• Health Policy and Management
• /
• v.21 no.4
• /
• pp.599-616
• /
• 2011

This research was performed to investigate the determination factors of medical service to cover the fee for selecting a doctor which is one of the most important causes of debilitating national health insurance in Korea. Data was from Korea Health Panel and analyzed by Dutton(1986)'s medical service model which was an extended Anderson Model and was widely used in the researches on determination factors of medical service. The results were as follows; In the determinants of selecting a doctor in specialized medical institutions and general hospitals, patients with serious diseases selected doctors more often than other patients. By industrial accident compensation insurance law and enforcement ordinances, insurance covers the fee of selecting a doctor in the hospitals appointed by Labor Welfare Corporation for the patients in critical conditions under industrial accident compensation insurance, while health insurance patients pay the fee themselves for selecting a doctor in all cases. It is suggested that patients with serious diseases proved by medical opinion be provided with health care insurance in selecting a doctor and that the health insurance benefit coverage be enhanced by staged lowering of patient's cost-sharing.

• Korea Journal of Hospital Management
• /
• v.10 no.4
• /
• pp.51-74
• /
• 2005

This paper presents an analysis of the current status of domestic hospital industry which went trough the time of new hospitals operated by chaebols from 1994 to 2003 and the dramatic changes of medical service environment such as IMF relief loan in 1997 and the separation of prescription and dispensing (SPD) in 2000. For the sake of righteous policy-making in the future, this paper presents a productivity analysis of the management and administration of 38 tertiary hospitals nationwide in the past 10 years. The analysis is based on the Malmquist index approach using linear programming. d prepare a productivity index that measures not merely efficiency but the technological evolution and adjustment to changing environments.

• Korean Journal of Adult Nursing
• /
• v.18 no.4
• /
• pp.632-641
• /
• 2006

Purpose: The purposes of this study were to analyze the core nursing interventions that are used in the medical and surgical units, and to present the basic data that can be applied in clinical fields. Method: The data was collected from 353 nurses of the medical and surgical units from Jan. 2005 to Dec. 2005, using the database of nursing process record system used at a tertiary hospital. Results: 190 interventions were performed in the medical units, with 21 core nursing interventions. 198 interventions were performed in the surgical units, with 16 core nursing interventions. There were 11 common core nursing interventions. Conclusion: The results revealed that the ratio of physiological interventions and the interventions related to safety were high. The interventions were classified according to one's field of specialization, together with the common interventions were also being performed. According to the changes in the demands of consumers, there was also increases in the performance of 'pain management' and 'fall prevention.' We expect that this study will allow for the performance of standardized interventions, and that it will be helpful in the role of the experienced nurse, and in the approach to the nursing specialty.

• Journal of Internet Computing and Services
• /
• v.11 no.3
• /
• pp.87-103
• /
• 2010

In the study, we introduce the trend in domestic and foreign web accessibility, as well as the legal system that ensures web accessibility. Based on Korean Web Content Accessibility Guidelines (KWCAG)1.0, we investigated the web content accessibility of 80 tertiary health-care hospitals and general hospitals in Korea. We evaluated accessibility by combining accessibility-based criteria (ABC) with usability-based criteria (UBC). ABC was limited to an alternative text for Guideline 1, using a small number of frames and keyboard accessibility for Guideline 2. UBC checked the voice service (TTS), resizing text, providing multi-lingual websites, and disclosing web accessibility policy. KADO-WAH2.0 was used for representing the compliance rate. The evaluation result was a considerable improvement from previous results, even though the rate of compliance with web accessibility was generally insufficient. There was a significant difference between those medical centers which did and did not comply with web accessibility. Incidentally, many hospitals were found to have attempted to confront and come to terms with web accessibility. In future, the following factors are advisable for medical centers with publicity or public interest: they must employ active and aggressive promotion of establishment of independent accessibility guidelines to secure web accessibility, they should effect an improvement of the realization of web accessibility, there can be constant education and promotion, and there can be an institutional supplementation, as well as others.

• Journal of radiological science and technology
• /
• v.33 no.3
• /
• pp.231-237
• /
• 2010

Computed tomography (CT) has been established as an important diagnostic tool in clinical medicine and has become a major source of medical exposure. A nationwide survey regarding CT examinations was carried out in 2007. Thanks to the appeasement policy regulating the import of CT scanners, there are 1,825 CT scanners across the country as of the end of March 2010, which means that we have 36.8 CT scanners per one million people. The annual number of examinations was 3.29 million, the number of examinations per 1000 population was 68. The most part of examinations was abdomen and pelvis. and the collective effective dose was in these parts. The effective dose per one population was evaluated as 0.952 mSv.

• Quality Improvement in Health Care
• /
• v.15 no.2
• /
• pp.83-86
• /
• 2009

연구배경: 수술적 치료가 필요한 척추관 협착증 환자들은 주로 60세 이상의 고령환자로 장기간의 입원 시 기회 감염의 증대와 불필요한 의료비의 증대를 가져오게 되며, 수술 후 환자들의 재원일수의 증가는 병원의 병상가동률을 감소시키고, 전공의에게는 불필요한 업무를 증가시킨다. 연구목적: 비용 효과면에서 최적화된 진료 지침의 개발은 불필요한 의료비의 감소 및 Hospital Induced Complication을 줄여 환자 만족도를 증진시킬 수 있으며, 각 환자에 대한 전공의 업무를 줄일 수 있다. 의료기관: 서울특별시에 소재한 2,075병상의 종합전문요양기관 연구방법: 정형외과 및 신경외과의 척추관 협착증 환자의 처방을 비교하여 최적의 표준진료지침을 개발하고 최종적으로 CP Master Program(EMR 프로그램)에 입력하여 환자에게 적용하였다. 연구결과: CP 적용 전, 후 비교를 통해 재원일수는 3.8일이 감소하였으며, 이에 따라 병상 가동률 및 진료수익이 증가했으리라고 예상되며 현재 비교 검토 중이다. 또한, CP 개발 및 CP Master Program의 사용을 통한 전공의 업무 감소에 대해 검토하고 있다.

