• Title/Summary/Keyword: 의료보험

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Analysis of the Continuity of Outpatient among Adult Patients with hypertension and its Influential Factors in Korea (우리나라 성인 고혈압환자의 외래진료 지속성과 이에 영향을 미치는 요인 분석)

  • Son, Kyung-Ae;Kim, Yoon-Shin;Hong, Min-Hee;Jeong, Mi-As
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.6
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    • pp.2161-2168
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    • 2010
  • The administration data of the national health insurance and health insurance bills were utilized in this study. The data of 485,953 patients who were at the age of 30 and up and used the out-patient departments of every medical institution located in some regions involving two southern and northern provinces once or more during a 184-day period from July to December, 2008. As a result of analyzing their Continuity of Ambulatory Care and factors affecting it, the following findings were given: The continuity of ambulatory care among the adult patients with hypertension in our country turned out to be on a high level(MMCI $0.96{\pm}0.13$, MFPC $0.96{\pm}0.12$). Given examining the outpatient medical-cure continuity level according to index, the averagely medical-cure continuity level was calculated to be high level with MMCI, $0.96{\pm}0.13$, and MFPC $0.96{\pm}0.12$. Thus, the tendency of visiting only one medical provider was high. The findings of the study illustrated that the average continuity of ambulatory care among the adult patients with hypertension in our country was on a high level, and it seemed that special care should be provided to patients with a low-level continuity of ambulatory care, such as women and elderly people aged 64 and over. The findings of the study are expected to serve as one of the barometers for the health care of patients with hypertension and for the performance of national hypertension management plans.

A Study of General Population's Awareness and Attitudes Toward Medical Records : Focusing on Open Notes (진료기록에 대한 일반인의 인식과 태도 : 오픈노트(Open Notes) 운동을 중심으로)

  • Choi, Ju-Hee;Chun, Kyung-Ju;Lee, Sang-Ok;Kim, Yoo-Ri;Pak, Ju-Hyun;Chang, Chul-Hun;Kim, Sung-Soo
    • The Journal of the Korea Contents Association
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    • v.16 no.9
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    • pp.512-522
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    • 2016
  • The purpose of this study was to investigate general population's awareness and attitudes toward medical records and an 'Open Notes' system which allows the general public to access their medical records anytime on the hospital website. This study also examines the possibility of making the 'Open Notes' system available to Korean medical community and the general public. The results of this study shows that the general population usually used internet for health information. They obtained their medical records from the hospital mostly for the purpose of submitting to insurance company. They also believed that medical records that hospital and doctors provided might be forged or falsified. The majority of them responded that they could trust their doctors and hospitals more if they could have access to their own medical records anytime. Most of the respondents agreed that the Open Notes system would be beneficial for the general public and that it should be implemented in Korea. And they would be willing to participate in the Open Notes system if it is introduced. In conclusion, if the Open Notes system which emphasizes transparency in medical records is introduced, it could enhance the trust between doctor and patient. The trust doctor-patient relation would make patients more likely to comply and be satisfied with doctors.

A Study on Influence Factors of Mobile Healthcare Service Using Structural Equation Modeling (구조방정식을 이용한 모바일 헬스케어 서비스에 대한 사용의도 영향요인 연구)

  • Lee, OK-Hee;Ham, Seung-Woo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.3
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    • pp.418-427
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    • 2017
  • The purpose of this study is to investigate the factors influencing the intention to use mobile healthcare services based on smartphones. Data collection was conducted from March 10, 2014 to April 8, 2005. The collected data were analyzed by SPSS WIN 23.0 and AMOS 18.0 using Path analysis and Structural equation modeling analysis. The results showed that service quality and innovativeness, which are external variables, had a statistically significant effect on perceived usefulness, and these two factors had a positive effect on the intention to use mobile healthcare services. Usefulness also has a significant effect on perceived usefulness, and content characteristics and cost rationality have a significant effect on usability. The usefulness of the service also directly affects the intention to use mobile health care services, and various factors affect their effective use. In response to the recent rise in medical expenses, mobile healthcare using smartphones has emerged and there is a need to develop awareness of the various attempts by companies to develop such apps. The government should also make effort to improve accessibility to healthcare services by introducing suitable policies. It is expected that future studies will be continuously conducted to confirm the development of differentiated services for mobile healthcare subjects and their intention to use them.

