1.Development And Evaluation Of Korean Diagnosis Related Groups: Medical Service Utilization Of Inpatients.
Young Soo SHIN ; Young Seong LEE ; Ha Young PARK ; Yong Kwon YEOM
Korean Journal of Preventive Medicine 1993;26(2):293-309
With expanded and extended coverage of the national medical insurance and fast growing health care expenditures, appropriateness of health service utilization and quality of care are concerns of both health care providers and insurers as well as patients. An accurate patient classification system is a basic tool for effective health care policies and efficient health services management. A classification system applicable to Korean medical information-Korean Diagnosis Related Groups (K-DRGs)-was developed based on the U. S. Refined DRGs, and the performance of the developed system was assessed in this study. In the process of the development, first the Korean coding systems for diagnoses and procedures were converted to the systems used in the definition of the U. S. Refined DRGs using the mapping tables formulated by physician panels. Then physician panels reviewed the group definition, and identified medical practice patterns different in two countries. The definition was modified for the difference in K-DRGs. The process resulted in 1,199 groups in the system. Several groups in Refined DRGs could not be differentiated in K-DRGs due to insufficient medical information, and several groups could not be defined due to procedures which were not practiced in Korea. However, the classification structure of Refined DRGs was retained in K-DRGs. The developed system was evaluated for its performance in explaining variations in resource use as measured by charges and length of stay(LOS), for both all and non-extreme discharges. The data base used in this evaluation included 373,322 discharges which was a random sample of discharges reviewed ad payed by the medical insurance during the five-month period from September 1990. The proportion of variance in resource use which was reduced by classifying patients into K-DRGs-r-square-was comparable to the performance of the U. S. Refined DRGs: .39 for charges and .25 for LOS for all discharges, and .53 for charges and .31 for LOS for non-extreme discharges. Another measure analyzed to assess the performance was the coefficient of variation of charges within individual K-DRGs. A total of 966 K-DRGs (87.7%) showed a coefficient below 100%, and the highest coefficient among K-DRGs with more than 30 discharges was 159%.
Classification
;
Clinical Coding
;
Delivery of Health Care
;
Diagnosis*
;
Diagnosis-Related Groups*
;
Health Expenditures
;
Health Personnel
;
Health Services
;
Humans
;
Inpatients*
;
Insurance
;
Insurance Carriers
;
Korea
2.Knee Ligament Injuries Combined with Tibial Condyle Fracture: Clinical Study of 30 Patients
Shin Ho CHANG ; Jae Do KANG ; Pil Seong HA ; Jun Hee LEE
The Journal of the Korean Orthopaedic Association 1988;23(3):722-732
Injuries to the ligament, bone and other supporting structures of the knee joint have a tendency to increase becsuse of the increasing traffics, popularity of sports and industrial accidents. It is well known that the knee joint is burdened on motion and weight bearing and structurally it is more frequently injuried than other joints. When there is injury to the knee, it is frequently combined with injury to ligaments and other supporting structures rather than pure tibial condyle fracture. There remains a residual instability of the knee joint because of neglecting of the injured ligaments if treatment is concerned only with tibial condyle fracture. To obtain complete recovery from the injury, early diagnosis, prompt treatment and well planned exercise are important. Thirty patients with ligaments injury and tibial condyle fracture who were treated at the Depsrtment of Orthopaedic Surgery of Wallace Memorial Baptist Hospital from 1983 to 1987 have been reviewed. Through combined operative and conservative treatment, excellant and good results were obtained in 93% of the cases.
Accidents, Occupational
;
Clinical Study
;
Early Diagnosis
;
Humans
;
Joints
;
Knee Joint
;
Knee
;
Ligaments
;
Protestantism
;
Sports
;
Weight-Bearing
3.Invasive aspergillosis of the maxillary antrum and lung in a patient with diabetes mellitus and liver cirrhosis
Ill Kyu KIM ; Seong Jun LEE ; Soo Yong HA ; Young Chae CHU ; Yong Woon SHIN
Journal of the Korean Association of Maxillofacial Plastic and Reconstructive Surgeons 1991;13(4):456-461
No abstract available.
Aspergillosis
;
Diabetes Mellitus
;
Humans
;
Liver Cirrhosis
;
Liver
;
Lung
;
Maxillary Sinus
4.Effect of the Mixture of Thrombin Powder and Gelfoam Powder on Control of Exposed Cancellous Bone Bleeding.
Sung Wan PARK ; Ha Young CHO ; Seung Myoung LEE ; Seong Hun JEONG ; Jin Kyu SONG ; Suk Jung JANG ; Ho SHIN
Journal of Korean Neurosurgical Society 2000;29(5):664-667
No abstract available.
Gelatin Sponge, Absorbable*
;
Hemorrhage*
;
Thrombin*
5.Anterior Decompression and Internal Fixation with Anterior Instrument and Surgical Titanium Mesh in Thoracolumbar Unstable Spine Injuries(Long-term Follow-up Results).
Hwan Min PARK ; Seung Myung LEE ; Ha Young CHO ; Ho SHIN ; Seong Heon JEONG ; Jin Kyu SONG ; Seok Jeong JANG
Journal of Korean Neurosurgical Society 2000;29(1):58-65
No abstract available.
Decompression*
;
Follow-Up Studies*
;
Spine*
;
Titanium*
6.Partial Pediculectomy for Spondylolisthesis with Radicular Pain Combined with Severe Osteoporosis.
Myoung Jin PARK ; Ho SHIN ; Ha Young CHO ; Seung Myoung LEE ; Seong Hun JEONG ; Jin Kyu SONG ; Suk Jung JANG
Journal of Korean Neurosurgical Society 2000;29(1):51-57
No abstract available.
Osteoporosis*
;
Spondylolisthesis*
7.Two cases of conservative management of 10 and 8 week cervical pregnancies.
