• Neonatal Medicine
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• 제25권4호
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• pp.144-152
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• 2018

Purpose: The aim of this study was to investigate the clinical characteristics of Respiratory syncytial virus (RSV) infection during the neonatal period to provide information that is useful in clinical practice and suggest extension of the palivizumab administration. Methods: Neonates admitted to the National Health Insurance Service Ilsan Hospital neonatal intensive care unit due to respiratory symptoms and for whom multiplex reverse transcription-polymerase chain reaction and multiplex real time-polymerase chain reaction tests were performed between October 2011 and May 2016 were included in this study. Medical records were retrospectively reviewed, and data was collected for 156 neonates. Results: Among the 156 neonates, RSV was detected in 114 (73.1%), non-RSV in 25 (16%), and no virus in 17 (10.9%). The majority were full term infants (92.4%) and peak incidence of RSV infection was in January. Post-natal care center infection was more common in the RSV group (46.6%) than that in the other virus groups (24%, P=0.0243). Clinical symptoms were severe in the RSV group in contrast to that in the non-RSV or others groups. The RSV group frequently needed oxygen therapy (P=0.0001) and the duration of hospital stays were longer (P=0.0001). Conclusion: RSV is a significant cause of respiratory infection in neonates and the severity is higher in contrast to that with other viral causes of infection. Infants in post-natal care centers have a high-risk of developing RSV infections; therefore, palivizumab administration may be considered in this group to prevent hospitalization and reduce the duration of hospital stay.

• 한국콘텐츠학회논문지
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• 제12권7호
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• pp.295-305
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• 2012

본 연구는 현재 급속히 증가하는 민간의료보험의 실태를 한국의료패널 데이터를 활용하여 실증적으로 분석하였다. 먼저 인구사회학적 요인이 민간의료보험 가입에 어떤 영향을 미치는 지를 살펴보았고, 다음으로 민간의료보험 가입과 의료이용 빈도 간에 어떠한 상관관계가 존재하는지를 찾아보았다. 패널데이터 분석결과를 살펴보면 경제적 능력이 낮은 사회적 취약계층은 상대적으로 민간의료보험의 가입이 낮은 경향이 있었다. 그리고 민간의료보험 가입자의 의료이용은 경향적으로 높게 나타났다. 이러한 결과는 지불능력이 있는 계층은 민간보험 가입을 통해 더 많은 의료서비스를 받게 되겠지만, 그렇지 못한 취약계층은 욕구가 있음에도 불구하고 의료서비스를 받을 기회가 점점 줄어들 수 있다는 가능성을 내포하고 있다. 따라서 민간보험을 보다 효과적으로 관리하기 위해서는 의료의 공공성을 사회적으로 보장하는 정책 방안이 시급히 필요하다고 사료된다.

• 한국보건간호학회지
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• 제29권3호
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• pp.403-411
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• 2015

Due to lack of an information system regarding the status of using home-visit nursing (HVN), it has barriers of providing improvement of the HVN for management of elderly health care in Korea. The twofold aims of the current review are to expose the existing agendas for HVN and to suggest the political implications for HVN of Korea based on the transition process and revised HVN system of Japan. This review suggests that an information evaluation system has to precede for HVN services in detail. And, the service provided per manpower should be assessed by separating the code of manpower (registered nurse, nurse aide, dental hygienist) as well as securing detailed and precise information on the HVN services. The other suggestion, development of a community-based home health care nursing model in order to provide necessary services for long-term health insurance beneficiaries. In addition, a master plan for health care for elderly should be established at the national level in order to establish an effective home health nursing delivery system.

• 한국병원경영학회지
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• 제26권1호
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• pp.71-82
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• 2021

