- Association Between Prophylactic Antibiotic Use and Surgical Site Infection Based on Quality Assessment Data in Korea.
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Kyoung Hoon Kim, Choon Seon Park, Jin Hee Chang, Nam Soon Kim, Jin Seo Lee, Bo Ram Choi, Byung Ran Lee, Kyoo Duck Lee, Sun Min Kim, Seon A Yeom
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J Prev Med Public Health. 2010;43(3):235-244.
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DOI: https://doi.org/10.3961/jpmph.2010.43.3.235
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 Abstract
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- OBJECTIVES
To examine the prophylactic antibiotic use in reducing surgical site infection. METHODS: This was a retrospective study for patients aged 18 years and older who underwent gastrectomy, cholecystectomy, colectomy, cesarean section and hysterectomy. The data source was quality assessment data of the Health Insurance Review & Assessment Service gathered from medical records of 302 national hospitals. Prophylactic antibiotic use was defined as: timely antibiotic administration or inappropriate antibiotic selection. We performed hierarchical logistic regression to examine the association between prophylactic antibiotic use and surgical site infection with adjustment for covariates. RESULTS: The study population consisted of 16 348 patients (1588 gastrectomies, 2327 cholecystectomies, 1,384 colectomies, 3977 hysterectomies and 7072 cesarean sections) and surgical site infection was identified in 351 (2.1%) patients. The rates of timely antibiotic administration and inappropriate antibiotic selection varied according to procedures. Cholecystectomy patients who received timely prophylactic antibiotic had a significantly reduced risk of surgical site infection compared with those who did not receive a timely prophylactic antibiotics (OR 0.64, 95% CI=0.50-0.83), but no significant reduction was observed for other procedures. When inappropriate prophylactic antibiotics were given, the risk of surgical site infection significantly increased: 8.26-fold (95% CI=4.34-15.7) for gastrectomy, 4.73-fold (95% CI=2.09-10.7) for colectomy, 2.34-fold (95% CI=1.14-4.80) for cesarean section, 4.03-fold (95% CI=1.93-8.42) for hysterectomy. CONCLUSIONS: This study examines the association among timely antibiotic administration, inappropriate antibiotic selection and surgical site infection. Patients who received timely and appropriate antibiotics had a decreased risk of surgical site infection. Efforts to improve the timing of antibiotic administration and use of appropriate antibiotic are needed to lower the risk of surgical site infection.
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Citations
Citations to this article as recorded by  - The effect of first- and third-generation prophylactic antibiotics on hospitalization and medical expenditures for cardiac surgery
Sung-Jin Bae, Inah Kim, Jaechul Song, Euy-Suk Chung
Journal of Cardiothoracic Surgery.2022;[Epub] CrossRef - Incidence and Risk Factors of Wound Infection in Women Who Underwent Cesarean Section in 2014 at King Abdulaziz Medical City, Jeddah
Roaa Gadeer , Nada Y Baatiah, Nourah Alageel, Mohammed Khaled
Cureus.2020;[Epub] CrossRef - Pay-for-performance reduces healthcare spending and improves quality of care: Analysis of target and non-target obstetrics and gynecology surgeries
Seung Ju Kim, Kyu-Tae Han, Sun Jung Kim, Eun-Cheol Park
International Journal for Quality in Health Care.2017; 29(2): 222. CrossRef - Comparing the Postoperative Complications, Hospitalization Days and Treatment Expenses Depending on the Administration of Postoperative Prophylactic Antibiotics to Hysterectomy
Mi Young Jung, Kyung-Yeon Park
Korean Journal of Women Health Nursing.2017; 23(1): 42. CrossRef - Risk Factors for Surgical Site Infections According to Electronic Medical Records Data
Young Hee Kim, Young-Hee Yom
Journal of Korean Academy of Fundamentals of Nursing.2014; 21(2): 151. CrossRef - Morbidity and risk factors for surgical site infection following cesarean section in Guangdong Province, China
Shi‐Peng Gong, Hong‐Xia Guo, Hong‐Zhen Zhou, Li Chen, Yan‐Hong Yu
Journal of Obstetrics and Gynaecology Research.2012; 38(3): 509. CrossRef - Overview of Antibiotic Use in Korea
Baek-Nam Kim
Infection & Chemotherapy.2012; 44(4): 250. CrossRef - The effect of surgical site infection on the length of stay and health care costs
Jin-Hee Chang, Kyoung-Hoon Kim, Soon-Man Kwon, Seon-A Yeom, Choon-Seon Park
Korean Journal of Health Policy and Administration.2011; 21(1): 44. CrossRef - Risk factors for surgical site infection in children at the teaching hospital Gabriel Touré, Bamako
A. Togo, Y. Coulibaly, B.T. Dembélé, B. Togo, M. Keita, L. Kanté, A. Traoré, I. Diakité, H. Ouologuem, G. Diallo
Journal of Hospital Infection.2011; 79(4): 371. CrossRef - The Feasibility of Short Term Prophylactic Antibiotics in Gastric Cancer Surgery
Jun Suh Lee, Han Hong Lee, Kyo Young Song, Cho Hyun Park, Hae Myung Jeon
Journal of Gastric Cancer.2010; 10(4): 206. CrossRef
- Factors Influencing Antibiotics Prescribing of Primary Health Physicians in Acute Upper Respiratory Infections.
