• Journal of Korean Public Health Nursing
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• v.30 no.2
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• pp.259-273
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• 2016

Purpose: The purpose of this study was to explore the barriers and solution of providing long-term care (LTC) services at home for the beneficiaries with mild dementia. Methods: The data were collected by interviewing three focus groups consisting of 10 home-visit nurses and analyzed through the analytic process by Morgan and Krueger. Results: The barriers of providing LTC services for clients were identified as follows: inadequateness of the current LTC model for elderly individuals with mild dementia and inappropriateness of the personal environment for home care. The solutions for these barriers were suggested as follows: building up a safe environment for home care and maintaining an appropriate standard utilization plan of LTC service. Conclusion: The current service model for the beneficiaries with mild dementia should be modified in order to provide comprehensive long-term care services based on their complex needs.

• Journal of Korean Public Health Nursing
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• v.28 no.1
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• pp.32-45
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• 2014

Purpose: The purpose of this study was to test the effectiveness of an eight session integrated case management program for improvement of medication adherence, physical function, pain, and depression among medical aid beneficiaries with osteoarthritis. Method: A nonequivalent control group pre-posttest design was employed. Participants were 55 medical aid beneficiaries who agreed to participate in this study, and were assigned to an experimental group (n=28) or control group (n=27). The framework of this research derived from Cox's Interaction Model of Client Health Behavior guided the overall intervention and the components. The program led by a case manager with a medication calendar, motivating interviewing and coaching strategies and collaboration with a pharmacist. Analysis included change in scores, ${\chi}^2$-test, and t-test. Result: The results showed significant increase in medication adherence, physical function and decrease joint pain, joint stiffness and depression in the experimental group compared to the control group. Conclusion: The eight session integrated case management program indicated an effect on medication adherence, pain, physical function, and depression. Partnership with a pharmacist is recommended for medication adherence and conduct of further studies will be needed in order to determine the long-term effect of an extended integrated program on health outcomes.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.50
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• pp.89-108
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• 2011

This work intends to study some issues in relation to the cancellation and amendment of letter of credit. Those issues in relation to the cancellation are the significance and formation time of cancellation of letter of credit and some points for practical attention of UCP 600 in the case of cancellation of letter of credit. Those issues in relation to the amendment are the significance and formation requirements of amendment of letter of credit and some points for practical attention of UCP 600 in the case of amendment of letter of credit. If exporters receive letters of credit from foreign countries, they must confirm the indication of irrevocable letter of credit. When they find revocable letters of credit, they should amend the credits to be irrevocable credits. If issuing banks amend letters of credit against beneficiaries, the banks should receive the beneficiaries' consent. If amendments devalue applicants' expectations in the underlying transaction, the applicants for whom the credit issues are not liable to reimburse. Beneficiaries and issuing banks may amend a credit, but the issuing bank acts at its own peril if it does not obtain the applicant's consent.

• Research in Community and Public Health Nursing
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• v.21 no.3
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• pp.351-361
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• 2010

Purpose: This study was done to analyze the effects of tele-care case management services using secondary data. Methods: A descriptive research design was utilized, and the participants were 134 medical aid beneficiaries who were in either the high-risk group or the preventive group. Casemanagement services were delivered by 8 care managers. Data were analyzed using PAWS Statistics 17 through descriptive statistics and paired t-test. Results: After the case management intervention, the participants' health quality of life, self-care competency, and reasonable medical care utilization increased significantly for the high-risk group. However there were no significant changes in the preventive group. Conclusion: The results showed that the tele-care case management services were effective for high-risk medical aid beneficiaries. Further studies with controls for constitutional variables and a comparison group are required to validate the robustness of the effectiveness of the case management program in the present study.

• Journal of Korean Public Health Nursing
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• v.17 no.2
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• pp.287-298
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• 2003

This study was conducted to identify the health care utilization, health care costs, and potential health care demands of the disabled in the Medicaid Aid beneficiaries. This study focused on the heath care costs not included in the medical aid allowance such as transportation, informal nursing costs, and ambulatory aids etc. Participants were the 864 subjects who were beneficiaries of the National Medical Aid program living in 10 district of Korea. A questionnaires were distributed to the disabled in the Medical Aid beneficiaries during August to September, 2001 through public offices. Data were collected through a home visiting by social workers working in public offices. Direct and indirect medical costs expended for one month by the participating disabled were examined. They expended 110.748 won $({\$}100)$ for heath care costs, which was not included in the medical aid allowance during the month. The disabled with cerebral diseases or who have level 4 disability expended more health care costs compare to those with other diseases. Gradual expansion of medical aid allowance for the disabled is recommended to alleviate economic burden of the disabled and their family.

