한양방 협진치료를 받은 치매와 경도인지장애 환자에 대한 후향적 의무기록 분석

Objectives: The aim of this study was to identify the complementary and substitute relationships between the use of Korean medicine (KM) and that of Western medicine (WM) in the treatment of musculoskeletal disease. Methods: We analyzed the 2009 Korea Health Panel dataset. General characteristics and the medical utilization of respondents were analyzed descriptively. Logistic regression, negative binominal regression, and Tobit regression analysis were used to identify the relationships between the use of KM and the use, visit frequency, and expenses of WM, respectively. Results: In the treatment of musculoskeletal disease, KM use and non-herbal treatments with Korean medicine significantly reduced WM use. Herb medication use significantly increased WM visit frequency. There were no significant relationships between KM use and WM expenses. Conclusions: There are substitute relationships between WM use and KM use, especially non-herbal treatments in KM. Therefore we need to develop the clinical protocols of KM and WM treatments in the treatment of musculoskeletal disease for proper distribution medical resources.

Background/Objectives: Parkinson's disease (PD) is a major neurodegenerative condition, mainly treated using dopamine-based therapies. However, the side effects and limitations of these therapies hinder their use. This study aimed to analyze the utilization of Korean medicine (KM) by patients with PD in Korea. Methods: Data of the Health Insurance Review and Assessment Service-National Patient Sample were used to investigate the status and trend of KM utilization by patients with PD in Korea from January 2010 to December 2019. Data of 18,562 patients were included, and analyses were performed on the status of KM and Western medicine (WM) utilization, cost of care, prescribed medications, comorbidities, and characteristics of patients with PD. Results: The number of patients who utilized KM services for PD gradually increased over the 10-year period, with 10.6% of all patients with PD using KM services in 2019. In addition, the number of KM users with PD, number of claims, and expenses all showed an increase. The rate of increase in KM service utilization was greater than that of WM. Among KM services, acupuncture had the highest expense (50.6%). Regarding comorbidities in patients with PD, musculoskeletal diseases were the most common (58.6%). Among WM medications prescribed for the KM users, dopa and dopa derivatives (15.5%) and anti-dementia drugs (11.7%) were the most common. Conclusions: This study provides useful information on KM utilization status and trends among patients with PD and the characteristics of these patients. Follow-up research is warranted on the utilization status of more diverse KM services.

BackgroundSouth Korea has maintained a dual healthcare delivery system that incorporates both traditional Korean and Western medicine. In this research, we identified the determinants of the frequency of using traditional Korean medicine among musculoskeletal patients, who are known to be the most frequent users of complementary and alternative medicine.MethodsIn this research, we reviewed 2 consecutive years of nationally representative survey data from the 2008 and 2009 Korea Health Panel Survey. We analyzed the utilization of outpatient services by musculoskeletal patients within 12 months of the 2009 survey date. A two-part model was used because some patients did not use traditional Korean medicine and skewness was present in the data on traditional Korean medicine use. In the first part, logistic regression analysis was performed to investigate the use of traditional Korean medicine. In the second part, multiple regression analysis was performed to analyze the frequency of traditional Korean medicine usage among the subjects who visited traditional Korean medical institutions.ResultsThe frequency of traditional Korean medicine usage was positively associated with ages of 40–49 years and over 60, restrictions on daily life, a greater number of chronic diseases, not being hospitalized, and more frequent visits (more than five times) to conventional hospitals or clinics for musculoskeletal disorders.ConclusionsThe important determinants of the frequency of traditional Korean medicine usage were age, activity restrictions, the number of chronic diseases, hospitalization history, and the number of visits to conventional hospitals for musculoskeletal disorders. The results contribute to our understanding of the characteristics of traditional Korean medicine users and may be used as a basic resource for related policymaking by government officials and medical professionals.

