1.Occupational disease monitoring by the Korea Occupational Disease Surveillance Center: a narrative review
Dong-Wook LEE ; Inah KIM ; Jungho HWANG ; Sunhaeng CHOI ; Tae-Won JANG ; Insung CHUNG ; Hwan-Cheol KIM ; Jaebum PARK ; Jungwon KIM ; Kyoung Sook JEONG ; Youngki KIM ; Eun-Soo LEE ; Yangwoo KIM ; Inchul JEONG ; Hyunjeong OH ; Hyeoncheol OH ; Jea Chul HA ; Jeehee MIN ; Chul Gab LEE ; Heon KIM ; Jaechul SONG
The Ewha Medical Journal 2025;48(1):e9-
This review examines the challenges associated with occupational disease surveillance in Korea, particularly emphasizing the limitations of current data sources such as the Industrial Accident Compensation Insurance (IACI) statistics and special health examinations. The IACI system undercounts cases due to its emphasis on severe diseases and restrictions on approvals. Special health examinations, although they cover a broad workforce, are constrained by their annual scheduling, which leads to missed acute illnesses and subclinical conditions. The paper also explores the history of occupational disease surveillance in Korea, highlighting the fragmented and disease-specific approach of earlier systems. The authors introduce the newly established Korea Occupational Disease Surveillance Center (KODSC), a comprehensive nationwide system designed to gather, analyze, and interpret data on occupational diseases through a network of regional centers. By incorporating hospital-based surveillance and focusing on acute poisonings and other sentinel events, the KODSC aims to overcome the limitations of previous systems and promote collaboration with various agencies. Although it is still in the early stages of implementation, the KODSC demonstrates potential for improving data accuracy and contributing valuable insights for public health policy.
2.Development and Application of New Risk-Adjustment Models to Improve the Current Model for Hospital Standardized Mortality Ratio in South Korea
Hyeki PARK ; Ji-Sook CHOI ; Min Sun SHIN ; Soomin KIM ; Hyekyoung KIM ; Nahyeong IM ; Soon Joo PARK ; Donggyo SHIN ; Youngmi SONG ; Yunjung CHO ; Hyunmi JOO ; Hyeryeon HONG ; Yong-Hwa HWANG ; Choon-Seon PARK
Yonsei Medical Journal 2025;66(3):179-186
Purpose:
This study assessed the validity of the hospital standardized mortality ratio (HSMR) risk-adjusted model by comparing models that include clinical information and the current model based on administrative information in South Korea.
Materials and Methods:
The data of 53976 inpatients were analyzed. The current HSMR risk-adjusted model (Model 1) adjusts for sex, age, health coverage, emergency hospitalization status, main diagnosis, surgery status, and Charlson Comorbidity Index (CCI) using administrative data. As candidate variables, among clinical information, the American Society of Anesthesiologists score, Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) 3, present on admission CCI, and cancer stage were collected. Surgery status, intensive care in the intensive care unit, and CCI were selected as proxy variables among administrative data. In-hospital death was defined as the dependent variable, and a logistic regression analysis was performed. The statistical performance of each model was compared using C-index values.
Results:
There was a strong correlation between variables in the administrative data and those in the medical records. The C-index of the existing model (Model 1) was 0.785; Model 2, which included all clinical data, had a higher C-index of 0.857. In Model 4, in which APACHE II and SAPS 3 were replaced with variables recorded in the administrative data from Model 2, the C-index further increased to 0.863.
Conclusion
The HSMR assessment model improved when clinical data were adjusted. Simultaneously, the validity of the evaluation method could be secured even if some of the clinical information was replaced with the information in the administrative data.
3.Risk Factors for the Occurrence of Intraoperative Hypothermia in Patients undergoing Breast Cancer Surgery
Asian Oncology Nursing 2025;25(1):28-37
Purpose:
This study aimed to analyze the risk factors influencing intraoperative hypothermia in patients undergoing breast cancer surgery.
Methods:
Data were collected from 129 patients who underwent breast cancer surgery at a general hospital in City B from May 7 to November 14, 2024. The collected data were analyzed using SPSS/WIN 27 with an independent t-test, a χ 2 test ( χ 2 -test), and logistic regression analysis.
