• Research in Community and Public Health Nursing
• /
• v.27 no.3
• /
• pp.272-283
• /
• 2016

Purpose: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. Methods: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. Results: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. Conclusion: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.

• 대한예방의학회:학술대회논문집
• /
• 2005.10a
• /
• pp.327-327
• /
• 2005

• Health Policy and Management
• /
• v.2 no.1
• /
• pp.66-79
• /
• 1992

The code of the International Classification of Disease(ICD) is seriously questioned on its effectiveness in identifing an independent disease entity from similar conditions at general practitioner's offices. This study has attempted to show individual coding variations in ICD for similar ambulatory care conditions. It has been assumed that a following outpatient visit is regarded as the sane kind of visit owing to the same disease if a visit to the different source of care would be mad within an interval of less than two days. The 'D' health insurance association was selected for this analysis. The 'D' association had 153,298 members and made claims of 642,605 outpatient care in 1990. Out of the total outpatient claims, 8.6%(55,102 claims) were counted as the same disease which could meet the above assumption. Percent of conditions classified as the 10 leading causes of frequent visits which were matched accurately to the subsequent ICD diagnostic code found to be 15.8% on the average. The URI was noted for the highest concurrence rate of 20.4%. This proportion was even decreased to 11.6% on the case of chronic disease. Despite the fact that the assumption underlying the definition of the above same disease is rather rough and inappropriate, this study reveals that the code of ICD currently in use has weaknesses in seperating a certain independent disease from similar conditions at the outpatient setting. Thus, efforts need to be elaborated to meet the need of a new system of classification for conditions and diseases encountering at ambulatory care.

• Korean Journal of Health Education and Promotion
• /
• v.29 no.2
• /
• pp.1-12
• /
• 2012

Objectives: Several practice guidelines recommended both medication and behavior modification to control hypertension. The objective of this study was to analyze ambulatory care utilization pattern and related factors. Methods: A retrospective cohort study was conducted among 45,267 new users who initiated treatment with hypertensive drugs in 2003. Korean National Health Insurance Claims Data was used to study the medical care utilization behavior and related factors after treatment initiation for up to four years. Taking prescription was considered as medical care utilization. Results: More than 20% of patients discontinued visiting physicians for prescription after initiating antihypertensive drug therapy. The average number of institutions visited by patients was about 1.3 annually. Clinic was the most frequently visited institution by patients. In GEE analysis, probability of continuous visit one institution after initiating antihypertensive drug treatment increased in patients who were women, old, have comorbidity, visited clinic or hospital mainly in previous year. Conclusions: Young hypertensive male patients who have no major comorbidity showed high possibility to discontinue medical service utilization. It is necessary to educate these targeted patients about importance of hypertension management in early stage after treatment initiation.

• Journal of Convergence for Information Technology
• /
• v.10 no.10
• /
• pp.253-258
• /
• 2020

This study analyzed, the characteristics of ambulatory care sensitive conditions(ACSCs) in patients visiting emergency departments(EDs) and compared characteristics according to two age groups (adults aged 19-64 years and, elderly people aged ≥65 years). By accessing data from the National Emergency Department Information System(NEDIS) from January 1 to December 31, 2018, we examined the proportions of different ED types and ACSCs, length of stay(LOS) in the ED, LOS hospital, and hospital admission rates. Regarding the types of EDs, we found that the proportion of local emergency medical centers was high(P<0.001). Regarding the rates of different ACSCs, 31.7% of adults were treated for gastroenteritis, a high proportion of the elderly people(48.2%) were diagnosed with and treated for pneumonia(P<0.001). The LOS in the ED was longer in elderly people for all diseases categories, except for congestive heart failure and diabetes(P<0.001). The LOS in the hospital was also significantly longer in elderly people for all ACSCs(P<0.05), and the admission rate was significantly higher in elderly people for all diseases, except for diabetes(P<0.01). Thus, analyzing the ED visits made by patients with ACSCs will need to strengthen the health-care policy to induce treatment centered on outpatient.

• 모자간호학회지
• /
• v.4 no.1
• /
• pp.24-32
• /
• 1994

Using data from the Korean National Health Survey conducted in the years 1989 and 1992, child and maternal ambulatory care utilization patterns were compared. Data from 3,002 families from the 1989 survey and 1,523 families from the 1992 survey which have a child 0-4 years old and mother in the same family were selected and used for the analysis. The results indicate that child medical utilization is closely accociated with maternal medical utilization, as measured by the number of visits to medical facilities. Maternal use appears to be a more powerful predictor of child use than any other family and maternal variables. These results confirm the result of the previous localized studies and suggest that intervention directed at the mother may be effective in ensuring equitable and efficient use of ambulatory services by childeren.

