• Title/Summary/Keyword: Collaborative treatment

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Economic Evaluation of Eastern, Western and Collaborative Treatments for Patients with Frozen Shoulder Pain (견비통의 한${\cdot}$양방 진료 및 협진의 경제성 평가)

  • Jang, Hye-Jung;Hong, Sang-Min;Park, You-Seon;Nam, Dong-Woo;Lim, Doo-Ik;Lee, Jae-Dong;Lee, Yun-Ho;Lim, Sabina
    • The Journal of Korean Medicine
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    • v.28 no.1 s.69
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    • pp.72-86
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    • 2007
  • Objectives : The purpose of this study was to evaluate and compare the cost-effectiveness of Eastern, Western, and collaborative treatments and suggest a cost-effective approach for patients with frozen shoulder pain. Methods : Using the data of fifty-two patients, treatment effectiveness was measured by CSA, SPABI, and ROM scales and changes from the baseline score were evaluated. Data source for cost estimation was based on the national health insurance (NHI) payment system. Because the price in NHI was differentiated by health care institutions, five collaborative types were considered in assessing costs. Cost-effective ratios were computed for economic evaluation. Results : Compared with Eastern treatment, collaborative and Western treatments showed better effects on CSA scale after 4 weeks' treatment. The collaborative approach was also the most effective treatment on SPADI and ROM scales. The direct cost per patient receiving Eastern treatment was less than other treatments. In general, collaborative treatment dominated Eastern and Western treatments in cost-effectiveness an analysis. However, the cost-effectiveness ratio of Eastern treatment resulted in \9,000 compared to \29,000 of collaborative treatment on SPADI. Four different indicators of ROM scales resulted in different approaches as the cost-effective treatment. Conclusions : Considering cost-effectiveness ratios, collaborative treatment was the best treatment on CSh and SPADI scales after 4 weeks' treatment. As for ROM scales, the recommended alternatives were Eastern treatment for patients with abduction and adduction disabilities, Western treatment for those with flexion disability, and collaborative approach fir those with extension disabiliry.

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A study on the facial palsy patients' use of Western-Korean collaborative treatment: Using Health Insurance Review & Assessment Service-National Patients Sample (얼굴마비 환자의 의·한의 협진 의료이용 연구: 건강보험심사평가원 환자표본 데이터를 이용)

  • Park, Hyo Sung;Uhm, Tae Woong;Kim, Nam Kwen
    • Journal of the Korean Data and Information Science Society
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    • v.28 no.1
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    • pp.75-86
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    • 2017
  • The facial palsy is one of the most common illness in Western-Korean collaborative treatment (hereinafter "collaborative treatment"). The purpose of this study is to analyze facial palsy patients'collaborative treatment use patterns. By analysing the 2014 National Health Insurance Review and Assessment Patient Sample Data (NPS 2014) with the episode of care unit, we have found the following results. First, the collaborative treatment is preferred by patients over 50 years old and female. Second, western medicine mainly focuses on diagnosis and medical examination while korean medicine and collaborative treatment focus more on treatment activity. Third, western medicine showed the shortest treatment period, followed by korean medicine and collaborative treatment. However, the cost of medical treatment per day is highest in western medicine. The analysis of the use patterns of collaborative treatment shown in the study is expected to provide a direction for the development of clinical practice guidelines and the establishment of medical policies in the future.

A study of Utilization behavior in patients receiving Korean Medicine and Western Medicine collaboration (의·한의 협진 의료이용 행태 분석 연구)

