Chul-Min Kim

Changho An, Kichul Kim, Jae young Park, Chulmin Kim. Korean J Fam Pract 2025;15:129-35. https://doi.org/10.21215/kjfp.2025.15.3.129

Background/Objectives: The Republic of Korea is undergoing a significant demographic shift toward a population with a high proportion of older adults. In response, the Act on Integrated Support for Community Care was enacted. This study explores the role of tertiary hospitals in integrated care, aiming to enhance healthcare systems that support older individuals by facilitating the transition from hospital- to community-based care. Methods: Seoul St. Mary’s Hospital, operating under the Catholic Foundation, provides care grounded in healing and spirituality. As part of its mission, a multidisciplinary task force (TF) was formed to examine the hospital’s role in integrated care for an aging society. The TF, composed of eight experts from various departments, engaged in open discussions from September 2024 to January 2025. Results: The Integrated Care Act, which seeks to integrate medical care and caregiving within communities, requires the development of a digital system, the establishment of a governance framework for multidisciplinary collaboration, and the creation of institutions for training professionals in integrated care. Tertiary hospitals must develop department-specific models for transitional care and establish policy research institutes focused on holistic, patient-centered care. Family medicine departments can play a central role in coordinating between tertiary hospitals and local communities. Conclusions: This study highlights the importance of collaboration between medical, caregiving, and social welfare professionals as key enablers of “aging in place”. The findings underscore the evolving role of tertiary hospitals and contribute to fostering a more sustainable healthcare model for Korea’s aging population.

The Republic of Korea is transitioning into a super-aged society. In response to this demographic shift, the Act on Integrated Support for Community Care Including Medical Cure and Nursing Care was passed in 2024, with full implementation scheduled for 2026. This law aims to integrate medical and long-term care services in local communities. Given the growing demand for elderly care, tertiary hospitals are expected to play a key role in the evolving healthcare system, bridging hospital-based care and community-based support. Seoul St. Mary’s Hospital, a major tertiary hospital in Korea, formed a multidisciplinary task force to explore its potential contributions to integrated care for an aging society. This study discusses the roles of tertiary hospitals in managing integrated care, particularly in the context of transitional care, home medical services, and the establishment of home medical centers. A key aspect of this role is the involvement of family medicine departments, which are central in coordinating patient care between tertiary hospitals and local communities. The study highlights the importance of collaboration between medical, caregiving, and social welfare professionals, and the need for policy changes to support these efforts. It also explores the potential of digital healthcare, including telemedicine and remote patient monitoring, as key tools for facilitating “aging in place.” The findings emphasize the need for a holistic, patient-centered approach to healthcare that ensures continuity of care, enhances the role of tertiary hospitals, and fosters a more sustainable healthcare model for Korea’s aging population.

Objectives: This study was conducted to assess the cost-effectiveness of prophylactic use of ramosetron compared to no antiemetic medications for the prevention of postoperative nausea and vomiting (PONV) from the healthcare payer and societal perspectives in South Korea. Method: A decision analytic model was constructed to assess the cost-effectiveness of prophylactic ramosetron use versus no antiemetic therapy at 24-hour and 48-hour periods post-surgery over a 5-day duration. The model was populated using costs and utility parameters from published studies as well as from surveys of an expert panel of physicians using structured questionnaires. The cost parameters included the costs of drugs, treatment, patient time, productivity loss, and transportation. Effectiveness was measured using quality adjusted life years (QALYs). The study outcome was the incremental cost-effectiveness ratio (ICER). The parameter uncertainties were addressed using deterministic and probabilistic scenario analyses. Results: The base-case analysis showed that, on average, patients treated with prophylactic ramosetron had lower costs from both the healthcare payer (US$16.88 vs US$17.33) and societal (US$16.89 vs US$18.72) perspectives and higher QALYs (0.0121 vs 0.0114) over the 5-day study duration compared to patients without any antiemetic medications. Deterministic and probabilistic sensitivity analyses were conducted to examine the robustness of results for the parameters included in the model. The acceptability curve probability showed that treating patients with ramosetron compared to no antiemetic medications was more than 99% cost-effective at a willingness-to pay threshold of US$5,000/QALY from both payer and societal perspectives. Conclusion: The results demonstrated that prophylactic use of ramosetron compared to no antiemetic therapy is highly cost-effective to prevent PONV for patients undergoing surgery from both healthcare payer and societal perspectives. The cost effectiveness is the result of the decrease in the incidence of PONV and the direct treatment costs of severe PONV with improved patient quality of life.

