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1
MRI 외부병원 판독 수가 인상의 효과 분석: 뇌 관련 자기공명영상을 중심으로

김록영 ( Logyoung Kim ),사공진 ( Jin Sakong ),조민호 ( Minho Jo ),위세아 ( Seah Wee ),이진용 ( Jinyong Lee ),김용규 ( Yongkyu Kim ) 한국보건행정학회 2021 보건행정학회지 Vol.31 No.3
- 원문보기 2
  ScienceON
  
  KISS
Background: In 2018, the government increased the fee for the magnetic resonance imaging (MRI) image deciphering services of the external hospital to discourage the redundant MRI scan and to induce appropriate use of the MRI services. It is important to evaluate the effect of the policy to provide the basis for establishing other MRI-related policies. Methods: The healthcare data of the patients who had brain MRI scans were organized by episode and analyzed using the panel study in order to find out the effect of the MRI-related policy on the substitution effect and the medical expenses. Results: As a result of the increase in the fee of deciphering the MRI image, there has been an uplift in deciphering the MRI scan of the external hospital. It implies that more hospitals chose to use the MRI scan taken by other clinics or hospitals, rather than the MRI scan taken at their own facilities. Conclusion: The research results imply that a policy that facilitates the exchange of the medical image data between the hospitals is needed in order to establish an efficient management system of the healthcare resources. Such improvement is expected to reduce the social cost and contribute to the stability in the finance of national health insurance.
2
Ambient temperature and hospital admissions for acute kidney injury: A time-series analysis

Lim, Youn-Hee,So, Rina,Lee, Choongho,Hong, Yun-Chul,Park, Minseon,Kim, Logyoung,Yoon, Hyung-Jin Elsevier 2018 Science of the Total Environment Vol.616 No.-
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Abstract Some studies have suggested that high ambient temperatures are a risk factor for kidney-related diseases. However, none have examined the association between ambient temperature and acute kidney injury (AKI). This study aimed to examine the association between daily mean temperature and AKI and identify high-risk subgroups in this association. We obtained health insurance claim data from the Health Insurance Review and Assessment Service (HIRA) for 24,800 admitted cases of AKI during the period 2007–2014 in Seoul, Korea. Using a time-series design and piecewise linear regression models, we estimated the percentage change in AKI admissions associated with daily mean temperature after controlling for relevant covariates. Daily mean temperature and AKI admissions displayed an inverse association in the cold season and a nonlinear relationship with a flexion point around 28.8°C in the warm season. AKI admissions increased by 23.3% (95% confidence interval [CI]: 14.3, 33.0) per 1°C increase in mean temperature above the 28.8°C flexion point in the warm season. The estimates were greatest among men with hypertension (55.1%; 95% CI: 25.1, 92.2). However, we did not observe significant increases in AKI admissions associated with ambient temperature in the cold season (0.4% [95% CI: −0.1, 0.9] per 1°C decrease in mean temperature). Our results suggest that hospital admissions for AKI increase in association with high temperature, particularly among men with hypertension in the warm season. Thus, early detection of AKI during heat wave periods is crucial. Our findings also provide evidence for the local government to target populations vulnerable to high ambient temperatures. Highlights <UL> <LI> High temperature and acute kidney injury have a strong relationship. </LI> <LI> A nonlinear relationship with a flexion point was observed in the warm season. </LI> <LI> Men with hypertension were most vulnerable to high ambient temperatures. </LI> </UL> Graphical abstract [DISPLAY OMISSION]
3
Metabolic comorbidities and medical institution utilization among breast cancer survivors: a national population-based study

( Jaesung Heo ),( Mison Chun ),( Young-taek Oh ),( O Kyu Noh ),( Logyoung Kim ) 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.2
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  KCI
  
  KISS
Background/Aims: We investigated metabolic comorbidity status and patterns of medical institution utilization among breast cancer survivors using medical claims data from the Health Insurance Review and Assessment Service (HIRA). Methods: Using claims data obtained from the HIRA, we selected breast cancer survivors between 2010 and 2015. Descriptive statistics were calculated to determine the frequency of metabolic comorbidities, as well as to analyze patterns of medical institution utilization in accordance with disease status. Results: A total of 89,953 breast cancer survivors were identified. Among these, 12,364 (13.7%) had hypercholesterolemia, 20,754 (23.1%) had hypertension (HTN), and 11,102 (12.3%) had diabetes mellitus (DM). In particular, more than half of breast cancer survivors older than 60 years had HTN, and other diseases sharply increased beginning at age 50 years. For HTN, a total of 531,292 claims were submitted; more than 80% (n = 473,737) were from primary medical institutions, whereas only 2.4% (n = 12,551) were from tertiary medical institutions. The number of claims submitted for DM was 231,526; those from primary medical institutions accounted for 68.5% (n = 158,566), whereas claims from tertiary medical institutions accounted for 12.0% (n = 27,693). In subgroup analyses, the utilization of secondary and tertiary medical institutions was higher among patients with severe diseases and those diagnosed following their breast cancer diagnosis. Conclusions: More than 10% of breast cancer survivors were diagnosed with a metabolic comorbidity. Through analysis of medical institution utilization patterns, we ascertained that a communication system linking secondary and tertiary medical institutions with primary medical institutions is needed.