Effectiveness of artificial intelligence in detecting and managing depressive disorders: Systematic review.

OBJECTIVES: This study underscores the importance of exploring AI's creative applications in treating depressive disorders to revolutionize mental health care. Through innovative integration of AI technologies, the research confirms their positive effects on preventing, diagnosing, and treating depression. The systematic review establishes an evidence base for AI in depression management, offering directions for effective interventions. METHODS: This systematic literature review investigates the effectiveness of AI in depression management by analyzing studies from January 1, 2017, to May 31, 2022. Utilizing search engines like IEEE Xplore, PubMed, and Web of Science, the review focused on keywords such as Depression/Mental Health, Machine Learning/Artificial Intelligence, and Prediction/Diagnosis. The analysis of 95 documents involved classification based on use, data type, and algorithm type. RESULTS: The study revealed that AI in depression management excelled in accuracy, particularly in monitoring and prediction. Biomarker-derived data demonstrated the highest accuracy, with the CNN algorithm proving most effective. The findings affirm the therapeutic benefits of AI, including treatment, detection, and disease prediction, highlighting its potential in analyzing monitored data for depression management. LIMITATIONS: This study exclusively examined the application of AI in individuals with depressive disorders. Interpretation should be cautious due to the limited scope of subjects to this specific population. CONCLUSIONS: To introduce digital healthcare and therapies for ongoing depression management, it's crucial to present empirical evidence on the medical fee payment system, safety, and efficacy. These findings support enhanced medical accessibility through digital healthcare, offering personalized disease management for patients seeking non-face-to-face treatment.

The impact of the expanded health insurance coverage policy on healthcare spending: evidence from Korea.

BACKGROUND: South Korea's National Health Insurance (NHI) system pursues universal health coverage, but it has not been able to alleviate patients' financial burden owing to limited coverage and a high proportion of out-of-pocket expenses. In 2017, the government announced a plan to strengthen universality by providing coverage for all unincluded services, expanding coverage, and alleviating household financial burden. We aimed to evaluate the effect of "Moon Care" with a focus on changes in health expenditures following policy implementation, and to provide empirical evidence for future policies to strengthen the NHI system's universality. METHODS: Using data from the 2016 and 2018 Korea Health Panel (KHP), we established a treatment group affected by the policy and an unaffected control group; we ensured homogeneity between the groups using propensity score matching (PSM). Subsequently, we examined changes in NHI payments, non-payments, and out-of-pocket payments (OOP); we performed difference-in-differences (DID) analysis to evaluate the policy's effect. RESULTS: Following policy implementation, the control group had a higher increase than the treatment group in all categories of health expenditures, including NHI payments, non-payments, and OOP. We noted significant decreases in all three categories of health expenditures when comparing the differences before and after policy implementation, as well as between the treatment and control groups. However, we witnessed a significant decrease in the interaction term, which confirms the policy's effect, but only for non-payments. CONCLUSIONS: We observed the policy's intervention effect over time as a decrease in non-payments, on the effectivity of remunerating covered medical services. However, the policy did not work for NHI payments and OOP, suggesting that it failed to control the creation of new non-covered services as noncovered services were converted into covered ones. Thus, it is crucial to discuss the financial spending of health insurance regarding the inclusion of non-covered services in the NHI benefits package.

Medical expenses and its determinants in female patients with urological disorder.

BACKGROUND: The rising older adult population has led to an increase in the prevalence of chronic diseases and medical expenses. Women tend to have a longer healthy life expectancy than men and are more likely to be exposed to urological disorders around the age of 50, resulting in substantial healthcare expenses throughout their lifetime. Urological disorders often require continuous treatment owing to their high risk of recurrence, contributing to an increased financial burden from medical costs. This study aimed to identify factors influencing medical expense in female patients with urological disorders and propose strategies to alleviate the associated financial burden. METHODS: We used data from the Korea Health Panel Survey conducted from 2011 to 2016. The final sample comprised 2,932 patients who visited hospitals for urological disorders. To identify the factors influencing medical expense among female patients with urological disorders, we employed a generalized estimating equation model. RESULTS: The results indicated that younger people and patients with middle-income levels tended to incur higher medical expenses. Furthermore, patients receiving treatment at tertiary hospitals and those enrolled in National Health Insurance also incurred higher health expenses. CONCLUSIONS: This study suggests that effective management of medical expenses related to urological disorders in women requires improvements in healthcare accessibility to facilitate early detection and continuous disease management. In addition, the findings highlight the potential benefits of digital health and non-face-to-face treatments in addressing these needs.