Purpose: The purpose of this study is to estimate incomes and costs of the medical clinics by using secondary data. Methodology: The medical incomes and costs were estimated from 405 clinics operated by sole practitioner providing out-patient services among all clinics subject to the Medical Cost Survey on National Health Insurance Patients in 2017, excluding dental clinics and oriental medical clinics. The incomes and costs of the medical clinics were reflected with incomes and costs of health insurance benefits and were calculated by types of medical services (i.e., basic care, surgery, general treatment, functional test, specimen test and imaging test). The costs were classified as follows: labor costs, equipment costs, material costs and overhead costs. Secondary data was used to estimate the incomes and costs of the medical clinics. For allocation bases for costs for each type of the medical service, the ratio of revenue from health insurance benefits by types of medical services was applied. However, labor costs were calculated with the activity ratio by types of medical services and occupations, using clinical expert panel data. Finding: The percentage of health insurance income for all medical income was 73.1%. The health insurance cost per clinic was 401,864 thousand won. Labor cost accounted for the largest portion of the health insurance income was 191,229 thousand won (47.6%), followed by management cost was 170,018 thousand won (42.3%), materials cost was 35,434 thousand won (8.8%), and equipment costs was 5,183 thousand won (1.3%). Practical Implications: This study suggests a method of estimating incomes and costs of medical clinic services by using secondary data. It could efficiently provide incomes and costs to assess an appropriate level of the health insurance fee to the clinics.

• 한국노년학
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• 제31권4호
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• pp.871-884
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• 2011

표준장기요양이용계획서는 노인장기요양보험 이용자와 가족의 급여이용을 지원하기 위한 목적으로 도입된 일종의 케어플랜이라고 할 수 있다. 본 연구는 가족수발자가 인지하는 표준장기요양이용계획서의 질과 만족도, 활용도를 파악하고 이들 간의 관계를 파악하는 것을 목적으로 한다. 연구자료는 2008년 11월~12월 현재 노인장기요양보험 1~3등급 판정을 받고 재가장기요양서비스를 이용하고 있는 수급자의 가족수발자를 대상으로 가정방문면접조사를 통해 수집하였고, 총 944명의 가족수발자 가운데 표준장기요양이용계획서를 읽어본 경험이 있으며 설문을 완성한 351명이 최종분석대상이 되었다. 조사도구는 가족수발자와 수급자의 인구사회학적 특성 및 장기요양특성, 질 측정항목(9개), 전반적 만족도 측정항목(1개), 활용도 측정항목(2개) 등을 포함하였고, 질, 만족도 및 활용도 간의 관계를 파악하기 위해 경로분석을 실시하였다. 연구결과, 표준장기요양이용계획서의 질은 장기요양 욕구평가 영역, 장기요양 이용계획 영역, 월 한도액 관리지원 영역 등 세 개 영역으로 구분되었고, 모든 영역이 만족도 및 활용도와 유의한 상관관계를 나타냈다. 다음으로 경로분석 결과, 표준장기요양이용계획서의 장기요양 욕구평가 영역의 질(간접효과, 경로계수=0.077)과 전반적 만족도(전체효과, 경로계수=0.324)가 활용도에 통계적으로 유의한 영향을 미쳤다. 본 연구결과는 표준장기요양이용계획서의 역할을 향상시키기 위한 전략을 개발하는데 도움이 될 것으로 기대된다.

• 한국직업건강간호학회지
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• 제16권2호
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• pp.188-196
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• 2007

Purpose: The objective of this study was to evaluate long-term care needs using RAI MDS-HC and MI-CHOICE among the disabled workers. Methods: Data were obtained from 45 personal care recipients with the disability of mental and nervous system, and analyzed using SAS 9.1 by applying t-test, ${\chi}^2$ test, or fisher's exact test. Results: Only 'bed mobility' and 'indoor ambulation' items of ADL and problem activity were statistically significant factors by the level of personal care benefit. By MICHOICE grouping, 20.0 percent of subjects belonged to nursing home group, 51.5 percent were home care service, 28.9 percent were intermittent personal care. Conclusion: Personal care services in industrial accident compensation insurance have been categorized with two groups according to level of disability. But our results could contribute to provide personal care service according to the long term care needs.

• 성인간호학회지
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• 제26권5호
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• pp.543-552
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• 2014

Purpose: The purpose of this study was to develop integrated evaluation indicators of home care services in the hope that the increasing group of long-term home care patients could receive quality care services. Methods: The development involves a methodological study on a development phase and a verification phase. The main survey at a verification stage was conducted by the staffs at 146 institutions who agreed to participate on this study. Results: The evaluation index for the integrated home visit care consisted of five categories and 57 indicators including Managing Institution (12), Environment and Safety (3), Right and Responsibility (7), Process of Care (31) and Results of Care (4). The criterion-related validity was verified in regard to the participation in the 2010 evaluation of long-term home-care institutions by the National Health Insurance Corporation. Conclusion: The evaluation index of the integrated home visiting care developed in this study is considered suitable to utilize as evaluating indicators in managing and evaluating the way of how institutions integrate and provide home visit care services as well as home nursing care services.

