To identify the factors influencing the charges per case of acute appendicitis and normal spontaneous vaginal delivery (NSVD), the personal data-base files and hospital-characteristics-reporting data files of Korea Medical Insurance Corporation were analyzed. One hundred and twenty-nine institutions were selected. The results of this study were as follows: 1. The differences of charges per case with respect to hospital ownership, location, and equipment levels were statistically significant. 2. The results of multiple regression analysis revealed that bed capacity was the most significant variable in both diseases. 3. Ownership was significant variable in acute appendicitis. In NSVD, ownership and hospital equipment level were statistically significant. In conclusion, bed capacity was statistically the most significant variable in the analysis of charges per case. And we thought that the results of this study would influence the policy of the hospital bed supply.
Appendicitis* ; Information Storage and Retrieval ; Equipment and Supplies, Hospital ; Humans ; Insurance ; Korea ; Ownership

The most common cause of small bowel obstruction is postoperative adhesion, and besides a hernia, metastatic or primary cancer and small bowel tumors are possible causes. Superior mesenteric artery (SMA) syndrome is a rare cause of upper gastrointestinal obstruction and is associated with debilitating conditions with marked weight loss. SMA syndrome results from the compression of the third part of the duodenum due to the narrowing of the aortomesenteric angle. We report a 28-year-old woman with SMA syndrome after acute gastroenteritis. Her stomach was severely dilated due to the duodenal obstruction and computed tomography showed the compression of the third portion of the duodenum by SMA. She was conservatively cared for and thus favorably improved.
Adult ; Duodenal Obstruction ; Duodenum ; Female ; Gastroenteritis ; Hernia ; Humans ; Mesenteric Artery, Superior ; Stomach ; Superior Mesenteric Artery Syndrome ; Weight Loss

It is very important to estimate the future medical care expenditure, because medical care expenditure escalation is a big problem not only in the health industry but also in the Korean economy today. This study was designed to project the medical care expenditure in view of population age change. The data of this study were the population projection data based on National Census Data (1990) of the National Statistical Office and the Statistical Reports of the Korea Medical Insurance Corporation. The future medical care expenditure was eatimated by the regression model and the optional simulation model. The significant results are as follows; 1. The future medical care expenditure will be 3,963 billion Won in the year 2000, 4,483 billion Won in 2010, and 4,826 billion Won in 2020, based on the 1990 market price considering only the population age change. 2. The proportion of the total medical care expenditure in the elderly over 65 will be 10. 4% in 2000, 13.5% in 2010, and 16.9% in 2020. 3. The future medical care expenditure will be 4,306 billion Won in the year 2000, 5,1101 billion Won in 2010, and 5, 699 billion Won in 2020 based on the 1990 market price considering the age structure change and the change of the case-cost estimated by the regression model. 4. When we consider the age-structure change and inflation compared with the preceding year, the future medical care expenditurein 2020 will be 21 trillion Won based on a 5% inflation rate, 42 trillion Won based on a 7.5% inflation rate, and 84 trillion Won based on a 10% inflation rate. Consideration of the aged (65 years old and over)will be essential to understand the acute increase of medical care expenditure due to changes in age structure of the population. Therefore, alternative policies and programs for the caring of the aged should be further studied.
Aged ; Censuses ; Population Forecast ; Health Expenditures* ; Humans ; Inflation, Economic ; Insurance ; Korea

No abstract available.
Captopril* ; Child* ; Humans ; Nephrotic Syndrome*

No abstract available.
Captopril* ; Child* ; Humans ; Nephrotic Syndrome*

No abstract available.
Hemolytic-Uremic Syndrome* ; Mycoplasma Infections* ; Mycoplasma*

