Purpose: This study analyzed the characteristics of pediatric patients’ (≤ 18 years) intentional injury-related visits to the emergency department (ED) using National Emergency Department Information System data from January 1 through December 31, 2023, providing foundational evidence for prevention strategies and policy development. Methods: The injuries were categorized into unintentional and intentional, and relevant characteristics were compared between the 2 categories. The intentional injuries were further divided into self-harm and violence. Percentages were calculated for each variable and compared using the chi-square or Fisher exact tests. Results: Among 301,852 pediatric patients, those with intentional injuries showed higher proportions of girls, adolescents, visits in the wee hours, visits via firehouse ambulances, injuries by collision, by penetration, or by poisoning, hospitalization, Korean Triage and Acuity Scale levels 1-3, an ED length of stay of 2 hours or longer, and primary care by psychiatrists, than those with unintentional injuries. The pediatric patients with self-harm injuries showed higher proportions of girls, adolescents, visits in the wee or morning hours, visits via firehouse ambulances, injuries by collision, by penetration, or by poisoning, hospitalization or inter-facility transfer, Korean Triage and Acuity Scale levels 1-3, an ED length of stay of 2 hours or longer, and primary care by psychiatrists as well as by orthopedic surgeons or pediatricians, than those with violence injuries. Conclusion This study highlights the need to develop strategies per age and sex for preventing self-harm among pediatric patients, and to ensure safe and effective psychiatric care in EDs. In addition, the prevention of child abuse requires a multidisciplinary approach that includes preventive education programs, mandatory reporting in EDs, and the adoption of screening tools such as the Finding Instrument for Non-accidental Deeds.

Background: and Purpose Although gastrointestinal (GI) surgery can affect drug efficacy, its impact on oral anticoagulants (OACs) remains unclear. This study investigated the impact of GI surgery on the comparative effectiveness and safety of direct oral anticoagulants (DOACs) versus warfarin in atrial fibrillation (AF). Methods: Using a nationwide South Korean claims database, AF patients prescribed OACs between 2015 and 2021 were analyzed. The primary outcome was ischemic stroke, and secondary outcomes were major bleeding, all-cause death, and composite outcome (ischemic stroke, major bleeding, all-cause death). Outcomes were compared by OAC type (DOAC vs. warfarin) and GI surgery status using inverse probability of treatment weighting and a Fine–Gray subdistribution hazard model with time-varying covariates. Results: Among 388,214 AF patients (mean age, 71.9 yr; 42.7% male), 6,907 (1.8%) underwent GI surgery. The effect of GI surgery differed between warfarin and DOACs for ischemic stroke (Pint= 0.018), with increased risk for warfarin (adjusted HR [aHR]: 2.32; 95% confidence interval [CI] 1.17–4.62), but not for DOACs (aHR: 0.97 [95% CI 0.77–1.22]) after surgery. Effects of surgery on major bleeding, all-cause death, and composite outcome did not differ. In post–GI surgery setting, DOACs demonstrated lower ischemic stroke risk (aHR: 0.35 [95% CI 0.17–0.72]) and comparable risks for other outcomes. Exploratory analyses by surgery location suggested a more favorable profile of DOACs after upper GI surgery. Conclusions In AF patients, GI surgery significantly increased ischemic stroke risk among warfarin users, but not among DOAC users. DOACs showed generally favorable profiles after GI surgery and may remain a reasonable anticoagulant, with potentially more favorable profile after upper GI surgery.

Purpose: This study aims to develop and test the psychometric properties of a scale for measuring the continuity of care specific to home health care patients in the context of Korean long-term care insurance services. Methods: In phase 1, the initial item pool was created based on the concept analysis results using a literature review and in-depth interviews. Phase 2 evaluated the psychometric properties of the scale in the survey conducted in 2021 using a sample of 202 receiving longterm care visiting nursing services. Exploratory factor analysis (EFA) was used to examine the construct validity. An internal consistency was examined using Cronbach’s α. Known group validity and criterion validity were assessed. Results: The EFA suggested five factors: therapeutic relationship, coordination of care, service availability, customized care plan, and consistency in service provision. The internal consistency reliability of the continuity of care scale was satisfactory (Cronbach’s α=.96). Known-group validity was established by comparing the continuity of care scores for high utilizers of home-visiting nursing services and low utilizers of home-visiting nursing services. Criterion validity was confirmed through the correlation between the developed scale and the performance of the visiting nurse service scale. Conclusion The developed scale was found to be reliable and relatively valid for measuring the patient’s perceived continuity of care within the Korean long-term care visiting nursing system.

