1.Variability in the Length of Stay and Daily Medical Expenses in Inpatient Care in Korea, 2010–2019:Hypertension and Pneumonia
Haejong LEE ; Jin-Won NOH ; Sanghee LEE ; Jung-Kyu CHOI ; Jin Yong LEE ; Hyejin LEE ; Jung-Hoe KIM
Journal of Korean Medical Science 2025;40(13):e120-
		                        		
		                        			
		                        			 This study examined the variability in the length of stay (LOS) and daily medical expenses (DME) for hypertension and pneumonia inpatient care. Using 10 years of National Health Insurance Service data (2010–2019), a multilevel analysis assessed variability at the patient and institutional levels. During the study period, the mean LOS decreased, whereas the DME increased for both hypertension and pneumonia. Institutional level variability in the LOS increased during the study period, demonstrating greater variability than that for pneumonia. For both conditions, institutional-level variability was more marked in smaller institutions (hospitals and clinics) than in larger institutions (general and tertiary hospitals).These findings indicate a need for standardized healthcare service protocols to promote consistent and efficient patient care. 
		                        		
		                        		
		                        		
		                        	
2.Variability in the Length of Stay and Daily Medical Expenses in Inpatient Care in Korea, 2010–2019:Hypertension and Pneumonia
Haejong LEE ; Jin-Won NOH ; Sanghee LEE ; Jung-Kyu CHOI ; Jin Yong LEE ; Hyejin LEE ; Jung-Hoe KIM
Journal of Korean Medical Science 2025;40(13):e120-
		                        		
		                        			
		                        			 This study examined the variability in the length of stay (LOS) and daily medical expenses (DME) for hypertension and pneumonia inpatient care. Using 10 years of National Health Insurance Service data (2010–2019), a multilevel analysis assessed variability at the patient and institutional levels. During the study period, the mean LOS decreased, whereas the DME increased for both hypertension and pneumonia. Institutional level variability in the LOS increased during the study period, demonstrating greater variability than that for pneumonia. For both conditions, institutional-level variability was more marked in smaller institutions (hospitals and clinics) than in larger institutions (general and tertiary hospitals).These findings indicate a need for standardized healthcare service protocols to promote consistent and efficient patient care. 
		                        		
		                        		
		                        		
		                        	
3.Development of a Korean version of the Frailty Model with a Holistic Perspective: A Delphi Study
Ju Hee LEE ; Gwang Suk KIM ; Sanghee KIM ; Eunyoung KIM ; Layoung KIM ; Jee-Hye YOO
Journal of Korean Academy of Fundamental Nursing 2025;32(2):220-232
		                        		
		                        			 Purpose:
		                        			This study aimed to develop a Korean version of the frailty model that reflects a holistic perspective. There were three phases of the study: a literature review, a two-round Delphi study, and a public hearing.  
		                        		
		                        			Methods:
		                        			The model was developed based on the middle-range theory generation approach proposed by Roy. A literature search was conducted, and a review of 36 studies on frailty involving Koreans led to the development of an initial frailty model. A two-round Delphi study was then conducted with nine experts to evaluate the appropriateness of the model. The revised model was presented at a public hearing to achieve consensus. Based on feedback indicating the need for improved visualization, a finalized diagrammatic model was developed.  
		                        		
		                        			Results:
		                        			The final frailty model comprised four domains, seven subdomains, and 30 items. It included specific items reflecting the distinctive characteristics of Korean culture, such as relationships with adult children (filial piety), nutritional status (consumption of red meat), and type of residential building.  
		                        		
		                        			Conclusion
		                        			The final frailty model provides a comprehensive perspective on the factors contributing to frailty, their interactions, and the potential interventions that healthcare providers can implement to prevent frailty. 
		                        		
		                        		
		                        		
		                        	
4.Development of a Korean version of the Frailty Model with a Holistic Perspective: A Delphi Study
Ju Hee LEE ; Gwang Suk KIM ; Sanghee KIM ; Eunyoung KIM ; Layoung KIM ; Jee-Hye YOO
Journal of Korean Academy of Fundamental Nursing 2025;32(2):220-232
		                        		
		                        			 Purpose:
		                        			This study aimed to develop a Korean version of the frailty model that reflects a holistic perspective. There were three phases of the study: a literature review, a two-round Delphi study, and a public hearing.  
		                        		
