• Title/Summary/Keyword: Care insurance service

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A Proposal on a Management Model Applicable to Visiting Nursing Program for a Low-income Group (저소득층 방문간호 관리를 위한 제안 - 강북구 방문간호 대상자를 중심으로-)

  • Ko Mee-Ja
    • Journal of Korean Public Health Nursing
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    • v.10 no.1
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    • pp.118-138
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    • 1996
  • Because of accelerated urbanization public body visiting nursing project that started according as matter of health on urban class in the lower brackets of income was concentrated on Social interests has a unsatisfied points to propel project efficiently from the lack of rating materials. Therefore centering around written contents in documentary literature of citizen health by household in five years from starting year of project to now. visiting frequency by medical manpower was evaluated quantitatively and qualitatively in aspect of management hereupon. for the sake of giving a basic materials for public health project of this field. This research presents documentary literature of citizen health which become materials is that as one person's charged region of nurse in duty scale. district is Kang-Buck Gu. the object is resident in the lower brackets of income grounded livelihood protection law and who is admitted by the head of organ~chief of health care). and the number of material centering around the head of a household is 415 copy. The result of research is summarized. as follow. 1. Average visiting frequency examinated by medical manpower show difference according to valuables of supervision characteristics namely average visiting. Frequency of nurse has long term residence in case registration season is early and supervision season is the first year and is high incase a kind of house is unlicdnsed mountain town. Average visiting frequency with doctor is high incase supervision season is the first year and the medical insurance system is admitted by chief of health care. That shows that a man of discomfort behavior left alone are yet many in local society. The meaning of this result shows that the continuity of official relation about class in the lowest brackets of income of long term residence goes well between househole who is a user of visiting nursing service of the object according to midway income under management influences a given duty of nurse s and so causes quantitative decrease. 2. In case behavier and condition of health that nurse diagnoses are bad. as the type matter is a lack of health and the number of patient is large. the average visiting frequency of nurse is high. because average visiting frequency with doctor is high as the condition of health is bad and the number of patient is large. That is similar with that of nurse. CD Average visiting frequency of nurse s seen by matter of disease is very high only in apoplexy by 39.50 and is confined within limits from 7.63 to 11.36 in other disease. But average visiting frequency with doctor is double as many as that of nurse but defined in apoplexy hypertension and articulate. (1) Average visiting frequency of nurse by existence in inoculation of hepatitis is low by 6.73 in unidentified group and very high by 26.89 in group of non-inoculation and the case of the antigenic positive man of B type hepatitis or epileptic who can't be inoculated shows 13.00 and that even family nursing service is needed to them. That result shows that though one person nurse of local charge has a large scale of duty. as visting nursing service is given a class who has a large demand preferentially by respectively accurate nursing diagnosis. the number of diagnosis service is similar with it. 3. During five years. average visiting frequency of nurse is 10.84 and average visiting frequency with doctor is 76.50 seeing from the official scale of nurse. visiting by household is performed two more per year to the average. Seeing this by type of service. average visiting frequency of nurse is higher in indirectly nursing than in directly nursing and that suggests that at the time of visiting household nurse performs education of protection lively save patient but at the time of contrastedly visiting with doctor. directly nursing is more contents of service show no difference by man power and medication dressing by demand is 14.3 and 18.6 the aid of hardship term of doctor and nurse is high by 18.7 and 17.00 in the request of hospitalization when seeing by demands. 4. Action by turns exemplified 1994 is well in sequence of 2/4 turn. 3/4 turn. 1/4 turn. 4/4 turn. When seen by average visiting frequency of nurse but gradually is even. Without difference by turns. average visiting frequency of doctor is much higher in 1/4 turn than other turns. Type of service by turns is all even but directly nursing is inactive in 4/4 and indirectly nursing. Very increases in 4/4 and so. Nurse's quantity of duty is plentiful that shows that by evaluation of last turn and plan of project. Contents of service follows that medication and dressing is the highest by' 5.57 in 1/4turn. goes down gradually by turn. becomes 3.57 in 3/4 turn. and increases again by 4.83 in 4/4 turn. the rest service is higher in 2/4 turn than other turns. 5. Total visiting frequency of nurse is explained to total $37.5\%$ by six valuables of visiting frequency of doctor. nursing demand. demand of diagnosis. condition of behavior. year. Special terms and magnitude of influential power is the same as sequence of enumerated valuables. Namely. the higher the visiting frequency of doctor. the bigger nursing and demand of diagnosis is. the worse the condition of behavior is. the older the object is and the more the household of special terms is. the high total visiting frequency of nurse is.

