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JKM > Volume 39(3); 2018 > Article
Kim, Kim, Lee, Sung, Park, Cho, Keum, Kim, and Kim: Survey on Satisfaction and Symptom Improvement of Korean Medicine Treatment in 122 Cases by Traffic Accident

Abstract

Objectives

This study conducted a survey research to characterize traffic accident(TA) patients seeking Korean medicine treatment and to analyze the symptom improvement and satisfaction scores.

Methods

A survey was conducted in 122 outpatients, who visited OO University Korean Hospital due to TA-associated symptoms from November, 2017 to May, 2018. The questionnaire included information on patient demographic characteristics, accident circumstance details, pain levels, reason for treatment selection, treatment methods, treatment purpose, symptom improvement and satisfaction. All statistical analyses were performed using Windows SPSS version 20.0

Results

The characteristics of traffic accident patients using Korean medical institution were usually accidents that occurred while driving slowly, and minor injuries like a sprain. The most important consideration in choosing Korean medical institution was its past experience. The biggest reason for switching treatment from Western medicine to Korean medicine was for diverse treatments. Satisfaction with Korean medicine was measured between very satisfaction and satisfaction. Patients showed the highest satisfaction with acupuncture, followed by pharmacopuncture and chuna manual therapy. Most treatments were measured between very satisfaction and satisfaction. After treatment, 95.90 percent of the patients said they would recommend Korean treatment.

Conclusions

Although this study has limitations as research in survey format, we intended to analyze determining factors for the use of Korean medicine treatment through satisfaction, symptom improvement, and Numeric rating scale (NRS) change.

Table 1
Demographic Characteristics
Factor No(%) Factor No(%)
Sex Age, y

<30 10(8.19)
Male 53(43.44) 30≤,<40 19(15.57)
40≤,<50 36(29.50)

50≤,<60 35(28.68)
Female 69(56.55) 60≤,<70 14(11.47)
70≤ 8(6.55)
Table 2
Traffic Accident Situation
Factor No(%) Factor No(%)
Traffic accident type Speed of the opponent car

Frontal impact 14(11.47) At rest 0(0.00)
Side impact 18(14.75) ~ 30km/h 21(17.21)
Rear impact 73(59.83) ~ 50km/h 18(14.75)
Multiple 3(2.45) ~ 70km/h 7(5.73)
Pedestrian 7(5.73) 70km/h ~ 6(4.91)
Bus 7(5.73) Don’t know 70(57.37)

Location Speed of my car

Driver’s seat 87(71.31) At rest 56(45.90)
Passenger seat 16(13.11) ~ 30km/h 28(22.95)
Back seat 5(4.09) ~ 50km/h 17(13.93)
Pedestrian 7(5.73) ~ 70km/h 6(4.91)
Other 7(5.73) 70km/h ~ 6(4.91)
Pedestrian 7(5.73)
Don’t know 2(1.63)

Loss of consciousness or trauma

Yes 10(8.19)
No 112(91.80)
Table 3
Symptoms after an Accident
Factor No(%) Factor No(%)
Region of pain* Additional Symptoms*

Neck 94(77.04) Headache 43(35.24)
Low back 82(67.21) Dizziness 29(23.77)
Shoulder 82(67.21) Anxiety 14(11.47)
Wrist 26(21.31) Indigestion 14(11.47)
Back 20(16.39) Others 14(11.47)
Knee 20(16.39)
Others 58(47.54)

The onset of pain Disease code*

~24 hours 82(67.21) S134: Sprain and strain of cervical spine 89(72.95)
24~48 hours 33(27.04) S3350: Sprain and strain of lumbar spine 70(57.37)
within a week 6(4.91) Others 57(46.72)
more than a week 1(0.81)

* Multiple choices were allowed for ‘region of pain.’, ‘additional symptoms’ and ‘disease code’.