Accumulated data on medical care utilization among the insured in Korea Medical Insurance Corporation can explain the health status of the population. The purpose of this study was to analyze a change of the disease-mix and utilization pattern by controlling the size of the population enrollment. Major findings of the study are as follows: 1. The changes of inpatient disease-mix a. Utilization rate was 139.2% in 1988 against 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. Meanwhile, disease groups seen less often were infections and parasistic diseases, diseases of bloodforming, diseases of the digestive system etc. c. Utilization rate was up 106.3% in 1988 compared to 1985, and diseases above that average level were ill-defined intestinal infections, chronic liver disease and cirrhosis, diabetes mellitus, essential hypertension, etc. d. The disease-mix by institution in 1988 compared to 1985 shows that chronic disorders rank high in general hospitals whereas opthalmologic, obstetric, and orthopedic diseases rank high in private clinics. 2. The changes of outpatient disease-mix a. Utilization rate was up 175.2% in 1988 compared to 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. And disease groups seen less often were infections and parasistic diseases, diseases of the respiratory system, diseases of the genitourinary system. etc. c. Utilization rate was up 104.0% in 1988 compared to 1985, and diseases above that average level were gastric ulcer, diseases of hard tissues of teeth, etc. And diseases seen below that average level were acute nasopharyngitis (common cold), acute upper respiratory infections of multiple or unspecified sites, etc. It was concluded that medical care utilization level was increased, and that, from 1980 to 1988, disease-mix shifted to the chronic disorders. Chronic disorders accounted for more medical care utilization in general hospitals.
Diabetes Mellitus ; Digestive System ; Fibrosis ; Hospitals, General ; Humans ; Hypertension ; Inpatients ; Insurance ; Insurance, Health* ; Korea ; Liver Diseases ; Mental Disorders ; Nasopharyngitis ; Nutritional and Metabolic Diseases ; Orthopedics ; Outpatients ; Respiratory System ; Respiratory Tract Infections ; Stomach Ulcer ; Tooth ; Urogenital System

PURPOSE: Focusing manner is very powerful mind-body self-help and self-awareness competence. So focusing manner may affect nurses' emotional labor and nursing performance, but few are known about it to date. The purpose of this study was to identify the degree of focusing manner, emotional labor, nursing performance of clinical nurses, and the factors that affect nursing performance. METHODS: In order to collect data, structured questionnaires were administered to 212 nurses who worked at 2 university hospitals located in D city. Data were analyzed by t-test, ANOVA, correlation and multiple regression using SPSS/WIN 20.0. RESULTS: Nursing performance had positive relationship with focusing manner (r=.45, p<.001), and negative relationship with emotional labor (r=−.25, p<.001). And the most prediction factor influencing nursing performance was focusing manner (β=.41, p<.001) and the other factors were age (β=.30, p=.002), and emotional labor (β=.14, p=.012). The total variance was 37.1% by those predictors (F=25.87, p<.001). CONCLUSION: Based on the results of this study, it is necessary to develop and educational program on focusing manner-oriented psychotherapy in order to improve the nursing performance. Also, the management system for controlling emotional labor needs to be set up for nurses in clinical settings.
Hospitals, University ; Mental Competency ; Nursing ; Psychotherapy

Objectives: The objective of this study was to introduce the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT), to describe use cases of SNOMED CT with the barriers and facilitators, and finally, to propose strategies for adopting and implementing SNOMED CT in Korea as a member of SNOMED International. Methods: We reviewed a collection of SNOMED CT documents, such as introductory materials, practical guides, technical specifications, and reference materials provided by SNOMED International and the literature on SNOMED CT published by researchers to identify use cases of SNOMED CT with barriers and facilitators. We also surveyed the attendees of SNOMED CT education and training series offered by the Korea Human Resource Development Institute for Health and Welfare to identify perceived barriers to adopting SNOMED CT in Korea. Results: We identified the barriers and facilitators to adopt SNOMED CT experienced by international terminology experts and prospective Korean users. They were related to governance and infrastructure, support services for use, education and training programs, use cases, and vendor capability to implement SNOMED CT. Based on these findings, we identified strategies for adopting and implementing SNOMED CT in Korea. They included the establishment of SNOMED CT management infrastructure, the development of SNOMED CT education and training programs for various user groups, the provision of support services for SNOMED CT use, and the development of SNOMED CT use cases. Conclusions These strategies for the adoption and implementation of SNOMED CT need to be executed step by step.

PURPOSE: The aim of this study was to compare the film thicknesses of several resin cements as a function of time after mixing and to examine the effect of working time on the film thicknesses. MATERIALS AND METHODS: The film thickness (microm) of 4 resin cements (n=10), 1 composite resin (Panavia F 2.0), 3 self-adhesive resin (Clearfil SA luting, Zirconite, RelyX U200) cements was measured at 20-second intervals after mixing of the cements up to 200 seconds under a load of 50 N. Linear regression was fitted to verify the effect of working time on the film thickness of each cement. Data were compared to the working time recommended by manufacturers using Wilcoxon test (alpha=.05). RESULTS: All of the materials showed a positive linear correlation between the film thickness and working time. There was no statistically significant difference between the working time based on our results and the values recommended by the manufacturers even though there was a discrepancy between those two values. CONCLUSION: The film thickness of resin cements could increase with the increase of working time. Working time to meet the ISO standard of 50-microm maximum film thickness could be different from the manufacturer's recommended value.
Linear Models ; Resin Cements ; Resins, Synthetic*