Background: There is debate about ultrasonography screening for thyroid cancer and its cost-effectiveness. This study aimed to evaluate the cost-effectiveness of early screening (ES) versus symptomatic detection (SD) for differentiated thyroid cancer (DTC) in Korea.Methods: A Markov decision analysis model was constructed to compare the cost-effectiveness of ES and SD. The model considered direct medical costs, health outcomes, and different diagnostic and treatment pathways. Input data were derived from literature and Korean population studies. Incremental cost-effectiveness ratio (ICER) was calculated. Willingness-to-pay (WTP) threshold was set at USD 100,000 or 20,000 per quality-adjusted life year (QALY) gained. Sensitivity analyses were conducted to address uncertainties of the model’s variables.Results: In a base case scenario with 50 years of follow-up, ES was found to be cost-effective compared to SD, with an ICER of $2,852 per QALY. With WTP set at $100,000, in the case with follow-up less than 10 years, the SD was cost-effective. Sensitivity analysis showed that variables such as lobectomy probability, age, mortality, and utility scores significantly influenced the ICER. Despite variations in costs and other factors, all ICER values remained below the WTP threshold.Conclusion: Findings of this study indicate that ES is a cost-effective strategy for DTC screening in the Korean medical system. Early detection and subsequent lobectomy contribute to the cost-effectiveness of ES, while SD at an advanced stage makes ES more cost-effective. Expected follow-up duration should be considered to determine an optimal strategy for DTC screening.

본 연구는 Yoon, Kim, Choi, Kim(2021)의 후속 연구로서 본 연구에서는 이전 연구와 동일한 텍스트를 영문으로 기계 번역한 다음, 통계 모형을 통해 도출한 토픽과 이전 연구의 국문 텍스트로부터 도출된 범주를 비교하였다. 이를 통해 단순히 기계 번역의 질 만을 평가하기 보다는 텍스트에 적용한 자연어처리 모형 및 모형 적합 후 결과 해석 과정에서 인간 연구자의 역할, 인간 번역과 기계 번역의 조화에 관한 문제에 대해서도 함께 살펴보고자 하였다. 분석 대상인 텍스트는 D 대학의 교양교육튜터링 프로그램으로부터 수집되었으며, 토픽 모델링에 자주 사용되는 잠재디리클레할당 모형에 대한 이론적인 서술과 R ‘topicmodels’ 라이브러리 사용에 관한 설명을 부가하였다. 분석 결과 이전 연구와 다소 상이한 토픽이 도출되었고 이에 대한 연구진의 해석을 제시하였다. 자연어처리의 폭발적인 성장 추세와 자연어처리의 한 갈래로서 기계 번역은 거스를 수 없는 흐름임을 인정하면서도, 인간 번역자의 개입 여지를 함께 논의하였다. 본 연구는 교양교육연구에 있어 자연어 처리를 활용한 데이터 분석 기법과 기계번역 논의를 결합시킴으로써 교양교육연구에 새로운 접근법을 제시하고 있다.This is a follow-up study by Yoon, Kim, Choi, and Kim (2021). In the current study, the same text as the previous study was machine-translated into English, and then the topics derived through a statistical model, which were compared with the categories derived from the Korean text of the previous study. By doing this, rather than simply evaluating the quality of machine translation, the present study examined 1) the natural language processing model applied to text, 2) the role of human researchers in the process of interpreting the results after fitting the model, and 3) the harmony between human and machine translation, The texts to be analyzed were collected from the liberal arts education tutoring program of D university. A theoretical description of the Latent Dirichlet Allocation model, which is often used for topic modeling, and an explanation of the use of the R library ‘topicmodels’ were added. The analyses revealed a somewhat different pattern of topics from the previous study, and the authors’ interpretation was presented. Finally, while acknowledging the explosive growth of natural language processing and machine translation as a branch of it that cannot be reversed, the room for human translators to complement machine translation was suggested. This study presents a new approach to liberal arts education research by combining data analysis techniques using natural language processing and machine translation discussions.