		                        			Methods:
		                        			The model was developed based on the middle-range theory generation approach proposed by Roy. A literature search was conducted, and a review of 36 studies on frailty involving Koreans led to the development of an initial frailty model. A two-round Delphi study was then conducted with nine experts to evaluate the appropriateness of the model. The revised model was presented at a public hearing to achieve consensus. Based on feedback indicating the need for improved visualization, a finalized diagrammatic model was developed.  
		                        		
		                        			Results:
		                        			The final frailty model comprised four domains, seven subdomains, and 30 items. It included specific items reflecting the distinctive characteristics of Korean culture, such as relationships with adult children (filial piety), nutritional status (consumption of red meat), and type of residential building.  
		                        		
		                        			Conclusion
		                        			The final frailty model provides a comprehensive perspective on the factors contributing to frailty, their interactions, and the potential interventions that healthcare providers can implement to prevent frailty. 
		                        		
		                        		
		                        		
		                        	
5.Variability in the Length of Stay and Daily Medical Expenses in Inpatient Care in Korea, 2010–2019:Hypertension and Pneumonia
Haejong LEE ; Jin-Won NOH ; Sanghee LEE ; Jung-Kyu CHOI ; Jin Yong LEE ; Hyejin LEE ; Jung-Hoe KIM
Journal of Korean Medical Science 2025;40(13):e120-
		                        		
		                        			
		                        			 This study examined the variability in the length of stay (LOS) and daily medical expenses (DME) for hypertension and pneumonia inpatient care. Using 10 years of National Health Insurance Service data (2010–2019), a multilevel analysis assessed variability at the patient and institutional levels. During the study period, the mean LOS decreased, whereas the DME increased for both hypertension and pneumonia. Institutional level variability in the LOS increased during the study period, demonstrating greater variability than that for pneumonia. For both conditions, institutional-level variability was more marked in smaller institutions (hospitals and clinics) than in larger institutions (general and tertiary hospitals).These findings indicate a need for standardized healthcare service protocols to promote consistent and efficient patient care. 
		                        		
		                        		
		                        		
		                        	
6.Development of a Korean version of the Frailty Model with a Holistic Perspective: A Delphi Study
Ju Hee LEE ; Gwang Suk KIM ; Sanghee KIM ; Eunyoung KIM ; Layoung KIM ; Jee-Hye YOO
Journal of Korean Academy of Fundamental Nursing 2025;32(2):220-232
		                        		
		                        			 Purpose:
		                        			This study aimed to develop a Korean version of the frailty model that reflects a holistic perspective. There were three phases of the study: a literature review, a two-round Delphi study, and a public hearing.  
		                        		
		                        			Methods:
		                        			The model was developed based on the middle-range theory generation approach proposed by Roy. A literature search was conducted, and a review of 36 studies on frailty involving Koreans led to the development of an initial frailty model. A two-round Delphi study was then conducted with nine experts to evaluate the appropriateness of the model. The revised model was presented at a public hearing to achieve consensus. Based on feedback indicating the need for improved visualization, a finalized diagrammatic model was developed.  
		                        		
		                        			Results:
		                        			The final frailty model comprised four domains, seven subdomains, and 30 items. It included specific items reflecting the distinctive characteristics of Korean culture, such as relationships with adult children (filial piety), nutritional status (consumption of red meat), and type of residential building.  
		                        		
		                        			Conclusion
		                        			The final frailty model provides a comprehensive perspective on the factors contributing to frailty, their interactions, and the potential interventions that healthcare providers can implement to prevent frailty. 
		                        		