The state of arts and health in the Republic of Korea.

BACKGROUND: The field of arts and health has been growing rapidly in the Republic of Korea (ROK) as a means to solve social problems with the development of arts and health government programs to prevent mental disorders and improve quality of life. This study addresses the history, policy and funding scale, practices, and challenges of the arts and health in the ROK and provides a global overview of different countries to guide development procedures and communicate directions to relevant stakeholders. METHODS: Data were collected using various methods, including policy reports, grey literature, peer-reviewed articles, and open data provided by Statistics Korea. RESULTS: Progress has been made in identifying specific opportunities for the arts to address mental health concerns in the Korean society. Specialty and digital arts are emerging as new professional practices in the arts and health fields. CONCLUSIONS: Establishing new government agencies is the next challenge toward identifying and reaching a consensus among relevant stakeholders for the future development of arts and health in the ROK.

Analyzing the Effectiveness of Data-Linked Projects for Health Promotion in Public Health Centers of South Korea.

Purpose: The purpose of this study lies in verifying the effectiveness of the health promotion project which the public health center at the local level conducted by systematically linking the health examination results from the Health Insurance Corporation. We intend to emphasize the importance of linking the health-related public data. Methods: A survey was conducted to measure the effect of improving health behavior using EQ-5D-5L and demographic variables. Results: As a result of the analysis, the residents (3.13) who had experienced the use of public health centers recognized more necessity for the service linked systematically with health checkup data than those (2.93) who had not. In addition, the residents who had experienced the use of public health centers responded that their chronic diseases had improved compared to a year ago (2.78→2.93). Next, those (3.04) who had experienced the services linked with health checkup data recognized that their chronic diseases and health conditions had been improved compared to those (2.81) who had not. However, in EQ-5D-5L, after using the service, mobility showed no difference between those who had used the service and those who had not. Furthermore, even in terms of self-management, daily life, etc., the management ability was further improved compared to those who had not used it, before using the service. Conclusion: This study showed the improved health level when the health promotion service of the public health center was provided by systematically linking the health checkup data of the Health Insurance Corporation in Korea. In order to increase the effectiveness of health data-linked projects, it is necessary to prepare guidelines for linking the public health data and to expand the data-linked project. It will be needed to further subdivide the health checkup results to provide customized services, and to secure dedicated personnel to reinforce the system link.

Strategic management and organizational culture of medical device companies in relation to corporate performance.

AIMS: Strategies focus on securing the competitiveness of medical device corporations by strengthening their organizational capabilities, which, in turn, ensure their continuous development. This study aims to investigate both management strategies and organizational culture, which may affect the performance of these companies, and analyzes the influence of education and training investment. MATERIALS AND METHODS: We used data from the 3rd to 6th Human Capital Corporate Panel surveys by the Korea Research Institute for Vocational Education and Training as well as data from the Korea Information Service and 6,112 workers and 260 companies were analyzed. For the analysis, management strategy and organizational culture were set as independent variables, and corporation performance was set as the dependent variable. Additionally, investment in education and training was set as a control variable between the independent and dependent variables. Corporate performance was analyzed by dividing into organizational satisfaction and organizational commitment. RESULTS: Differentiation strategy and innovative culture had a positive (+) effect on organizational satisfaction, while cost leadership strategy and hierarchical culture had a negative (-) effect. On the other hand, in the case of interaction with education and training investment, cost leadership strategy and hierarchical culture had a positive (+) effect, while differentiation strategy and innovation culture had a negative (-) effect. In organizational commitment, innovation culture had a positive (+) effect, and hierarchical culture had a negative (-) effect. In the case of interaction with investment in education and training, only the hierarchical culture had a positive (+) effect. CONCLUSIONS: The innovation culture positively influenced the performance of medical device companies. Furthermore, cost leadership strategy, hierarchical culture, education and training investment improved the corporate performance of these companies. To enhance corporate performance, these companies should create an innovation culture and invest in education and training in accordance with the organizational culture.

