No abstract available.
Hearing Loss, Sensorineural*

No abstract available.

A gap in the number of physicians caring for inpatients is expected in 2014 based on the restricted working hours for Korean medical residents. One potential solution is the use of hospitalists. The US hospitalist movement has proliferated due to high-quality care and economics. This movement has brought positive changes including a shorter length of hospital stay, increased quality of care, and greater patient satisfaction. Because the Korean government controls all suppliers and maintains a low financial compensation level for universal coverage, hospitals do not have the financial resources to introduce hospitalists. Therefore, in contrast to the US, the use of hospitalists must be developed as a cost-compensated system in Korea. Institutional strategies must be introduced to develop a hospitalist system in Korea. A hospitalist system in Korea would be distinct from that in the US. Further studies and specific strategies are needed that consider Korea's circumstances to effectively introduce a hospitalist system.
Compensation and Redress ; Hospital Medicine ; Hospitalists* ; Humans ; Inpatients ; Korea ; Length of Stay ; Patient Satisfaction ; Universal Coverage

Unmet healthcare needs are being used as an important indicator of the accessibility of healthcare services worldwide. To examine current status and trends of unmet needs in Korea, we used data from four sources: the Korea National Health and Nutrition Examination Survey (KNHANES, 2007–2017); the Community Health Survey (CHS 2008–2017); the Korea Health Panel Survey (KHP 2011–2015); and the Korean Welfare Panel Study (KOWEPS 2006–2017). The proportion of individual reporting unmet healthcare needs as of 2017 was 8.8% (KNHANES), 10.6% (CHS), and 12.4% (KHP as of 2015). The proportion of households reporting unmet healthcare needs due to cost was 0.5% (KOWEPS). Annual percentage change was −19.2%, −13.3%, −5.8%, and −13.3% respectively. Low income populations had more unmet healthcare needs than high income populations. However, unlike the last two studies, the main reason for unmet medical reasons was that there was no time regardless of income level.
Delivery of Health Care ; Family Characteristics ; Health Surveys ; Korea ; Nutrition Surveys ; Population Growth ; Poverty

Unmet healthcare needs do not end with the phenomenon itself, but lead to possibilities of increased severity of illness. Missed opportunities for treatment at the right timing increase possibilities of complications, and affect prognosis of disease. To examine current status and trends of unmet needs in Korea, we used data from four sources: the Korea National Health and Nutrition Examination Survey (KNHNES, '2007–2016); the Community Health Survey (CHS '2008–2016); the Korea Health Panel Survey (KHP '2011–2014); and the Korean Welfare Panel Study (KOWEPS '2006–2016). The proportion of individual reporting unmet healthcare needs as of 2016 was 8.8% (KNHNES), 11.5% (CHS), and 12.8% (KHP, as of 2014). Annual percentage change which characterizes trend for the follow-up period was −9.9%, −3.1%, and −1.3%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost was 1.8% (KNHNES), 1.5% (CHS), and 3.0% (KHP). The proportion of households reporting unmet healthcare needs due to cost was 1.0% (KOWEPS). Annual percentage change was −10.0%, −15.2%, −5.4%, and −17.5%, respectively. Low income populations had more unmet healthcare needs than high income populations. Therefore, in order to improve unmet healthcare needs, it is necessary to focus on low income populations.
Delivery of Health Care ; Family Characteristics ; Follow-Up Studies ; Health Surveys ; Korea ; Nutrition Surveys ; Population Growth ; Poverty ; Prognosis