		                        		
		                        		
		                        	
7.Variability in the Length of Stay and Daily Medical Expenses in Inpatient Care in Korea, 2010–2019:Hypertension and Pneumonia
Haejong LEE ; Jin-Won NOH ; Sanghee LEE ; Jung-Kyu CHOI ; Jin Yong LEE ; Hyejin LEE ; Jung-Hoe KIM
Journal of Korean Medical Science 2025;40(13):e120-
		                        		
		                        			
		                        			 This study examined the variability in the length of stay (LOS) and daily medical expenses (DME) for hypertension and pneumonia inpatient care. Using 10 years of National Health Insurance Service data (2010–2019), a multilevel analysis assessed variability at the patient and institutional levels. During the study period, the mean LOS decreased, whereas the DME increased for both hypertension and pneumonia. Institutional level variability in the LOS increased during the study period, demonstrating greater variability than that for pneumonia. For both conditions, institutional-level variability was more marked in smaller institutions (hospitals and clinics) than in larger institutions (general and tertiary hospitals).These findings indicate a need for standardized healthcare service protocols to promote consistent and efficient patient care. 
		                        		
		                        		
		                        		
		                        	
8.Optimal withdrawal time in initial surveillance colonoscopy after colorectal cancer surgery: comparison between anterior/low anterior resection and right hemicolectomy
Jun Woo BONG ; Ji Young KIM ; Yeonuk JU ; Chinkock CHEONG ; Sanghee KANG ; Sun Il LEE ; Byung Wook MIN
Annals of Surgical Treatment and Research 2024;107(4):212-220
		                        		
		                        			 Purpose:
		                        			This study aimed to investigate the optimal withdrawal time (WT) for initial surveillance colonoscopy after curative resection for colorectal cancer (CRC) by comparing anterior/low anterior resection (AR/LAR) and right hemicolectomy (RHC) groups. 
		                        		
		                        			Methods:
		                        			This retrospective study analyzed 1,212 patients who underwent initial surveillance colonoscopy after CRC resection between 2015 and 2022. The patients were divided into the AR/LAR (n = 846) and RHC (n = 366) groups. The optimal WT was determined using receiver operating characteristic curve analysis and validated using logistic regression models. The adenoma and advanced neoplasia detection rates (ADR/ANDR) were evaluated based on the optimal WT. 
		                        		
		                        			Results:
		                        			The optimal WT was 7 and 6 minutes in the AR/LAR and RHC groups, respectively. In multivariate analysis, WT ≥7 and ≥6 minutes in the AR/LAR (odds ratio [OR], 2.38; 95% confidence interval [CI], 1.75–3.24; P < 0.001) and RHC (OR, 2.64;95% CI, 1.59–4.39; P = 0.001) groups, respectively, were significant factors for adenoma detection. In the AR/LAR group, ADR was 41.5% for WT ≥7 minutes compared to 21.9% for WT <7 minutes (P < 0.001). In the RHC group, ADR for WT ≥6 minutes was 33.9% compared to 15.8% for WT <6 minutes (P < 0.001). The ANDR also significantly improved with longer WTs in both groups. 
		                        		
		                        			Conclusion
		                        			This study suggests that a minimum WT of 7 and 6 minutes for AR/LAR and RHC patients, respectively, during the initial surveillance colonoscopy after CRC resection is optimal for maintaining a satisfactory ADR and ANDR. These findings highlight the importance of tailoring colonoscopic procedures according to the type of surgical resection. 
		                        		
		                        		
		                        		
		                        	
9.Effective utilization of polypectomy in endoscopic salvage treatment of rectal neuroendocrine tumors: a retrospective cohort study
Yeonuk JU ; Jun woo BONG ; Chinock CHEONG ; Sanghee KANG ; Byung wook MIN ; Sun il LEE
Annals of Surgical Treatment and Research 2024;107(3):151-157
		                        		
		                        			 Purpose:
		                        			Current guidelines recommend endoscopic resection for rectal neuroendocrine tumors (RNETs) under 10 mm. Incomplete resections necessitate salvage procedures, highlighting the need for complete R0 resection. This study evaluates the efficacy and safety of wide hot snare polypectomy (WHSP) compared to endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) for the salvage treatment of small RNETs. 
		                        		
