• Health Policy and Management
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• v.13 no.1
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• pp.1-22
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• 2003

The principal objective of this study was to analyze and conceptualize the socio-psychological burden in utilizing a nursing home for elderly. The subjects were five elderly from a private nursing home located in Seoul and their familial caregivers. An old male and three females were currently staying at the facility, and a female had been discharged already from there. Data were collected through depth interviews, observations and review of records at the facility For analysis, the data were classified by similar contents among significant expressions and factors in common. The subjects' motives to consider admission to the nursing home might be attributed to familial caregivers' burden, a shortage of support, environmental improvement and feeling of helplessness for the case elderly. The concept of burden is including family members' being badly off in living, their weariness, complications among family members, feeling psychological uneasiness, and hospital expenses. The identified image of nursing homes for the elderly in Korea was generally negative at the point of high cost, unreasonable requisites and limitations for admission to the facilities, inferior situations, and especially in that there were few long-term care facilities within the community boundary. From their experience of nursing homes, the interviewees have felt the sentiments of sorry for their old parents, with the thought of being an undutiful, bitterness, and empathy. Additionally, they expressed a sense of anxiety of relative deprivation against the fact that there were no long-term care facilities available for the middle class. On the basis of these, multi-dimensional needs could be identified for the elderly with chronic illnesses.

• Journal of Preventive Medicine and Public Health
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• v.57 no.4
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• pp.407-419
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• 2024

Objectives: This study was conducted to measure financial toxicity (FT) among patients with cancer in Vietnam using the COmprehensive Score for financial Toxicity (COST) and to describe the cost management strategies employed by these patients. Methods: This comprehensive cross-sectional study enrolled 634 patients from 2 specialized oncology hospitals in Vietnam. Using COST cut-off scores, FT was classified as none/mild (≥26), moderate (14-25), or severe (≤13). Cost management strategies, or coping mechanisms, were classified into 4 groups: lifestyle changes, financial resource strategies, treatment modifications, and support seeking. Results: The prevalence of FT was 91.8%, with 51.7% of participants demonstrating severe and 40.1% exhibiting moderate FT. Severe FT was significantly associated with female, low education level, unstable employment, low household economic status, and advanced cancer stage. The most common coping strategies were as follows: among lifestyle changes, reducing spending on basic items and leisure activities (78.7%) and cutting back on essential household expenses (66.4%); among financial resource strategies, borrowing money from relatives or friends (49.1%) and withdrawing funds from retirement or savings accounts (34.1%); within treatment modifications, switching treatment facilities or doctors due to cost concerns (9.3%); and within support seeking, obtaining help from welfare or community organizations (18.8%). All strategies were significantly more likely to be used by patients with severe FT. Conclusions: FT was highly prevalent among patients with cancer. Most patients relied on lifestyle adjustments and coping strategies, underscoring the need for improved financial support systems to alleviate the economic burden associated with cancer care.

• Journal of Preventive Medicine and Public Health
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• v.42 no.3
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• pp.190-198
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• 2009

Objectives : The objective of this study is to estimate the economic costs of cancer on society. Methods : We estimated the economic burden of people with cancer in South Korea. To perform the analysis, we reviewed the records of people who were cancer patients and those who were newly diagnosed with cancer. The data was compiled from the National Health Insurance Corporation, which included the insurance claims database, a list of cancer patients, a database that records the cancer rates, the Korea Central Cancer Registry Center s cancer patient registry database and the Korea National Statistical Office s causes of death database. We classified the costs as related to cancer into direct costs and indirect costs, and we estimated each cost. Direct costs included both medical and non-medical care expenses and the indirect costs consisted of morbidity, mortality and the caregiver's time costs. Results : The total economic costs of cancer in South Korea stood at 14.1 trillion won in 2005. The largest amount of the cost 7.4 trillion won, was the mortality costs. Following this were the morbidity costs (3.2 trillion won), the medical care costs (2.2 trillion won), the non-medical care costs (1.1 trillion won) and the costs related to the caregiver's time (100 billion won). As a result, the economic cost of cancer to South Korea is estimated to be between 11.6 trillion won to 14.1 trillion won for the year 2005. Conclusions : We need to reduce the cancer burden through encouraging people to undergo early screening for cancer and curing it in the early stage of cancer, as well as implementing policies to actively prevent cancer.

