• Journal of Digital Convergence
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• v.15 no.7
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• pp.259-269
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• 2017

This study analyzed medical aid case management effects based on the number of access by visits, phone calls, letters, internal investigation, resource links, and requests, in medical aid case management business that is carried out to improve the quality of life of medical care beneficiaries and reduce financial cost. Secondary analysis study using data of 564 high-risk group in the medical aid case management and their healthcare utilization data. Letters had positive correlations with the scores of all case management domains. The higher visits was, the lower the score of self-health care ability was, and the higher the number of phone calls was, the higher the score for reasonable medical use was. While there was no significant difference in medical cost according to aid management by interventions, the higher visits and resource links were, the lower the subjects' total number of payment days was. There is a difference in the various areas of the quality of health -related life and medical use depending on case management by intervention method and its number. It is necessary to carry out the efficient number of access to case management by intervention method.

• Journal of Korean Academy of Nursing
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• v.53 no.5
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• pp.556-569
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• 2023

Purpose: This phenomenological study tried to understand the essence of the transitional care experience of medicaid case managers and its structural meaning. In addition, it was attempted to establish a system of transitional care and seek support measures for medicaid case managers. Methods: The participants of this study were 7 medicaid case managers who had spent more than 1 year and 6 months in medicaid pilot project. Data were collected with individual in-depth interviews from June to December 2021. The data were analyzed by Giorgi's phenomenological analysis method. Results: The seven constituents derived from the results of this study were 'struggle to establish a living environment', 'dedication to supporting independent living', 'anxiety about safety', 'pressure on care responsibilities', 'distress in building the pilot project', 'pride in role', and 'expectation for improvement'. Conclusion: The study results provide a comprehensive understanding of the transition care reality for medicaid case managers. They also shed light on managers' perceptions and attitudes. These findings can serve as fundamental information for establishing support measures for medicaid case managers and transitional care systems.

• 한국노년학
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• v.36 no.3
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• pp.595-609
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• 2016

The purpose of this study was to test the effectiveness of an eight session self-management support program for improvement of patient activation, joint flexibility and health-related quality of life among medical aid beneficiaries with osteoarthritis. This study was part of a randomized and controlled research of a self-management support intervention. Participants were 60 medical aid beneficiaries who agreed to participate in this study, and were assigned to an experimental group (n=30) or control group (n=30). The 8-session and tailored program led by a trained case manager with the patient-centered approaches and cognitive-emotional-behavioral skills. Analysis included change in scores, ${\chi}^2-test$, Fisher's exact test, t-test and ANCOVA. The results showed significant increase in patient activation, joint flexibility (shoulder and right knee) except health-related quality of life in the experimental group compared to the control group. The self-management support program indicated an effect on patient activation and joint flexibility. Further research is needed to examine the outcome in the long term(9 and 12-month follow up).

• Korean Journal of Occupational Health Nursing
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• v.20 no.3
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• pp.299-307
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• 2011

Purpose: The purpose of this study is to establish the standards for duty of Medical Care Client Managers and analyze the extent of accomplishment, importance, and difficulty according to the standards. Methods: The draft for duty of Medical Care Client Managers was formed by the method of developing a curriculum (DACUM) and data were collected from 185 Medical Aid Client Managers in 234 areas to evaluate the actual frequency of accomplishment, importance and difficulty in comparison with the standards for duties. Results: The standard duty draft for Medical Care Client Manager is composed of five separate groups of duties and thirty five tasks. The five duties are Case Management, Extension Approval, External Cause of Injury, Duplicate Claims and Other Administrations. Seven Tasks are allocated to each duty such as Case Management, Extension Approval and External Cause of Injury. Five tasks are allocated to 'Duplicate Claims' duty and nine tasks are allocated to 'Other Administrations' duty. Conclusion: From the results of analysis for duties, it was apprehensive about overburdened responsibilities and carelessness in professional duties. It was necessary to establish specific guidelines for duties because of redundent application or regional variation in frequency of accomplishing other administrative duties. It was necessary to relieve a regional disparity of business charge and also was necessary to propose an alternative plan to relieve the overburdened responsibilities.

• Research in Community and Public Health Nursing
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• v.30 no.2
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• pp.195-205
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• 2019

Purpose: This study was conducted to identify effects of Medicaid Case Manager's communication competence and stress on their job satisfaction. Methods: The current work is descriptive research, and the participants were 154 medicaid case managers. Data were collected between May and July, 2017 through Embrain, a specialized research organization. The data were analyzed using independent t-test, ANOVA, and multiple regression. Results: The mean communication competence of the medicaid case managers was 3.61, stress 1.76, and their job satisfaction 2.74. Age and average monthly compensation brought significant differences in their job satisfaction. Their communication competence was correlated with stress (r=-.35, p<.001), but not with their job satisfaction. The stress was the most influential factor in job satisfaction (${\beta}=-.45$). Conclusion: The results of this work show that the medicaid case managers' communication competence was not an influence factor of their job satisfaction, which is different from implications from the previous studies and needs confirmation through future research. In addition the results of this study also suggest that stress management can be a useful approach to the improvement of medicaid case managers' job satisfaction.