According to the Diagnosis Related Groups (DRGs) policy initiated in Taiwan in 2010, hospital payments within a given diagnosis group should be fixed, making it critical for hospitals to monitor growth of medical care costs. This study investigates how to monitor the cost of unusual factors on single vessel percutaneous transluminal coronary angioplasty (PTCA) and attempts to build a surveillance mechanism for DRGs medical care expenses. This investigation sampled objects from the National Health Insurance Database of Taiwan during 2010. This study analyzed variation in fees of single vessel PTCA in selected medical centers, and chose inpatients over 17 years old as objects for study. This study used two nonparametric control charts, Nonparametric Shewhart control chart and Nonparametric Exponentially Weighted Moving Average control chart, contributing further to constructing the mechanism for surveying medical care expenses. The selected medical center underwent construction changes, and medical expenses rose gradually increased following August 2010. The selected medical center thus had good fiscal control of single vessel PTCA surgery, and the medical expenses for most cases were lower than the standardized payment rate of National Health Insurance. This study used a Nonparametric Shewhart control chart to analyze monthly medical costs and identify unusual months. This approach was suitable for monitoring large changes in process. This study also used the Nonparametric Exponentially Weighted Moving Average control chart to estimate the current data and long-term trend data to reduce Nonparametric Shewhart control chart error, because this could not be achieved by analyzing past long-term trends. Nonparametric Exponentially Weighted Moving Average control chart had better detection of small process changes and achieved early awareness of gradual financial losses. This study used two nonparametric control charts to build the surveillance mechanism for DRGs. This study provided effective information to medical providers seeking to maintain health care quality and obtain sufficient profits to enable sustainable development by developing a mechanism for surveying medical care expenses.

How far is arterial spin labeling MRI from a clinical reality? Insights from arterial spin labeling comparative studies in Alzheimer's disease and other neurological disorders.

BackgroundThis cross-sectional, retrospective, observational study analyzed the demographics of patients with peripheral facial palsy in South Korea and their use of healthcare services.MethodsThe 2016 Korean Health Insurance Review and Assessment National Patient Sample dataset was used; a total of 4790 patients, diagnosed with facial palsy, who had used healthcare services at least once between January 2016 and December 2016 were included, and data on the use of medical services, hospitalizations, sociodemographic factors, treatments, and medications were analyzed.ResultsOverall, 326 patients per 100,000 individuals used healthcare services at least once because of peripheral facial palsy in 2016, with higher numbers for women and those aged 50–59 years. The percentage of patients who used Korean traditional medicine (KM), Western medicine (WM), and both KM and WM was 54.4, 23.3, and 22.3%, respectively. Users of both WM and KM had higher per capita medical costs, more visits, and longer treatment durations. Physiotherapy was the most frequent WM treatment (44.4%), and “examinations” was the costliest (24.7%) category. “Procedures” was both the most frequent and costliest KM category (99.9 and 57.3%, respectively). “Continuous intravenous injections” (8.6%) and “superficial heat therapy” (8.3%) were the most frequent WM treatments, while acupuncture accounted for 98% of all KM treatments.ConclusionsThis study analyzed the demographic characteristics and medical service use of patients with peripheral facial palsy in detail. These results can be used as basic information to improve clinical and policy strategies for the management and treatment of peripheral facial palsy.