  • Kim, Hyun-Min;Kim, Nam-Kwen;Nam, Soon-Hoo;Lee, Hye-Yoon
    • Journal of Society of Preventive Korean Medicine
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    • v.22 no.2
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    • pp.25-32
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    • 2018
  • Objectives : This study was conducted to investigate the frequent diseases among the people who had been treated by collaborative treatment of Korean medicine and Western medicine, and to compare their medical use behaviors before and after the collaborative first-stage pilot project between Korean medicine and Western medicine. Methods : 4,467 patients were identified as the patients who are participated in the collaborative first-stage pilot project between Korean medicine and Western medicine during the period between July 15, 2016 and March 31 2017. We used 28,480 records of Korean national health insurance claim data from January 1 2016 to March 31 2017 to analyzed present condition of cooperative medical usage. Also we conducted a paired t test to compare the percentage of collaborative treatment days before and after the pilot project period. Results : We found that the most frequent diseases treated in the pilot project were the diseases of musculoskeletal and nervous system and then 10 major diseases such as H, K, J, C (D), N, L, E, A, H and F disease codes in order. Also it was confirmed that 14 major and 53 medium diseases are included from more than 90% of total patients. As a result of high frequency of medical treatment in Western medicine or Korean medicine is "administration of Korean medicine", which is same as before and within the pilot project. The ratio of utilizing both Western and Korean medical care for the same disease on the same day by both general patients and patients in KCD-7 disease code group C, G, I, M and S had been increased significantly. Conclusions : The pilot project might change the behavior of utilizing the medical care service by increasing the ratio of collaborative treatment of Western medicine and Korean medicine for the same disease on the same day.

Comparison of Efficacy between Acupuncture Treatment and Collaborative Treatment with Prednisolone on Acute Bell's Palsy (급성 Bell's Palsy의 침 치료와 Prednisolone을 병행한 협진 치료의 효과 비교)

  • Yi, Joo-Il;Kim, Hae-Jin;Ryu, Eun-Kyung
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.3
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    • pp.125-132
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    • 2013
  • Objectives The purpose of this study was to compare the effects of acupuncture treatment with those of collaborative treatment regarding acute Bell's palsy. Methods Twenty-six patients who received outpatient treatment between March 2012 and February 2013 were divided into 2 groups. The East-West treatment group (EW group, n=12) received prednisolone and then acupuncture afterwards. The Eastern treatment group (E group, n=14) received just acupuncture. Acupuncture was administered 3 to 4 times a week, and both groups were educated to practice facial muscle exercises at home. Evaluations were made before treatment, after 1 week, 2 weeks, and 3 weeks using the House-Brackmann facial nerve grading system. Results Compared to before treatment, the House-Brackmann grades of both EW and E groups after 1, 2 and 3 weeks of treatment significantly decreased (p<0.05). Regarding group comparison, the House-Brackmann grade of the EW group was significantly lower than the E group at 1 week (p=0.043), but there was no significant difference at 2 and 3 weeks. Regarding improvement of House-Brackmann grades, there was no significant difference between the two groups at 1, 2 and 3 weeks (p>0.05). Conclusions Compared to just acupuncture treatment, collaborative treatment with prednisolone significantly improved the House-Brackmann grade after 1 week, but there was no difference as time passed. Because early intervention determines the prognosis of Bell's palsy, collaborative treatment at the early stage will be clinically helpful to patients.

Comparison of Efficacy between Medial Branch Block and Collaborative Treatment with Acupuncture on Acute Low Back Pain (급성 요통의 내측지 차단술 단독 치료와 침을 병행한 협진 치료의 효과 비교)

  • Yi, Joo-Il;Na, Yu-Jin;Kim, Byung-Hean;Ryu, Eun-Kyung
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.2
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    • pp.151-161
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    • 2013
  • Objectives : The purpose of this study was to compare the effects of acupuncture and medial branch block(collaborative treatment) with just medial branch block regarding acute low back pain. Methods : Forty inpatients who received treatment between January 2012 and February 2013 were divided into 2 groups. The East-West treatment group(EW group, n=20) received one treatment of medial branch block and then acupuncture afterwards. The Western treatment group(W group, n=20) received one treatment of medial branch block. Both groups continued to receive manual therapy 3 times a week. Evaluations were made before medial branch block, 7 days after, and 14 days after using the Numerical Rating Scale(NRS). Results : Compared to before treatment, the NRS score of both EW and W groups after 7 and 14 days of treatment significantly decreased(p=0.0001). But only the EW group showed additional improvement between days 7 and 14(p=0.005). Regarding group comparison, the NRS score of the EW group was significantly lower than the W group at 7 days(p=0.037), and even more at 14 days(p<0.0001). Conclusions : Although medial branch block alone significantly improved acute low back pain, collaborative treatment with acupuncture was even more effective, with increased efficacy as time passed. Further research is recommended regarding the effects of collaborative treatment with acupuncture on acute low back pain.

