• Journal of Digital Convergence
• /
• v.14 no.7
• /
• pp.309-319
• /
• 2016

There is a need to develop a data quality management algorithm in order to improve the quality of health care data. In this study, we developed a data quality control algorithms associated diseases related to diabetes in patients with hypertension. To make a data quality algorithm, we extracted hypertension patients from 2011 and 2012 discharge damage survey data. As the result of developing Data quality management algorithm, significant factors in hypertension patients with diabetes are gender, age, Glomerular disorders in diabetes mellitus, Diabetic retinopathy, Diabetic polyneuropathy, Closed [percutaneous] [needle] biopsy of kidney. Depending on the decision tree results, we defined Outlier which was probability values associated with a patient having diabetes corporal with hypertension or more than 80%, or not more than 20%, and found six groups with extreme values for diabetes accompanying hypertension patients. Thus there is a need to check the actual data contained in the Outlier(extreme value) groups to improve the quality of the data.

• Health Policy and Management
• /
• v.34 no.2
• /
• pp.196-210
• /
• 2024

Background: In January 2018, revised elderly fixed outpatient copayment for the elderly were implemented. When people ages 65 years and older receive outpatient treatment at clinic-level medical institutions (clinic, dental clinic, Korean medicine clinic), with medical expenses exceeding 15,000 won but not exceeding 25,000 won, their copayment rates have decreased differentially from 30%. This study aimed to examine the changes of health utilization of elderly after revised elderly fixed outpatient copayment. Methods: We used Korea health panel data from 2016 to 2018. The time period is divided into before and after the revised elderly fixed outpatient copayment. We conducted Poisson segmented regression to estimate the changes in outpatient utilization and inpatient utilization and conducted segmented regression to estimate the changes in medical expenses. Results: Immediately after the revised policy, the number of clinic and Korean medicine outpatient visits of medical expenses under 15,000 won decreased. But the number of clinic outpatient visits in the range of 15,000 to 20,000 won and Korean medicine clinic in the range of 20,000 to 25,000 won increased. Copayment in outpatient temporarily decreased. The inpatient admission rates and total medical expenses temporarily decreased but increased again. Conclusion: We confirmed the temporary increase in outpatient utilization in the medical expense segment with reduced copayment rates. And a temporary decrease in medical expenses followed by an increase again. To reduce the burden of medical expense among elderly in the long run, efforts to establish chronic disease management policies aimed at preventing disease occurrence and deterioration in advance need to continue.

• Journal of Preventive Medicine and Public Health
• /
• v.30 no.2 s.57
• /
• pp.437-461
• /
• 1997

Because of a significant improvement in the economic situation and development of scientific techniques in Korea during the last 30 years, the life expectancy of the Korean people has lengthened considerably and as a result, the number of the elderly has markedly increased. Such an increase of the number of aged population brought about many social, economic, and medical problems which were never seriously considered before. This study was conducted to assess the trend of medical care utilization and medical expenditure of the elderly. The data of each patient in the study were taken from computer database maintained for administrative purpose by the Korea Medical Insurance Corporation. The study population was 132,670 who were 60 years old or more and registered in Korean Medical Insurance Corporation from 1989 to 1993. The study subjects were predominantly female(56.3%) and 10,000-20,000 Won premium group(50.6%). The following are summaries of findings : The total increase of the number of inpatient cases was 40.5% from 1989 through 1993. The average annual increase was 3.7% in inpatient medical expenditures per case, 4.4% in inpatient medical expenditures per day and 0.08% in length of stay per case from 1989 through 1993. Cataract was the most prevalent disease of 10 leading frequent diseases in all ages from 1989 through 1993. The case mix in 1993 compared to 1989 revealed that cataract and ischemic cerebral disease were increased whereas essential hypertension and pulmonary tuberculosis were decreased . The average annual increase of medical expenditures was 3.8% in general hospitals, 6.3% in hospitals and 2.4% in clinics. From 1989 through 1993, medical expenditures used by high-cost patients accounted for about 14% to 20% of all expenditures for inpatient care, while they represented less than 2.5% of the elderly population. Time series analysis revealed that total medical expenditures and doctor's fee for inpatient will be progressively increased whereas drug expenditures for inpatient will be decreased. And there will be no change in length of stay. Based on the above results, the factors increasing medical cost and utilization should be identified and the method of cost containment for the elderly health care should be developed systematically.