<sec> <title>BACKGROUND</title> Primary headache disorders, including migraine and tension-type headache, are among the most prevalent neurological conditions worldwide, significantly contributing to disability and socioeconomic burden. While Western medicine (WM) predominantly focuses on pharmacological symptom management, Korean medicine (KM) emphasizes a holistic, individualized approach using modalities such as acupuncture and herbal medicine. Collaborative treatment, which combines these approaches, has been proposed as an alternative approach; however, robust evidence on its clinical effectiveness and cost-effectiveness remains limited. </sec> <sec> <title>OBJECTIVE</title> This study aims to evaluate the clinical effectiveness and economic value of collaborative treatment compared with usual care (UC) in patients with primary headache disorders in real-world clinical settings. </sec> <sec> <title>METHODS</title> This prospective, 2-arm, multicenter observational study will assess and compare the clinical effectiveness and economic value of collaborative treatment versus UC alone for patients with primary headache disorders. Adults aged ≥19 years with a primary diagnosis of primary headache disorders visiting participating hospitals under South Korea’s national collaborative treatment pilot project will be enrolled. Participants will receive either collaborative treatment (integrating WM pharmacotherapy with KM therapies such as acupuncture, pharmacopuncture, and herbal medicine) or UC (monodisciplinary care with WM or KM alone) based on informed choice. Clinical and cost-related outcomes will be assessed at baseline and 6 and 12 weeks. Clinical outcomes include monthly headache days, the numeric rating scale, the Headache Impact Test, the EQ-5D-5L, and the EuroQol visual analogue scale. The cost-effectiveness evaluation includes the cost per quality-adjusted life year, the incremental cost-effectiveness ratio, and the cost-effectiveness acceptability curve. Both intention-to-treat and per-protocol analyses will be performed. </sec> <sec> <title>RESULTS</title> The study protocol was approved by the institutional review boards in July 2025. The study is funded by the Ministry of Health and Welfare, Republic of Korea (grant 202500900001). Participant recruitment commenced in August 2025, aiming to enroll 312 patients across multiple centers. Data collection is currently ongoing and is projected to be completed by December 2027, with results expected to be published in 2028. </sec> <sec> <title>CONCLUSIONS</title> This study is designed to generate real-world evidence on whether collaborative treatment yields superior clinical outcomes and greater cost-effectiveness compared to UC for primary headache disorders. The findings are expected to address existing evidence gaps by integrating multidimensional clinical and economic measures, supporting informed decision-making for health policy, and contributing to the advancement of collaborative treatment models for headache management within South Korea’s medical system and beyond. </sec> <sec> <title>INTERNATIONAL REGISTERED REPORT</title> DERR1-10.2196/82819 </sec>

(Reprinted with permission from American Psychiatric Association, http://psychiatryonline.org/guidelines).

Purpose To report on a patient with subarachnoid hemorrhage and deep vein thrombosis treated with a combination of Korean and Western medicine. Methods A patient diagnosed with subarachnoid hemorrhage and deep vein thrombosis was treated with herbal medicine (åŠ æ¸›æ·¸ç†±ç€‰æ¿•æ¹¯ (Gagam-cheongyeolsaseub-tang)), acupuncture (GV2, GB20, LI11, LI4, TE5, GB34, ST36, SP9, ST38, GB39, SP6, LR3), moxibustion (CV6, CV9), and Western medicine for deep vein thrombosis and subarachnoid hemorrhage. To evaluate edema, one of the classic symptoms of deep vein thrombosis, we measured leg circumference at a specified time. Results After taking Gagam-cheongyeolsaseub-tang and being treated with acupuncture, moxibustion, and Western medicine, the patient showed improvement in leg edema. The left calf circumference decreased from 37.5 cm to 34.5 cm. Conclusions Korean medicine, acupuncture, moxibustion, and Western medicine may provide effective treatment for deep vein thrombosis in patients with subarachnoid hemorrhage, but further study is needed. Keywords: subarachnoid hemorrhage, deep vein thrombosis (DVT), Korean medicine, åŠ æ¸›æ·¸ç†±ç€‰æ¿•æ¹¯ (Gagam-cheongyeolsaseub -tang)

Background: The purpose of this study was to report the improvement of a patient with one-and-a-half syndrome, vertigo, and paresthesia caused by acute primary pontine hemorrhage (PPH) after a combination treatment of traditional Korean and Western medicine.Case report: A 51-year-old female with one-and-a-half syndrome, vertigo, and paresthesia after PPH was treated with Korean medicine, including herbal medication, acupuncture, and moxibustion, and Western medicine, including medication and rehabilitation therapy during hospitalization. Her progress was evaluated by checking for changes in symptoms with the extraocular muscle (EOM) function test, numeral rating scale (NRS), and follow-up brain computed tomography scans and magnetic resonance imaging (MRI). After 41 days of treatment, the EOM movement was improved, leaving limited abduction of the left eye. The NRS scores for vertigo and paresthesia decreased from 10 to 5 and from 10 to 3, respectively. Improvement was noted in hematoma in MRI, but a new ischemic lesion was also discovered.Conclusion: This case reports the clinical course of one-and-a-half syndrome and suggests that a combined therapy of traditional Korean and Western medicine can be useful for PPH patients with one-and-a-half syndrome, vertigo, and paresthesia. However, studies of larger populations are required.

