• 제목/요약/키워드: Care insurance service

검색결과 816건 처리시간 0.03초

Projections of Demand for Cardiovascular Surgery and Supply of Surgeons

  • Lee, Jung Jeung;Park, Nam Hee;Lee, Kun Sei;Chee, Hyun Keun;Sim, Sung Bo;Kim, Myo Jeong;Choi, Ji Suk;Kim, Myunghwa;Park, Choon Seon
    • Journal of Chest Surgery
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    • 제49권sup1호
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    • pp.37-43
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    • 2016
  • Background: While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. Methods: After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected. Results: The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040-an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309-an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario. Conclusion: Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time, effort, and resources; therefore, by analyzing the various factors affecting the supply of cardiovascular surgeons, an active intervention of policies can be prescribed for the areas that have failed to meet the appropriate market distributions.

호스피스 전달체계 모형

  • 최화숙
    • 호스피스학술지
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    • 제1권1호
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    • pp.46-69
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    • 2001
  • Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

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Evaluation of Geographic Indices Describing Health Care Utilization

  • Kim, Agnus M.;Park, Jong Heon;Kang, Sungchan;Kim, Yoon
    • Journal of Preventive Medicine and Public Health
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    • 제50권1호
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    • pp.29-37
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    • 2017
  • Objectives: The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. Methods: We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates. Results: In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index. Conclusions: Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit.

건강보험 연구동향에 대한 키워드 네트워크 분석 (A Keyword Network Analysis on Research Trends in the Area of Health Insurance)

  • 이수정;이선희
    • 보건행정학회지
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    • 제31권3호
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    • pp.335-343
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    • 2021
  • Background: The purpose of this study was to extract the major areas of interest in health insurance research in Korea, and infer policy agendas related to health insurance by analyzing research keywords. Methods: For this study, 2,590 articles were selected from among 7,459 academic papers related to health insurance published between January 1987 and December 2018, which were looked up using the Research Information Sharing Service (RISS). Keyword extraction and keyword network analysis were performed using the KrKwic, KrTitle, and UCINET software. Results: First, the number of studies in the area of health insurance continued to increase in all government terms, and it was not until after the 2000s that the subjects of health insurance researches were diversified. Second, degree centrality showed that 'medical expenditure' and 'medical utilization' were consistently high-ranking keywords regardless of the government in power. Aging and long-term care insurance-related keywords were ranked higher in the Lee Myung-bak government, Park Geun-hye government, and Moon Jae-in government. Third, betweenness centrality showed the same high ranking in key topics such as medical expenditure and medical utilization, while the ranking of key keywords differed depending on the interests and characteristics of each government policy. Conclusion: We confirm that health insurance as a research topic has been the main theme in Korean health care research fields. Research keywords extracted from articles also corresponded to the main health policies promoted during each government period. Efforts to systematically investigate policy megatrends are needed to plan adaptive future policies.

일본 요개호노인 거주시설의 면적변화에 관한 연구 - 개호노인보건시설과 개호노인복지시설을 중심으로 - (A Study on the Change of Area Resulted of Welfare Facilities on the High-Care degree Elderly in Japan - Focused on the Geriatric Health Services Facility and Special Nursing Home for the elderly -)

  • 박영철;박재승
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제16권2호
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    • pp.55-64
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    • 2010
  • The Japanese elderly welfare policy has focused on facility policy for the aged and preventive care service for healthy elderly people. This paper has conducted a comparative analysis on Geriatric Gealth Services Facility and Special Nursing Home for the Elderly. For this, each service function has been divided into six categories; daily life / nursing and caring / medical service / management / supply / miscellaneous. Then the change in real structure by category has been analyzed through a plan analysis on case facilities. In the Geriatric Health Services Facility, the biggest change was observed in 'livelihood' among six categories. In the Special Nursing Home for the Elderly, 'the nursing and care parts' and 'medical service part' are decreased since 1999. At that time, the facilities started to be individualized and divided into a unit. To pursue home-like care instead of unit care, there was a change in construction planning to help the aged with dementia live a self-sufficient life.

의사결정분석을 이용한 우리나라 노인의 요양시설서비스 이용 결정요인에 관한 연구 (A Study on Factors of Elderly Residential Care Service Utilization for using Decision Tree Regression)

  • 임정기
    • 한국사회복지학
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    • 제60권3호
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    • pp.129-150
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    • 2008
  • 본 연구는 노인장기요양보험제도 2차 시범사업 결과를 바탕으로 우리나라 노인의 요양시설 서비스 이용에 영향을 미치는 요인을 탐색해 보고자 하였다. 이론적 모형으로는 앤더선과 뉴만(Andersen and Newman)의 행동주의 모델을 토대로 하여 영향요인을 구분하였으며, 연구방법은 의사결정분석을 이용하였다. 분석결과 서비스 이용에 가장 큰 영향을 미치는 것은 대상 노인의 서비스 이용의향이었으며, 이러한 선행요인 다음 중요한 요인으로 자원 요인(수발자 있음 및 동거가족 여부)으로 나타났다. 욕구요인으로는 인지장애가 있는 경우, 치매로 인한 문제행동이 있는 경우, 기본적 일상생활수행능력에 있어 완전도움을 받아야 하는 경우로 나타났다. 이러한 분석결과는 앤더슨과 뉴만의 행동주의 이론의 과정을 그대로 보여주고 있음을 알 수 있는데, 즉 선행요인과 자원요인에 의해 서비스 이용형태가 달라지며, 이러한 선행요인과 자원요인은 욕구요인과 결합하여 실제 서비스 이용에 영향을 주는 것으로 나타났다. 이를 통해 본 연구는 시설 서비스 이용 대상자의 욕구요인을 정확히 파악하여 이에 적절한 서비스 내용을 구축하고 지역사회 내 시설서비스 이용노인을 선별하는데 기초 자료를 제공하는데 기여하고자 한다.

