This paper aims to introduce Korea’s total current health expenditure (CHE) and National Health Accounts of the year 2021 and their 2022 preliminary figures constructed on the basis of the System of Health Accounts 2011. As CHE includes expenditures for prevention, tracking, and treatment of coronavirus disease 2019 (COVID-19) and compensation for losses to medical institutions from 2020, the details are also introduced. Korea’s total CHE in 2021 is 193.3 trillion won, which is 9.3% of gross domestic product (GDP). The preliminary figure in 2022, 209.0 trillion won, exceeded the 200 trillion won line for the first time, and its “ratio to GDP” of 9.7% is expected to exceed the average of Organisation for Economic Co-Operation and Development member countries for the first time. Korea’s health expenditures, which were well controlled until the end of the 20th century, have increased at an alarming rate since the beginning of the 21st century, threatening the sustainability of national health insurance. The increase in health expenditure after 2020 is partly due to a temporary increase in response to COVID-19. However, when considering the structure of Korea’s health insurance price hike, where the ratchet effect of increased medical expenses works particularly strongly, it is unlikely that the accelerating growth trend that has lasted for more than 20 years will stop easily. More aggressive policies to control medical expenses are required in the national health insurance which not only constitutes the main financing sources of the Korean health system but also has the most powerful policy means in effect for changes in the health care provision.

Objective: The risk of suicide is assessed by identifying the relationship between alcohol-use patterns and suicidal ideation in Korean employees. Methods: The study involved 13,858 employees who underwent workplace mental health screening at the Workplace Mental Health Institute of Kangbuk Samsung Hospital over a 6-year period between 2014 and 2019. Analysis was performed separately for Alcohol Use Disorders Identification Test-Korea (AUDIT-K) items related to the frequency/volume of alcohol consumption (items 1 to 3, AUDIT-C) and those regarding alcohol dependence/related problems (items 4 to 10, AUDIT-D/P). Subjects were then classified into three groups on the basis of the presence or absence of clinical depression and suicidal ideation. The groups’ sociodemographic factors and clinical features of depression, anxiety, and alcohol-use patterns were analyzed with a chi-square test as well as one-way analysis of variance, followed by a post hoc test using the Bonferroni correction. Results: AUDIT-K and AUDIT-D/P scores were significantly associated with the presence or absence of clinical depression as well as the presence or absence of suicidal ideation (p<0.05). However, no significant differences were found among the three groups with regard to the AUDIT-C score (p=0.054). Conclusion Identifying or treating alcohol dependence/related problems can help lower the occurrence of mental health problems, and suicidal ideation in particular, in employees and reduce social costs.

YH4808 is a novel selective potassium-competitive acid blocker demonstrated to be safe and to have inhibitory effects against gastric acid secretion in previous studies. A randomized, open-label, multiple-dose, 3-treatment, 1-period, parallel design study was conducted to compare the Helicobacter pylori eradication rates and acid suppression capacities of three regimens in 60 healthy subjects with H. pylori-positive, and the potential of YH4808 to replace proton-pump inhibitors (PPIs) in standard regimens for H. pylori eradication. Group 1 received YH4808, amoxicillin, and clarithromycin as a novel triple regimen, while Group 2 received YH4808 and amoxicillin only, and Group 3 received esomeprazole, amoxicillin, and clarithromycin, as the standard triple regimen. H. pylori eradication rates were 85.0% for Group 1, 25.0% for Group 2, and 83.3% for Group 3. Relative response rate between Group 1 and 3 was 1.02 (0.50–2.07; 95% CI, χ2 test p = 0.8881). Furthermore, the novel triple regimen, YH4808, amoxicillin, and clarithromycin, stably inhibited acid secretion and maintained a gastric pH greater than 4 or 5 for 24 hours, which was comparable to the pH range in the standard triple regimen. However, the onset times of the YH4808 regimens were earlier than that for the regimens using esomeprazole. There were no differences in the incidences or severity of adverse events among the three groups. Overall, the novel triple regimen was safe and well-tolerated. YH4808 could replace PPIs in standard triple regimens used for H. pylori eradication.