A Study on the System of Collaborative Practice between Korean Traditional Medicine and Western Medicine for Dementia based on a Case Study (증례를 통해 본 치매의 한양방 협진 모델 연구)

  • Lee, Go-Eun;Yang, Hyun Duk;Jeon, Won Kyung;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.3
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    • pp.211-228
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    • 2013
  • Objectives : This report describes the diagnostic and therapeutic procedures of Collaborative Practice between Korean Traditional Medicine and Western Medicine for two dementia patients. Furthermore, through these cases, we suggest a model of collaborative practice between Korean traditional medicine and western medicine for the treatment of dementia. Methods : Two patients suffering from several symptoms related to dementia received collaborative practice between Korean traditional medicine and western medicine. Physicians of deparment which paient first visit interviewed patient and patient's guardians, discussed the symptoms and the status of the patient. Since then, the medical team made a differential diagnosis based on the results of brain imaging, hematology, urine test. and apprehended the status of dementia by the neuropsychological test. Korean traditional physicians examined the physical symptoms and identified the pattern of dementia in Korean traditional medicine. Following this, they decided on the method of acupuncture, moxibustion, cupping and herbal treatment. Western physicians decided on the type of medication after consideration of the patient's other medical conditions. Every intervention was decided by both Korean traditional physicians and western physicians after discussion. The medical team provided education on dementia and counseled the guardians. They also wrote the paper for using the long-term care insurance for the aged. Results : Two patients showed no improvement on the neuropsychologic and activity of daily living tests. However, the patients' subjective physical symptoms were improved. The collaborative practice between Korean traditional medicine and western medicine improved the patients' and guardians' satisfaction. Conclusions : Through these cases, we propose a model of collaborative practice between Korean traditional medicine and western medicine for dementia categorized diagnosis-test, treatment, prevention, management. More specifically, we supplement qigong and psychotherapy which was inadequate in these cases.

Analysis of Lumbar Herniated Intervertebral Disc Patients' Healthcare Utilization of Western-Korean Collaborative Treatment: Using Health Insurance Review & Assessment Service's Patients Sample Data (요추 추간판 탈출증 환자의 의·한의 협진 의료이용 현황 분석: 건강보험심사평가원 환자표본 데이터를 이용하여)

  • Ko, Jun-Hyuk;Yu, Ji-Woong;Seo, Sang-Woo;Seo, Joon-Won;Kang, Jun-Hyuk;Kim, Tae-Oh;Cho, Whi-Sung;Seo, Yeon-Ho;Ahn, Jong-Hyun;Lee, Woo-Joo;Kim, Bo-Hyung;Choi, Man-Khu;Kim, Sung-Bum;Kim, Hyung-Suk;Kim, Koh-Woon;Cho, Jae-Heung;Song, Mi-Yeon;Chung, Won-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.4
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    • pp.105-116
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    • 2021
  • Objectives Lumbar herniated intervertebral disc (L-HIVD) is common disease in which Western-Korean collaborative treatment is performed in Korea. This study aimed to analyze Western-Korean collaborative treatment utilization of Korean patients with L-HIVD using Health Insurance Review & Assessment Service's Patients Sample Data. Methods This study used the Health Insurance Review & Assessment Service-National Patient Sample (HIRA-NPS) in 2018. Claim data of L-HIVD patients were extracted. The claim data were rebuilt with the operational concept of 'episode of care' and divided into Korean medicine episode group (KM), Western medicine episode group (WM) and collaborative treatment episode group (CT). General characteristics, medical expenses and healthcare utilization were analyzed. In addition, the difference of average visit day and average medical expenses between non-collaborative group (KM plus WM) and CT were analyzed by the propensity score matching method. Results A Total of 64,333 patients and 365,745 claims were extracted. The number of episodes of WM, KM and CT was 69,383 (92.97%), 3,903 (5.23%), and 1,341 (1.80%) respectively. The frequency of collaborative treatment episode was higher in women and the age of 50s. The most frequently described treatment in CT was acupuncture therapy. As a result of the propensity score matching, the number of visit days and medical expenses in the collaborative treatment group was higher than in the non-collaborative group. Conclusions The analysis of healthcare utilization of Korean-Western collaborative treatment may be used as basic data for establishing medical policies and systematic collaborative treatment model in the future.

