PURPOSE: The purpose of this study was to measure home health resource utilization using a Case-Mix Adjustor Model developed in the U.S. METHOD: The subjects of this study were 484 patients who had received home health care more than 4 visits during a 60-day episode at 31 home health care institutions. Data on the 484 patients had to be merged onto a 60-day payment segment. Based on the results, the researcher classified home health resource groups (HHRG). RESULT: The subjects were classified into 34 HHRGs in Korea. Home health resource utilization according to clinical severity was in order of Minimum (C0) < 'Low (C1) < 'Moderate (C2) < 'High (C3), according to dependency in daily activities was in order of Minimum (F0) < 'High (F3) < 'Medium (F2) < 'Low (F1) < 'Maximum (F4). Resource utilization by HHRGs was the highest 564,735 won in group C0F0S2 (clinical severity minimum, dependency in daily activity minimum, service utilization moderate), and the lowest 97,000 won in group C2F3S1, so the former was 5.82 times higher than the latter. CONCLUSION: Resource utilization in home health care has become an issue of concern due to rising costs for home health care. The results suggest the need for more analytical attention on the utilization and expenditures for home care using a Case-Mix Adjustor Model.
Risk Adjustment ; Middle Aged ; Male ; Korea ; Humans ; Home Care Services/*utilization ; Health Resources/*utilization ; Female ; Aged, 80 and over ; Aged ; Adult

Congenital M llerian anomalies of uterus are so infrequently encountered and endometriosis, primary infertility, hematometra, and urinary tract anomalies are claimed to be common complaints in women with unicornuate uterus. We report one case of rudimentary horn associated with agenesis of right kidney and pelvic endometriosis which is presented with brief review of literature about anomaly of the female genital tract.
Animals ; Endometriosis* ; Female ; Hematometra ; Horns* ; Humans ; Infertility ; Kidney* ; Urinary Tract ; Uterus

Purpose: This study investigated whether the work environment affects nurses' turnover intention with career motivation and job satisfaction acting as mediating factors. Methods: Data were collected from January 6-25, 2022, using a cross-sectional design. The participants were 205 nurses who had worked for more than six months at four small-to-medium-sized general hospitals in South Korea. Data analysis consisted of descriptive statistics, Pearson's correlation coefficients, independent t-tests, one-way ANOVAs, Scheffé test, and mediation analysis using Hayes’ PROCESS Macro Model 6. Results: The nursing work environment had a significant positive association with career motivation and job satisfaction and negative effects on nurses' turnover intention. The single mediating effect of job satisfaction and the serial mediation effects of career motivation and job satisfaction on the relationship between the nursing work environment and turnover intention were significant. Thus, nurses' positive perceptions of the work environment strengthened career motivation, which in turn increased job satisfaction and reduced turnover intention. Conclusion Providing a healthy work environment to nurses can help reduce their turnover intention. Therefore, the government and hospitals should implement human resource strategies to improve nursing work environments and take steps to enhance career motivation and job satisfaction to strengthen nurse retention.

PURPOSE: The purpose of this study was to investigate relationships among intention of retention, nursing organizational culture, empowering leadership and organizational socialization of new graduate nurses, and identify factors affecting intent to stay. METHODS: Data were collected from 184 new nurses who were graduated in 2017 and are now working in three tertiary hospitals. The relationship among the variables was analyzed with Pearson coefficient correlations and factors affecting intention of retention were identified by using multiple linear regression analysis. RESULTS: The mean score for intention of retention was 5.23±1.25 (out of 8). Intent to stay had positive relationships with innovation-oriented culture, relation-oriented culture, task-oriented culture, empowerment leadership, organizational socialization. Factors influencing intent to stay were ‘motivation for selection of nursing (β=.19, p<.001)’, ‘organizational commitment (β=.45, p<.001)’, ‘job identity (β=.18, p=.005)’, and ‘interpersonal relationship of personal characteristics (β=.16, p=.005)’ in organizational socialization, and ‘coaching (β=.29, p=.001)’, and ‘showing concerning (β=−.19, p=.036)’ by empowering leadership. These factors explained 53.0% of the variance in intention of retention (F=35.96, p<.001). CONCLUSION Focusing on the factors of influence derived from this study, relevant institutions and nursing organizations require the creation of a work environment and leadership to increase the retention of new graduate nurses.