YH4808 is a novel selective potassium-competitive acid blocker demonstrated to be safe and to have inhibitory effects against gastric acid secretion in previous studies. A randomized, open-label, multiple-dose, 3-treatment, 1-period, parallel design study was conducted to compare the Helicobacter pylori eradication rates and acid suppression capacities of three regimens in 60 healthy subjects with H. pylori-positive, and the potential of YH4808 to replace proton-pump inhibitors (PPIs) in standard regimens for H. pylori eradication. Group 1 received YH4808, amoxicillin, and clarithromycin as a novel triple regimen, while Group 2 received YH4808 and amoxicillin only, and Group 3 received esomeprazole, amoxicillin, and clarithromycin, as the standard triple regimen. H. pylori eradication rates were 85.0% for Group 1, 25.0% for Group 2, and 83.3% for Group 3. Relative response rate between Group 1 and 3 was 1.02 (0.50–2.07; 95% CI, χ2 test p = 0.8881). Furthermore, the novel triple regimen, YH4808, amoxicillin, and clarithromycin, stably inhibited acid secretion and maintained a gastric pH greater than 4 or 5 for 24 hours, which was comparable to the pH range in the standard triple regimen. However, the onset times of the YH4808 regimens were earlier than that for the regimens using esomeprazole. There were no differences in the incidences or severity of adverse events among the three groups. Overall, the novel triple regimen was safe and well-tolerated. YH4808 could replace PPIs in standard triple regimens used for H. pylori eradication.

Protective ventilation is a prevailing ventilatory strategy these days and is comprised of small tidal volume, limited inspiratory pressure, and application of positive end-expiratory pressure (PEEP). However, several retrospective studies recently suggested that tidal volume, inspiratory pressure, and PEEP are not related to patient outcomes, or only related when they influence the driving pressure. Therefore, this review introduces the concept of driving pressure and looks into the possibility of driving pressure-guided ventilation as a new ventilatory strategy, especially in thoracic surgery where postoperative pulmonary complications are common, and thus, lung protection is of utmost importance.

PURPOSE: This study was conducted to develop an empowering education program for Maternal-Fetal Intensive Care Unit (MFICU) nurses who provide intensive care to high-risk mother and fetus at hospitals, to test effects of the education program on nursing care confidence and nursing knowledge, and to examine program satisfaction. METHODS: This study comprised of 2 phases: program development and evaluation. First, we have followed a process of program development to develop and refine an empowering education program for MFICU nurses through collaborative works among clinical obstetrics and gynecology doctors and nurses and academic nursing professors. Second, the empowering education program was provided to 49 nurses and evaluated from July 5 to 6, 2019. Levels of MFICU nursing care confidence and knowledge were measured. RESULTS: The empowering education program included 18 hours of lectures, discussion, and Q & A, which continued for 2 days. This program significantly improved high-risk maternal-fetal nursing care confidence and knowledge of nurses. The program was well met with nurses' education need and goals, and found to be highly satisfactory. CONCLUSION: The empowering education program was observed to be effective in terms of improve nursing care confidence and knowledge of nurses in MFICU. It is proposed that this program should be open regularly for nurses to obtain and improve their clinical knowledge, confidence, and competency. Further study is needed to develop and run 2-levels of education such as basic and advanced levels based on nurses' clinical background and competency.
Critical Care ; Education ; Fetus ; Gynecology ; Humans ; Intensive Care Units ; Lectures ; Mothers ; Nursing ; Nursing Care ; Obstetrics ; Pregnancy, High-Risk ; Program Development

BACKGROUND: Physical activity is an important factor for preventing osteoporosis. This study aimed to investigate the association of work- and leisure-time physical activities with osteoporosis in postmenopausal women.METHODS: Data were obtained from the Korea National Health and Nutritional Examination Survey 2015–2016. A total of 2,885 postmenopausal women were included in the analysis. The subjects were divided into 3 groups according to the intensity of the work- and leisure-time physical activities. T-test, chi-square test, and multivariable logistic regression analysis were used.RESULTS: No association was found between work-time physical activity and osteoporosis prevalence. However, a dose-response relationship was found in case of leisure-time physical activity. People with leisure-time physical activity of at least >1,000 MET-min/week showed lower prevalence of osteoporosis.CONCLUSION: An appropriate level of leisure-time physical activity should be recommended to prevent and treat osteoporosis.
Female ; Humans ; Korea ; Leisure Activities ; Logistic Models ; Motor Activity ; Nutrition Surveys ; Osteoporosis ; Prevalence