The Present State and Prospect of Geriatric Denture Prosthetic Dentistry Affairs among Community Dental Hygienists (전국보건소 치과위생사의 노인의치보철사업 현황 및 전망)

  • Yoon, Young-Suk;Kwon, Yang-Ok
    • Journal of dental hygiene science
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    • v.6 no.4
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    • pp.255-261
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    • 2006
  • The purpose of This study was to survey the present state and prospect of geriatric denture prosthetic dentistry among community dental hygienists in Korea. Questionnaires about the present state and prospect of geriatric denture prosthetic dentistry were distributed to the community dental hygienists in Korea, July 2006. Collected questionnaires from 89 cases were analyzed. All collected data were analyzed using the SPSS program. The significance of differences among groups were assessed using chi-square test or Fisher's exact test. The results of this study were summarized as follows: The public relations of the geriatric denture prosthetic dentistry were enforced good, mainly by village offices. Appointed dental clinics made a production of full dentures connecting in Korean Dental Association. Above findings suggest that further study about the present state and prospect of geriatric denture prosthetic dentistry is necessary in improving the oral health related quality of life in elders.

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A Comparative Study on Awareness of Review Work of Medical Institutions and Review Institutions - Focusing on Insurance Claim Officers at General Hospitals and Review Officers at Health Insurance Review Agency - (의료기관과 심사기관의 심사업무인식도 비교연구 - 종합병원 청구직원과 건강보험심사평가원심사직원을 중심으로 -)

  • Lee, Soo-Yun;Ha, Ho-Wook;Sohn, Tae-Yong
    • Korea Journal of Hospital Management
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    • v.9 no.3
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    • pp.71-97
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    • 2004
  • This study conducted a comparative analysis of awareness level of review standards, continuing education, and awareness about the need for speciality and educational courses in order to improve quality of Korean health insurance review work and to present directions for policies of personnel development and continuing education to smoothly perform hospital's insurance claim work and Agency's review work. The analysis unit of the study is individuals, and survey was conducted among hospital's claim officers and Agency' review officers by distributing questionnaires. The major results of the study are as follows: First, it is found that hospital's claim officers and Agency's review officers have conflicting awareness about review standards; more Agency's review officers think that current review standards are universal and reasonable, while more hospital's claim officers believe that they need to be revised. Especially, hospital's claim officers replied that it is possible that review results can differ according to government's policies. Second, there is no significant difference between the two groups in the opinion that there are individual differences in awareness level of review standard. In particular, both groups share the opinion that review results can differ according to officer's interpretation of review standards. Third, Both review officer groups feel the need for further training and continuing education. Fourth, there is no difference between the two groups in the opinion that both groups members should be educated in review related educational institutions. However, while 81.5% of Agency's review officers the education should be offered at the Agency, only 45.2% of hospital's claim officers agreed to it. Fifth, both review personnel do not show any difference in awareness of needed experience to successfully perform review work; both groups replied that three to four years experience is necessary to smoothly perform claim work and review work. This study was tried in order to search for directions to improve Korean insurance review work in quality rather than to explore characteristics themselves of individual factors. In this sense, this study presupposed an intention that the educational subjects for further training and continuing education for the two groups should be the same in order to narrow the awareness gap between hospital's claim officers and Agency's review officers. Thus, this study suggests that it is desirable to offer beginner courses at junior colleges or in undergraduate courses and advanced courses in professional graduate school for six to twelve months. In that a comparison of awareness level of hospital's claim officers and Agency's review officers who are actually in practice should precede appropriate presentation of directions for the qualitative improvement of insurance review work in Korea, the significance of this study lies in comparatively analyzing the awareness level of hospital's claim officers and Agency's review officers and in presenting the establishment of future further training and continuing education.