COVID-19 has proven the excellence of Korea's medical devices, and the medical device industry is expected to continue to grow due to the increase in chronic disease and non-face-to-face treatment. However, the current medical device industry is monopolized by global companies with capital and technological prowess. To overcome this, Korean medical device companies are developing innovative medical devices centered on start-ups, but now is the time to strategically respond to them in order to compete with global companies. In general, companies establish management strategies for survival and growth by analyzing threats and opportunities based on the market environment to maintain the optimal organization according to market competition, government policies, and changes in consumer needs. Strategies are often established based on the culture of the organizations that make up the company. When it comes to strategy establishment, the medical device industry has special characteristics compared to other industries. The medical device industry is based on advanced technology and puts patient safety first, requiring continuous product upgrades. Therefore, it is an essential industry for employees to invest in education and training. The analysis shows the effectiveness of investment in education and training according to the management strategy and organizational culture of medical device companies. It was confirmed that when medical device companies create an Innovation culture, their performance improves. It also shows that when medical device companies adopt a cost leadership strategy, they need to increase their investment in education and training to improve corporate performance.

An analytic hierarchy process analysis for reinforcing doctor-patient communication.

BACKGROUND: As the health paradigm shifts toward patient-centeredness, patients can actively participate in their own treatment. However, there is still a unilateral aspect of doctor-patient communication, so it is necessary to specify obstacles between doctors and patients. Therefore, this study attempted to extract obstacles that block doctor-patient communication and to analyze differences in perception of doctor-patient communication. METHODS: A total of 35 questionnaires composed of brainstorming for the study were distributed, and a total of 21 questionnaires were used for analysis. The collected data was analyzed by AHP using dress ver 17.0. RESULTS: As a result of the study, doctors ranked the priority of health communication in the order of professionalism, reliability, fairness, communication, and psychologically. On the other hand, for patients, the priority factors of health communication were communication, fairness, professionalism, reliability, and psychologically. CONCLUSION: In order to improve the quality of health communication between doctors and patients, doctors will be able to communicate from the patient's point of view and strengthen communication with patients by providing consistent medical services and patients need to trust the doctor and patients need to trust their doctors and participate in the medical process faithfully.

How to calculate the life cycle of high-risk medical devices for patient safety.

In this study, we analyzed Korean and foreign systems, focusing on high-risk medical devices that urgently need to be managed, and we present an life cycle calculation method for determining replacement time. A literature review was conducted to confirm the regulations of the medical device management system and life cycle by country, and a case analysis was performed to verify the replacement evaluation criteria of actual medical institutions. In addition, durability data from the Public Procurement Service, American Hospital Association, and Samsung Medical Center were used to calculate the life cycle of high-risk medical devices. The analysis showed that in the case of Korean and foreign medical device regulatory agencies, there were no specific life cycle regulations for high-risk medical devices. In addition, the important items in the medical device replacement evaluation were found to be the year of introduction, repair cost, component discontinuation, and several failures. On calculating the life cycle of high-risk medical devices revealed that the replacement time is 13 years for anesthesia machines, 14 years for defibrillators, 16 years for heart-lung machines, and 13 years for ventilators. To introduce a uniform medical device replacement standard and life cycle calculation method, the government will need to reorganize the medical device replacement laws and systems. In addition, in the case of medical institutions, it is necessary to secure patient safety by using expert groups to prepare specific life cycle standards that consider the characteristics of medical devices.

Factors associated with quality of life in patients with benign prostatic hyperplasia, 2009-2016.

