• Title/Summary/Keyword: 보건의료비

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Analysis of Frequent Disease and Medical Expenses Structure of Patients Admitted in a Vaterans Hospital (일개 보훈병원 입원환자의 상병 및 진료비 구조분석)

  • Kim, Kyoung-Hwan;Lee, Sok-Goo;Kim, Jeong-Yeon
    • Journal of agricultural medicine and community health
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    • v.30 no.1
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    • pp.1-14
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    • 2005
  • Objectives: This study attempts to analyze the length of hospital stay and expenses of frequent disease admitted in a Vaterans Hospital. Methods: Data was collected from January 1, 2001 to December 31, 2003 from the Claim records of 9,640 patients in a Vaterans Hospital. Results: The results were as follows: 1. In age & sex distribution, there was male 70.9%, female 29.1%, and 35.8% of them is 70 age group. Frequency by insurance program was Health insurance 78.1%, Medical aid 14.2%, no insurance 4.1%, others 3.6%. Distribution of each department was internal medicine 28.3%, orthopedic surgery 21.3%, surgery 16.6%, neurosurgey 7.1%, pediatrics 5.9%. Also, in the veterans group, male to female patient ratio was 99.3% male to 0.7% female, them over 70 years old was 51.6%, and them which live in daejeon was 43.5%. 2. In frequency of disease, there was gastroenteritis 4.8%, pneumonia 3.8%, cartaract 3.7%, cerebral infarct 3.2%, hyperplasia of prostate 3.0%. In frequency of korean standard classification of diseases, there was injury and poisoning and certain other consequences of external causes 17.1%, diseases of digestive system 16.1%, diseases of musculoskeletal system and connective tissue 13.9%, diseases of respiratory system 9.4%, diseases of genitourinary system 8.6%. Also, in veterans group, frequency of them was diseases of musculoskeletal system and connective tissue 19.4%, diseases of digestive system 16.8%, injury and poisoning and certain other consequences of external causes 15.7%, diseases of genitourinary system 9.7%, diseases of circuatory system 8.2%. 3. Average length of hospital stay was 29.0 days for total patients, 51.8 days for the veterans group, 15.7 days for the non-veterans one. Average total expenses was 3,669,579 won, the veterans group 7,263,877 won, the non-veterans one 1,560,333 won. The ratio of insurer to insuree was 55.2 : 44.8, the ratio of amount paid by patient in the veterans group 61.7%, in the non-veterans one 33.0%. 4. In items of medical expenses, fee for hospital accommodation was 34.7%, fee for medication 13.2%(injection 7.8%, drug 5.4%), fee for service 48.6%(physical therapy 26.3%, operation 9.7%, laboratory examination 5.2%, radiological examination 3.1%, etc), others 3.4%. In them for the veterans group, fee for physical therapy was 35.3%, fee for hospital accommodation 35.2%, fee for injection 6.2%, fee for operation 5.9%, for the non-veterans one, fee for hospital accommodation 35.7%, fee for operation 16.4%, fee for injection 11.4%, fee for laboratory examination 8.3%. 5. In the comparison of the frequency by Korean standard classification of diseases and distance between the hospital and home, the region under 21.5Km was more frequent in symptoms, signs an abnormal clinical and laboratory findings 56.0%, injury and poisoning and certain other consequences of external causes 55.6%, diseases of the eye and adnexa 52.9%, the one over 21.5Km was more frequent in neoplasms 57.4%, diseases of musculoskeletal system and connective tissue 55.9%, diseases of genitourinary system 53.5%.