• 한국치위생학회지
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• 제18권4호
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• pp.455-462
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• 2018

Objectives: This study was carried out to identify plans to activate home visit oral care services by dental hygienists in Long-term care insurance. Methods: In-depth interviews were carried out with 21 Long-term Home Care Center Managers as target. A total of 21 (27%) Home Care Centers were selected through convenience sampling among 78 Home Care Centers that are located in Won-ju city. The Managers were presented with questions and answered in 20-30 minutes in accordance with the interview instructions. The interview results were analyzed through content analysis, and their experiences and perceptions were classified into two themes and categorized again into four components. Results: The Home Care Center Managers suggested that dental hygienists should activate home-visit oral hygiene services. It is necessary to improve the management process and awareness of the elderly. Conclusions: To activate oral hygiene services, it is necessary to improve the service guideline and enhance the efficiency of the service process. This should be acceptable both to the elderly who need the services and the dental hygienists who provide them.

• 대한장애인치과학회지
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• 제14권1호
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• pp.11-16
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• 2018

In order to increase the accessibility of dental care for people with disabilities, National Health Insurance Service has implemented an additional point system of National Dental Insurance for dental treatment of patients with a special health care need (AID). The purpose of this study is to investigate the types and status of AID in Korea using data of the Health Insurance Review and Assessment Service from 2011 to 2017. The basic consultation fee is increased by 9.03 points (713 won) for brain disorder, intellectual disability, mental disability, or autistic disorder. From 2011 to 2015, the number of claims with a basic consultation fee increased from 90,456 to 141,179. Dental treatment and surgical treatment fee is increased by 100% of the defined insurance score for each of the 15 items. During the five years from 2012 to 2016, the number and amount of claims for each item increased steadily. Of the total claims for 5 years, endodontic treatment was highest, with 107,477 cases, followed by 51,641 cases of scaling. There are two types of dental safety observation fee, simple and complex. The simple safety observation fee is 10,370 won per day, and the complex safety observation fee is 20,750 won per day. Dental safety observation fees were charged 34 times in 2015, 14 times in 2016, and 41 times through May 2017. From 2011 to 2017, the number and amount of claims using AID for dental care for people with disabilities increased. However, considering that the number of registered dental users with disability was about 560,000 in 2016, the number of claims using AID is 1-20,000, which is less than 2% of registered dental users with disability. Therefore, it is necessary to expand dental services for people with disabilities including AID.

• 보건행정학회지
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• 제33권3호
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• pp.355-362
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• 2023

Background: Financial efficiency in monetary units and operational efficiency in non-monetary units are separately classified and evaluated. This is done to prevent the duplication of monetary units and non-monetary units in inputs and outputs. In addition, analyses are conducted to determine the factors that affect each aspect of efficiency. To prevent duplication of monetary and non-monetary units in inputs and outputs, financial efficiency, consisting of monetary units, and operational efficiency, comprising non-monetary units, are separately classified and evaluated. Furthermore, an analysis is conducted to identify the factors that affect each aspect of efficiency. Methods: This study conducted a panel analysis of 34 regional public hospitals and influencing factors on efficiency for 5 years from 2015 to 2019. Financial efficiency and operational efficiency were calculated through data envelopment analysis. Moreover, multiple regression analysis was conducted to identify the factors that influence both financial efficiency and operational efficiency. Results: The factors that affect financial efficiency include the number of medical institutions within the treatment area and the ratio of patients receiving medical care. Additionally, operational efficiency is influenced by the type of medical institution, the number of medical institutions within the treatment area, and the number of nursing positions per 100 beds. Conclusion: In order for regional public hospitals to faithfully fulfill their functions and roles as regional base public hospitals, several measures are necessary. Firstly, continuous monitoring and reasonable support are required to ensure efficient operation and performance. Secondly, a financial support plan tailored to the characteristics of local medical centers is needed. Additionally, local medical centers should strive to enhance their own efficiency.