Results:
A total of 61 (47.3%) out of 129 patients experienced intraoperative hypothermia. According to the results of the logistic regression analysis, lower BMI (odds ratio [OR]=0.85, CI=0.74~0.98, p=.028), a total amount of IV fluid of ≥500 mL (odds ratio [OR]=4.47,CI=1.07~18.75, p=.041), a surgery duration of ≥120 minutes (odds ratio [OR]=4.10, CI=1.02~16.51, p=.047), and intraoperative hypotension (odds ratio [OR]=3.64, CI=1.22~10.86, p=.020) were associated with an increased risk of intraoperative hypothermia.
Conclusion
To prevent intraoperative hypothermia, continuous observation and nursing intervention are required for patients with low BMI or those expected to undergo prolonged surgery. The use of warm fluids during surgery and proper intraoperative blood pressure management is also recommended.
4.Risk Factors for the Occurrence of Intraoperative Hypothermia in Patients undergoing Breast Cancer Surgery
Asian Oncology Nursing 2025;25(1):28-37
Purpose:
This study aimed to analyze the risk factors influencing intraoperative hypothermia in patients undergoing breast cancer surgery.
Methods:
Data were collected from 129 patients who underwent breast cancer surgery at a general hospital in City B from May 7 to November 14, 2024. The collected data were analyzed using SPSS/WIN 27 with an independent t-test, a χ 2 test ( χ 2 -test), and logistic regression analysis.
Results:
A total of 61 (47.3%) out of 129 patients experienced intraoperative hypothermia. According to the results of the logistic regression analysis, lower BMI (odds ratio [OR]=0.85, CI=0.74~0.98, p=.028), a total amount of IV fluid of ≥500 mL (odds ratio [OR]=4.47,CI=1.07~18.75, p=.041), a surgery duration of ≥120 minutes (odds ratio [OR]=4.10, CI=1.02~16.51, p=.047), and intraoperative hypotension (odds ratio [OR]=3.64, CI=1.22~10.86, p=.020) were associated with an increased risk of intraoperative hypothermia.
Conclusion
To prevent intraoperative hypothermia, continuous observation and nursing intervention are required for patients with low BMI or those expected to undergo prolonged surgery. The use of warm fluids during surgery and proper intraoperative blood pressure management is also recommended.
5.Occupational disease monitoring by the Korea Occupational Disease Surveillance Center: a narrative review
Dong-Wook LEE ; Inah KIM ; Jungho HWANG ; Sunhaeng CHOI ; Tae-Won JANG ; Insung CHUNG ; Hwan-Cheol KIM ; Jaebum PARK ; Jungwon KIM ; Kyoung Sook JEONG ; Youngki KIM ; Eun-Soo LEE ; Yangwoo KIM ; Inchul JEONG ; Hyunjeong OH ; Hyeoncheol OH ; Jea Chul HA ; Jeehee MIN ; Chul Gab LEE ; Heon KIM ; Jaechul SONG
The Ewha Medical Journal 2025;48(1):e9-
This review examines the challenges associated with occupational disease surveillance in Korea, particularly emphasizing the limitations of current data sources such as the Industrial Accident Compensation Insurance (IACI) statistics and special health examinations. The IACI system undercounts cases due to its emphasis on severe diseases and restrictions on approvals. Special health examinations, although they cover a broad workforce, are constrained by their annual scheduling, which leads to missed acute illnesses and subclinical conditions. The paper also explores the history of occupational disease surveillance in Korea, highlighting the fragmented and disease-specific approach of earlier systems. The authors introduce the newly established Korea Occupational Disease Surveillance Center (KODSC), a comprehensive nationwide system designed to gather, analyze, and interpret data on occupational diseases through a network of regional centers. By incorporating hospital-based surveillance and focusing on acute poisonings and other sentinel events, the KODSC aims to overcome the limitations of previous systems and promote collaboration with various agencies. Although it is still in the early stages of implementation, the KODSC demonstrates potential for improving data accuracy and contributing valuable insights for public health policy.
6.Development and Application of New Risk-Adjustment Models to Improve the Current Model for Hospital Standardized Mortality Ratio in South Korea
Hyeki PARK ; Ji-Sook CHOI ; Min Sun SHIN ; Soomin KIM ; Hyekyoung KIM ; Nahyeong IM ; Soon Joo PARK ; Donggyo SHIN ; Youngmi SONG ; Yunjung CHO ; Hyunmi JOO ; Hyeryeon HONG ; Yong-Hwa HWANG ; Choon-Seon PARK
Yonsei Medical Journal 2025;66(3):179-186
Purpose:
This study assessed the validity of the hospital standardized mortality ratio (HSMR) risk-adjusted model by comparing models that include clinical information and the current model based on administrative information in South Korea.