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Nam Soon Kim, Soong Nang Jang, Sun Mee Jang
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J Prev Med Public Health. 2005;38(1):1-8.
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To explore the factors influencing antibiotics prescription by primary health physicians for acute upper respiratory infections (URI). METHODS: We performed a survey of 370 primary health physicians randomly sampled in April, 2003. The questionnaire consisted of a prescription on the scenario of acute bronchitis case, along with opinions and reasons for prescribing antibiotics on URI. RESULTS: We found that 54.7% of the physicians prescribed antibiotics on the example case of acute bronchitis which is known as not needing antibiotics. Female physicians and ENT physicians had a greater tendency to prescribe antibiotics. The factors influencing antibiotics prescription on URI were the belief about the effectiveness of antibiotics, preference for their own experiences rather than clinical guidelines, perception of patients' expectations, and perception of competitive environment. The prescription of antibiotics in the example case was affected by how much they usually prescribe antibiotics (OR=2.400, 95% CI=1.470-3.917) and the physicians who thought that antibiotics were helpful for their income prescribed antibiotics more than others (OR=6.773, 95% CI=1.816-25.254). CONCLUSION: These findings demonstrated that the false belief on the effectiveness of antibiotics, patient's expectation of medication and fast relief of symptoms, and perception of competitive environment all affected the physicians' prescription of antibiotics on URI. It may help to find barriers to accommodate scientific evidence and clinical guidelines among physicians and to specify subgroups for education about appropriate prescription behaviors.
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- Socioeconomic Costs of Obesity for Korean Adults.
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Baek Geun Jeong, Ok Ryun Moon, Nam Soon Kim, Jae Heon Kang, Tae Ho Yoon, Sang Yi Lee, Sin Jae Lee
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Korean J Prev Med. 2002;35(1):1-12.
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To estimate the socioeconomic costs of obesity in Korea, 1998. METHODS: The 1998 National Health and Nutrition Examination Survey (1998 NHNES) data was used and 10,880 persons who had taken health examinations were selected for study. Essential hypertension, NIDDM (non insulin-dependent diabetes mellitus), dyslipidemia, osteoarthritis, coronary heart disease, stroke were included as obesity related disease. The data of direct costs of obesity was obtained from the National Federation of Medical Insurance. The category of indirect costs was the loss of productivity caused by premature death and admission, time costs, traffic costs, nursing fees due to obesity. Multiple logistic regression model was developed to estimate prevalence odds ratio by obesity class adjusted demographic and socio-ecnomic factors and calculate PAF (Population Attributable Fraction) of obesity on obesity related disease. And we finally calculated the socioeconomic costs of obesity in relation to BMI with PAF. RESULTS: The direct costs of obesity were 2,126 billion~965 billion Won in considering out of pocket payment to uninsured services, and the indirect costs of obesity were 2,099 billion~1,086 billion Won. Consequently, in considering out of pocket payment to uninsured services, the socioeconomic costs of obesity were 4,225 billion~2,050 billion Won, which corresponded to about 0.094% ~0.046% of GDP and 1.88%~0.91 of total health care costs in Korea. CONCLUSIONS: Obesity represents a major health problem with significant economic implications for the society. This results are conservative estimates as far as all obesity related disease and all health care and indirect costs were not included due to missing information. Further studies are needed to caculate socioeconomic costs of obesity more exactly.