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The Associated Factors of Health Examinations Behaviors among Some Elderly Persons in Urban and Rural Areas (일부 도시·농촌지역 고령자의 건강검진 수진행동에 관련된 요인)

  • Kim, Yong-Ik;Cho, Young-Chae
    • Journal of agricultural medicine and community health
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    • v.29 no.1
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    • pp.1-14
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    • 2004
  • Objectives: We investigated the factors related to health examination behaviors, sociodemographic aspects and lifestyles of elderly persons with different social backgrounds, and compared sexual and regional differences in urban and rural elderlies. Methods: The total study subjects(464 individuals) from urban(236) and rural areas(228), recruited by a stratified cluster random sampling were interviewed and examined about their sociodemographic profiles, daily lifestyles, subjective health status, conditions concerning use of medical resources, hearing acuity, visual acuity and ADL(activity of daily living), and whether they receive health examination or not. For statistical analysis, Chi-square test was used for sexual and regional comparisons among the groups who have been given a health examination and the one who have not. Results: In urban areas, the rate of having underwent health examination was 54.5% in men and 46.9% in women, and in rural areas, it was 59.8% in men and 42.7% in women, showing its higher rate in men than in women in both areas. For regional differences between the group who have taken a health examination and the one who have not, there was a significant difference in terms of age, family pattern, current job, monthly household income, owning a house, drinking status, eating habit, subjective health status, whether they have taken outpatient medical service for the recent 3 months or not, anxiety for the health, and IADL conditions according to whether the community is rural or urban. In multiple regressions, the influential factors on the health examination behaviors were selected such as having their own house, their family doctor, amnesia, urinary incontinence and chronic disease in urban districts. But in rural districts, the variables were selected such as having or not of their family doctor, urinary incontinence, anxiety for the health, educational level, their own house and chronic disease. Conclusions: It is suggested that the approach to the health examination of an older patient requires substantial consideration of highly variable individual sociodemographic characteristics involving regional attributes as well as their daily life styles, subjective health status, status of performing health examination, physical health status and ADL conditions.

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The Use and its Affecting Factors of patients aged 30 and over with single and multiple chronic diseases and their usage outpatient Korean medicine clinics - Based on the Ministry of Health and Welfare's 2011 Report on usage of Korean medicine - (30세 이상 한방의료기관 외래환자 중 비복합 및 복합만성질환자의 의료이용과 결정요인 - 2011년 한방의료이용 및 한약소비실태조사보고서(보건복지부)자료를 중심으로 -)

  • Yoon, Jinwon;Choi, Sungyong;Lee, Sundong
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.1
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    • pp.95-107
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    • 2015
  • Objective : To use and its affecting factors of patients' outpatient treatment that have single and multiple chronic illnesses Method : We used the 2011 study by the Ministry of Health and Welfare, "Report on Usage and Consumption of Korean Medicine." This report was conducted on outpatients and inpatients that visited Korean traditional medicine, from August 25th, 2011, to September 30th, 2011. Our research was based on 1729 patients with chronic diseases aged 30 and over who received outpatient treatment during the last three months. Results : There were 1365 patients with non-complex chronic diseases, while there were 364 patients with complex chronis diseases. Patients had 1 - 8 chronic diseases, and the average number (standard deviation) was 1.26 (0.59). There were statistically significant differences by sex(P<0.0001), age(p=0.0045), marriage (p=0.0060), education level(p<0.0001), income level(P=0.0063), and types of health insurance(p=0.0023). The diseases most common among patients with non-complex chronic diseases were: low back pain, arthritis, gastrointestinal disorder, frozen shoulder, side effects from motor accidents, high blood pressure, fracture, stroke, diabetes, cancer, atopic dermatitis, and asthma. The diseases most common among patients with non-complex chronic diseases were: arthritis+low back pain, low back pain+gastrointestinal disorder, low back pain+side effects from motor accidents, low back pain+frozen shoulder, arthritis+gastrointestinal disease, gastrointestinal disease+frozen shoulder, arthritis+low back pain+gastrointestinal disease, high blood pressure+arthritis, arthritis+low back pain+frozen shoulder, arthritis+fracture, and arthritis+side effects from motor accidents. There were statistically significant differences among the usage of medical clinics by: frequently used clinic (p<0.0001), number of treatment (p<0.0001), the cost of outpatient treatment (p=0.0073), the satisfaction rate (p=0.0171), whether the clinic is the preferred clinic (p=0.0040). In model 1, men than women, people who had local benefits instead of type 1 medical aid, and patients with complex chronic diseases were more likely to use Korean medical clinics. In model 2, men than women, people who had local benefits than people with types 1 and 2 medical aids, people who went to pharmacies and Korean medicine pharmacies than people who went to hospitals, people who went to get treatment 1-10 times than people who visited 11-20 times and more than 41 times, and people who spent less than ten thousand Korean won than people who spent 1 to 2 million Korean won, and people without complex chronic diseases were more likely to use Korean medical treatment. Conclusion : There were differences in sociodemographic characteristics and the usage of medical clinics between patients with non-complex chronic diseases and patients with complex chronic diseases. Among patients with complex chronic diseases, women, patients with types 1 and 2 medical aid, patients who used Korean medical clinics, patients who were treated 11-20 times and more than 41 times, and patients who spent 1 million to 2 million Korean won on outpatient treatment used less treatment than patients with non-complex chronic diseases. However, patients with complex chronic diseases used pharmacies and Korean medicine pharmacies more.