Materials and Methods:
The data of 53976 inpatients were analyzed. The current HSMR risk-adjusted model (Model 1) adjusts for sex, age, health coverage, emergency hospitalization status, main diagnosis, surgery status, and Charlson Comorbidity Index (CCI) using administrative data. As candidate variables, among clinical information, the American Society of Anesthesiologists score, Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) 3, present on admission CCI, and cancer stage were collected. Surgery status, intensive care in the intensive care unit, and CCI were selected as proxy variables among administrative data. In-hospital death was defined as the dependent variable, and a logistic regression analysis was performed. The statistical performance of each model was compared using C-index values.
Results:
There was a strong correlation between variables in the administrative data and those in the medical records. The C-index of the existing model (Model 1) was 0.785; Model 2, which included all clinical data, had a higher C-index of 0.857. In Model 4, in which APACHE II and SAPS 3 were replaced with variables recorded in the administrative data from Model 2, the C-index further increased to 0.863.
Conclusion
The HSMR assessment model improved when clinical data were adjusted. Simultaneously, the validity of the evaluation method could be secured even if some of the clinical information was replaced with the information in the administrative data.
7.Occupational disease monitoring by the Korea Occupational Disease Surveillance Center: a narrative review
Dong-Wook LEE ; Inah KIM ; Jungho HWANG ; Sunhaeng CHOI ; Tae-Won JANG ; Insung CHUNG ; Hwan-Cheol KIM ; Jaebum PARK ; Jungwon KIM ; Kyoung Sook JEONG ; Youngki KIM ; Eun-Soo LEE ; Yangwoo KIM ; Inchul JEONG ; Hyunjeong OH ; Hyeoncheol OH ; Jea Chul HA ; Jeehee MIN ; Chul Gab LEE ; Heon KIM ; Jaechul SONG
The Ewha Medical Journal 2025;48(1):e9-
This review examines the challenges associated with occupational disease surveillance in Korea, particularly emphasizing the limitations of current data sources such as the Industrial Accident Compensation Insurance (IACI) statistics and special health examinations. The IACI system undercounts cases due to its emphasis on severe diseases and restrictions on approvals. Special health examinations, although they cover a broad workforce, are constrained by their annual scheduling, which leads to missed acute illnesses and subclinical conditions. The paper also explores the history of occupational disease surveillance in Korea, highlighting the fragmented and disease-specific approach of earlier systems. The authors introduce the newly established Korea Occupational Disease Surveillance Center (KODSC), a comprehensive nationwide system designed to gather, analyze, and interpret data on occupational diseases through a network of regional centers. By incorporating hospital-based surveillance and focusing on acute poisonings and other sentinel events, the KODSC aims to overcome the limitations of previous systems and promote collaboration with various agencies. Although it is still in the early stages of implementation, the KODSC demonstrates potential for improving data accuracy and contributing valuable insights for public health policy.
8.Development and Application of New Risk-Adjustment Models to Improve the Current Model for Hospital Standardized Mortality Ratio in South Korea
Hyeki PARK ; Ji-Sook CHOI ; Min Sun SHIN ; Soomin KIM ; Hyekyoung KIM ; Nahyeong IM ; Soon Joo PARK ; Donggyo SHIN ; Youngmi SONG ; Yunjung CHO ; Hyunmi JOO ; Hyeryeon HONG ; Yong-Hwa HWANG ; Choon-Seon PARK
Yonsei Medical Journal 2025;66(3):179-186
Purpose:
This study assessed the validity of the hospital standardized mortality ratio (HSMR) risk-adjusted model by comparing models that include clinical information and the current model based on administrative information in South Korea.
Materials and Methods:
The data of 53976 inpatients were analyzed. The current HSMR risk-adjusted model (Model 1) adjusts for sex, age, health coverage, emergency hospitalization status, main diagnosis, surgery status, and Charlson Comorbidity Index (CCI) using administrative data. As candidate variables, among clinical information, the American Society of Anesthesiologists score, Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) 3, present on admission CCI, and cancer stage were collected. Surgery status, intensive care in the intensive care unit, and CCI were selected as proxy variables among administrative data. In-hospital death was defined as the dependent variable, and a logistic regression analysis was performed. The statistical performance of each model was compared using C-index values.
