improving self-efficacy and the ability to monitor their health status.
Compliance ; Diet ; Education* ; Follow-Up Studies* ; Humans ; Kidney Transplantation ; Kidney* ; Korea ; Seoul ; Telephone*

Medically refractory ventricular tachycardia (VT) storm can be controlled with radiofrequency catheter ablation (RFCA), however, it may be difficult to control in some patients with hemodynamic overload. We experienced a patient with intractable VT storm controlled by hemodynamic unloading. The patient had mid-septal hypertrophic cardiomyopathy with an implantable cardioverter defibrillator (ICD) back-up. Because of the severe mid-septal hypertrophy, his left ventricle (LV) had an hourglass-like morphology and showed apical ballooning; the focus of VT was at the border of apical ballooning. Although we performed VT ablation because of electrical storm with multiple ICD shocks, VT recurred 1 hour after procedure. As the post-RFCA monomorphic VT was refractory to anti-tachycardia pacing or ICD shock, we reduced the hemodynamic overload of LV with beta-blockade, hydration, and sedation. VT spontaneously stopped 1.5 hours later and the patient has remained free of VT for 24 months with beta-blockade alone. In patients with VT storm refractory to antiarrhythmic drugs or RFCA, the mechanism of mechano-electrical feedback should be considered and hemodynamic unloading may be an essential component of treatment.
Cardiomyopathy, Hypertrophic/complications/diagnosis/*physiopathology/therapy ; Catheter Ablation ; Electrocardiography ; Gated Blood-Pool Imaging ; Heart Catheterization ; Humans ; Male ; Middle Aged ; Tachycardia, Ventricular/diagnosis/etiology/*physiopathology/therapy ; Takotsubo Cardiomyopathy/complications/diagnosis/*physiopathology/therapy

Objectives: This study was conducted to investigate the effect of quality of life and interpersonal relationship satisfaction on academic achievement among dental hygiene students. Methods: A survey was conducted on 210 dental hygiene students from Chungcheong, Jeolla, and Gyeongsang. Results: The factors affecting the academic achievement of dental hygiene students were interpersonal relationship satisfaction (β=0.489), quality of life (β=0.243), and grade_dum3 (<2.5/≥3.5; β=0.206). The most significant factor was interpersonal satisfaction, with an explanatory power of 37%. Conclusions As a result of the above, it was found that quality of life and interpersonal satisfaction were closely related to the academic achievement of dental hygiene students. Further research on ways to improve academic achievement is needed.

PURPOSE: The study was performed to investigate the effects of empathy on interpersonal relationships through the mediating effect of ego-resilience in nursing students. METHODS: Data were collected from June 5 to 30, 2018 using a self-report questionnaire measuring empathy, interpersonal relationships and ego-resilience. The sample was 204 nursing college students. SPSS WIN 23.0 programs were used to analyze the data. RESULTS: Ego-resilience was positively related to empathy (r=.37, p < .001) and interpersonal relationships (r=.36, p < .001) and empathy was positively related to interpersonal relationships (r=.37, p < .001). Regression analysis showed that ego-resilience was affected by empathy (β=0.37, p < .001), interpersonal relationships were affected by empathy (β=0.37, p < .001). Interpersonal relationships were affected by empathy (β=0.28, p < .001) and ego-resilience (β=0.26, p < .001). Therefore ego-resilience mediates between empathy and interpersonal relationships. CONCLUSION: It is necessary to develop an effective intervention program to improve nursing students' empathy and ego-resilience.
Education, Nursing ; Empathy ; Humans ; Interpersonal Relations ; Negotiating ; Nursing ; Students, Nursing

PURPOSE: This study aimed to investigate the effect of smoking duration, smoked cigarettes per day and smoking cessation period on pulmonary function among ex-smokers: based on the 6th Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: This study was analyzed using the 6th KNHANES data. Pulmonary function tests were performed on a total of 4,214 adults (>40 years old). A total of 770 adults ex-smokers were eligible for inclusion in the final analysis. Forced vital capacity (FVC), forced expiratory volume in one second (FEV₁) and FEV₁/FEV were measured to evaluate pulmonary function. RESULTS: This study showed that there were significant differences in both FEV₁ and FVC values based on gender, age and height, among ex-smokers. FEV₁/FVC significantly differed by age, height and the smoking duration prior to smoking cessation. Multiple regression analysis revealed that, FEV₁/FVC accounted for 26.0% of the variance by age, height and smoking duration. There was a difference in the mean value of FEV₁/FVC with or without smoking for more than 10 years. CONCLUSION: This study's findings show that smoking for over 10 years in an ex-smoker can lead to problems with the respiratory system. The long-term cigarette has progressive ill effects on the respiratory system.
Adult ; Forced Expiratory Volume ; Humans ; Korea ; Lung Diseases ; Nutrition Surveys ; Respiratory Function Tests ; Respiratory System ; Smoke ; Smoking Cessation ; Smoking ; Tobacco Products ; Vital Capacity