Development of an Efficient Management Program for the Home-based Cancer Patient Management Project of Public Health Centers (보건소 재가 암환자 관리사업의 효율적 관리 방안 개발)

  • Cho, Hyun;Son, Joo-Young;Heo, Jeom-Do;Jin, Eun-Hee
    • Journal of Hospice and Palliative Care
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    • v.10 no.3
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    • pp.128-136
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    • 2007
  • Purpose: The purpose of this study is to investigate the current state of the home-based cancer patient management project of public health centers throughout the country. The results of the investigation is employed to identify obstacles to the execution of the program and, finally, to develop an efficient management program of home-based cancer patients. Methods: Data on the home-based cancer patient management project were collected and analyzed through visiting interviews or telephone interviews with 225 public health centers throughout the country for six months from July to December, 2006. Results: Obstacles to the present execution of the home-based cancer patient management project were identified. Some of them are : (1) patients' low trust in cancer patient management by local health centers, (2) absence of programs customized to local communities, (3) lack of personnel and vehicles for home-based cancer patient management, (4) lack of education program for personnel in charge of home-based cancer patient management, (5) problems in public health doctors, weak connection to private medical institutions, (6) absence of medical institutions and hospice facilities for cancer patients, and (7) non-standardized volunteer workers, so on. Considering all these problems, some effective management methods are proposed. The basic concept is to keep the autonomy and variety of the local helath centers. And based on this concept, three models of (1) public health center controlled model, (2) medical institutions and hospice facilities-entrusted model and (3) medical institutions and hospice facilities-cooperative model are developed. Conclusion: By adopting an adequate model among proposed three models, the public health centers are expected to achieve an efficient utilization of material resources and manpower. In addition, by inventing their own programs that are proper for the local societies, they can improve the home-based cancer patient management.

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The Clinical Characteristics, Diagnosis, Treatment, and Outcomes of Patients with Tuberculosis at a Private University Hospital in Korea (국내 한 민간종합병원에서 결핵 환자의 진료 실태)

  • Jung, Young Ju;Park, I-Nae;Hong, Sang Bum;Oh, Yeon-Mok;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.194-204
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    • 2006
  • Background : Even though tuberculosis (TB) is still a major public concern in Korea, there is little data on the management of TB patients and its outcomes in the private sector. This study evaluated the status of TB treatment in the private sector. Methods : Sixteen-hundred-sixty-six TB patients who were notified in a private university hospital from 2001 to 2002 were enrolled in this study. The patients were divided into pulmonary ($TB_P$), extrapulmonary ($TB_E$), and combined ($TB_{P+E}$) groups, and were also divided into initial and retreatment groups. The clinical characteristics, diagnostic methods, treatment regimens, and outcomes were analyzed and compared. Results : The mean age of the 1,666 patients was 48.9 years and the male-to-female ratio was 1.3:1. The number of patients in the initial and retreatment groups of $TB_P$, and those of ($TB_E+TB_{P+E}$) were 809, 276, 480, 101, respectively. A bacteriological study was performed in 92.0% of cases, and a positive culture was confirmed in 58.1% and 31.7% of patients with TBP and ($TB_E+TB_{P+E}$), respectively (p<0.05). The AFB smear was positive in 45.4 % of the $TB_P$ patients. PCR was carried out in 60.4% of the ($TB_E+TB_{P+E}$) group. The MDR was detected in 14.0% of isolates. Overall, the treatment completion, default, and death rates were 70.2%, 13.5% and 1.9%, respectively. Conclusion : Even though the management of TB patients in a private hospital was satisfactory in terms of the national guidelines, the high default rate was is still a problem. Efforts to decrease the default rate either independently or in cooperation with the public sector will be needed.