Background: A total of 8,303 individuals (4.3%) with adverse reactions (n=191,860) after vaccination developed serious conditions or died. Such health developments could cause people not vaccinated yet or waiting for a booster shot to become fearful of the vaccination. Methods: The 3-month (July–September 2021) clinical data of 41 patients from the family medicine department of a single medical center were analyzed retrospectively to determine risk factors and to investigate the clinical course to identify the cause of symptoms in detail.Results: A significant number of older adults aged over 50 years reported experiencing general weakness (P=0.026) but fewer incidences of fever than patients aged 50 years or younger (P=0.011). Eighteen of the 41 patients were requested to visit more than twice or consult a specialist. In 14 patients, the symptoms were explained by other medical causes.Conclusion: The primary physician has a pivotal role in thoroughly evaluating patients who complain of adverseeffects after vaccination, considering the broad multitude of symptoms and medical conditions presented. To thoroughlyevaluate and appropriately advise patients with adverse reactions to their chosen vaccine, taking detailedmedical history and nutritional counseling are required to identify possible underlying causes, resolve symptoms,and educate them on self-care and regarding vaccines.

Baek HS, et al. J Korean Med Sci. 2023 Aug;38(34):e264. https://doi.org/10.3346/jkms.2023.38.e264

Introduction: Owing to the coronavirus disease 19 pandemic, the demand for telemedicine has increased. However, the awareness of and experience with telemedicine among the Korean population have not been investigated. Therefore, we examined Korean outpatients' experience with and awareness of telemedicine. Methods: From December 2020 to March 2021, we conducted a survey exploring the awareness of and experience with telemedicine of outpatients who were consecutively enrolled by family physicians from four hospitals. The participants completed questionnaires on sociodemographic characteristics and knowledge, experience, satisfaction, preference, and future considerations concerning telemedicine. We evaluated factors associated with satisfaction with telemedicine experiences using multivariate logistic regression analysis. Results: Among the 563 study participants, 364 participants had experience with telemedicine. More than 95% of the telemedicine visits were performed by telephone consultation, and the most common disease type for telemedicine visits was chronic diseases (67.5%). Overall, 82.4% of the participants were satisfied with telemedicine. More than 90% of the participants were satisfied with telemedicine in terms of saving time and money relative to hospital visits, no risk of infection, and convenience. According to the multivariate logistic regression analysis, adults aged ≥65 years (odds ratio [OR] 3.53, 95% confidence interval [CI] 1.44–8.68), residents of a metropolitan city (OR 6.8, 95% CI 1.41–32.55), and those with knowledge of telemedicine (OR 2.96, 95% CI 1.21–7.26) were more likely to be satisfied with their telemedicine experience, compared with their counterparts. For chronic diseases, participants with telemedicine experience were significantly more likely to prefer telemedicine for revisits, compared with those with no telemedicine experience. Nonetheless, most respondents recognized that telemedicine requires improvement. Conclusions: Most Korean outpatients showed high satisfaction with telemedicine. Telemedicine may be considered in various medical situations in the future. Therefore, building a practical system for telemedicine and changes in the medical environment are required.

The purpose of this study is to explore the difficulties and improvement process of teachers who operate non-face-to-face physical education classes at Gyeonggi Dream University. The participant in this study is 'I', the instructor. I used the autoethnography methodology to discover educational meaning in the class.. For the research, self-recovery diary and reflective journal collected. Data analysis were used Spradley(1979)'s area and classification analysis method. As a result of the study, first, students did not turn on the camera during class, showed passive behavior, focused on something else, participated in the class for student record, and were not interested in the class. Second, the class was changed to lead students to participate in the class. It was ducted to select a learning topic by reflecting students' opinions, to communicate freely using text and voice, to present interesting learning activities using the Internet, and to increase students' competence. Third, students opened their closed minds and participated in classes to acquire knowledge of physical education and learn about their careers. Accordingly, the necessity of strengthening the physical career education system and practical ability of Gyeonggi Dream University, enhancing the non-face-to-face education competency of instructors, and research on physical education was proposed.