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A study on the change of complication incidence rate according to introduction of quality evaluation by the DRG payment -focussing on patients with lens surgery (질병군 포괄수가 적정성 평가 도입에 따른 합병증 발생률 변화에 대한 연구 -수정체 수술 환자를 대상으로)

  • Kim, Myoung-Ok;Park, Arma;Lee, Chong Hyung;Kim, Kwang-Hwan
    • Journal of the Korea Convergence Society
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    • v.9 no.6
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    • pp.99-106
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    • 2018
  • The purpose of this study is to investigate incidence rates of complications in response to the introduction of quality evaluation of the DRG(diagnosis related group) payments, focusing on an increasing number of patients with lens surgery as the population aging increases.Fourthly, there were three dependent variables ('vitreous prolapse', 'IOP elevations', and 'other complications') in this study, and therefore multivariate logistic regression was performed. The result of the analysis indicates that as the number of hospitalized days increased, vitreous prolapse decreased to 0.27 times(95% CI 0.08~1.00) and IOP elevation decreased by 0.14 times(95% CI 0.03~1.59), compared to other complications, and this was statistically significant. From the above results, this study is meaningful in that it has compared the evaluation results of the appropriateness of DRG payment and the medical quality for lens surgery complications patients, in response to the introduction of quality evaluation by DRG payment.

Trends of Health Care Utilization and Relevance Index of Stroke Inpatients among The Self-Employed Insured and Their Dependents of National Health Insurance (1998-2005) (국민건강보험 지역가입자 중 뇌졸중 입원환자의 의료이용 양상 및 지역친화도 추이 (1998-2005))

  • Kim, Ji-Hyun;Cho, Byung-Mann;Hwang, In-Kyung;Son, Min-Jeong;Yoon, Tae-Ho
    • Health Policy and Management
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    • v.18 no.4
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    • pp.66-84
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    • 2008
  • Objectives: This study aimed to. offer some fundamental evidences for the stroke management policy by investigating the trends of medical care utilization and regionalization in stroke inpatients. Methods: We used the National Health Insurance claims and registry data for stroke inpatients from 1998 to 2005. Among all stroke inpatient claims data, self-employed insured and their dependents were only included in this study. The classification of stroke was based on ICD-10(I60-I69) and its subtype was divided by hemorrhage(I60-I62) and infarction(I63-I64) type. To evaluate regionalization of medical care utilization, relevance index was calculated by regions. The regions were classified 8 large catchment areas and 163 self authorized areas. Results: The overall medical care utilization rate of stroke inpatient has been increased, especially infarction subtype. Among medical care institutions, the utilization of hospital has been the most rapidly increased. Although considered annual rate of interest, total medical cost of stroke inpatients has been increased, Totally, more than 84% of stroke inpatient were admitted to medical care institutions in their own large catchment area during 1998-2005. The relevance indices in their own large catchment area (self sufficiency rates) were more than 70% in most areas regardless of stroke subtype except Chungbuk catchment area. Self sufficiency rates of stroke inpatients among 163 self authorized areas in 1998 and 2005 were 84.2% and 83.1% in metropolitan, 46.7% and 45.5% in urban, and 19.5% and 22.6% in rural areas, respectively. Conclusion: Stroke management policy for improvement of distribution at the district level, especially in rural areas, may be helpful for reducing regional inequality in stroke.