• Journal of Korean Public Health Nursing
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• v.29 no.3
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• pp.412-425
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• 2015

Purpose: This study was conducted to understand the trend in research by analyzing previous studies related to the case management of Medicaid and to explore the direction of future research. Methods: Thirty three studies conducted from January 2003 to June 2015 were analyzed according to characteristics of researchers and subjects, research methods, measurable variables, and key words. Results: Of the studies analyzed, 69.7% were conducted on Medicaid beneficiaries, and 65.6% were conducted on the group of high risk for over medical utilization. The mainly used research design was a survey study design, which was 51.5% of them, followed by experimental (24.2%), and qualitative (12.1%) study design. Most frequently measured variables were medical utilization (62.5%), needs for case management (41.7%), and health status (25.0%). The topics most frequently studied were related to medical utilization, effect of case management, self-care, and program development in Medicaid beneficiaries and job and socio-psychological factors in case managers. Conclusion: The future direction of nursing research in Medicaid case management is to be vitalized through the expansion of the research population, and concretization and diversification of the research topics. In addition, conduct of further studies on intervention strategies and contents for improving quality of case management program is also needed.

• Health Policy and Management
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• v.24 no.4
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• pp.349-356
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• 2014

Background: This study aimed to explore factors associated with the non-use of beneficiaries of long-term care insurance services for the elderly in Jeollanam-do Province by analyzing a dataset obtained from National Health Insurance Service. Methods: The study sample consists of 1,663 individuals who were evaluated as eligible for long-term care insurance services in Jeollanam-do Province during the period of July 1, 2008 through June 30, 2009. As a dependent variable, the non-use of the service was defined as one when a beneficiary had used it once or more times during one year after he or she was evaluated as eligible and as zero otherwise. A proportion analysis was conducted to describe characteristics of study sample. Chi-square tests were used to compare general characteristics between beneficiaries who had used the services and those who had not used them. Multiple logistic regressions were performed by three models including additional sets of explanatory variables such as socio-demographic characteristics, health conditions, and economic status. Results: Main results are summarized as follows. The proportion of beneficiaries who had not used the service was 14.5% of all beneficiaries. According to the results from the model using all explanatory variables, the factors associated with the non-use of the services were residence location, dwelling place, type of desired service, level of care needs, and instrumental activities of daily life limitations. Conclusion: In particular, regarding the type of desired service, the cash benefit showed a high likelihood of the non-use of the service; it had an odds ratio (OR) of 50.212 (95% confidence interval [CI], 24.00-105.04) compared with home service. In case of dwelling place, a hospital showed also a high likelihood of the non-use with an OR of 20.71 (95% CI, 10.12-42.44) compared with home.

• 한국사회정책
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• v.25 no.1
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• pp.99-123
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• 2018

Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.

• Journal of agricultural medicine and community health
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• v.16 no.2
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• pp.125-133
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• 1991

The medical insurance system has been adopted in rural areas in 1988. Since then, the utilization of medical care services has increased rapidly in rural areas. According to the various study on medical care utilization, the people in rural areas used more curative care services than urban areas. The purpose of this study was to analyze the utilization and expenses of medical care services in designated rural areas : Choonseong Gun, Kangwon Province ; and Soonchang Gun, Cheonbuk province in Korea. Medical care utilization of medical care beneficiaries showed slightly increase, while there was a decrease of 18% and more for the medicaid. Regarding selection of medical care institutions, medical care beneficiaries used more hospitals and clinics than health center networks, but the health center networks was used more by the medicaid. However, the hospitalized Soonchang health center was able to provide more curative care to the people than the other two health centers. More than 50% of the patients treated by hospitalized health center were residents of the place in which health center was located.

• Journal of Preventive Medicine and Public Health
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• v.49 no.1
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• pp.53-60
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• 2016

Objectives: The purpose of this study is to examine the magnitude of and the factors associated with the downward mobility of first-episode psychiatric patients. Methods: This study used the claims data from the Korean Health Insurance Review and Assessment Service. The study population included 19 293 first-episode psychiatric inpatients diagnosed with alcohol use disorder (International Classification of Diseases, 10th revision [ICD-10] code F10), schizophrenia and related disorders (ICD-10 codes F20-F29), and mood disorders (ICD-10 codes F30-F33) in the first half of 2005. This study included only National Health Insurance beneficiaries in 2005. The dependent variable was the occurrence of downward mobility, which was defined as a health insurance status change from National Health Insurance to Medical Aid. Logistic regression analysis was used to assess factors associated with downward drift of first-episode psychiatric patients. Results: About 10% of the study population who were National Health Insurance beneficiaries in 2005 became Medical Aid recipients in 2007. The logistic regression analysis showed that age, gender, primary diagnosis, type of hospital at first admission, regular use of outpatient clinic, and long-term hospitalization are significant predictors in determining downward drift in newly diagnosed psychiatric patients. Conclusions: This research showed that the downward mobility of psychiatric patients is affected by long-term hospitalization and medical care utilization. The findings suggest that early intensive intervention might reduce long-term hospitalization and the downward mobility of psychiatric patients.