• Journal of the Korean Data and Information Science Society
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• v.28 no.1
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• pp.75-86
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• 2017

The facial palsy is one of the most common illness in Western-Korean collaborative treatment (hereinafter "collaborative treatment"). The purpose of this study is to analyze facial palsy patients'collaborative treatment use patterns. By analysing the 2014 National Health Insurance Review and Assessment Patient Sample Data (NPS 2014) with the episode of care unit, we have found the following results. First, the collaborative treatment is preferred by patients over 50 years old and female. Second, western medicine mainly focuses on diagnosis and medical examination while korean medicine and collaborative treatment focus more on treatment activity. Third, western medicine showed the shortest treatment period, followed by korean medicine and collaborative treatment. However, the cost of medical treatment per day is highest in western medicine. The analysis of the use patterns of collaborative treatment shown in the study is expected to provide a direction for the development of clinical practice guidelines and the establishment of medical policies in the future.

• The Journal of the Korea Contents Association
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• v.13 no.11
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• pp.187-197
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• 2013

Objectives : The purpose of this study was to analyze the effect of outpatient cost sharing reduction on health care utilization of children under 6 years old. Methods : The data in this analysis was the health insurance claims data between August 2006 and July 2008. The study group was divided into two age groups, namely 0-5 years old and 6-10 years old. This study evaluated the impact of policy change on office visits per person and expenditure per visit. In order to do so, the double difference analysis is used. Results: The results showed that outpatient cost-sharing reduction has never really had a huge impact on office visits per person and expenditure per visit. Conclusions: This study showed that the outpatient cost sharing reduction for children under 6 years old policy is not working. Therefore, cost sharing of National Health Insurance by income class is needed.

• Health Policy and Management
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• v.32 no.2
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• pp.190-204
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• 2022

Background: In Korea, the population is rapidly aging, and the types of households for the elderly are also diversifying. The self-rated health of the elderly is a valuable health indicator that can comprehensively represent the overall quality of life along with physical, mental, and functional health. On the other hand, studies on the association between household type and self-rated health of the elderly are still insufficient. Thus, this study analyzed the association between household type and self-rated health by gender in Korean older adults. Methods: Using data from the analysis of the National Survey of Older Koreans 2017, 10,299 elderly people aged 65 and over were targeted. For the accuracy of the analysis data, 9,910 people were selected as the study sample by excluding proxy responses, those diagnosed with dementia, and non-response. And technical analysis, univariate analysis using the Rao-Scott chi-square test, and logical regression analysis involving survey characteristics were conducted by gender. Results: According to the adjusted model with all variables, in both men and women, the odds ratio of self-rated health 'bad' in 'couple (with ill spouse)' was significantly higher than 'couple (with spouse)'. It was 2.54 (95% confidence interval [CI], 2.05-3.15) for men and 2.11 (95% CI, 1.70-2.62) for women. In addition, the odds ratio of self-rated health 'bad' in 'living with adult children' was 1.43 (95% CI, 1.09-1.87) for men and 1.42 (95% CI, 1.15-1.75) for women, which was more significant in women than men. Conclusion: This study states that there is an association between gender, household type, and self-rated health of the elderly, and the health of a spouse and cohabitation with children have a significant effect on self-rated health. As a result, in order to improve the health status of the elderly, health promotion and health care policies involving the characteristics of the elderly's gender and household type are needed.

• Tuberculosis and Respiratory Diseases
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• v.83 no.3
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• pp.242-247
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• 2020

Background: The purpose of this study was to evaluate the long-term survival rates of very elderly (age ≥80) critically ill patients admitted to a medical intensive care unit (MICU) at a regional tertiary-care hospital in Korea. Methods: We retrospectively analyzed data from patients who survived after discharged from the MICU of our hospital. Survival rates at 90 days, 1 year, 2 years, and 3 years were assessed between patients age ≥80 and those age <80. Survival status was evaluated using the National Health Insurance Service data. Results: A total of 468 patients were admitted, 286 (179 males, 97 females; mean age, 70.18±13.2) of whom survived and were discharged soon after their treatment. Among these patients, 69 (24.1%) were age ≥80 and 217 (75.9%) were age <80. The 90-day, 1-year, 2-year, and 3-year survival rates of patients age ≥80 were significantly lower than those in patients age <80 (50.7%, 31.9%, 15.9% and 14.5% vs. 68.3%, 54.4%, 45.6%, and 40.1%, respectively) (p<0.01). The Kaplan-Meier survival curves showed significantly lower survival rates in patients age ≥80 than in those age <80 (p=0.001). Conclusion: The poor rates of long-term survival in very elderly (age ≥80) and critically ill patients admitted to an ICU should be considered while managing and treating them.

