Ex) Article Title, Author, Keywords
HIRA Research 2023; 3(2): 125-129
HIRA Research 2023; 3(2): 130-141
HIRA Research 2023; 3(2): 142-154
Methods: We used National Health Insurance claims data of patients under the age of 20 from 2011 to 2021. CCCs were classified as pediatric CCCs by Feudtner et al. Patients who repeatedly utilize medical services due to CCCs were defined as patients who sought medical care twice or more within the past 3 years. Their sex, age, CCC categories, and the number of CCC categories were presented using descriptive analyses.
Results: The number of children and adolescents with CCCs increased from 345,320 (3.04%) in 2011 to 451,238 (5.33%) in 2021. Patients who repeatedly utilized medical services due to CCCs increased by 71,889 during the same period. The proportion of patients with two or more CCC categories increased from 35.80% in 2011 to 43.67% in 2021. In 2021, patients with other congenital or genetic defect were most common. Medical expenditures associated with CCCs increased from 475,654 million won (12.34%) in 2011 to 768,467 million won (19.11%) in 2021.
Conclusion: The number of patients with CCCs and their medical expenditures increased in Korea between 2011 and 2021. The results indicate that consistent national efforts are required to maintain the specialized pediatric care. Further studies are needed to identify pediatric patients who require specialized medical services through various methods.
HIRA Research 2023; 3(2): 155-170
Methods: In this study, we applied PAF to the neurological/surgical ICUs of a tertiary hospital starting from March 1, 2023, we compared the data of 6 months before (from September 2022 to February 2023) and after (from March 2023 to August 2023) the implementation to assess the difference in antimicrobial use density (AUD) and the acquisition rates of antibiotic-resistant bacteria. Furthermore, we surveyed the satisfaction of PAF using a questionnaire. PAF was conducted twice a week during rounds by the ASP team, which consisted of an infectious disease specialist and one assistant.
Results: Before and after the implementation of PAF, AUD showed a tendency to decrease in the classes of beta-lactam/beta-lactamase inhibitors, cephalosporins and glycopeptides, although the changes were not statistically significant. The acquisition rate of carbapenem-resistant
Conclusion: Implementing PAF twice a week in the neurological/surgical ICUs could reduce antibiotic usage and the acquisition rates of some resistant bacteria.
HIRA Research 2023; 3(2): 171-181
Methods: The study sample comprised WL prescriptions (Rxs) shared via a portal site for 1 year (from June 2022 to May 2023). WL drugs were classified into four categories: (1) on-label WL drugs; (2) off-label WL drugs; (3) medication-induced symptom management drugs; (4) dietary supplements and others. We calculated prescribing occurrence rates for each category and drugs. Further, we investigated the usage of off-label and psychotropic drug prescribing.
Results: The study sample included 66 Rxs consisting of 63 active ingredients. The average number of medications per Rxs was seven (range, 1–13). Acetaminophen/caffeine/(pseudo)ephedrine (59.1%) and topiramate (54.5%) were the most commonly used medicines. The most frequently prescribed drug regimen involved a combination of on-label WL, off-label WL, and medication-induced symptom management drugs.
Conclusion: Psychotropic appetite suppressants have been prescribed with unapproved WL drugs or psychotropic anti-anxiety/hypnotics. Further research is needed to provide evidence on drug combinations to ensure the safety of WL treatments.
HIRA Research 2023; 3(2): 182-195
Methods: We conducted a cross-sectional study using the National Health Insurance Claims Database. This study included all patients with depression aged 18 years or older who were newly admitted to hospitals from January 1, 2017 to December 31, 2018. A generalized estimating equation was used to explore the association between receiving outpatient follow-up care within 7 days of hospital discharge and various factors, such as age, sex, insurance type, comorbidity, and previous outpatient care.
Results: Of the 15,018 patients included in the study, 60.2% were female, and 6,886 patients (45.9%) received outpatient follow-up care within 7 days after hospital discharge. Patients who were females and those with previous outpatient care experience were more likely to receive outpatient follow-up care (odds ratio [OR] 1.410, 95% confidence interval [CI] 1.317-1.511; OR 2.502, 95% CI 2.269-2.759; respectively). In contrast, older and medicaid patients were less likely to receive outpatient care within 7 days after discharge.
Conclusion: To prevent suicide and relapse, discharge planning interventions should be actively provided to vulnerable groups, such as older individuals, males, medicaid patients, and patients without previous outpatient care experience.
HIRA Research 2023; 3(2): 196-204
Methods: We examined National Health Insurance claims data in the Health Insurance Review & Assessment Service (HIRA) from 2008 to 2016 and identified all dementia cases. We calculated crude age- and sex-standardized prevalence by socioeconomic status. Health insurance types (Medical Aid and National Health Insurance beneficiaries) were used as socioeconomic status indicators.
Results: The age- and sex-standardized prevalence for dementia by health insurance type consistently increased, which was prominent among patients aged ≥85 years from 2008 to 2016. Rate ratio of age- and sex-standardized prevalence in Medical Aid beneficiaries (904.1–1,793.3 per 100,000 individuals, from 2008 to 2016) was approximately three times higher than that in National Health Insurance beneficiaries (311.0–622.6). Among patients aged <60 years, rate ratio difference of the age- and sex-standardized prevalence was estimated at 15.4 times in 2008 (15.2 in National Health Insurance and 233.6 in Medical Aid) and 26.5 times in 2016 (21.4 in National Health Insurance and 565.8 in Medical Aid).
Conclusion: The rate ratio of age- and sex-standardized prevalence for dementia in Medical Aid beneficiaries was approximately three times higher than that in National Health Insurance beneficiaries from 2008 to 2016. Moreover, difference in prevalence of early onset dementia (<60 years of age) highly increased. Therefore, Korean healthcare policy must prioritize dementia prevention and treatment according to socioeconomic status (Medical Aid beneficiaries), specifically for early onset dementia.
HIRA Research 2023; 3(2): 205-212
HIRA Research 2023; 3(2): 213-221