		                        			Methods:
		                        			This retrospective study was conducted at Korea University Guro Hospital from January 2018 to December 2022. It compared the outcomes of salvage resections for RNETs ≤10 mm using 2 approaches: ESD and EMR vs. WHSP. Demographics, tumor characteristics, and clinical outcomes were compared. Efficacy was evaluated by the histological complete resection rate and procedure time, while safety was assessed by the incidence of complications. 
		                        		
		                        			Results:
		                        			Out of 135 patients undergoing salvage resection for RNET, 14 who underwent transanal excision were excluded. Of the remaining 121, 99 underwent EMR or ESD, and 22 underwent WHSP. Baseline characteristics were similar between the 2 groups. The WHSP group demonstrated a significantly higher R0 resection rate (72.7% vs. 49.5%, P = 0.010) and a shorter median procedure time (3.5 minutes vs. 8.3 minutes). No complications were reported in the WHSP group. 
		                        		
		                        			Conclusion
		                        			WHSP is a rapid, straightforward, safe, and effective approach for the salvage treatment of RNETs less than 10 mm in diameter, particularly in patients without additional risk factors. 
		                        		
		                        		
		                        		
		                        	
10.Epidemiology of Respiratory Viruses in Korean Children Before and After the COVID-19 Pandemic: A Prospective Study From National Surveillance System
Hyo Jin CHO ; Jee Eun RHEE ; Dayun KANG ; Eun Hwa CHOI ; Nam-Joo LEE ; SangHee WOO ; Jaehee LEE ; Sang-Won LEE ; Eun-Jin KIM ; Ki Wook YUN
Journal of Korean Medical Science 2024;39(19):e171-
		                        		
		                        			 Background:
		                        			The coronavirus disease 2019 (COVID-19) pandemic led to a decrease in the seasonal incidence of many respiratory viruses worldwide due to the impact of nonpharmaceutical interventions (NPIs). However, as NPI measures were relaxed, respiratory viral infections re-emerged. We aimed to characterize the epidemiology of respiratory viruses in Korean children during post-COVID-19 pandemic years compared to that before the pandemic. 
		                        		
		                        			Methods:
		                        			A nationwide prospective ongoing surveillance study has been conducted for detection of respiratory viruses between January 2017 and June 2023. We included data on adenovirus (AdV), human bocavirus (HBoV), human coronavirus (HCoV), human metapneumovirus (HMPV), human rhinovirus (HRV), influenza virus (IFV), parainfluenza virus (PIV), and respiratory syncytial virus (RSV), which were detected in children and adolescents younger than 20 years. We analyzed the weekly detection frequency of individual viruses and the age distribution of the affected children. The study period was divided into prepandemic (2017–2019) and postpandemic (2021–2023) periods. 
		                        		
		                        			Results:
		                        			A total of 19,589 and 14,068 samples were collected in the pre- and postpandemic periods, respectively. The overall detection rate of any virus throughout the study period was 63.1%, with the lowest occurring in the 2nd half of 2020 (50.6%) and the highest occurring in the 2nd half of 2021 (72.3%). Enveloped viruses (HCoV, HMPV, IFV, PIV, and RSV) almost disappeared, but nonenveloped viruses (AdV, HBoV, and HRV) were detected even during the peak of the COVID-19 pandemic. The codetection rate increased from 15.0% prepandemic to 19.1% postpandemic (P < 0.001). During the postpandemic period, a large out-of-season PIV and HMPV epidemic occurred, but the usual seasonality began to be restored in 2023.The mean age of children with each virus detected in 2023 was significantly greater than that in prepandemic years (P = 0.003 and 0.007 for AdV and HCoV, respectively; P < 0.001 for others). The mean age of children with IFV increased in 2022 (11.1 ± 5.2 years) from prepandemic years (7.9 ± 4.6 years) but decreased to 8.7 ± 4.1 years in 2023. 
		                        		
		                        			Conclusion
		                        			With the relaxation of NPI measures, several seasonal respiratory viruses cocirculated with unusual seasonal epidemic patterns and were associated with increasing age of infected children. 
		                        		
		                        		
		                        		
		                        	
            
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