• Journal of radiological science and technology
• /
• v.35 no.3
• /
• pp.211-218
• /
• 2012

This study was performed to understand the bacteriologic contamination level of radiological equipments which have frequent contacts with patients in the Department of Radiology of an university hospital in Busan area. Before sterilizing in-patient of the radiology rooms, MRSA, VRE, acinetobacter baumannii, candida albicans, and enterococcus sp. were detected. After sterilization, all the bacteria were not found. As examine times become longer, more bacteria were detected and after 7 hours, bacillus sp.(GPR), CNS, acinetobacter baumannii, and Enterococcus sp. were detected. After examining infected patients, bacillus sp.(GPR), VRE, enterococcus sp. CNS, and micrococcus sp. were detected and on the hands of radiological technologists, CNS, enterococcus sp. escherichia coli, and enterobacter sp. were detected. Similar species of bacteria were detected from each radiology room, but pseudomonas aeruginosa was detected on the handles of portable radiological equipments and the chair in the waiting room. Therefore, it is the most important to regularly sterilize radiological equipments and devices which have frequent contacts with patients and to sterilize them right after the use of infected patients in order to prevent the spread of infection. Also, thorough hand washing, education on infection and management for the characteristics of Department of Radiology should be performed for the systematic prevention of infection.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.21 no.12
• /
• pp.651-659
• /
• 2020

The objective of this study is to provide high-quality medical service, by understanding the characteristics and death risk factors of patients at V long-term care hospital, that has established and operated the cooperative treatment system in connection with a public institution, the S veterans hospital. A follow-up survey targeting a total of 850 discharged patients was conducted for the year 2017. Average age of patients was 79.2 years, with 86.4% belonging to the 70 years or over group. The men of national merit were 75.4%, which was more than three times higher than general patients. Hospitalization for 180 days or more was 46.4%, which was higher than general long-term care hospitals (37%). The major death risk factors were age and the number of hospitalized days. Our data indicate that transfer to S veterans hospital results in providing quicker treatment and higher effectiveness of the numerous recovery therapies. We therefore propose that the cooperative treatment system should be expansively operated to increase the quality of happy life, by alleviating the health of patients with chronic diseases in a long-term care hospital.

• Journal of Industrial Convergence
• /
• v.17 no.4
• /
• pp.77-86
• /
• 2019

The purpose of this study was to identify the effect of Home Health Nursing based Respiratory Management Program (HHNbRMP) on unmet healthcare need and healthcare resource utilizations of patients applying the home mechanical ventilator in the home with amyotrophic lateral sclerosis. The subjects of this study were 40 patients placed in an experimental group(n=19) and a control group(n=21), respectively. This HHNbRMP based on Cox's interaction model was consisted of cognitive assent (education, specialized medical care, case management), internal motivation (airway clearance, thoracic and air accumulated exercise) and psychological response (meditation & active listening). The intervention was applied to experimental group during 12 weeks. As variables was measured at baseline, twelve, twenty-four weeks and healthcare unmet need, resource utilizations (admission, out patient department, emergency room) was measured at 24 weeks. The data were analyzed by t-test, ANOVA and Repeated Measures ANCOVA. This intervention was not effective the unmet healthcare need. But the admission in to the hospital among the healthcare resource utilizations variables showed a significant difference at twenty-four weeks(t=4.17, p=.049). This results suggest that applying this program tailored to patients condition, utility of medical resource would be decreased, specially admission.