Table 4-1
Characteristics of Korean Medicine Service
Factor No(%)
The person who decide to visit

Own decision 65(53.27)
Recommendations 57(46.72)

Reasons for choosing a Korean medical institution*

Looking at press reports 5(4.09)
Not satisfied with the treatment of other western medical institutions 18(14.75)
Other western medical institution services are unkind 4(3.27)
Concerned about side effects of western medical treatment 19(15.57)
Experience with korean medicine before 55(45.08)
Get more treatments than Western treatments. 35(28.68)
Close to home or work 28(22.95)
Others 6(4.91)

Primary treatment goal

Relief from pain 54(44.26)
Improvement of functions of inconvenient parts 35(28.68)
Improving quality of life 3(2.45)
Reducing the need for medication 2(1.63)
A smooth return to daily life 20(16.39)
Recovery of deterioration caused by traffic accidents. 8(6.55)

A pre-visit medical institution

Western & Korean medical institution 11(9.01)
Western medical institution 44(36.06)
Korean medical institution 11(9.01)

The more effective case of Korea medicine

Any traffic accident that does not require surgical treatment 77(63.11)
Additional symptoms such as dizziness, anxiety 11(9.01)
For old or frail people 1(8.19)
Has a chronic disease associated with the pain caused by a traffic accident. 33(27.04)

Recommend to others

Yes 117(95.90)
No 1(0.81)
Don’t know 4(3.27)

* Multiple choices were allowed for ‘regions of visit.’

† Only patients with a transit hospital(n=66) responded.

Table 4-2
Reason for Changing from Western Medicine to Korean Medicine
Question* Mean±SD Very considerate No(%) Considerate Neutral Inconsiderate Very inconsiderate No reply
Korean medicine works better than western medicine treatments. 1.91±0.92 23(42) 15(27) 14(25) 2(4) 0(0) 1(2)
Western medical treatments show no signs of improvement. 2.19±1.08 19(54) 12(22) 19(54) 2(4) 2(4) 1(2)
Korean medicine treatment(acupuncture, herbal medicine,, etc.) is preferred to western medicine treatments (pain anti-inflammatory, physical therapy) 1.87±1.01 26(47) 13(24) 12(22) 2(4) 1(2) 1(2)
After western medicine treatment, the symptoms come back again. 2.77±1.19 9(16) 12(22) 19(54) 8(15) 5(9) 2(4)
Concerned about side effects of western medical treatment 2.38±1.30 18(33) 11(20) 12(22) 7(13) 4(7) 3(5)
Korean medicine is effective in treating car accident aftereffect 2.07±1.01 19(11) 17(31) 14(25) 3(5) 1(1) 1(1)
Get more treatments than Western treatments. 1.45±0.86 40(73) 8(15) 4(7) 3(5) 0(0) 0(0)
Korean doctors and employees are more friendly. 1.98±1.05 24(44) 12(22) 14(25) 3(5) 1(2) 1(2)

* Multiple choices were allowed.

Table 5-1
NRS, Improvement and Satisfaction of All Patients
Initial NRS Post-treatment NRS Symptom Improvement Satisfaction

Mean±SD
All(n=122) 6.15±2.09 3.11±1.54 1.87±0.43 1.71±0.60
Table 5-2
Improvement and Satisfaction by Demographic Characteristics
Factor Symptom improvement Satisfaction

Mean±SD
Age, y

<30 (n=10) 1.90±0.32 1.80±0.63
30≤,<40 (n=19) 1.95±0.23 1.68±0.58
40≤,<50 (n=36) 1.92±0.50 1.64±0.59
50≤,<60 (n=35) 1.80±0.47 1.71±0.57
60≤,<70 (n=14) 1.79±0.43 1.79±0.70
70≤ (n=8) 1.88±0.35 1.88±0.64
p=0.77 p=0.90

Sex

Male (n=53) 1.85±0.41 1.75±0.59
Female (n=69) 1.88±0.44 1.68±0.61
p=0.65 p=0.50

Statistical analyses were performed using the Independent 2-sample T -test or analysis of variance(ANOVA).

Table 5-3
NRS, Symptom Improvement and Satisfaction of Korean Medicine by Accident
Factor Initial NRS Recent NRS Improvement Satisfaction

Mean±SD
Traffic accident type

Frontal(n=14) 5.86±2.28 2.79±1.72 1.64±0.50 1.64±0.63
Side(n=18) 6.56±2.09 3.67±1.71 1.89±0.47 1.78±0.65
Rear(n=73) 5.85±1.97 2.93±1.28 1.90±0.41 1.71±0.61
Multiple(n=3) 6.33±1.53 4.00±1.73 2.00±0.00 1.67±0.58

Pedestrian (n=7) 7.57±2.37 2.71±2.14 1.71±0.49 1.71±0.49
Bus(n=7) 7.29±2.36 4.14±2.04 2.00±0.00 1.71±0.49

p value 0.19 0.28 0.27 0.79

Location

Driver(n=87) 6.07±1.90 3.03±1.36 1.87±0.42 1.76±0.61
Passenger (n=16) 5.50±2.38 3.38±1.82 1.88±0.50 1.44±0.51
Back(n=5) 4.60±1.67 2.20±1.64 1.80±0.45 1.60±0.55

Pedestrian(n=7) 7.57±2.37 2.71±2.14 1.71±0.49 1.71±0.49
Bus(n=7) 7.29±2.36 4.14±2.04 2.00±0.00 1.71±0.49

p value 0.0029* 0.12 0.86 0.71

Statistical analyses were performed using analysis of variance(ANOVA) or the Kruskal-Wallis test.