• Research in Community and Public Health Nursing
• /
• v.15 no.2
• /
• pp.308-322
• /
• 2004

Purpose: 'The purpose of the present study was to understand students' experiences from their standpoint, to identify relevant variables and to examine into their relations by analyzing and describing what phenomenon 'nursing students' visiting ambulatory bathing service' is, what are the reasons for the phenomenon, and what interactions are in the phenomenon. Method: The subjects were thirteen students. Data were collected through in-depth interviews and analyzed by Strauss and Corbin's analysis method. Result: With regard to ambulatory bathing service, participants responded 'lack of education', 'inexperienced personal relations' and 'disappointment with recipients families'. They recognized 'burden' and 'compassion'. The intensity of generated 'burden' and 'compassion' was determined by volunteering persons, the degree of health care service, recipients' response and interaction of climate. When 'burden' and 'compassion' were generated, participants selected their own coping strategies. Strategies in the situation of 'burden' and 'compassion' were significantly influenced by 'burden' and 'compassion' and structural situation - 'mutual relation structure,' 'volunteers' capability,' 'the degree of volunteering guidance,' 'community participation,' 'recipients' environment,' 'information sharing,' 'special vehicle equipment' and 'economical burden.' Strategies include' service training,' 'receiving volunteering training,' 'preliminary service preparation,' 'volunteering.' 'connection to local medical center,' 'intention,' 'information sharing,' 'passive response to recipients' appreciation' and 'the understanding of publicity'. The results of selected 'burden' and 'compassion' are described with 'worthiness' and 'cohesion' as follows. Conclusion: This study is significantly meaningful in that it examined bathing service welfare in its initial stage. There are not much outcome from previous studies. However. it is meaningful that this study intended to develop theories on the nature of experiences and the relations among concepts derived from the visiting ambulatory bathing service process of nursing students. Professors who taught social volunteering in universities understood the experience of nursing students who did the visiting ambulatory bathing service. Consequently, professors will provide an effective instruction to enable these students to carry out visiting ambulatory bathing services efficiently in order to meet demands when they conduct the services. For the volunteering service activity in major-related fields among college students' social volunteering activities, they recognized the necessity of systematic education and preparation.

• Korea Journal of Hospital Management
• /
• v.4 no.2
• /
• pp.41-59
• /
• 1999

Objectives: This study was done to compare patient satisfaction and hospital charges of surgery performed in an outpatient basis(ambulatory surgical procedures). Methods : This retrospective study was performed in 20(vitrectomy 11, tonsillectomy 9) randomly selected ambulatory surgical procedures patients and 50(vitrectomy 26, tonsillectomy 24) inpatients who. received the same procedure at a general hospital in Seoul since January 1, 1998 to October 31, 1998. The operative procedures were vitrectomy and tonsilletomy which could be performed on a ambulatory surgical procedures basis or on an inpatient basis. Results: The results of this study shows that the patients thought the expenses and the surgical operative time was an important factor in a ambulatory surgical procedures but there were no differences in the patient satisfaction by the method of surgery. The charges of vitrectomy and tonsilletomy were reduced up to 495,000 won and 380,000 won from l,589,000 won 842,000 won inpatient surgery respectively. Conclusions: This study focused only on the charges of the surgical procedures and did not include the cost of patient helper, the lost salary due to missing days of work to care for a member of the family, transportation costs, and other indirect costs. Therefore, if those fees were included, ambulatory surgical procedures would be more economical. Therefore, by giving incentives at the fee schedule, the government health policies it would reduce the total hospital charges.

• 대한예방의학회:학술대회논문집
• /
• 2004.10a
• /
• pp.47.1-47.1
• /
• 2004

• Journal of Preventive Medicine and Public Health
• /
• v.31 no.3 s.62
• /
• pp.460-470
• /
• 1998

By expanding health insurance, customers will carry a smaller burden of medical costs. As a result, the number of visits to a physician increase and this result in the improvement of medical accessibility. But medical care utilization may be changed not only by insurance status but also by socio-demographic factor, economic status and other factors. The question thus remains, at which level of accessibility and what price of medical care service in health insurance will the customer and the medical care service be satisfied. The price of medical care service ls comprised of the customer's out-of-pocket money and the costs not covered by health insurance. If the price of medical care services in health insurance are appropriate, medical care utilization should not differ because of the difference in income status or the acuteness of illness. But If the price is not adequate, low income groups will receive relatively low medical care utilization, particularly in the case of chronic disease. The purpose of this study is to evaluate the differences in medical care utilization among the various income groups and those with varying acuteness of illness. The major hypotheses to test in this study are : (i) whether there are differences in medical care utilization among different income groups exist, (ii) whether differences in medical care utilization among different income groups exist with the hospital type. (iii) whether differences in medical care utilization among different income groups exist with the acuteness of illness and with age. The data was collected from the JongRo District Health Insurance Society in Seoul. A total of 118,336 persons were selected as the final sample for this study. The major findings of this study were as follows; 1. The volume of ambulatory utilization among users was statistically significant by income level. 2. Among different income groups, the volume of ambulatory utilization was statistically significant by the acuteness of illness. 3. Higher income groups with chronic diseases had a greater volume of ambulatory utilization than other groups.