• Health Policy and Management
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• v.31 no.4
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• pp.423-436
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• 2021

This article summarizes the structure of China's current social health insurance system and reviews the development status of China's private health insurance (PHI). China's medical security system is mainly composed of two parts: basic medical insurance (BMI) and PHI. Among them, the BMI provides reimbursement of basic medical expenses for the insured persons according to different proportions. PHI is a necessary supplement to the BMI and provides assistance to the insured persons in the event of illness or accident. By having PHI, people can obtain medical protection outside the coverage of BMI. In the development of PHI in China, the total medical cost is high and the insurance market size is large, but the proportion of PHI expenditure is low and the personal burden is high. Through this Chinese case, it will be helpful for mutual development between Korean PHI and national health insurance, for Korean insurance companies to enter the Chinese market, and for removing the medical burden on the people.

• 제어로봇시스템학회:학술대회논문집
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• 2004.08a
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• pp.1153-1157
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• 2004

The report of the Korean National Statistics Office shows that Korea has been emerging as an elderly society rapidly, and it will burden the Korean society with excessive social welfare cost for the aged in the near future. If we can help the aged to live healthy in some ways, the social burden for the health care of the aged will be lessened. In order to help physical and mental health of the elderly person, we have developed an exercise apparatus called intelligent arm wrestling machine system. This paper presents the mechanism and scenario of the proposed intelligent arm wrestling machine system. The proposed mechanism and scenario are peculiar. In particular, the proposed scenario determines randomly who will win between the man and the robot and generates a game process that the arm-wrestler cannot predict in advance.

• Journal of Yeungnam Medical Science
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• v.40 no.2
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• pp.218-222
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• 2023

A holistic approach to diabetes considers patient preferences, emotional health, living conditions, and other contextual factors, in addition to medication selection. Human and social factors influence treatment adherence and clinical outcomes. Social issues, cost of care, out-of-pocket expenses, pill burden (number and frequency), and injectable drugs such as insulin, can affect adherence. Clinicians can ask about these contextual factors when discussing treatment options with patients. Patients' emotional health can also affect diabetes self-care. Social stressors such as family issues may impair self-care behaviors. Diabetes can also lead to emotional stress. Diabetes distress correlates with worse glycemic control and lower overall well-being. Patient-centered communication can build the foundation of a trusting relationship with the clinician. Respect for patient preferences and fears can build trust. Relevant communication skills include asking open-ended questions, expressing empathy, active listening, and exploring the patient's perspective. Glycemic goals must be personalized based on frailty, the risk of hypoglycemia, and healthy life expectancy. Lifestyle counseling requires a nonjudgmental approach and tactfulness. The art of diabetes care rests on clinicians perceiving a patient's emotional state. Tailoring the level of advice and diabetes targets based on a patient's personal and contextual factors requires mindfulness by clinicians.

• 한국노년학
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• v.29 no.3
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• pp.1043-1061
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• 2009

The purpose of this study is to evaluate cost side by type of long term care services economically, and then to discuss the findings and implications for the results of analysis. For this research, primary caregivers that provide care the elderly requiring long term care services sanctioned by National Health Insurance Corporation were drawn and surveyed. Among collected data, data for 422 primary caregivers were used for this study. The subjects used in this study consisted of family caregivers from various settings that give care to the elderly. The results of this study can be summarized as follows. First, caregiver's household income level is low. Therefore, caregiving families with the elderly are likely to have financial difficulties. Second, under coverage of long term care insurance system, the direct cost caregiving households pay for the elderly is still very high. Third, indirect cost of caregiving households accounted for the larger proportion caregiving costs. Fourth, social cost burden for caregiving the elderly is very high. This cost amount is appropriately equal to household income of caregivers surveyed in the research. Fifth, service use cost of caregiving households is differentiated by type of long term care service. Sixth, direct cost of caregiving households is statistically significantly differentiated by type of long term care service, but is differentiated less than service use cost. Seventh, social indirect cost for caregiving the elderly is statistically significantly differentiated by type of long term care service. Eighth, social cost amounts for the elderly utilizing long term care service is very high, total social cost per capita by types of long term care service tend to converge on average social cost per capita of total service.