* Statistically significant(p<0.05)

Table 5-4
Symptom Improvement and Satisfaction of Korean Medicine by Additional Symptoms
Factor Symptom improvement Satisfaction

Mean±SD
Additional symptom

Yes(n=60) 1.85±0.44 1.66±0.54
No(n=62) 1.89±0.41 1.77±0.64
p value 0.67 0.45

Statistical analyses were performed using the Independent 2-sample T -test or analysis of variance(ANOVA).

Table 5-5
NRS, Improvement and Satisfaction of Korean Medicine by the Pain Characteristic
Factor Initial NRS Recent NRS Improvement Satisfaction

Mean±SD
The onset of pain

~24 hours(n=82) 6.18±2.30 3.56±1.87 1.85±0.47 1.70±0.60
24~48 hours(n=33) 5.97±1.63 3.76±1.64 1.94±0.24 1.82±0.58
more than 48 hours(n=7) 6.57±1.27 4.00±1.83 1.71±0.49 1.43±0.53

p value 0.76 0.75 0.38 0.26

Region of pain

Neck(n=94) 6.20±1.90 3.69±1.69 1.87±0.42 1.74±0.60
Low back(n=82) 6.33±2.10 3.70±1.75 1.88±0.43 1.73±0.63
Shoulder (n=82) 6.48±1.99 3.93±1.70 1.87±0.44 1.72±0.61
Wrist(n=26) 6.12±2.07 3.42±1.86 1.77±0.51 1.54±0.58
Back(n=20) 6.90±1.92 4.20±1.58 1.75±0.44 1.55±0.60
Knee(n=20) 6.55±2.48 4.25±2.34 1.85±0.49 1.60±0.60

p value 0.73 0.47 0.77 0.50

Statistical analyses were performed analysis of variance(ANOVA)or the Kruskal-Wallis test.

Table 6
Satisfaction by Treatment
Acupuncture (n=122) Cupping (n=94) Herbal medicine (n=65) Herbal acupuncture (n=61) Physical therapy (n=61) Moxibustion (n=42) Extract (n=30) Wet cupping (n=29) Chuna (n=24) Bee venom (n=17)
mean±SD 1.57±0.67 1.68±0.72 2.01±0.91 1.61±0.71 1.74±0.79 1.64±0.73 1.87±0.86 1.66±0.55 1.58±0.72 1.76±0.83
Very satisfied No(%) 62(51) 41(44) 20(31) 29(48) 26(43) 21(50) 13(43) 11(38) 13(54) 8(47)
Satisfied 53(43) 44(47) 29(45) 29(48) 27(44) 15(36) 8(27) 17(59) 8(33) 5(29)
Neutral 6(5) 8(9) 12(18) 2(3) 7(11) 6(14) 9(30) 1(3) 3(13) 4(24)
Dissatisfied 0(0) 0(0) 3(5) 0(0) 0(0) 0(0) 0(0) 0(0) 0(0) 0(0)
Very dissatisfied 1(1) 1(1) 1(2) 1(2) 1(2) 0(0) 0(0) 0(0) 0(0) 0(0)
Table 7-1
Symptom Improvement and Satisfied by Pre-visit Medical Institution
A pre-visit medical institution Symptom improvement Satisfied
mean±SD
Western & Korean medical institution (n=11) 1.63±0.50 No(%) 1.45±0.52 No(%)
Very improvement 4(36) Very satisfied 5(45)
Improvement 7(64) Satisfied 5(45)
Neutral 0(0) Neutral 1(9)
Deteriorated 0(0) Dissatisfied 0(0)
Very deteriorated 0(0) Very dissatisfied 0(0)
Western medical institution (n=44) 1.81±0.50 Very improvement 10(23) 1.56±0.55 Very satisfied 20(46)
Improvement 32(73) Satisfied 23(52)
Neutral 2(5) Neutral 1(2)
Deteriorated 0(0) Dissatisfied 0(0)
Very deteriorated 0(0) Very dissatisfied 0(0)
Korean medical institution (n=67) 1.91±0.38 Very improvement 8(12) 1.81±0.61 Very satisfied 20(30)
Improvement 57(85) Satisfied 40(60)
Neutral 2(3) Neutral 7(10)
Deteriorated 0(0) Dissatisfied 0(0)
Very deteriorated 0(0) Very dissatisfied 0(0)
p value p=0.05 p=0.02*

* Statistically significant(p<0.05)

Statistical analyses were performed using analysis of variance(ANOVA).