Arsenic Trioxide Inhibits Cell Growth and Invasion via Down-Regulation of Skp2 in Pancreatic Cancer Cells

  • Gao, Jian-Kun;Wang, Li-Xia;Long, Bo;Ye, Xian-Tao;Su, Jing-Na;Yin, Xu-Yuan;Zhou, Xiu-Xia;Wang, Zhi-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3805-3810
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    • 2015
  • Arsenic trioxide (ATO) has been found to exert anti-cancer activity in various human malignancies. However, the molecular mechanisms by which ATO inhibits tumorigenesis are not fully elucidated. In the current study, we explored the molecular basis of ATO-mediated tumor growth inhibition in pancreatic cancer cells. We used multiple approaches such as MTT assay, wound healing assay, Transwell invasion assay, annexin V-FITC, cell cycle analysis, RT-PCR and Western blotting to achieve our goal. We found that ATO treatment effectively caused cell growth inhibition, suppressed clonogenic potential and induced G2-M cell cycle arrest and apoptosis in pancreatic cancer cells. Moreover, we observed a significant down-regulation of Skp2 after treatment with ATO. Furthermore, we revealed that ATO regulated Skp2 downstream genes such as FOXO1 and p53. These findings demonstrate that inhibition of Skp2 could be a novel strategy for the treatment of pancreatic cancer by ATO.

Fouling and cleaning protocols for forward osmosis membrane used for radioactive wastewater treatment

  • Liu, Xiaojing;Wu, Jinling;Hou, Li-an;Wang, Jianlong
    • Nuclear Engineering and Technology
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    • v.52 no.3
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    • pp.581-588
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    • 2020
  • The membrane fouling is an important problem for FO applied to the radioactive wastewater treatment. The FO fouling characteristics for simulated radioactive wastewater treatment was investigated. On-line cleaning by deionized (DI) water and external cleaning by ultrasound and HCl were applied for the fouled membrane. The effectiveness and foulant removing amount by each-step cleaning were evaluated. The membrane fouling was divided into three stages. Co(II), Sr(II), Cs(I), Na(I) were all found deposited on both active and support layers of the membrane surface, resulting in membrane surface became rougher and more hydrophobic, which increased membrane resistance. On-line cleaning by DI water recovered the water flux to 69%. HCl removed more foulants than ultrasound.

The Study on the Korean Traditional Medical Treatment and System of Collaborative Practice Between Korean Traditional Medicine and Western Medicine for Dementia: Based on Analysis of Questionnaire Survey in Professional Group (치매의 한방치료와 한양방 협진치료에 관한 전문가 집단 설문연구)

  • Lee, Go-Eun;Jeon, Won-Kyung;Heo, Eun-Jung;Yang, Hyun Duk;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.23 no.4
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    • pp.49-68
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    • 2012
  • Objectives : Recently, the elderly population and dementia prevalence have been rapidly increasing in Korea. Dementia is a concept of syndrome composed of characteristic symptoms. However, there have been no approved treatments for dementia with proven efficacy. Therefore, we investigated Korean traditional treatment being used in clinic and collaborative practice for dementia in the professional group. Methods : We conducted a survey using questionnaires to professors of oriental neuropsychiatry for a month. Items of the questionnaire consisted of overall Korean traditional medical treatment for dementia, which included herbal medicine, acupuncture, moxibustion, cupping, psychotherapy and others. Results : 1. It was shown that Yukmijihwangtanggamibang, Jowiseungcheongtang, Seonghyangjeonggisan have been used the most in herbal medicine. 2. Chechim, Saamchimbeop, and scalp acupuncture have been used the most in acupuncture treatment. 3. In Korean traditional psychotherapy, Ijeongbyeongi, Jieongoronyobeop, Gigongyobeop have been used, and effective in anxiety, agitation, improvement of comprehension for caregiver and environment. 4. Most professors answered that collaborative practice between Korean traditional medicine and western medicine has been needed for dementia. They suggested that herbal medicine, followed by acupuncture, and moxibustion can be used with western medicine simultaneously. Conclusions : The survey revealed that professors use herbal medicine and acupuncture as main treatments for dementia. They share perspective regarding the need of long period to treat dementia patients, and there are needs of collaborative practice for dementia.