Objectives: The purpose of this study is to figure out the current state of patient safety research in Korea and to evaluate whether the research fund support project for patient safety research is proceeding in priority order. Methods: Through the literature search, a list of research projects in the field of patient safety in Korea were collected as of January 6, 2017. Four researchers independently evaluated the subject using the priority list of patient safety research derived from the previous study. Results: As of January 2017, a total of 21 research projects were conducted in the Korea Health Industry Development Institute and 42 research studies were conducted in the National Science & Technology Information. The results of the priority evaluation showed that there were no researches that ranked first and second priority. Many of the research topics were �쁀dverse drug events/drug errors,�� �쁇ealth information technology/information systems,�� and �쁋ess relevance.�� Conclusion: Patient safety research projects are not only diverse but also quantitative in Korea. Support for research topics that need to be prioritized is needed, such as developing safety indicators and measuring patient safelty levels, improving communication, and improving patient safety incident reporting systems. ; open
This study examined the influence of the separation of prescribing and dispensing roles(SPD) policy implemented in Korea in July 2000, especially on the change in the net profit of medical institutions. Using the data set from the Korea's National Health Insurance and the previous research, this study elicited the following main results. First, tertiary care institutions was estimated to lose about 631 billion won after the SPD policy. Second, general hospitals and hospitals gained about 557 billion and 564 billion won, respectively. Third, it is shown that clinics also gained 389-659 billion won. Finally, however, the change in net profit of medical institutions after the SPD policy largely depends on different estimation models. Moreover, it also varies from the assumptions on the price differential of a reimbursable drug which worked as cross-subsidy to insufficient physician's fee before the SPD policy. Despite such limitations as lack of data outside of the National Health Insurance's coverage, this study differs from others. This is the first research to explore the effect of the SPD policy on different types of medical institutions and to attempt to purely focus on the SPD policy. In this study, we can draw the policy implication that preparing for a policy change, the government should set up the policy evaluation system to collect the concerned data and develop the methodologies in advance to the policy implementation. ; open
Background Originating from poultry, particularly chickens, Campylobacter jejuni is the leading foodborne pathogen worldwide and a major cause of campylobacteriosis. Isolating C. jejuni is difficult due to its specific growth requirements, the presence of viable but non-culturable bacteria, and because it is often masked by competing flora. Currently, there is no optimized method for isolating C. jejuni from chicken feces. Here, we evaluated the method for isolating C. jejuni from chicken feces using culture-independent sequence-based metagenomics and culture-dependent tools. Further, we assessed changes in microbial communities during microbe isolation to determine how the process can be improved. Results Fourteen different variations of C. jejuni isolation procedures were applied to all 35 chicken fecal samples. These variations included using different enrichment broths (without enrichment or enrichment in Bolton or Preston broth), different ratios of sample-to-enrichment broth (1:101, 1:102, and 1:103), and different selective agars (modified charcoal-cefoperazone-deoxycholate agar (mCCDA) or Preston agar). Enrichment during isolation of C. jejuni was evaluated on the basis of microbial diversity and taxonomic composition using metagenomics tools. The effect of selective media was evaluated using a combination of metagenomics and culture-dependent tools. Microbial diversity significantly decreased during the enrichment process, regardless of the type of enrichment broth, with the most significant decrease observed at a feces-to-broth ratio of 1:103. Particularly, in 103-Preston broth, the relative abundance of Campylobacter increased, while extended-spectrum beta-lactamase-producing Escherichia coli, which interfere with Campylobacter isolation, decreased. Metagenomics results were validated by quantitative PCR and culture-dependent analysis. Additionally, selective media affected the isolation results, although microbes with high relative abundance during enrichment were also frequently isolated using culture-dependent methods. Significantly more C. jejuni was isolated from mCCDA than from Preston agar enriched in 103 Preston broth. Conclusions Enrichment in Preston broth at a ratio of 1:103 followed by spreading onto mCCDA was the most effective method for isolating C. jejuni. This is the first study to apply metagenomics to evaluate a method for isolating a targeted microbe, C. jejuni, from chicken feces, a source with high microbial contamination. Thus, metagenomics can be applied to improve methods for isolating bacteria that are difficult to separate. ; This research was supported by a grant from National Research Foundation of Korea Grant funded by the Korean Government (NRF-2018R1A2B6002396) and a grant from the Ministry of Food and Drug Safety (16162MFDS029).