Table 7-2
NRS Change by Pre-visit Medical Institution
A pre-visit medical institution Initial NRS Recent NRS p value Rate of change
mean±SD
Western & Korean medical institution (n=11) ~1 week 1 6.63±1.96 6 3.36±1.12 5 0.00* 17%
~2 weeks 2 6.5 5 23%
~1 month 1 7 2 71%
~2 months 2 7 3.5 50%
~6 months 3 6.7 3.3 51%
6 months 2 6.5 2 69%
Western medical institution (n=44) ~1 week 3 6.63±2.17 3.7 3.64±1.63 2.3 0.00* 38%
~2 weeks 4 6.5 4.8 26%
~1 month 18 6.0 3.2 47%
~2 months 7 8.1 3.9 52%
~6 months 7 8.5 4.8 44%
6 months 8 7.4 4.6 38%
Korean medical institution (n=67) ~1 week 5 5.79±1.91 4.4 3,30±1.55 3 0.00* 27%
~2 weeks 19 5.7 3.3 42%
~1 month 31 5.8 3.1 46%
~2 months 10 6.2 3.3 47%
~6 months 7 6.3 3.6 43%
6 months 4 6.5 4.3 34%

* Statistically significant(p<0.05)

Statistical analyses were performed using paired sample t-test or analysis of variance(ANOVA).

참고문헌

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2 Kim JS, Suh WS. Changes in Providers’ Behavior after the Reviewer Unification of Auto Insurance Medical Benefit Claims. HPM. 2017; 27:1. 30–38.


3 Song YA. The Present Status and Future Direction of Oriental Medical Services in the Automobile Insurance. KIRI weekly. 2016; 403:0. 1–9.


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5 Hong SJ, Park WP, Ha SY. A Real-world Accident Study on Vehicle Damage Types and Occupant Injury. Transaction of KSAE. 2013; 21: 1. 107–112.
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10 Park DS, Pi CH, Lee JH, Gong JC, Baek DG, Song YS, et al. Survey of Satisfaction with Oriental Medical Care for Traffic Accident Patients; 35 Case Report. JKMR. 2008; 18:3. 99–118.


11 Chiang SY, Park JW, Shin HG, Shin JH, Lee SY, Koh YJ, et al. Survey of Satisfaction of Korean Medicine Treatment in 131 Cases by Traffic Accident. J Acupunct Res. 2012; 29:3. 67–79.


12 Cho SW. Survey on Expectation of Korean Medicine Treatment in 39 Cases by Traffic Accident. JKMR. 2013; 23:3. 187–199.


13 Bae KJ, Jeong JW, Song MY, Choi JB, Kim ST, Kwon MG, et al. Survey on Satisfaction of Korean Medicine Treatment in 103 Cases by Traffic Accident. JKMR. 2015; 25:3. 65–79.


14 Kim NH, Lee YJ, Suh CY, Lee GB, Yang KJ, Kim TG, et al. A Cross-Sectional Satisfaction Survey of 845 Traffic Accident Patients Treated with Korean Medicine. J Acupunct Res. 2018; 35: 2. 69–74.
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15 Park JE, Kwon SM. Determinants of the Utilization of Oriental Medical Services by the Elderly. J Korean Oriental Med. 2011; 32:1. 97–108.


16 Jung KH, Hwang HS, Jeon JC, Kim MS, Park JY, Lee TH, et al. Correlation Analysis of Subjective Stress Caused by Traffic Accident with Prognosis. J Acupunct Res. 2009; 26:6. 161–169.


17 Park SY, Lee YK, Kim JS, Lim SC, Lee BH, Jung TY, et al. Survey of Oriental Medical Care for Traffic Accident Patients with Automobile insurance; 544 Cases Report. J Acupunct Res. 2009; 26:3. 1–10.


18 Cho SW, Kang YK, Jang DH, Lee IS. Review on the Tendencies of Diagnosis and Treatment of Traffic Accidental Patients. The Journal of Korea CHUNA Manual Medicine for Spine & Nerves. 2009; 4:2. 197–209.


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