Background: The Republic of Korea has maintained a stable number of convalescent hospitals; however, the presence of Korean Medicine(KM) doctors in such establishments has increased. Despite this trend, it is hard to find the recent researches on KM within convalescent hospitals. Objective: This study aimed to investigate the current status of convalescent hospitals, particularly focused on patient characteristics and the provision of KM.Method: Data were obtained from the Health Insurance Review&amp;Assessment Service, relying on the Korea Institute Healthcare Accreditation, spanning from January to March 2024. Analysis was conducted through the categorization of in-patients and the provision of KM, utilizing R software.Results: Among the 143 convalescent hospitals, the majority(83.9%) provided KM, with 43.4% of them located near Seoul. Convalescent hospitals offering KM were characterized by a higher number of doctors(p=0.003) and a greater total bed number(p&lt;0.001). The hospitals with KM specializing in dementia care located near Seoul and exhibited a higher proportion of doctors, total beds(p=0.010), uninsured beds, grade of certification evaluation(Gr) and supported activities of daily living(ADL)(p&lt;0.001, respectively). However, the hospitals with KM specializing in cancer care had higher rate of doctors(p=0.036), total beds, uninsured beds, Gr, and average daily out-of-pocket per person and lower levels of self ADL(p&lt;0.001, respectively). In addition, the hospitals with specialists in KM belonging to dementia care only located near Seoul(p=0.042) and exhibited a higher rate of total beds(p=0.007).Conclusion: These findings indicate significant differences among convalescent hospitals based on patient characteristics and the provision of KM. Consequently, such distinctions merit consideration in future studies.

Background Korean medicine (KM) is one of East Asian traditional medicine similar to traditional Chinese medicine and Kampo medicine in Japan. Korean medicine doctors mainly use herbal medicine, acupuncture, cupping, and manual therapies when treating patients. When Korean medicine doctors examine pediatric patients, they use questionnaires to measure the overall health status of children. Although a variety of patient-reported outcome measures (PROMs) for children have been developed, there was no validated pediatric PROM specific to KM. The aim of this study was …

Objectives: Currently, Korea’s medical services are divided into Western medicine and Korean medicine, and people who are not satisfied with the existing treatments are looking for complementary and alternative medicine(CAM). Therefore, this study attempted to confirm patients' perception of the ongoing collaborative treatment and integrated medical service that added CAM to collaborative treatment based on tertiary hospital users. So that we can confirm the expected advantage and disadvantage of integrated medical service system and the necessity of supporting medical expenses for it.Methods: The survey was conducted on 100 people who experienced tertiary hospital treatment and other 100 people who experienced both tertiary hospital treatment and Korean medicine treatment at the same period. The survey was conducted until the number of respondents in both group reached 100. The survey was conducted through e-mail and was conducted from September 27, 2021 to October 8, 2021.Results: For the advantages of collaborative treatment ‘increased in psychological stability,’ and for disadvantages ‘longer time spent for treatment’ were the most common. If integrated medical services are implemented in the future, expected advantages include ‘consideration of various treatments.’ and expected disadvantages include ‘increased medical cost.’ The needs to expand support for health insurance for integrated medical services were 75.5% among responders.Conclusions: We were able to find out the (expected) advantages and disadvantages of the collaborative medical care and the integrated medical system that medical users experienced or expected, also confirmed positive answers to the expansion of health insurance support for the integrated medical system.

Commentary on “A roadmap for the prevention of dementia II: Leon Thal Symposium 2008.” Subjective cognitive impairment as an antecedent of Alzheimer's dementia: Policy import

High Occurrence of Dementia in Older Adults Returning to Community From Prison