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간병범죄에 관한 연구 (A Study on nursing crime)

  • 이철호
    • 한국콘텐츠학회:학술대회논문집
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    • 한국콘텐츠학회 2015년도 춘계 종합학술대회 논문집
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    • pp.125-126
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    • 2015
  • According to the provisions of the United Nations, the proportion was 65 years of age or older population is 7% more than in the total population aged society. Due to the rapid decrease fertility and medical technologies and the improvement of living standards, the average life expectancy has emerged as an aging society. In the case of our country, and in 2011 the proportion of the population aged 65 and over 11.4%, the future is even faster aging rate is expected to launch in 2026, the super aged society. The days went by relying on caring for personal piety. Nursing crime is often due to the patriarchal family culture and afford. To care for patients with severe human or plant in the home, not to assume that society. Expanding the scope of long-term care insurance service person and the family burden reduced through measures to apply for health insurance, nursing care can prevent crime.

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노인장기요양보험 등급외자의 등급유지 영향요인 분석 (A Study of Factors Affecting the Grade Maintenance of the non-graded of Long-Term Care Insurance)

  • 서수진;문용필
    • 한국콘텐츠학회논문지
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    • 제20권7호
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    • pp.149-160
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    • 2020
  • 본 연구는 노인장기요양보험 등급외자의 특성을 파악하고 등급유지 영향요인을 분석하여, 그들의 지속적 재가생활을 위한 정책제언을 제시하는 것에 목적이 있다. 이를 위해 국민건강보험공단의 장기요양 인정조사 및 급여자료를 활용하여 등급외자의 등급외 유지여부에 영향을 미치는 관련요인을 분석하였다. 분석결과는 다음과 같다. 등급외자의 등급외 유지와 관련하여 소인성 요인에서 연령이 낮을수록, 남성이 여성보다 등급외 상태를 유지할 확률이 높게 나타났다. 촉진요인에서는 독거노인이 가족과 동거하는 노인에 비해, 국민기초생활수급권자가 일반대상자보다 등급외 상태를 유지할 확률이 높게 나타났다. 욕구요인에서 치매가 없는 자가 치매가 있는 자에 비해, 최초 판정받은 등급이 낮을수록, 등급판정 재신청 횟수가 낮을수록 등급외 상태를 유지할 확률이 높게 나타났다. 이상의 연구결과에 기초하여 등급외자의 장기요양서비스 제도개선에 대한 정책적 시사점을 제시하였다.

ICT 활용 방문간호서비스가 재가노인의 건강관련 삶의 질에 미치는 효과 (The Effects of ICT Enhanced Home-visit Nursing in Long-Term Care Insurance on Health-related Quality of Life among Community-Dwelling Older Adults)

  • 유근주;신진희;조은희;홍석원
    • 지역사회간호학회지
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    • 제33권1호
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    • pp.1-12
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    • 2022
  • Purpose: This secondary data analysis study evaluated the effects of ICT enhanced home-visit nursing in long-term care insurance on health-related quality of life among community-dwelling older adults. Methods: This study included data of 131 older adults who had experienced a pilot service for ICT enhanced home-visit nursing. ICT enhanced home-visit nursing refers to a method of sharing health records and teleconference between a visiting nurse and a doctor during the home-visit nursing services to community-dwelling older adults. Health-related quality of life and influencing factors were analyzed by t-tests, logistic regression analysis using the Stata 17/SE program. Results: After a pilot service for ICT enhanced home-visit nursing, their health-related quality of life increased. The teleconferencing method had a significant effect on the increase in health-related quality of life. Conclusion: The findings indicate a pilot service for ICT enhanced home-visit nursing can be applied to the domestic community-based healthcare service model in terms of health management. In the future, the advanced service model of a pilot service for ICT enhanced home-visit nursing in which subjects conduct detailed for each health problem, and a well-designed evaluation system should be developed.

의료용 마약류 유통 관리에 대한 고찰과 정책적 함의: 유통자료 및 청구자료 분석을 중심으로 (A Study on the Policy Implication on the Management of Narcotics Distribution for Medical Use)

  • 유수연;조현민;강현아;김수경
    • 한국임상약학회지
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    • 제25권4호
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    • pp.280-285
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    • 2015
  • Objectives: To suggest direction for improving policies by understanding current management of narcotics or psychotropic drugs and analyzing their distributions and usage. Method: We conducted a comparison analysis between health insurance claims and the amount supplied to health care institutions for narcotics or psychotropic drugs through health insurance claims data and drug distribution supply data from 2010 to 2012 collected from Korea Pharmaceutical Information Service Center (KPIS). Furthermore, we carried out literature investigation and online search to comprehend the current management of narcotics drugs in Korea. Results: The amount supplied to medical institutions for all drugs in 2012 was 19.4 trillion won, which increased from 19.5 trillion in 2011 by 0.54%. For narcotic drugs, the amount supplied was 318.4 billion won in 2011 and increased to 335.1 billion won by 5.3% in 2012, which exceeded the rate of increase for the amount supplied for all drugs. The proportion of amount claimed in the total amount supplied to medical institutions for all drugs was 60.5% in 2012, whereas the proportion of amount claimed for narcotic drugs was 55.6%, which showed that narcotic drugs were used relatively less within health insurance. Furthermore, management of the current domestic distribution supply data focuses on manufacturing and medical institution supply stages. Conclusion: Hereafter, the management of narcotics or psychotropic drugs needs to be improved by reinforcing active monitoring in optimal prescription and usage in patients by collecting and analyzing information on drug usage of patients.