Purpose: This study aims to develop and test the psychometric properties of a scale for measuring the continuity of care specific to home health care patients in the context of Korean long-term care insurance services. Methods: In phase 1, the initial item pool was created based on the concept analysis results using a literature review and in-depth interviews. Phase 2 evaluated the psychometric properties of the scale in the survey conducted in 2021 using a sample of 202 receiving longterm care visiting nursing services. Exploratory factor analysis (EFA) was used to examine the construct validity. An internal consistency was examined using Cronbach’s α. Known group validity and criterion validity were assessed. Results: The EFA suggested five factors: therapeutic relationship, coordination of care, service availability, customized care plan, and consistency in service provision. The internal consistency reliability of the continuity of care scale was satisfactory (Cronbach’s α=.96). Known-group validity was established by comparing the continuity of care scores for high utilizers of home-visiting nursing services and low utilizers of home-visiting nursing services. Criterion validity was confirmed through the correlation between the developed scale and the performance of the visiting nurse service scale. Conclusion The developed scale was found to be reliable and relatively valid for measuring the patient’s perceived continuity of care within the Korean long-term care visiting nursing system.

Purpose: This study aims to develop and test the psychometric properties of a scale for measuring the continuity of care specific to home health care patients in the context of Korean long-term care insurance services. Methods: In phase 1, the initial item pool was created based on the concept analysis results using a literature review and in-depth interviews. Phase 2 evaluated the psychometric properties of the scale in the survey conducted in 2021 using a sample of 202 receiving longterm care visiting nursing services. Exploratory factor analysis (EFA) was used to examine the construct validity. An internal consistency was examined using Cronbach’s α. Known group validity and criterion validity were assessed. Results: The EFA suggested five factors: therapeutic relationship, coordination of care, service availability, customized care plan, and consistency in service provision. The internal consistency reliability of the continuity of care scale was satisfactory (Cronbach’s α=.96). Known-group validity was established by comparing the continuity of care scores for high utilizers of home-visiting nursing services and low utilizers of home-visiting nursing services. Criterion validity was confirmed through the correlation between the developed scale and the performance of the visiting nurse service scale. Conclusion The developed scale was found to be reliable and relatively valid for measuring the patient’s perceived continuity of care within the Korean long-term care visiting nursing system.

Purpose: This study aims to develop and test the psychometric properties of a scale for measuring the continuity of care specific to home health care patients in the context of Korean long-term care insurance services. Methods: In phase 1, the initial item pool was created based on the concept analysis results using a literature review and in-depth interviews. Phase 2 evaluated the psychometric properties of the scale in the survey conducted in 2021 using a sample of 202 receiving longterm care visiting nursing services. Exploratory factor analysis (EFA) was used to examine the construct validity. An internal consistency was examined using Cronbach’s α. Known group validity and criterion validity were assessed. Results: The EFA suggested five factors: therapeutic relationship, coordination of care, service availability, customized care plan, and consistency in service provision. The internal consistency reliability of the continuity of care scale was satisfactory (Cronbach’s α=.96). Known-group validity was established by comparing the continuity of care scores for high utilizers of home-visiting nursing services and low utilizers of home-visiting nursing services. Criterion validity was confirmed through the correlation between the developed scale and the performance of the visiting nurse service scale. Conclusion The developed scale was found to be reliable and relatively valid for measuring the patient’s perceived continuity of care within the Korean long-term care visiting nursing system.

