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의료환경 변화에 따른 감염성 심내막염의 양상 변화

Other Titles
 Changing trends of infective endocarditis according to the change in health care system in Korea 
 신소연  ;  박윤수  ;  최준용  ;  조정호  ;  박윤선  ;  김창오  ;  윤희정  ;  김효열  ;  염준섭  ;  이꽃실  ;  최영화  ;  허애정  ;  홍성관  ;  송영구  ;  김준명 
 Korean Journal of Medicine (대한내과학회지), Vol.68(2) : 157-167, 2005 
Journal Title
Korean Journal of Medicine(대한내과학회지)
Issue Date
Endocarditis ; Health care reform ; Microbiology
Endocarditis ; Health care reform ; Microbiology
Background: In July 2000, there was a dramatic change in Korean health care system with the medical reform, the separation system of pharmacies and prescriptions. Before then, patients could easily get antibiotics without doctors’ prescriptions. Since the symptoms and signs of infective endocarditis are very nonspecific, prior self treatment with antibiotics before admission was common. This study was performed to determine the changing trends of infective endocarditis according to the change in health care system.

Methods: One hundred eighty eight patients from 8 different medical institutions were included. Medical records were reviewed retrospectively for each patient who was diagnosed as infective endocarditis by Modified Duke criteria. Patients were separated into two different groups (Group I : patients diagnosed before July 2000, Group II : patients diagnosed after November 2000). Clinical characteristics, blood culture positivity, and in-hospital mortality were compared.

Results: There was no difference in clinical manifestation between two groups other than malaise. Blood culture positivity was 57.4% in group I and 71.1% in group II. Blood culture positivity was significantly higher in group II (p=0.038). In-hospital mortality tends to be lower in group II, which was 22.3% in group I and 12.9% in group II (p=0.066). The relationship between higher blood culture positivity and lower in-hospital mortality couldn’t be clarified.

Conclusion: There was an increase in blood culture positivity and a tendency to decrease in in-hospital mortality after July, 2000, possibly due to health care reform. This, to my knowledge, is the first effort to investigate the changing trends of an actual clinical disease according to the change in health care system.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, June Myung(김준명)
Kim, Chang Oh(김창오) ORCID logo https://orcid.org/0000-0002-0773-5443
Park, Yoon Seon(박윤선)
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Shin, So Youn(신소연)
Yoon, Hee Jung(윤희정)
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
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