• Korean Journal of Adult Nursing
• /
• v.19 no.2
• /
• pp.260-273
• /
• 2007

Purpose: This study was performed to understand the perceived importance and performance frequencies of nursing interventions and identify the core and major interventions in oncology units. Methods: Questionnaires using 151 nursing interventions were given to 45 nurses. The performance frequency was measured through the database of the nursing process recording system for 1 year. Results: The perceived importance of the nursing interventions averaged out to be 3.5 among 4 and on average 36.5 times of nursing interventions were performed on each patient. Fifteen core nursing interventions including 'pain management' were identified and they made up 82.7% of the entire performance frequency rate. And 26 interventions including 'drug administration: Amphotericin-B' were identified as major nursing interventions and occupied 10.6% of the entire performance frequency rate. Conclusion: Since the core and the major nursing interventions were identified and these occupied 93.3% of the all nursing interventions, these results can be utilized as baseline data for establishing the guidelines and standards of nursing interventions and providing systematic education for oncology nurses in Korea.

• Journal of Hospice and Palliative Care
• /
• v.20 no.1
• /
• pp.8-17
• /
• 2017

Globally, efforts are being made to develop and strengthen a palliative care policy to support a comprehensive healthcare system. Korea has implemented a hospice and palliative care (HPC) policy as part of a cancer policy under the 10 year plan to conquer cancer and a comprehensive measure for national cancer management. A legal ground for the HPC policy was laid by the Cancer Control Act passed in 2003. Currently in the process is legislation of a law on the decision for life-sustaining treatment for HPC and terminally-ill patients. The relevant law has expanded the policy-affected disease group from terminal cancer to cancer, human immunodeficiency virus/acquired immune deficiency syndrome, chronic obstructive pulmonary disease and chronic liver disease/liver cirrhosis. Since 2015, the National Health Insurance (NHI) scheme reimburses for HPC with a combination of the daily fixed sum and the fee for service systems. By the provision type, the HPC is classified into hospitalization, consultation, and home-based treatment. Also in place is the system that designates, evaluates and supports facilities specializing in HPC, and such facilities are funded by the NHI fund and government subsidy. Also needed along with the legal system are consensus reached by people affected by the policy and more realistic fee levels for HPC. The public and private domains should also cooperate to set HPC standards, train professional caregivers, control quality and establish an evaluation system. A stable funding system should be prepared by utilizing the long-term care insurance fund and hospice care fund.

• Korea Journal of Hospital Management
• /
• v.14 no.4
• /
• pp.71-87
• /
• 2009

This study was conducted to present strategies for efficient use of older people's medical expense and efficient management of hospital beds 삭제by analyzing factors which influenced medical charge of inpatients with stroke and medical charge of each medical treatment. The subjects was 1,070 inpatients with stroke in Academic hospital. The result of this study can be summarized as follows. In the case of cerebral hemorrhage, the rate of female was higher than that of male. In the case of cerebral infarction, the rate of male was higher than that of female. With increase of age, patients with cerebral hemorrhage decreased and patients with cerebral infarction increased. Medical charge for cerebral hemorrhage was 12,600,000 won, while that for cerebral infarction was 572,000 won. The medical charge with surgery was four times of that with non-surgery. The total medical charge for inpatients with stroke was 6,860,000 won. The patient payed 2,240,000 won(32.6%) and National Health Insurance Corporation payed 4,620,000 won(67.3%). Among charges of specific medical treatments, operation and treatment charge was highest(27.7%) in the case of cerebral hemorrhage, while examination charge was highest(32.2%)in the case of cerebral infarction. This study will provide basic information for efficient use of Medical Charge for Inpatients with Stroke.

• Health Policy and Management
• /
• v.15 no.4
• /
• pp.46-64
• /
• 2005

This study was conducted to verify the current criteria and classification system used to determine specialized general hospitals status. In this study, we proposed a new classification system which Is simpler and more convenient than the current one. In the new classification system clinical procedure was chosen as the unit of analysis in order to reflect all the resource consumption and the complexities and degree of medical technologies in determining specialized general hospitals. We developed a statistical model and applied this model to 117 general hospitals which claim their national insurance through electronic data interchange(EDI). Analysis based on 984 clinical procedures and medical facilities' characteristic variable discriminated specialized general hospital in present without misclassification. It means that we can determine specialized general hospital's permission In new way without using the current complicated criteria. This study discriminated specialized general hospital by the new proposed model based on clinical procedures provided by each hospital. For clustering the same types of medical facilities using 984 clinical procedures, we executed multidimensional scale analysis and divided 117 hospitals into 4 groups by two axises : a variety of procedure and the Proportion of high technology Procedure. Therefore, we divided 117 hospitals into 4 groups and one of them was considered as specialized general hospital. In discriminating analysis, we abstracted proportion of 16 clinical procedures which effect on discriminating the specialized general hospital in statistical system also we identify discriminating function which include these variables. As a result, we identify 2 discriminating functions, one is for current discriminating system and the other two is for new discriminating system of specialized general hospital.