Analysis of the cause by Pre Exposure Tube Voltage and Actual Exposure Tube Voltage deviation in Mammography Examination (유방 촬영검사에서 사전조사 관전압과 실제조사 관전압 편차에 따른 원인 분석)

  • Cho, Ji-Hwan;Lee, Hyo-Yeong;Im, In-Chul
    • Journal of the Korean Society of Radiology
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    • v.11 no.2
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    • pp.79-85
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    • 2017
  • The purpose of this study is to investigate the cause analysis according to the difference between the pre exposure tube voltage and actual exposure tube voltage in mammography in connection with breast pressure thickness, breast size and body mass index and to find the improvement. The study tracked 377 women age 40 and older among the mammography examiners conducted by the National Health Insurance Corporation. It was analyzed that breast pressure thickness, breast size and body mass index according to the difference between the pre exposure tube voltage and actual exposure tube voltage among the parameters of dose report been sent to the picture archiving communication system with reference to the image with cranio-caudal projection in mammography. As are result, it shows that the thicker the breast thickness, smaller the breast size and lower body mass index, the higher the difference of tube voltage. In conclusion, the minimum tube voltage of mammography machine should be reset in order to set the tube voltage according to breast pressure thickness and breast size that are suitable for our country in mammography, in addition, it was considered that radiologist should make an effort to reduce radiation exposure and make a good quality image with reducing the difference of mammography condition by making a correct exposure condition in case of examining the patients with thin breast pressure and small breast size.

A Study on Characteristics of Medical Expenses and the Hospitalization Period of Hospitalized Patients Using Diem Payment System at Convalescent Hospitals (요양병원 일당정액제 입원환자의 입원일수 및 진료비 특성에 관한 연구)

  • Roh, Ock-Hee;Lee, Chong Hyung;Park, Arma;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.407-414
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    • 2016
  • This study was conducted to provide basic data to evaluate the appropriateness of convalescent hospitalization treatment by investigating the number of hospitalization days and the total treatment expenses of a total of 44,037 monthly billing statements requested from the Health Insurance Review and Assessment Service. Evaluated data consisted of medical care expenses of patients of the diem payment system hospitalized at convalescent hospitals in Daejeon, Chungnam, Chungbuk and Sejong from January through December of 2014. According to the analysis result of the general characteristics of the study objects and the canonical correlation analysis of the top 15 main diagnosis names, 7 canonical functions have been deducted. Among them, six canonical functions were shown to be statistically significant (p<0.001), and canonical function 1 had a chi-squared value of 5955.49 and 98 degrees of freedom at p<0.001 level. Overall, the results indicated that if health and welfare service in the regional society is magnified, social hospitalization can be reduced.

Factors influencing metabolic syndrome perception and exercising behaviors in Korean adults: Data mining approach (대사증후군의 인지와 신체활동 실천에 영향을 미치는 요인: 데이터 마이닝 접근)

  • Lee, Soo-Kyoung;Moon, Mikyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.12
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    • pp.581-588
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    • 2017
  • This study was conducted to determine which factors would predict metabolic syndrome (MetS) perception and exercise by applying a machine learning classifier, or Extreme Gradient Boosting algorithm (XGBoost) from July 2014 to December 2015. Data were obtained from the Korean Community Health Survey (KCHS), representing different community-dwelling Korean adults 19 years and older, from 2009 to 2013. The dataset includes 370,430 adults. Outcomes were categorized as follows based on the perception of MetS and physical activity (PA): Stage 1 (no perception, no PA), Stage 2 (perception, no PA), and Stage 3 (perception, PA). Features common to all questionnaires for the last 5 years were selected for modeling. Overall, there were 161 features, categorical except for age and the visual analogue scale (EQ-VAS). We used the Extreme Boosting algorithm in R programming for a model to predict factors and achieved prediction accuracy in 0.735 submissions. The top 10 predictive factors in Stage 3 were: age, education level, attempt to control weight, EQ mobility, nutrition label checks, private health insurance, EQ-5D usual activities, anti-smoking advertising, EQ-VAS, education in health centers for diabetes, and dental care. In conclusion, the results showed that XGBoost can be used to identify factors influencing disease prevention and management using healthcare bigdata.