This study analyzed the factors affecting the health-related quality of life of patients with benign prostatic hyperplasia (BPH) according to age. We also aimed to determine appropriate strategies to improve their quality of life. Data from the Korea Health Panel Survey (2009-2016) were used in this study. A total of 3806 patients with BPH were divided into 2 groups: younger adults (aged under 65 years) and older adults (aged over 65 years). In addition, a logistic regression analysis was conducted to identify factors affecting the quality of life of young and older patients with BPH. In younger adult patients with BPH, the higher the level of education, the higher the quality of life by a factor of 1.379, and the more intense the physical activity, the lower the quality of life by a factor of 0.791. Also, the longer the sitting time, the lower the quality of life by a factor of 0.765. In contrast, for older adult patients with BPH, the quality of life improved by factors of 1.601 and 2.921, respectively, for health insurance and higher income level. In addition, it was found that the quality of life decreased by a factor of 0.754 in patients who drink alcohol. In order to improve the quality of life of the middle-aged adult population with BPH, it is necessary to reduce sitting time through constant physical activity. Moreover, the cost of medical care should be reduced and the quality of life increased through reductions in surgical treatment, as the burden of medical expenses will degrade the quality of life for older adults.

Digital Health Care Industry Ecosystem: Network Analysis.

BACKGROUND: As the need for digital health care based on mobile devices is increasing, with the rapid development of digital technologies, especially in the face of the COVID-19 pandemic, gaining a better understanding of the industrial structure is needed to activate the use of digital health care. OBJECTIVE: The aim of this study was to suggest measures to revitalize the digital health care industry by deriving the stakeholders and major issues with respect to the ecosystem of the industry. METHODS: A total of 1822 newspaper articles were collected using Big Kings, a big data system for news, for a limited period from 2016 to August 2021, when the mobile health care project was promoted in Korea centered on public health centers. The R and NetMiner programs were used for network analysis. RESULTS: The Korean government and the Ministry of Health and Welfare showed the highest centrality and appeared as major stakeholders, and their common major issues were "reviewing the introduction of telemedicine," "concerns about bankruptcy of local clinics," and "building an integrated platform for precision medicine." In addition, the major stakeholders of medical institutions and companies were Seoul National University Hospital, Kangbuk Samsung Hospital, Ajou University Hospital, Samsung, and Vuno Inc. CONCLUSIONS: This analysis confirmed that the issues related to digital health care are largely composed of telemedicine, data, and health care business. For digital health care to develop as a national innovative growth engine and to be institutionalized, the development of a digital health care fee model that can improve the regulatory system and the cost-effectiveness of patient care, centering on the Ministry of Health and Welfare as a key stakeholder, is essential.

Comparative Analysis of Factors Affecting Quality of Community-Based Care Services in Korea.

Aging societies have an increased need for care services. To solve the problem of care, we suggest community care, through which medical services are provided that meet individual needs. Korea provides care services in advance of the community care project and implements quality control to improve the quality of these social services. Therefore, this study aims to compare and analyze the factors affecting user satisfaction in care services in both 2013 and 2016. We analyzed secondary data from 2013 and 2016 collected by the Social Security Information Service. These data include standardized metrics for the quality of care. Based on the evaluation indexes for care service in 2013 and 2016, we used commonly used indexes for analysis. Specifically, non-profit organizations were influenced by sales, accounting management, lifetime tenure rate, etc., while for-profit organizations were affected by number of users, contract termination, etc. In addition, on-site evaluation had a negative effect on the change rate of user satisfaction. Therefore, in order to increase satisfaction with care services, evaluation indexes by service type should be diversified and differentiated. In addition, field evaluations related to user satisfaction should be performed in order to provide care services appropriate for local characteristics.

The usefulness of patient-specific 3D nasal silicone implant using 3D design and order form.

PURPOSE: The need for customized implants has continuously increased, but patient-specific silicone implants are not yet commonly used in the plastic surgery market. We sought to validate the effectiveness of a 3D customized nasal implant design in terms of design and lead time compared with a manually customized implant by a surgeon. MATERIALS AND METHODS: Based on the computed tomography (CT) findings of 15 patients who planned rhinoplasty, a surgeon wrote order forms reflecting the surgical plan and subsequently designed implants manually using epoxy on a 3D printed skull. Separately, engineers analyzed the CT findings and designed 3D implants based on the order forms. RESULTS: Epoxy designs were 3D-scanned, converted into a stereolithography format and compared with 3D implant designs to assess which method had a smaller margin of error as per the preoperative order form. Moreover, the lead time in all steps are compared. Nasion thickness, tip thickness, glabella starting point, glabella width, radix width, and total volume were comparatively analyzed. In all parameters, the error rate of the 3D design is relatively lower than that of the epoxy design. The former also had a lower total volume and a faster manufacturing time. CONCLUSION: With novel 3D customized nasal implants, the limitations of ready-made silicone implants are addressed, and it is now possible to preoperatively design implants more accurately, quickly, and conveniently.