A Study on the Clinical Statistics of Oriental Medicine Service in the Health Center (보건소내(保健所內) 한방의료(漢方醫療)에 대(對)한 임상통계연구(臨床統計硏究) (전주시(全州市) 완산구(完山區) 보건소(保健所) 중심으로))

  • Song, Beom-Yong;Yuk, Tae-Han
    • The Journal of Korean Medicine
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    • v.18 no.1
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    • pp.40-57
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    • 1997
  • The Background and Purpose It is done the study on the public health care of oriental medicine and improvement of its system recently, I think that these effect a good health care for a people through the public health care of oriental medicine. Since Woosuk university and Chonju-Wansan health center had taken upon the oriental medicine service in the health center in 1995, we have public favor from the local population. So in other to a study on the clinical statistics of oriental medicine service in the health center, I investigated general character, style of diseases, effect of treatments and the like for a paitents received oriental medicine treatments in there. Objective and Methods This study researched into clinical statistics for paitents received oriental medicine treatments in the Chonju-Wansan health center during one year period from January 4 1996 to December 26 1996. The number of object was 238 case of 234 persons. Results and Conclusions Analyzing these 234 persons, the proportion of males to females was 1 to 6.8. As for the distribution of age, the ages of 61 to 70 occupied 34.62 per cent in the ages of 51 to 90 occupied 88.89 per cent in the whole paitons. Therefor female was very highly more than male and paitents were for the most part, old ages(51years old and over). Musculoskeletal system and connective tissue disease of 238 case occupied 82.77 per cent. were the greatest proportion. At the duration of disease, 1 year to 5 years occupied 32.35 per cent, was the highest The grade Ⅲ was the most of the sign of paitents at first visit, it occupied 55.88 per cent. The good(++) and over effect of treatments occupied 62.18 per cent, the fair(+) and over effect of treatments occupied 78.99 per cent. As for the duration of treatment, the case of 2 times to 5 times visit occupied 34.03 per cent, was the highest. And the case of 2 times to 10 times visit was 4 times as good effect as the case of only one visit. By medication of treatment, O-Juk-San(五積散) occupied 32.21 per cent, was the greatest proportion, and Pal-Mj-Hoan(八味丸) occupied the second greatest proportion. Therefor the most of paitents had the chronic diseases and was diagnosed Sin-Yang-He(腎陽虛). The average 22.58 persons received acupuctural treatment a day, the average 0.58 persons received the moxibustion a day, the average 2.28 persons received venesection (bloodletting) a day. And others treatment performed physical therapy and the like. The case received treatment of the oriental and western medicine at the same time. marked 21 persons among 30 persons and had a good effect by 70 per cent. The average 26.95 persons received treatment of oriental medicine a day, the average 3.9 persons received the first medical examination a day.

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Availability of Oral Hygiene Devices for the Patients with Smoking in some Dental Clinics (일부 치과병원 흡연환자의 구강위생용품 이용도)