• Korean Journal of Occupational Health Nursing
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• v.17 no.2
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• pp.146-154
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• 2008

Purpose: The purpose of this study is to investigate the degree of job stress and job satisfaction and the relationship between job stress and job satisfaction of Medical Aid Client Managers. Method: Data were collected from 185 Medical Aid Client Managers in 234 areas between April 2-15, 2007. Collected data was analyzed for the frequency, t-test, ANOVA, Pearson's Correlation Coefficient etc. Results: The average score of job stress was 2.6. Job instability was highest as 2.9 and job autonomy was lowest as 2.2. in eight items. When the job stress of Medical Aid Client Managers was converted to 100 point, the average was 51.7 and ranked in upper 50% of Korean woman workers' job stress. Among the eight items, because the relationship satisfaction and the instability of duty regime ranked in upper 25% of Korean woman workers' job stress, those items were identified to have high stress. The average score of job satisfaction was 2.3 out 4.0 which could be interpreted as unsatisfactory. The correlation between the job stress and the job satisfaction demonstrated significant difference. Decrease of the job satisfaction was associated with increase of the job stress. In regard to the eight items, the inverse correlation was demonstrated to be significant in organization, inappropriate compensation, and workplace culture. Conclusion: Medical Aid Client Managers have high stress in carrying out their duties. They have experienced very severe instability in their duty regime. Also, they have felt alienated from their organization and experienced unfair rewards. They had low duty satisfaction but got a heavy workload and experienced overtime work. To relieve job overburden of Medical Aid Client Managers. it was necessary to improve business system and also was necessary to relieve a regional disparity of business charge.

• The Korean Chronic Disease News
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• no.319
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• pp.1-18
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• 2007

복지시대의 첨병-구례군보건의료원 김영락 원장/노인복지시설 통합.개편/비만치료도 건강보험급여 대상/보건소 중심, 만성질환 관리시스템 구축/임의왕진 의료급여비 환수/적절한 운동이 '대장암' 예방한다/모유수유 오래하면 유방암 감소/50대 두통, 어지러움은 중풍 의심/축수산물 항생제 잔류 기준 엄격 적용/담배연기 없는 깨끗한 병원/레이저 이용 암 세포만 선택적 파괴/'주민 삶의 질 적인 개선' 지향-구례구보건의료원/농촌지역 공공보건의료 질적 발전에 정열 쏟아-김영락 원장/동아제약, 유럽 시장 본격진출/LG, 세계 최초 항구토 패치 도입/한미약품, 의약사 금융지원 한다/국내 첫 생약제제 임상시험 지침 마련/암환자 완치율 44.4% 수준/고혈압.당뇨병치료율 2배 증가/혈압 없어도 '코골면' 고혈압 위험 높아/조기위암 전체 위암 절반 넘었다/항암면역세포치료제 NKM 허가/OECD Health Data 2007 보건의료실태분석

• Journal of Korean Academy of Nursing
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• v.38 no.6
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• pp.789-801
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• 2008

Purpose: The purpose of this study was to develop a substantive theory of case management (CM) practice by investigating the experience of nurse case managers caring for Medical Aid enrollees in Korea. Methods: A total of 12 nurses were interviewed regarding their own experience in CM practice. Data were recorded and analyzed using grounded theory. Results: Empowerment was the core category of CM for Medical Aid enrollees. The case managers engaged in five phases as follows, phase of inquiring in advance, building a relationship with the client, giving the client critical mind, facilitating positive changes in the client's use of healthcare services, and maintaining relationship bonds. These phases moved gradually and were circular if necessary. Also, they were accelerated or slowed depending on factors including clients' characteristics, case managers' competency level, families' support level, and availability of community resources. Conclusion: This study helps understand what CM practice is and how nurses are performing this innovative CM role. It is recommended that nurse leaders and policy makers integrate empowerment as a core category and the five critical CM phases into future CM programs.

• Journal of Hospice and Palliative Care
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• v.18 no.4
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• pp.329-334
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• 2015

Purpose: This study was aimed at analyzing the characteristics and symptoms in home-based hospice-palliative care (HBHPC) patients registered at local public health centers. Methods: A retrospective study was performed; Data of 144 HBHPC patients registered at six public health centers in Pusan City were analyzed, including their initial visit records (registration cards, initial pain evaluation and symptom evaluation). Results: The average age of the patients was 67.7 years old. Among all, 46.2% of the patient lived alone, and 65% had middle school education or lower. The most popular (36.3%) religion was Buddhism, and 47.5% received medical assistance from the government. The most frequent diagnosis was lung cancer followed by stomach cancer and liver cancer in that order. Of all, 48.9% were functionally too weak to lead a daily life, 39.6% were under cancer treatment when registered at the public health center, and 84.5% were aware of the fact that they have reached the terminal phase. Moreover, 83.6% complained about pain, and the pain level was moderate or severe in 36.5% of them. Besides pain, fatigue was the most complained symptom (84.7%), and 49.3% of them rated their fatigue as moderate or severe. Conclusion: Most of the HBHPC patients were socio-economically underprivileged and complained about moderate or worse pain and symptoms. Therefore, it appears necessary to develop an integrated strategy that is tailored for each patient reflecting their characteristics.

• Journal of dental hygiene science
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• v.13 no.4
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• pp.493-500
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• 2013

The study aims to determine the status of oral health of mental illness patients and establish the preliminary data. The examinations and questionnaire survey were done 92 psychiatric patients to measure sociodemographic characteristics, decayed, missing and filled teeth (DMFT) index, patient hygiene performance (PHP) index, community periodontal index of treatment need (CPITN). Result of the missing teeth index in the state of oral health was higher in the hospital group (6.42) while the filled teeth index was higher in the center group (4.78). In the DMFT index, mental illness patients were higher than the national sample. The oral health status of medical aid recipients was poorer as the subjects were older and less educated (p<0.05). The PHP index was 3.41, close to the bad oral hygiene state. The hospital group (81.7%) required higher need for periodontal treatment. The periodontal health state was much poorer especially when the subject was in the age of 40's and 60's, received less education, and had no family (p<0.05). $CPITN_3$ was higher in the hospital group (13.3%) than the national sample (5.7%). The mental illness patients were socially vulnerable, therefore oral health care program should be needed and age, education level, health insurance type, presence of family and other factors needs to be considered in this approach.