The definition of a policy problem is important in all stages of the policy processes, and especially in presidential election seasons, which usually open the political window. We propose priorities among the policy problems of Korean healthcare by the positioning approach, which compares Korea with Organization for Economic Cooperation and Development (OECD) countries using OECD health data. The range of positioning is 1 to -1 where 1 is the best or highest level among OECD countries, 0 is the average level, and -1 is the worst or lowest level. The positioning results show that the overall health status of Korea is good (positioning=0.34), but the suicide rate (-1.00) is a major problem. Healthcare human resources are scarce (-0.46), but rapidly increasing. Hospital beds and medical equipments are over-supplied (respectively 0.37, 0.33), but medical equipments that are utilized mainly in tertiary hospitals are below average. The utilization of healthcare is at the top level in doctors' consultations (0.97) and average length of stay (0.65). The quality of in-patient care is good (0.35), but quality of out-patient care is poor (-0.36). Healthcare costs are low (-0.73), but their growth rate is high. Among healthcare costs, the policy problems are large pharmaceutical expenditures and many households with catastrophic expenditures. This study determined the priorities of healthcare policy problems in Korea. The next step is to search for the factors that influence these policy problems and develop their solutions.
Delivery of Health Care ; Family Characteristics ; Health Care Costs ; Health Expenditures ; Humans ; Korea ; Length of Stay ; Outpatients ; Referral and Consultation ; Seasons ; Suicide ; Tertiary Care Centers

PURPOSE: To investigate the effect of unilateral inferior oblique weakening procedures on contralateral inferior oblique muscle functions and factors that may have an effect on contralateral inferior oblique muscle overaction (IOOA). METHODS: A retrospective chart review was conducted of medical records of 40 patients who underwent unilateral inferior oblique (IO) muscle weakening procedures from 2007 to 2011 and were observed during a follow-up period of more than 6 months. These patients were composed of primary IOOA (4 patients), secondary IOOA due to superior oblique muscle (SO) palsy (21 patients), secondary IOOA due to inferior rectus muscle palsy (1 patient), and dissociated vertical deviation (DVD) accompanied with IOOA (14 patients). Factors that may have an effect on contralateral IOOA after undergoing the operation were assessed. RESULTS: There were 7 patients (17.5%) who had over +2 IOOA after operation. IOOA on contralateral eye was increased from average of +0.00 to average of +0.66 +/- 0.14 in 6 months after operation (p < 0.01). There were no statistically significant differences between preoperative factors and functional changes in contralateral IO muscle. CONCLUSIONS: There were no statistical factors that may have an effect on contralateral IOOA but the possibility of masked SO palsy before performing unilateral IO weakening procedures should be considered. In patients who have unilateral DVD associated with IOOA or small hypertropia, the contralateral IOOA can be more definite after operation; thus caution should be taken before operation.
Follow-Up Studies ; Humans ; Masks ; Medical Records ; Paralysis ; Retrospective Studies ; Strabismus

The term juxta-facet cyst has been used to characterize two types of periarticular cystic alterations, synovial and ganglion, that can occur in the paraspinal region. Synovial cysts arise from synovial outpouchings through the weakened or destroyed capsular tissue.Ganglion cysts are commonly found about the wrist and hand.But theoretically they can occur at any site in the body where periarticular connective tissue is present. In spinal canal these cysts may cause pressure on adjacent nerve root to produce a variety of neurological symptoms. The clinical features indicated an acute onset of symptoms favoring a diagnosis of disc herniation, so differential diagnosis is important.We have experienced two cases of the intraspinal extradural cysts connected to posterior longitudinal ligament by a sheath, causing nerve root compression. those were managed with excision of the cyst, and no recurrence has been identified during follow up evaluation.
Connective Tissue ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Ganglion Cysts ; Longitudinal Ligaments ; Radiculopathy ; Recurrence ; Spinal Canal ; Synovial Cyst ; Wrist

Chronic cavities of the dorsum of the foot often have bare bone and are unsuitable for free skin grafting. Local Flaps are often impossible because of surrounding scar tissue and dead space. A simple method is presented; it consists of the excision of the lesion, filling the cavity by a two staged random-pattern de-epithelialised turn over flap, and skin graft.
Cicatrix ; Foot ; Methods ; Skin ; Skin Transplantation ; Transplants

No abstract available.
Blepharoplasty*