  • Jang, Kyeung-Ae;Seong, Mi-Gyung;Kang, Hyun-Kyung;Choi, Jung-Ok;Kim, Yoon-Sin
    • Journal of dental hygiene science
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    • v.8 no.1
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    • pp.7-12
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    • 2008
  • The purpose of this study is to improve the oral health after understanding the usage status of oral health items and to conduct active guidance for prohibition of smoking. The survey of 326 visitors for continuous oral health management in the dentist from April 2nd 2007 to May $20^{th}$ is accomplished. The data is handled from the SPSS 12.0 statistics program and we can get the results like below. 1. The number of people answering the usage of the smooth toothbrush is 64.5% which is higher in smoking peoples than in non-smoking ones (p < 0.001). Non-smoking people 61.4% answering '3 minutes more' per brushing their teeth is higher than smoking respondents. 2. The more used device is the interdental brush by non-smoking people 36.7% than smoking ones and the answer. 3. The percentage answering 'recommendation in the dentist' in the question about the motive using the oral health devices are nearly same in 69.6 % and 67.5% by non-smoking and smoking persons. The most reason not using these devices is 'don't know how to use this' and the number of smoking guys is 38.7% which is higher than that of non-smoking ones(p < 0.05). 4. The percentage of answering 'regular visiting the dentist', the method for oral health management is 28.3% in smoking parts and 35.3% in non-smoking ones which is slightly higher. From this study, the usage and the recognition of oral hygiene devices of the patient with smoking is a little bit lower than those of non-smoking patients and small difference is shown. So public relations of the effects and the necessity of the oral hygiene devices to all people have to be performed and the education and the activity prohibiting smoking are expanded by the dental hygienist based on the understanding of oral health when the patients are smoking or not.

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Oral Health and Related Factors for the Elderly (Structural Equation Modeling을 통한 노인(老人)의 구강건강(口腔健康) 관련요인(關聯要因) 분석(分析))

  • Seung, Jeung-Hee
    • Journal of dental hygiene science
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    • v.4 no.3
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    • pp.91-95
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    • 2004
  • This study aims to analyze realities of oral health and related factors, and establish Structural Equation Modeling. The subjects of study were 9,340 elderly over age 65 who took the health examination(the first) for the local insured which National Health Insurance Corporation carried out in the survey area mentioned below from January 2002 to December 2002. The areas surveyed were 4 big cities including Seongbuk-ku, Seoul, 5 medium cities including Wonjusi, Gangwon-do, and 5 Counties including Yeong deok County, Kyeongbuk. Considering location and the scale of population, firstly, big unit areas(metropolitan city, province) were selected according to convenience, secondly, low unit areas(city, county, district) were selected randomly. The subjects were the elderly who took all tests including an oral examination and filled in the questionnaire. Major results from analysis are as follows: 1. Review of Composition Conception Validity As a result of analyzing composition conception validity of SEM including posture test, urine test, blood test, habits of eating, drinking and smoking, oral symptoms, and oral health status, using fit index such as GFI, CFI, TLI, and RMSEA, all were within fit range and composition conception validity was recognized. 2. As a result of analyzing SEM to find the relationship between each factor and oral health status, it was confirmed that all factors except urine test affected oral health status and the synthetic SEM to explain it could be established. In result, we could verify that the elderly of rural areas who had lesser experience of visiting a clinic and oral prophylaxis had a higher rate of caries, missing teeth, and denture need, and drinking and smoking negatively affected the rate of caries, periodontal, and missing teeth. Also, periodontal diseases were observed from 43.2% of the total elderly and much from the lower age. Most of oral disease can be prevented by right oral health behavior. Therefore through oral health professionals from each district public health center of the nation, oral health education for the elderly about right eating habits and oral health care should be carried out systematically and policy change to increase access to dental service is required lest that visiting a dental clinic should be impossible or oral health behaviors such as oral prophylaxis and denture wearing should be neglected by economic, geographical barriers. Also, to establish SEM to explain the relationship between oral health status and systemic health, more accurate test methods and effective index development should be preceded. Because items developed by National Health Insurance Corporation applied to this study without alteration, structuring a model had the uppermost limit. Continual study seems to be needed.