Purpose: This study attempted to recommend a revision of inpatient nursing fees based on analyzing current and appropriate staffing levels. Methods: Staffing grades and their inpatient nursing fees as of the first quarter of 2022 were analyzed. Nurse managers and staff nurses answered surveys about the current and appropriate staffing levels, working days, and monthly salary. A total of 101 nurse managers and 588 staff nurses working in general wards at tertiary hospitals and general hospitals participated in the study. Results: The results showed that grade 1 staffing was found in 73.3% of tertiary hospitals and 63.7% of general hospitals. The current staffing ratios of tertiary hospitals and general hospitals were 1:9.3 and 1:10.4, respectively. The appropriate staffing ratios according to nurse managers and staff nurses at tertiary hospitals were 1:7.6 and 1:7.0, respectively, and 1:8.7 and 1:8.8 in general hospitals, respectively. The average estimated annual working days of staff nurses were 235.2 days in tertiary hospitals and 240.0 days in general hospitals. The median monthly salary for staff nurses was 4.957 million won in tertiary hospitals and 4.140 million won in general hospitals. The new staffing grade system was suggested from 1:6 (Grade 1) to 1:12 (Grade 5). The new inpatient nursing fee schedules were recommended to be paid based on nursing hours per patient day of each grade. Conclusion The new staffing grade and inpatient nursing fee schedules are expected to increase staffing levels, improve the quality of nursing care, and provide a better work environment for nurses.

PURPOSE: We quantified and described the economic burden of overactive bladder and stress urinary incontinence in Korea. We calculated direct costs by identifying public and private data sources that contain population-based data on resource utilization by patients with stress urinary incontinence and overactive bladder. METHODS: For estimating indirect costs (productivity loss), the human capital approach was applied. Data were collected from several institutes, including the Health Insurance Review Agency. RESULTS: The estimated total economic cost in treating overactive bladder was 117 billion Korean Won (KRW, the currency of South Koea) in 2006 and 145 billion KRW in 2007. The estimated total cost in treating stress urinary incontinence was 122 billion KRW in 2006 and 59 billion KRW in 2007. CONCLUSIONS: By quantifying the total economic costs of overactive bladder and stress urinary incontinence, this study provides an important perspective in Korea. Because the average age of the Korean population is rapidly increasing, this study provides important information on the direct and indirect costs of overactive bladder and stress urinary incontinence for an aging society.
Academies and Institutes ; Aging ; Costs and Cost Analysis ; Humans ; Information Storage and Retrieval ; Insurance, Health ; Korea ; Urinary Bladder, Overactive ; Urinary Incontinence

OBJECTIVE: To determine the safety and efficacy of immune ablation followed by autologous hematopoietic stem cell transplantation (HSCT) in refractory systemic lupus erythematosus (SLE). METHODS: Three patients who had been refractory to steroid and one or more immunosuppressive drug were included. Peripheral blood stem cells were mobilized with cyclophosphamide (CTX, 3 g/m(2)), followed by granulocyte-colony stimulating factor (5mug/kg/day). T lymphocytes were depleted from the graft by selection of CD34 positive cells. Conditioning regimens composed of high dose CTX (total dose 200 mg/kg) and anti-thymocyte globulin (total dose 90 mg/kg) in 2 patients and BEAM (BCNU 300 mg/m(2), etoposide 200 mg/m(2), cytarabine 200 mg/m(2), melphalan 200 mg/m(2)) in 1 patient. Stored stem cells were reinfused 48 hours after conditioning. RESULTS: Among 3 patients, first patient had lupus nephritis, second patient had overlap syndrome combined with rheumatoid arthritis (rhupus) and the last patient had severe thromobocytopenia and intractable polyserositis. No life threatening complications were observed during the treatment. All patients demonstrated rapid and marked improvement in organ function and quality of life just after HSCT. Previous massive proteinuria in first patient was decreased to less than 500 mg/day with 6 months follow up. Rhupus patient satisfied American college of rheumatology 70% response criteria with 3 months follow up. But third patient improved polyserositis dramatically 1 month after HSCT and relapsed at 9 weeks. CONCLUSION: In refractory SLE patients, HSCT can be performed safely with marked improvement and sustained withdrawal of all immunosuppressive medication. A further randomized trial is needed to confirm the efficacy and durability of remission.
Antilymphocyte Serum ; Arthritis, Rheumatoid ; Cyclophosphamide ; Cytarabine ; Etoposide ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Melphalan ; Proteinuria ; Quality of Life ; Rheumatology ; Stem Cells ; T-Lymphocytes ; Transplants