Factors influencing the health satisfaction of users of public health and medical institutions in South Korea.

Introduction: In this study, we investigated the health satisfaction levels of users of regional health and medical institutions in South Korea and the influencing factors. Methods: We included randomly selected 300 people with experience in using health and medical institutions from panel data targeting the entire nation. We used questionnaire (EQ-5D-5L) and sociodemographic characteristics to analyze the health satisfaction. EQ-5D-5L was used to measure health-related quality of life in five areas: mobility, self-management, daily activities, pain/discomfort, and anxiety/depression. Hierarchical linear regression analysis was performed in three steps to examine the factors influencing health satisfaction. Results: The analysis showed that the health satisfaction was positively (+) correlated with monthly income, mobility, self-management, daily life, pain/discomfort, and anxiety/depression, and negatively (-) correlated with the number of chronic diseases and type of health insurance. The influencing factors in Step 1 and 2 were chronic diseases (ß = -0.380, -0.385), respectively. The influencing factors in Step 3 were pain/discomfort (ß = 0.202), anxiety/depression (ß = 0.257), and the number of chronic diseases (ß = -0.222). Discussions: The current data suggested that regional health and medical institutions should focus their services on residents with chronic diseases. Moreover, they should expand physical activities to relieve physical pain or discomfort and provide services related to mental health. To accomplish these, we suggested that the government will need to promote post-service health checkup results as a key project, provide user-customized services, provide online services utilizing ICT, expanding the government's financial support, and building infrastructure.

Healthy City Project: An application of data envelopment analysis.

PURPOSE: The importance of Korea's Healthy City Project has recently increased due to the growth of the elderly population and chronic diseases. Consequently, local governments are expanding the project to manage health at the local level; however, because local government resources are limited, efficient business operation is required. Thus, the purpose of this study is to present a plan for effective project management by developing a strategy for a Healthy City Project that is suitable for the scale of local governments. METHODS: For efficiency analysis, data were collected from the homepages of 90 local governments that are implementing the Healthy City Project in Korea, and data envelopment analysis (DEA) was conducted using both the CCR model and the BCC model. The input variables for the DEA included budget, manpower, organization, planned projects, and research education. In addition, we selected program, network, and project performance as output variables. RESULTS: Analysis results indicated that the CCR model identified 22 (out of 90) municipalities in which Healthy City Projects are implemented efficiently, while 68 are inefficient. The BCC model identified many more efficient regions than the CCR model; however, the difference was insignificant. Thus, the budget, manpower, planned projects, and network must be increased to improve efficiency. CONCLUSION: First, to improve the efficiency of the Healthy City Project, a sufficient budget must be secured during its implementation. Second, long- and short-term plans are needed to expand the Healthy City Program. Third, networks must be created for local governments to benchmark Healthy City Projects.

Innovative Culture and Firm Performance of Medical Device Companies: Mediating Effects of Investment in Education and Training.

This research explored the mediating effect of investment in education and training relating to the innovative culture and organizational performance of medical device companies. We used the Human Capital Corporate Panel data provided by the Korea Vocational Competency Development Institute. In the industrial classification system of panel data, the industries related to medical devices were extracted and conclusively analyzed for 8629 workers and 368 companies. The independent and dependent variables were innovative culture and corporation performance, respectively. Investment in training and education was a mediating variable between the independent and dependent variables. Quantitative data were analyzed using SPSS software. A higher level of organizational satisfaction emerged in an innovative culture. Innovative culture positively affected organizational satisfaction. Further, investment in education and training to promote an innovative culture positively affected organizational satisfaction. Medical device companies should improve their performance by creating an innovative culture.

Factors affecting revisit intention for medical services at dental clinics.