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The Changes in Patients and Medical Services by Separation of Prescribing and Dispensing Practice in Health Center (의약분업 실시 전후 보건소 내소환자 진료내용 변화)

  • Chun, Jae-Kyung;Kam, Sin;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.75-86
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    • 2002
  • This study was conducted to investigate the changes in patients and medical services before and after the Separation of Prescription and Dispensing in Health Center. For the purpose of this study, prescription data of 5,890 prescribed patients in March 2000(before the Separation of Prescription and Dispensing) and 3,496 prescribed patients in March 2001(after the Separation) in 4 Health Centers located in Gyeongsangbuk-do and Gyeongsangnam-do were collected. For investigation of the change of character of prescribed patients and the disease, sex, age, chief diagnosis, the hind of medical insurance, days of visit, days of prescription were investigated by using National Health Insurance claim data. And for investigation of change of prescription, prescribed drugs per each claim, the use rate of antibiotics, injection, and high-price antiphlogistic drug were investigated for acute respiratory disease and musculoskeletal disease. The major results were as follows: For the changes of prescribed patients of each disease, patients with acute respiratory disease were decreased by 49.7% after the Separation of Prescription and Dispensing than before the Separation of Prescription and Dispensing and patients with hypertension(18.1%), patients with musculoskeletal disease(70.5%), patients with diabetes(8.5%), patients with digestive organ disease(71.2%), patients with chronic respiratory disease(76.4%) were decreased. But patients with urethritis were increased by 66.7%. The mean Health Center visited days of prescribed patients decreased significantly after the Separation of Prescription and Dispensing than before in both male and female(p<0.01) and in health insurance patients(p<0.01). For the each of the disease, hypertension, diabetes, musculoskeletal disease decreased. The mean prescribed days increased after the Separation of Prescription and Dispensing than before(p<0.01). According to the kine of disease, the mean prescribed days increased after the Separation of Prescription and Dispensing than before in all the diseases except the urethritis(p<0.01). For acute respiratory diseases, number of prescribed drugs per each claim decreased significantly after the Separation of Prescription and Dispensing(4.7 drugs) than before(4.9 drugs) and the prescription rate of injection decreased significantly from 63.8% to 7.70%, and the prescription rate of antibiotics decreased significantly from 337% to 19.1%(p<0.01). For musculoskeletal diseases before and after Separation of Prescription and Dispensing, number of prescribed drugs per each claim decreased significantly from 3.7 to 3.2 and the prescription rate of injection decreased significantly from 64.9% to 1.7%, and the prescription rate of high-price antiphlogistic drugs increased significantly from 29.1% to 397%(p<0.01). In consideration of above findings, the mean visited days decreased and on the contrary, the mean prescribed days per each prescription increased after Separation of Prescription and Dispensing than before in health centers. For the prescription pattern of physicians, number of prescribed drugs and the prescription rates of injection and antibiotics per each claim decreased, but the prescription rate of high-price antiphlogistic drugs increased after Separation of Prescription and Dispensing.

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Factors Influencing Sexuality Knowledge and Gender Sensitivity During Adolescents and Early Adulthoods (청소년기 및 초기 성인기의 성지식과 성인지 감수성에 영향을 미치는 요인)

  • Hae Su Na;Sun Goo Lee;Kang Min Baek;Woo Young Im;Seung-Gul Kang;Seong-Jin Cho;Kyoung-Sae Na;Jae Myeong Kang;Seo-Eun Cho;Seung Min Bae
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.25-32
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    • 2023
  • Objectives : This study investigated the level of sexuality knowledge and gender sensitivity and factors influencing on them among Korean high school and college students. Methods : 129 questionnaires from high school and college students with consent forms, collected from July to December of 2022, were analyzed. After identification of participants' gender, age, major, their report of the practicality of sex education, and their experience of violence or sexual assaults, participants' level of sexuality knowledge and gender sensitivity were compared. Results : Females showed higher gender sensitivity, regardless of age and group (p=0.004). The early adulthood group (≥19 years old) showed higher sexuality knowledge and gender sensitivity, compared to those adolescents (<19 years old). Among college students, those who majored in health science were identified with higher sexuality knowledge and gender sensitivity, compared to non-health science major students(p<0.001; p=0.005). Conclusions : This study revealed the significant differences in sexuality knowledge and gender sensitivity according to sex, age, and majors in adolescents and early adults. Therefore, it seems to be necessary to consider the differences in sexuality knowledge and gender sensitivity among age, sex, and majors when establishing public policy or legislation for sex crimes, including digital sex crimes.