Leflunomide is a disease-modifying antirheumatic drug that has been available in Korea since 2003. Leflunomide induced interstitial pneumonitis has been reported as an adverse effect in other countries but not in Korea. A 57-year-old woman was treated with leflunomide since she had been resistant to methotrexate, hydroxychloroquine and sulfasalazine. She developed high fever, dyspnea, and non-productive cough 3 months after the administration of leflunomide. She was diagnosed leflunomide-induced interstitial pneumonitis based on history, physical, laboratory, radiologic and pathologic findings. The patient was treated by prednisolone 1 mg/kg/day with cholestyramine 24 g/day, resulting in dramatic improvement. Here we report a case of leflunomide induced pneumonitis treated successfully with high dose steroid.
Arthritis, Rheumatoid ; Cholestyramine Resin ; Cough ; Dyspnea ; Female ; Fever ; Humans ; Hydroxychloroquine ; Korea ; Lung Diseases, Interstitial* ; Methotrexate ; Middle Aged ; Pneumonia ; Prednisolone ; Sulfasalazine

OBJECTIVES: To assess the absorption of α-tocopherol acetate and 18β-glycyrrhetinic acid, which are used as active ingredients in toothpaste, into a reconstructed gingival tissue. METHODS: EpiGingival™ tissues were treated with a 25% slurry of toothpaste containing 2% α-tocopherol acetate and 0.3% 18β-glycyrrhetinic acid, for 2 minutes. The treatment was repeated up to 6 times, with 1 hour intervals. After completion of all treatments, the active ingredients in the tissue extracts and receiver solutions were measured by high performance liquid chromatography. RESULTS: Although α-tocopherol acetate was not detected, α-tocopherol was detected in the tissue extracts, indicating that α-tocopherol acetate was bioconverted to α-tocopherol after absorption. We could detect 18β-glycyrrhetinic acid both in the tissue extracts and in the receiver solutions, with a positive correlation to the number of treatments. CONCLUSIONS: We found that our toothpaste effectively delivered α-tocopherol acetate and 18β-glycyrrhetinic acid to a reconstructed gingival tissue in vitro.
Absorption* ; Chromatography, Liquid ; In Vitro Techniques* ; Periodontal Diseases ; Tissue Extracts ; Toothpastes

PURPOSE: This study identified the prevalence of depressive symptoms and explored correlates of depressive symptoms among Korean women care-workers caring older adults living in community. METHODS: A total of 465 participants were recruited for the study. Depressive symptoms was measured by the CES-D10 and distress was assessed using a single question given 5 Likert scale. RESULTS: The prevalence of depressive symptoms and distress among care-workers were 32.5% and 32.0% respectively. Work environment safety, violence exposure experience, work-family conflict, weekly care work time, and poor health status were significantly associated with depressive symptoms. Only violence exposure experience and poor health status were associated with distress. CONCLUSION: Our findings suggest more attention on mental health of care-workers and their risky work condition such as violence.
Adult* ; Depression* ; Exposure to Violence ; Female ; Humans ; Mental Health ; Prevalence ; Violence