Results:
There was a strong correlation between variables in the administrative data and those in the medical records. The C-index of the existing model (Model 1) was 0.785; Model 2, which included all clinical data, had a higher C-index of 0.857. In Model 4, in which APACHE II and SAPS 3 were replaced with variables recorded in the administrative data from Model 2, the C-index further increased to 0.863.
Conclusion
The HSMR assessment model improved when clinical data were adjusted. Simultaneously, the validity of the evaluation method could be secured even if some of the clinical information was replaced with the information in the administrative data.
9.Occupational disease monitoring by the Korea Occupational Disease Surveillance Center: a narrative review
Dong-Wook LEE ; Inah KIM ; Jungho HWANG ; Sunhaeng CHOI ; Tae-Won JANG ; Insung CHUNG ; Hwan-Cheol KIM ; Jaebum PARK ; Jungwon KIM ; Kyoung Sook JEONG ; Youngki KIM ; Eun-Soo LEE ; Yangwoo KIM ; Inchul JEONG ; Hyunjeong OH ; Hyeoncheol OH ; Jea Chul HA ; Jeehee MIN ; Chul Gab LEE ; Heon KIM ; Jaechul SONG
The Ewha Medical Journal 2025;48(1):e9-
This review examines the challenges associated with occupational disease surveillance in Korea, particularly emphasizing the limitations of current data sources such as the Industrial Accident Compensation Insurance (IACI) statistics and special health examinations. The IACI system undercounts cases due to its emphasis on severe diseases and restrictions on approvals. Special health examinations, although they cover a broad workforce, are constrained by their annual scheduling, which leads to missed acute illnesses and subclinical conditions. The paper also explores the history of occupational disease surveillance in Korea, highlighting the fragmented and disease-specific approach of earlier systems. The authors introduce the newly established Korea Occupational Disease Surveillance Center (KODSC), a comprehensive nationwide system designed to gather, analyze, and interpret data on occupational diseases through a network of regional centers. By incorporating hospital-based surveillance and focusing on acute poisonings and other sentinel events, the KODSC aims to overcome the limitations of previous systems and promote collaboration with various agencies. Although it is still in the early stages of implementation, the KODSC demonstrates potential for improving data accuracy and contributing valuable insights for public health policy.
10.Development and Application of New Risk-Adjustment Models to Improve the Current Model for Hospital Standardized Mortality Ratio in South Korea
Hyeki PARK ; Ji-Sook CHOI ; Min Sun SHIN ; Soomin KIM ; Hyekyoung KIM ; Nahyeong IM ; Soon Joo PARK ; Donggyo SHIN ; Youngmi SONG ; Yunjung CHO ; Hyunmi JOO ; Hyeryeon HONG ; Yong-Hwa HWANG ; Choon-Seon PARK
Yonsei Medical Journal 2025;66(3):179-186
Purpose:
This study assessed the validity of the hospital standardized mortality ratio (HSMR) risk-adjusted model by comparing models that include clinical information and the current model based on administrative information in South Korea.
Materials and Methods:
The data of 53976 inpatients were analyzed. The current HSMR risk-adjusted model (Model 1) adjusts for sex, age, health coverage, emergency hospitalization status, main diagnosis, surgery status, and Charlson Comorbidity Index (CCI) using administrative data. As candidate variables, among clinical information, the American Society of Anesthesiologists score, Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) 3, present on admission CCI, and cancer stage were collected. Surgery status, intensive care in the intensive care unit, and CCI were selected as proxy variables among administrative data. In-hospital death was defined as the dependent variable, and a logistic regression analysis was performed. The statistical performance of each model was compared using C-index values.
Results:
There was a strong correlation between variables in the administrative data and those in the medical records. The C-index of the existing model (Model 1) was 0.785; Model 2, which included all clinical data, had a higher C-index of 0.857. In Model 4, in which APACHE II and SAPS 3 were replaced with variables recorded in the administrative data from Model 2, the C-index further increased to 0.863.
Conclusion
The HSMR assessment model improved when clinical data were adjusted. Simultaneously, the validity of the evaluation method could be secured even if some of the clinical information was replaced with the information in the administrative data.

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