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- Increasing Prevalence of Obesity Related Disease for Koreans Associated with Overweight and Obesity.
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Nam Soon Kim, Ok Ryun Moon, Jae Heon Kang, Sang Yi Lee, Baek Geun Jeong, Sin Jae Lee, Tae Ho Yoon, Kyung Hwa Hwang
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Korean J Prev Med. 2001;34(4):309-315.
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To develop a better understanding of the relationship between weight status and the prevalence of obesity related diseases in the Korean population. METHODS: The 1998 Korean National Health and Nutrition Survey was used and 10,880 persons who had previously taken health examinations were selected for study. The Korean Society for the Study of Obesity's classification of weight status was used. Hypertension, diabetes mellitus, dyslipidemia, osteoarthritis, chronic heart disease, stroke were included as obesity related disease. A logistic regression model was developed to estimate the prevalence odds ratio by obesity class adjusted for demographic and socio-economic factors and we converted the odds ratio to a prevalence ratio using the base line prevalence of disease to aid in the interpretation of the ratios. RESULTS: The prevalence of obesity was 26.3% based on the KSSO classification (BMI> or =25). A graded increase in the prevalence ratio was observed with increasing severity of overweight and obesity for all health outcomes with the exception of chronic heart disease in men and stroke in both men and women. With normal weight individuals as the reference, for men who were younger than 50 years, the prevalence ratios were highest for hypertension BMI<23-25: 1.70(95% CI=1.41-2.05), 25 or =30: 4.83(95% CI=3.78-5.84). The prevalence ratios for dyslipidemia were as high as hypertension, but were lower than hypertension for diabetes mellitus and osteoarthritis. Prevalence ratios generally were greater in younger adults. The prevalence of having 2 or more obesity related diseases increased with weight status category, except in people who were older than 50 years. CONCLUSIONS: Based on results, obesity is an increasingly important health problem in Korea and the disease burden increases according to weight status. For Korean adults, the strongest relationship was seen between weight status and hypertension and dyslipidemia. In older people the impact of excess weight and obesity is stronger than that seen in younger people. Increased efforts in the study of obesity and prevention and treatment of obesity and obesity related disease are required.
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- Change of Medical Utilization Claims in Self-employees before and after the Economic Crisis in Korea.
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Sin Jae Lee, Ok Ryun Moon, Won Ki Jhang, Soon Ae Choi, Sang Yi Lee, Nam Soon Kim, Baek Geun Jeong
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Korean J Prev Med. 2001;34(1):28-34.
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To investigate the changing pattern of medical utilization claims following the economic crisis in Korea. METHODS: The original data consisted of the claims of the 'Medical insurance program of self-employees' between 1997 and 1998. The data was selected by medical treatment day ranging between 1 January and 30 June. Medical utilizations were calculated each year by the frequency of claims, visit days for outpatients, length of stay for inpatients, total days of medication, and the sum of expenses. RESULTS: The length of stay as an inpatient in 1998 was decreased 4.7 percent in comparison to 1997. However, inpatient expenses in 1998 increased 10.8 percent as compared to 1997. Inpatient hospital claims in 1998 increased 6.2 percent over 1997, although general hospital inpatient claims in 1998 decreased 3.3 percent in comparison to 1997. The outpatient claim frequency decreased 7.3 in 1998 percent as compared to 1997. Outpatient visit days of in 1998 were decreased 8.5 percent in comparison to that recorded in 1997. Outpatient claim frequencies of 'gu region' in 1998 decreased 10.5 percent comparison to that in 1997, but 'city and gun region' decreased less than 'gu region'. CONCLUSIONS: Medical utilization in 1998 deceased in relation to 1997. Medical utilization by outpatients decreased more than that of inpatients. Medical utilization by 'gu regio n' decreased more than the other regions.
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