PURPOSE: This study evaluates the efficacy of a Self-Care Reinforcement Program (SCRP) based on the Selection Optimization Compensation (SOC) model, in socially vulnerable elderly women with metabolic syndrome. METHODS: This study adopts a pretest-posttest nonequivalent control group design. The participants were 64 socially vulnerable elderly Korean women with metabolic syndrome (experimental group: 31, control group: 33). Participants' body composition analysis, nutrient intake, risk factors of metabolic syndrome, depressive symptoms, and social network were measured. Data were analyzed with an independent t-test; statistical significance levels were set at p<.05. The SCRP, including metabolic syndrome education, nutritional education, exercise, and social network, was performed three times a week for 8 weeks. RESULTS: There were statistically significant differences between the experimental and control groups in terms of systolic blood pressure, diastolic pressure, fasting blood sugar, triglycerides, sodium intake, depressive symptoms, and social networks. CONCLUSION: The SCRP is effective and can be recommended as a community health nursing intervention for socially vulnerable elderly women with metabolic syndrome.
Aged ; Blood Glucose ; Blood Pressure ; Body Composition ; Community Health Nursing ; Compensation and Redress ; Depression ; Depressive Disorder ; Education ; Fasting ; Female ; Humans ; Korea ; Nutrition Assessment ; Risk Factors ; Self Care ; Social Networking ; Sodium ; Triglycerides ; Vulnerable Populations

PURPOSE: To determine the effect of sex communication with friends and sexual double standard on contraceptive self-efficacy among university students. METHODS: With a survey design, data were collected from 251 university students from three universities in G city from September 2016 to October 2016. Data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and stepwise multiple regression. RESULTS: Sex communication with friends, sexual double standard, and contraceptive self-efficacy scores of participants were 58.82±8.78, 21.73±6.00, and 44.20±5.91, respectively. Sex communication with friends and sexual double standard were related to contraceptive self-efficacy. Sexual double standard, sex communication with friends, female, contraceptive education, and contraceptive experience explained 33% of contraceptive self-efficacy of participants. CONCLUSION: Sexual double standard and sex communication with friends were influencing factors of contraceptive self-efficacy. To improve contraceptive self-efficacy of university students, a program is needed to eliminate sexual double standard and improve sex communication with friends among university students in Korea.
Contraception ; Education ; Female ; Friends* ; Humans ; Korea

BACKGROUND AND OBJECTIVES: Supervised lifestyle interventions, including dietary and exercise programs, may be infeasible to implement in real-world settings. Therefore, this study aimed to evaluate the effectiveness of a home-based lifestyle modification intervention on blood pressure (BP) management. METHODS: Eighty-five patients aged over 20 years and diagnosed with prehypertension or mild hypertension were randomly assigned to an advice-only comparison group (C group, n=28), a Dietary Approaches to Stop Hypertension (DASH) diet education group (D group, n=30), or a DASH and home-based exercise group (D+Ex group, n=27). The intervention lasted for 8 weeks. The primary outcome was the difference in office systolic blood pressure (SBP) before and after the study period (Trial registry at ClinicalTrials.gov, NCT01637909). RESULTS: Seventy-two participants (87.8%) completed the trial. The degree of change in office SBP did not significantly differ among the intervention groups; however, the D+Ex group demonstrated a tendency toward decreased SBP. Upon analysis of 24-hour ambulatory BP measurements, daytime ambulatory SBP was significantly lower in the D+Ex group (134 mmHg; 95% confidence interval [CI], 131 to 137; p=0.011) than in the C group (139.5 mmHg; 95% CI, 130.9 to 137), and daytime ambulatory SBP was significantly decreased in the D+Ex group (−5.2 mmHg; 95% CI, −8.3 to −2.1; p=0.011) compared to the C group (0.4 mmHg, 95% CI, −2.5 to 3.3). CONCLUSIONS: In conclusion, lifestyle modification emphasizing both diet and exercise was effective for lowering BP and should be favored over diet-only modifications.
Blood Pressure ; Diet ; Education ; Humans ; Hypertension ; Life Style ; Prehypertension