• The Journal of the Korea Contents Association
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• v.17 no.4
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• pp.585-595
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• 2017

The purpose of this study is to analyze the difference of medical care between medical assistance and health insurance patients to evaluate the increase of medical care costs due to the moral hazard of medical care patients and to provide a basis for rational medical care policy decision. For this purpose, we compared health insurance benefit data for Seoul citizens by gender, age, and type of medical institutions. The results of the analysis are as follows. First, all of the hospitalized and outpatient use of the advanced general Hospitals, medical assistance patients were less than those of the health insurance patients, so that the medical assistance patients could not use the high cost medical services. Second, in general hospitals, patients with health insurance are often hospitalized. On the other hand, medical assistance patients use a lot of outpatient services because they are less burdened. Third, in hospitals and clinics, medical benefits patients often use inpatient and outpatient services. Therefore, medical assistance patients are likely to use unnecessary medical care of outpatient and hospitalization clinics and hospitals, outpatient of general hospitals. But, in hospitalization and outpatient use in advanced general hospitals and medical assistance patients can not use due to excessive medical burden. Therefore, the policy to reduce the burden of medical expenses for patients with severe illness will continue, and the medical care patients using clinics and hospitals should be careful not to use unnecessary medical services.

• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.51-59
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• 2023

Purpose: We evaluated the status of patients enrolled in South Korea's pediatric palliative care pilot project based on the experience of a single center. This study examined factors related to end-of-life services and differences in medical costs. Methods: The medical records of 120 patients referred by a pediatric palliative care team were analyzed retrospectively. Data from July 1 to February 28, 2022 were collected and analyzed using the chi-square test and the Mann-Whitney U test. Results: Volunteer programs and psychological support (100%), family support and education (99.2%), and financial support through institutional linkage (62.5%) were provided to the participants. In the deceased group, there were no significant differences in general characteristics, which included age, gender, primary disease, religion, duration of hospitalization in an intensive care unit (ICU) and non-intensive care unit (non-ICU). However, the ICU group had fewer opportunities to access individual pain and physical symptom management than the non-ICU group and there were limitations in linking with external resources. Medical expenses were significantly different for the ICU group, with a 3-times higher average cost than the non-ICU group. Conclusion: Although an individualized approach is needed for each patient in pediatric palliative care, psychosocial care is essential. In addition, if early intervention for end-of-life pediatric patients is available from a palliative care team, the cost burden of medical care for patients and their families should be minimal.

• Journal of Hospice and Palliative Care
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• v.19 no.1
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• pp.61-69
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• 2016

Purpose: It is important to alleviate care burden for terminal cancer patients and their families. This study investigated the factors associated with care burden among family caregivers (FCs) of terminally ill cancer patients. Methods: We analyzed data from 289 FCs of terminal cancer patients who were admitted to palliative care units of seven medical centers in Korea. Care burden was assessed using the Korean version of Caregiver Reaction Assessment (CRA) scale which comprises five domains. A multivariate logistic regression model with stepwise variable selection was used to identify factors associated with care burden. Results: Diverse associating factors were identified in each CRA domain. Emotional factors had broad influence on care burden. FCs with emotional distress were more likely to experience changes to their daily routine (adjusted odds ratio (aOR), 2.54; 95% confidence interval (CI), 1.29~5.02), lack of family support (aOR, 2.27; 95% CI, 1.04~4.97) and health issues (aOR, 5.44; 2.50~11.88). Family functionality clearly reflected a lack of support, and severe family dysfunction was linked to financial issues as well. FCs without religion or comorbid conditions felt more burdened. The caregiving duration and daily caregiving hours significantly predicted FCs' lifestyle changes and physical burden. FCs who were employed, had weak social support or could not visit frequently, had a low self-esteem. Conclusion: This study indicates that it is helpful to understand FCs' emotional status and family functions to assess their care burden. Thus, efforts are needed to lessen their financial burden through social support systems.