• The Journal of Korean society of community based occupational therapy
• /
• v.4 no.1
• /
• pp.1-10
• /
• 2014

Objective : The purpose of this study was to comparatively analyze time use and quality of life in stroke patients who use Local community or convalescent Hospital environment. Methods : The study subjects were 74 stroke patients who were admitted to convalescent Hospital or who were being rehabilitated as outpatients. The Occupational Questionnaire(OQ)was used for measuring time use and the Stroke Specific Quality of Life(SS-QOL) utilized to measure Quality of life. Excluding 8 patients who did not fit selection criteria, 66 patients were selected and analyzed. Results : After comparatively analyzing time use in Local community and convalescent Hospital environment, significant differences were found in daily living(p<.05), resting(p<.05). In addition, in quality of life, significant differences were found in family(p<.05), self-management(p<.05), and social roles(p<.05). Conclusion : Local community patients used their time in daily living, resting more efficiently than convalescent Hospital patients, and also had a higher quality of life.

• Journal of Korean Academy of Nursing Administration
• /
• v.19 no.5
• /
• pp.565-577
• /
• 2013

Purpose: This study was done to propose an improvement in the Nursing Fee Differentiation Policy to alleviate polarization of nursing staffing level among hospitals and to rectify the confusion of legally mandated standards between the Korean Medical Law and National Health Insurance Act. Methods: The policy regulation was reconstructed related to nurse staffing standards and nurse-to-patients ratios. Data on nurse staffing grades were obtained from database of the Health Insurance Review & Assessment Service (HIRA) for the third quarter of 2010 for 44 tertiary hospitals, 274 general hospitals, and 1,262 hospitals. A break-even analysis was used to estimate financial burden of the revised policy improvement proposal. An industrial engineering method was used to calculate Nurse-to-Patients ratios per shift. Results: Twelve tertiary hospitals were downgraded. 74 general hospitals and 102 hospitals were upgraded after application of the regulation. Finances for total hospitalization expenditures changed from -3.55% to +3.14%. Conclusion: The results indicate that the proposed policy would decrease polarization between tertiary hospitals and small hospitals, and would not put a major strain on the finances of the Korean National Health Insurance. Therefore, it is suggested that government stake-holders and many interest groups consider this policy proposal and build a consensus.

• The Korean Society of Law and Medicine
• /
• v.19 no.1
• /
• pp.23-80
• /
• 2018

Since the 1960s, the United States' (U.S.) deinstitutionalization policy has reinstated people with mental illness into communities. Unfortunately, when untreated, some people with psychiatric disorders become homeless, and some commit serious crimes during a psychological crisis. Assisted Outpatient Treatment (AOT), also known as Kendra's Law in New York and Laura's Law in California, provides treatment, services and support to people with mental illness in the community. AOT has repeatedly been found effective and is recognized as an evidence-based practice. The response to the mental health crisis (crisis intervention) in the U.S. has also been successful in preventing worsening mental illness and related criminality and other issues. This paper provides an opportunity to create a platform from which to learn how to successfully apply the AOT and crisis intervention of the U.S. to South Korea within the cultural and societal context when establishing social services for people with mental illness in South Korea's communities.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.19 no.1
• /
• pp.506-516
• /
• 2018

This study was conducted to identify pain intensity and factors affecting pain intensity in patients with advanced cancer. Data were collected between June 1 and September 30, 2016 using a questionnaire. The sample size was 221 patients with advanced cancer who were admitted to the oncology department or who visited the outpatient of the general hospital. Data were evaluated by descriptive and Pearson's correlation analyses, one way ANOVA, t-tests and stepwise multiple regression analysis. The mean scores of pain intensity of cancer patients were 4.23 (${\pm}1.68$) based on the average daily pain intensity. Factors influencing pain intensity were illness perception (${\beta}=.27$, p<.001), pain opioid analgesics beliefs (${\beta}=.24$, p<.001), education (middle school, ${\beta}=.24$, p=.001), economic status (${\geq_-}400$, ${\beta}=.20$, p=.001), gender (female, ${\beta}=.14$, p=.017), pain management education (${\beta}=-.14$ p=.020) and diagnosis (Pancreatic Ca, ${\beta}=.14$, p=.020). It explained 28%. Overall, the results of this study revealed that illness perception and pain opioid analgesics beliefs were important factors influencing pain intensity, but that the most important influencing factor was illness perception. Accordingly, it is necessary to develop pain management strategies that include not only pain management knowledge and pain opioid analgesics beliefs, but also illness perception.