Purpose: This study aims to develop and test the psychometric properties of a scale for measuring the continuity of care specific to home health care patients in the context of Korean long-term care insurance services. Methods: In phase 1, the initial item pool was created based on the concept analysis results using a literature review and in-depth interviews. Phase 2 evaluated the psychometric properties of the scale in the survey conducted in 2021 using a sample of 202 receiving longterm care visiting nursing services. Exploratory factor analysis (EFA) was used to examine the construct validity. An internal consistency was examined using Cronbach’s α. Known group validity and criterion validity were assessed. Results: The EFA suggested five factors: therapeutic relationship, coordination of care, service availability, customized care plan, and consistency in service provision. The internal consistency reliability of the continuity of care scale was satisfactory (Cronbach’s α=.96). Known-group validity was established by comparing the continuity of care scores for high utilizers of home-visiting nursing services and low utilizers of home-visiting nursing services. Criterion validity was confirmed through the correlation between the developed scale and the performance of the visiting nurse service scale. Conclusion The developed scale was found to be reliable and relatively valid for measuring the patient’s perceived continuity of care within the Korean long-term care visiting nursing system.

Purpose: The authors aimed to identify the factors affecting interhospital transfer (“transfer”) of severe pediatric patients who visited to an emergency department (ED). Methods: Using the Korean National ED Information System, we analyzed high-acuity patients aged 18 years or younger who visited EDs of local or regional emergency centers nationwide. The high acuity was defined as a Korean Triage and Acuity Scale 1-2. To investigate the factors associated with transfer, a multilevel modeling was selected, examining independent variables at both individual- and hospital-levels with transfer as a dependent variable. Results: A model consisting of variables at individual- and hospital-levels showed the factors as follows: mode of arrival(self-transport: odds ratio, 0.48 [95% confidence interval, 0.38-0.61]; other ambulances: 0.41 [0.24-0.71]; compared with firehouse ambulance), visit at 18:00-07:59 (0.75 [0.64-0.88]), intentional injury (1.59 [1.03-2.47]; compared with non-injury), decreased level of consciousness (drowsy: 1.94 [1.33-2.84]; stupor: 4.08 [2.99-5.57]; coma: 1.81 [1.26-2.60]; compared with alert), severe illness diagnosis (1.49 [1.12-1.98]), the number of all beds in EDs (1.02 [1.01-1.04]), and acceptance for treatment (0.92 [0.87-0.98]; with increment of 1%). Conclusion This study confirms that both individual-level and hospital-level factors affect the transfer risk of severe pediatric patients in EDs. The study suggests the needs for direct transportation to specialized pediatric treatment facilities, and concentrated support for the pediatric emergency medical centers and pediatric trauma centers.

Objectives: . The recent expansion of eligibility for cochlear implantation (CI) by the U.S. Food and Drug Administration (FDA) to include infants as young as 9 months has reignited debates concerning the clinically appropriate cut-off age for pediatric CI. Our study compared the early postoperative trajectories of receptive and expressive language development in children who received CI before 9 months of age with those who received it between 9 and 12 months. This study involved a unique pediatric cohort with documented etiology, where the timing of CI was based on objective criteria and efforts were made to minimize the influence of parental socioeconomic status. Methods: . A retrospective review of 98 pediatric implantees recruited at a tertiary referral center was conducted. The timing of CI was based on auditory and language criteria focused on the extent of delay corresponding to the bottom 1st percentile of language development among age-matched controls, with patients categorized into very early (CI at <9 months), early (CI at 9–12 months) and delayed (CI at 12–18 months) CI groups. Postoperative receptive/expressive language development was assessed using the Sequenced Language Scale for Infants receptive and expressive standardized scores and percentiles. Results: . Only the very early CI group showed significant improvements in receptive language starting at 3 months post-CI, aligning with normal-hearing peers by 9 months and maintaining this level until age 2 years. During this period (<2 years), all improvements were more pronounced in receptive language than in expressive language. Conclusion . CI before 9 months of age significantly improved receptive language development compared to later CI, with improvements sustained at least up to the age of 2. This study supports the consideration of earlier CI, beyond pediatric Food and Drug Administration labeling criteria (>9 months), in children with profound deafness who have a clear deafness etiology and language development delays (<1st percentile).