• 한국노년학
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• v.29 no.1
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• pp.37-50
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• 2009

The purpose of the present study was to develop a community-based intensive health care program for the community dwelling elderly to strength their functional status and to verify the effect on their geriatric syndrome. A one-group pretest-posttest design was used for the study. A total of 69 frail elderly, who lived in the area within 20 minutes by car, were committed themselves to the day care center(Sangikjae), and had the ability of verbal communication were selected from G city in Kyunggi province. The participants completed a set of questionnaires to measure the sub-score of frailty, fall, urinary incontinence, malnutrition, and mild cognitive disorder domain, using the Otasha-Kensin through the physical examinations and interviews. After 4 weeks of intervention, the outcome was measured to evaluate the effects of the program, and the data obtained were analyzed using descriptive statistics, paired t-test and McNemar test. The results showed that the sub-score of frailty, fall, urinary incontinence, and malnutrition domain were statistically significantly decreased after intervention except those of urinary incontinence and mild cognitive disorder domain, implying that the risk of frailty, fall, and malnutrition was decreased. These findings indicated that community-based the intensive health care program is effective for relieving geriatric syndrome of the community dwelling elderly.

• Journal of agricultural medicine and community health
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• v.18 no.1
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• pp.77-91
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• 1993

This study was conducted to assess health medical center utilization pattern and its related factors among the rural inhabitants for the purpose of contribution to establishment of health medical center institutions. A questionnaire survey was carried out for object of 3,754 population of three primary school and three middle school student's parents (total 832 household) in Kyungbook Ulchin Gun rural area from 24 to 28 September, 1990. The summarized result are as follows, Respondents are 60.3% in male, 39.7% in female and 30-40s 81.3% in age, high school graduates 40.3% in education level and a regional medical insurance scheme in 44.1% in forms of health insurance. Recognition for health medical center was showed higher according to high educational, high income level, and short distance for location of health medical center of respondents (p < 0.01). Recognition for health medical center services was showed higher about care of medicaid in medical treatment services and higher preventive vaccination in health prevention services by respondents. Utilization rates of health medical center by out-patient care and preventive care service were 11.1 and 4.5 per 100 persons by year, but admission utilization rate was 34.6 per 10.000 persons by year. Motivations of health medical center utilization were showed a good care(45.7%), a good drugs(45.2%), and nearby health medical center(42.9%). In comparison health service levels of health medical center with general clinic was better (16.3%), similar(38.7%), 7(19.0%), and worse(19.0%) in view of health medical center utilizators. Inconvinience about health medical center utilized was the most higher longtime waiting, the next was limited utilization times. Transportation utilited were on foot(55%), by bus(35.5%), and so on. As mentioned above, there are many inhabitants who less understanding and less acknowledgement about health medical center and even mistake health center for health medical center. Therefore, there must be more information about health medical center. For higher utilization of health medical center, there must be considered expansion of health equipment, facilities, accomplishment with reinforcement of health staffs and efficiency management.

• Journal of Preventive Medicine and Public Health
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• v.27 no.3 s.47
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• pp.609-626
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• 1994

This study was conducted to investigate whether variations in hospital services utilization across small geographic areas in Korea existed, and if so, what factors are responsible for the variation. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main findings of the research can be summarized as follows: 1 Extremal Quotients (EQ) of hospital expenditure per capita and hospital days per capita were 2.69 and 2.73, and Coefficient of Variation (CV) were 0.14, both, respectively. The EQ and the CV of admission rate were also 2.71, 0.15. The EQ and the CV of expenditure per admission were 1.73, 0.10 and those of hospital days per admission were 1.29, 0.06. All these statistics were statistically significant and this result provides strong evidence for the existence of small area variations. 2. Comparing patterns of variation among areas, the area which showed higher utilization amounts is Chansungp'o. Koje area, whereas the areas which showed lower utilization amounts are Yongju, Changhung, Miryang, Mokp'o, Koch'ang area. 3. Multivariate analytic methods were used to examine factors related to the variation across areas. In terms of the health resource availability variables, beds per capita or physicians per capita were positively associated with all utilization indices. As for the health service market structure variables, the proportion of health care institutions operating for less than f years was positively related to the expenditure per capita, hospital days per capita and expenditure per admission. In addition the proportion of the private health care institutions also had a negative relationship with total utilization amount and admission rate and the proportion of physicians under age 40 was negatively associated with expenditure per capita and expenditure per admission. With regard to the socio-demographic characteristics, proportion of medicaid population was positively related to hospital days per capita, and percentage of paved road was positively related to hospital days per admission. As a conclusion, wide variations existed across small areas in Korea and supply factors were found to be important in explaining the variation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.3
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• pp.1234-1243
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• 2011

