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        요추 추간판 탈출증 환자의 의·한의 협진 의료이용 현황 분석: 건강보험심사평가원 환자표본 데이터를 이용하여

        고준혁 ( Jun-Hyuk Ko ),유지웅 ( Ji-Woong Yu ),서상우 ( Sang-Woo Seo ),서준원 ( Joon-Won Seo ),강준혁 ( Jun-Hyuk Kang ),김태오 ( Tae-Oh Kim ),조휘성 ( Whi-Sung Cho ),서연호 ( Yeon-Ho Seo ),안종현 ( Jong-Hyun Ahn ),이우주 ( Woo-Joo 한방재활의학과학회 2021 한방재활의학과학회지 Vol.31 No.4

        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. (J Korean Med Rehabil 2021;31(4):105-116)

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        소아 경골 간부 골절 후 발생하는 과성장

        김하용(Hayong Kim),나규현(Kyu Hyun Na),고준혁(Joon Hyuk Ko),김갑중(Kap Jung Kim),안재훈(Jae Hoon Ahn),최원식(Won Sik Choi) 대한정형외과학회 2006 대한정형외과학회지 Vol.41 No.2

        목적: 소아 경골 간부 골절 후 하지 4 장골의 상대적 성장을 측정하고, 이에 영향을 미치는 요인을 분석하고자 하였다. 대상 및 방법: 소아 경골 간부 골절 환자 중 도수 정복 후 장하지 석고 붕대 고정으로 치료받았던 38예의 의무 기록과 Bell-Thmpson 사진을 후향적으로 분석하였다. 평균 추시 기간은 54.4개월(24-96개월)이었다. 결과: 전예에서 임상적으로는 우수하였다. 환측 경골의 과성장은 4.4±3.3 ㎜이었다. 환측 대퇴골은 평균 0.9±3.7 ㎜의 과성장을 보였다. 전체적으로 환측 하지는 5.3±5.4 ㎜의 과성장을 보였다. 성별, 골절 부위와 비골 골절 유무는 과성장에 유의한 영향을 미치지 않았다. 수상 당시 연령은 통계적으로 유의하게 과성장에 영향을 주었다. 4예에서 환측 대퇴골이 10 ㎜ 이상의 과성장을 보였다. 결론: 소아의 하지 장골은, 경골 골절로 치료 받은 후, 다양한 성장을 보였다. 최종 하지 길이의 치는 골절된 경골뿐 아니라, 환측 대퇴골의 과성장도 관여한다고 생각된다. Purpose: To assess the comparative growth of the four long bones of the lower extremities after the tibial shaft fractures in children. Materials and Methods: Thirty-eight children (age, 8.2±2.6) with tibial shaft fractures treated with a closed reduction and a long leg cast were enrolled in this study. The mean follow-up was 54.4 months (range, 24-96). The medical records and Bell-Thompson images were retrospectively reviewed. Results: The clinical results were excellent in all cases. The fractured tibia showed overgrowth (4.4±3.3 ㎜) compared with the contralateral side. The ipsilateral femur showed mild over-growth (0.9 ㎜±3.7), and the final leg length discrepancy was 5.3 ㎜±5.4. Four ipsilateral femurs showed overgrowth > 10 ㎜. Gender, the level of the fractures and associated fibular fractures did not affect the overgrowth of the fractured tibia (p>0.05). However, age might affect the amount of overgrowth (p=0.005). Conclusion: Tibial shaft fractures in children treated with a long leg cast showed variable overgrowth. The final leg length discrepancy was influenced by the overgrowth of the ipsilateral femur as well as by overgrowth of the tibia.

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