Recent changes in the medical paradigm highlight the importance of patient-centered communication. However, because of the lack of awareness of dental clinics and competency of medical personnel, the quality of medical services in terms of the communication between doctors and patients has not improved. This study analyzed the impact of health communication and medical service quality, service value, and patient satisfaction on the intention to revisit dental clinics. The study participants were outpatients treated at 10 dental clinics in Seoul. The research data were collected using a questionnaire during visits to these dental clinics from December 1 to December 30, 2016. A total of 600 questionnaires were distributed (60 copies to each clinics) and 570 valid questionnaires were used for the analysis. The influence of the factors was determined using structural equation modeling. The factors influencing service value were reliability (ß = 0.364, p < 0.001), expertise (ß = 0.319, p < 0.001), communication by doctors (ß = 0.224, p < 0.001), and tangibility (ß = 0.136, p < 0.05). In addition, the factors influencing patient satisfaction were reliability (ß = 0.258, p < 0.001), tangibility (ß = 0.192, p < 0.001), communication by doctors (ß = 0.163, p < 0.001), and expertise (ß = 0.122, p < 0.01). Further, service value (ß = 0.438, p < 0.001) raised patient satisfaction, which was found to influence the intention to revisit dental clinics (ß = 0.383, p < 0.001). Providing accurate medical services to inpatients based on smooth communication between doctors and patients improves patient satisfaction. In addition, doctors can build long-term relations with patients by increasing patients' intention to revisit through patient-oriented communication.

How Should the Social Service Quality Evaluation in South Korea Be Verified? Focusing on Community Care Services.

The quality evaluation (QE) of social services tends to have a large variation in results depending on the object and method of service measurement. To overcome these limitations, an analysis of the internal consistency or validity of the social service QE index is necessary, but meta-research on this is insufficient. This study analyzes the internal consistency and validity of evaluation indexes based on the results of social service QE. We utilized the social services QE manual of the Social Security Information Service's Facility Evaluation Department. The social service QE indexes implemented in 2013 and 2016 were coded and analyzed. We found that there was internal consistency between the results of the care services evaluation in 2013 and 2016. In addition, there were differences between the care services QE indexes by service type in 2013 and 2016. It is necessary to construct effective indexes by simplifying, diversifying, and differentiating social service QE indexes. In addition, control devices for external factors (region, composition of the evaluation team, etc.) must be prepared to maintain the consistency of evaluation scores, and in the long term, standardization of social service QE indexes is necessary.

Quality of Life in Older Adults with Benign Prostatic Hyperplasia.

The purpose of this study is to identify factors that affect health-related quality of life (HRQOL) of older patients with Benign Prostatic Hyperplasia (BPH) and suggest ways to improve the same. Through this, we will improve the self-management practice of patients and promote the treatment of BPH in older patients. The 2015 Korea Health Panel Survey data were used in this study. A total of 422 BPH patients aged 65 or older were included. Logistic regression analysis was conducted to identify factors affecting the HRQOL of older patients with BPH. General characteristics of factors affecting older patients with BPH included income level and type of insurance. In addition, among medical-related characteristics and health behavior factors, subjective health status, unmet medical care needs, moderate physical activity, sitting time, and drinking influenced the HRQOL. Therefore, in order to improve the HRQOL of adult patients with BPH, it is necessary to improve medical accessibility by strengthening primary care. In addition, it is necessary to increase the amount of activity in daily life through healthcare medical devices.

Unmet Medical Needs of Patients with Benign Prostate Enlargement.

This study aimed to analyze the factors affecting the unmet medical needs of patients with benign prostate enlargement (BPE) based on Andersen's behavioral model. The data were taken from the 2009-2016 Korea Health Panel Study and 3003 participants were used for analysis. "Unmet medical needs" was used as a dependent variable. Independent variables were predisposing variables: age, educational attainment, and marital status; enabling factors: income, job type, and insurance type; and need factors: lying in a sickbed, activity limitation, subjective health status, and having chronic diseases. Results showed that younger patients experienced a higher probability of unmet medical needs. Those with higher educational attainment had a lower chance of experiencing unmet medical needs. Patients with national health insurance were less likely to experience unmet medical needs. In addition, patients who experienced lying in a sickbed had a higher probability of experiencing unmet medical needs. Therefore, in order to reduce the unmet medical needs of patients with BPE, it is necessary to allow patients to be treated early and give them accurate information about the disease. In addition, access to medical care should be strengthened through continuous care focused on primary care.