Our study was carried out to develop the severity-adjustment model for length of stay in hospital for community-acquired pneumonia so that we analysed the factors on the variation in length of stay(LOS). The subjects were 5,353 community-acquired pneumonia inpatients of the Korean National Hospital Discharge In-depth Injury Survey data from 2004 through 2006. The data were analyzed using t-test and ANOVA and the severity-adjustment model was developed using data mining technique. There are differences according to gender, age, type of insurance, type of admission, but there is no difference of whether patients died in hospital. After yielding the standardized value of the difference between crude and expected length of stay, we analysed the variation of length of stay for community-acquired pneumonia. There was variation of LOS in regional differences and insurance type, though there was no variation according whether patients receive their care in their residences. The variation of length of stay controlling the case mix or severity of illness can be explained the factors of provider. This supply factors in LOS variations should be more studied for individual practice style or patient management practices and healthcare resources or environment. We expect that the severity-adjustment model using administrative databases should be more adapted in other diseases in practical.

• The Korean Journal of Health Service Management
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• v.1 no.1
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• pp.59-74
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• 2007

Considering the characteristics of the Korean family which maintain a close connection with their patients from the moment of their falling sick to hospitalization to discharge, the family is the most important environmental factor of the social supporting system, and is the important object of the client as well as activity system. The medical social work intends to meet the practical needs of aged chronic patients, providing them and their family with a professional human service. The end of this study is to find out the hardships of both the aged chronic patients and their family as well as their needs for the social welfare service, and to search out the way of comprehensive social work service. The summary of the analysis of the survey is as follows: 1. The needs of aged chronic patients are divided into those of the solution of the problems of falling ill, social welfare program and discharge. Those needs arc affected by the various factors of the types of hospitals, the patients' age, the kinds of insurance, and the supporting systems, etc. Accordingly, the assessment of the needs of the patients are asked to be done comprehensively in accordance with the kinds of diseases and social environments. 2. The importance of the family to the aged chronic patients is evident. The family plays a decisive role in the patients' hospitalization and discharge, the family being an important supporting system and making it necessary to take an approach to client system. The family has difficulty in getting connection of community resources, in adapting to social life after the patient's discharge, and in paying the treatment. The family suffers the secondary hardships more than the burden of the treatment expenses. 3. For this reason various interventions are needed to reduce the stress caused by supporting and nursing patients. Thus the social welfare service for the aged chronic patients and their family needs the following prepositions: 1. It is the characteristics of the aged chronic patients that they need continuous care and that the strengths of the patients and their family cannot be too much emphasized, and that comprehensive assessment based on the connection 'with the community and the mutual interchange 'with the environment, is much emphasized. 2. The family of the aged chronic patient is a resources system as well as a client one. 3. Another characteristic of the aged chronic patients is that with the resources connection in mind, it needs an active intervention of social workers in the community. With these prepositions considered, the development of practical social work service for the aged chronic patients is thought urgently needed.

• Health Policy and Management
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• v.19 no.2
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• pp.21-35
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• 2009

Limited studies examined Medical Aid recipients' perception for amount of medical use. This study aimed to identify self-perception(optimal, under and overutilization) for amount, and real amount of medical use, and to determine factors associated with the perception. Subjects were 2,489 Medical Aid recipients among top 2% overusers in 2005. 200 case managers(CM) managing them conducted survey. CM interviewed them using 2005 medical claiming data from the Health Insurance Review & Assessment Service and structured questionnaire. Despite of overusers, perception of overutilization was only 26.9% and 23.6% in Class I and Class II, and that of underutilization was 21.4% and 18.7% respectively. In Class I, monthly total outpatient cost per capita of overutilization perception in 2006 was 206 thousand won higher than 150 thousand won of optimal utilization. Amounts of outpatient visit-days and prescribed cases of overutilization perception were higher than those of optimal and underutilization(p <0.0001). In Class II, overutilization perception had more prescribed cases(p 0.004). After adjustment of confounding factors including age and sex, the associated factors(odds ratio) with overutilization perception were hypertension(1.25), arthritis(1.32), depression(1.66), visit of multi medical institutions(3.09), and those of the underutilization were female(1.34), disabled(1.27), no family support(1.49), living in medium and small city(1.48), experience of unabled-visit to medical institution(2.54), frequent visit-recommendation from physician (1.36). In conclusion, education and consult are needed for subjects to improve the reasonable decision of medical use, and the self-care ability to manage diseases and symptoms. We suggest reinforcing the alternative service in community instead of costly medical institution.