Seong Eun KIM ; Myoung Chan KIM ; Se Won SHIN ; Sang Byum HA ; Yong Seok CHOI ; Bong Choon JO
Korean Journal of Obstetrics and Gynecology 1999;42(9):2088-2093
Cervical pregnancy is a rare and dangerous form of ectopic pregnancy in which the blastocyst implants within the cervical canal below the internal os of the uterine cervix. The characteristic clinical sign is a severe asymptomatic uterine bleeding in early pregnancy or during curettage. Most cervical pregnancies result in early spontaneous abortion, complicated by severe hemorrhage from the eroded blood vessels within the cervical tissue. Because of uncontrolled profuse vaginal bleeding, total hysterectomy has been the mostly necessitated to control life-threatening bleeding. Transvaginal sonography allows early diagnosis, and conservative treatment (two-time treatment : first treatement with systemic or intraamnionic methotrexate, secondly with curettage or ligature of the uterine arteries) improves the patient's fertility. Successful treatment is defined as elimination of the cervical pregnancy with preservation of the uterus. We report two cases of cervical pregnancy managed, successfully with methotrexate, leucovorin and curettage.
Abortion, Spontaneous
;
Blastocyst
;
Blood Vessels
;
Cervix Uteri
;
Curettage
;
Cytochrome P-450 CYP1A1
;
Early Diagnosis
;
Female
;
Fertility
;
Hemorrhage
;
Humans
;
Hysterectomy
;
Leucovorin
;
Ligation
;
Methotrexate
;
Pregnancy*
;
Pregnancy, Ectopic
;
Uterine Hemorrhage
;
Uterus
8.A case of congenital dyserythropoietic Anemia.
Sang Oh NA ; Seong Hoon HA ; Hong Hoe KOO ; Hee Young SHIN ; Il Soo HA ; Hyo Seop AHN ; Doek Ja OH ; Myoung Hee PARK
Journal of the Korean Pediatric Society 1990;33(3):410-415
No abstract available.
Anemia, Dyserythropoietic, Congenital*
9.A prospective study of totally implanted venous access system in 19 children with cancer.
Kyung Duk PARK ; Eun Sil DONG ; Seong Hoon HA ; Hong Hoe KOO ; Hee Young SHIN ; Hyo Seop AHN ; Seong Eun JUNG ; Gui Won PARK
Journal of the Korean Pediatric Society 1993;36(5):687-692
A totally implanted venous access system was inserted in 19 children with cancer. The devices were utilized for the administration of antineoplastic drugs, parenteral fluids, antibiotics, and blood products. Total duration of implantation was 4,046 days for 23 implanted system (range 7-445 days). Complications included cather infection (0.247/100 catheter days), occlusion (0.692/100 catheter days), and dislodgement of needle (0.643/100 catheter days). There were major complications that necessitated removal of catheters, including systemic infections (0.09/100 catheter days) and complete occlusions (0.09/100 catheter days). The system was thought to be safe and convenient in chemotherapy, and permitted full physical activity.
Anti-Bacterial Agents
;
Antineoplastic Agents
;
Catheters
;
Child*
;
Drug Therapy
;
Humans
;
Motor Activity
;
Needles
;
Prospective Studies*
10.Cosmetic Results of Conservative Treatment for Early Breast Cancer.
BoKyoung KIM ; Seong Soo SHIN ; Seong Deok KIM ; Dong Young NOH ; Sung Whan HA
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2001;19(1):21-26
PURPOSE: This study was performed to evaluate the cosmetic outcome of conservative treatment for early breast cancer and to analyze the factors influencing cosmetic outcome. MATERIALS AND METHODS: From February 1992 through January 1997, 120 patients with early breast cancer were treated with conservative surgery and postoperative radiotherapy. The types of conservative surgery were quadrantectomy and axillary node dissection for 108 patients (90%) and lumpectomy or excisional biopsy for 10 patients (8.3%). Forty six patients (38%) received adjuvant chemotherapy (CMF or CAF). Cosmetic result evaluation was carried out between 16 and 74 months (median, 33 months) after surgery. The cosmetic results were classified into four categories, i.e., excellent, good, fair, and poor. The appearances of the patients' breasts were also analyzed for symmetry using the differences in distances from the sternal notch to right and left nipples. A logistic regression analysis was performed to identify independent variables influencing the cosmetic outcome. RESULTS: Cosmetic score was excellent or good in 76% (91/120), fair in 19% (23/120) and poor in 5% (6/ 120) of the patients. Univariate analysis showed that tumor size (T1 versus T2) (p=0.04), axillary node status (N0 versus N1) (p=0.0002), extent of surgery (quadrantectomy versus lumpectomy or excisional biopsy) (p=0.02), axillary node irradiation (p=0.0005) and chemotherapy (p=0.0001) affected cosmetic score. Multivariate analysis revealed that extent of surgery (p=0.04) and chemotherapy (p=0.0002) were significant factors. For breast symmetry, univariate analysis confirmed exactly the same factors as above. Multivariate analysis revealed that tumor size (p=0.003) and lymph node status (p=0.007) affected breast symmetry. CONCLUSION: Conservative surgery and postoperative radiotherapy resulted in excellent or good cosmetic outcome in a large portion of the patients. Better cosmetic results were achieved generally in the group of patients with smaller tumor size, without axillary node metastasis and treated with less extensive surgery without chemotherapy.
Biopsy
;
Breast Neoplasms*
;
Breast*
;
Chemotherapy, Adjuvant
;
Drug Therapy
;
Humans
;
Logistic Models
;
Lymph Nodes
;
Mastectomy, Segmental
;
Multivariate Analysis
;
Neoplasm Metastasis
;
Nipples
;
Radiotherapy