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Comparative Evaluation of Drug Use for Outpatients Prescribed by General Practitioner and Specialized Practitioner in ENT Area (이비인후과 영역에서 일반의와 전문의에 의한 외래처방전의 비교 평가)

  • Min, Hyun-Seong;Song, Tae-Beom;Lee, Myung-Koo;Jang, Je-Kwan;Lee, Chong-Kil;Lim, Sung-Cil
    • YAKHAK HOEJI
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    • v.54 no.4
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    • pp.258-269
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    • 2010
  • As people are easy to access the National Health Insurance, medical health service has been increased. It contributed to extend human's average life expectancy and to get better health care. But also increased unnecessary health service or inappropriate drug use. Therefore, DUR (Drug Use Review) is needed to induce appropriate drug use. The purpose of this study is to evaluate outpatient prescriptions by General Practitioner (GP) and Specialized Practitioner, especially indication for ENT referral including common cold which is the frequent indications that have patient see doctor. This study was reviewed retrospectively prescriptions for ENT referral collected at the A pharmacy for ENT Clinic in Cheong-Ju, B pharmacy for GP Clinic in BoEun from Feb 2nd, 2009 to Feb 28th, 2009. Each pharmacy located closed to the each enrolled clinic. The numbers of collected prescriptions were each A pharmacy (n=2501), B pharmacy (n=1343). This study was classified Drug Related Problems (DRPs) those prescriptions had as total 6 groups according to following 6 categories; 1) Unnecessary Drug, 2) Wrong Drug, 3) Low Dose, 4) Overdose, 5) Wrong Instruction, 6) Wrong Combination. In results, Specialized Practitioner's prescriptions had more DRPs than General Practitioner's prescriptions (ENT 155.34% vs GP 130.01%). In detail, Specialized Practitioner's prescriptions had more DRPs in Low Dose (ENT 16.95% vs GP 4.77%), Overdose (ENT 6.72% vs G.P 5.51%), Wrong Instruction (ENT 7.91% vs GP 5.81%), Wrong Combination (ENT 29.31% vs GP 25.09%). These DRPs would be caused from lack of consideration for dosage and drug interaction. General Practitioner's prescriptions had more DRPs in Unnecessary Drug (ENT 70.37% vs GP 78.85%), Wrong drug (ENT 4.12% vs GP 9.98%). These DRPs would be associated with drug selection. This study was assumed that Specialized Practitioner is better prescriber than General Practitioner because Specialized Practitioner complete additional intern and residency training. But, Specialized Practitioner is not always better prescriber than General Practitioner. Furthermore, prescriptions of both Specialized Practitioner and General Practitioner had many problems. In conclusion, It could be cut down the excessive medical expense and expected more efficient medical care by reducing DRPs, thus contributing to the improvement of national health. In order to pharmacist must have good professional ability of pharmacotherapy to help the physician for the drug selection.

Analysis of Lumbar Herniated Intervertebral Disc Patients' Healthcare Utilization of Western-Korean Collaborative Treatment: Using Health Insurance Review & Assessment Service's Patients Sample Data (요추 추간판 탈출증 환자의 의·한의 협진 의료이용 현황 분석: 건강보험심사평가원 환자표본 데이터를 이용하여)

  • Ko, Jun-Hyuk;Yu, Ji-Woong;Seo, Sang-Woo;Seo, Joon-Won;Kang, Jun-Hyuk;Kim, Tae-Oh;Cho, Whi-Sung;Seo, Yeon-Ho;Ahn, Jong-Hyun;Lee, Woo-Joo;Kim, Bo-Hyung;Choi, Man-Khu;Kim, Sung-Bum;Kim, Hyung-Suk;Kim, Koh-Woon;Cho, Jae-Heung;Song, Mi-Yeon;Chung, Won-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.4
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    • pp.105-116
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    • 2021
  • Objectives Lumbar herniated intervertebral disc (L-HIVD) is common disease in which Western-Korean collaborative treatment is performed in Korea. This study aimed to analyze Western-Korean collaborative treatment utilization of Korean patients with L-HIVD using Health Insurance Review & Assessment Service's Patients Sample Data. Methods This study used the Health Insurance Review & Assessment Service-National Patient Sample (HIRA-NPS) in 2018. Claim data of L-HIVD patients were extracted. The claim data were rebuilt with the operational concept of 'episode of care' and divided into Korean medicine episode group (KM), Western medicine episode group (WM) and collaborative treatment episode group (CT). General characteristics, medical expenses and healthcare utilization were analyzed. In addition, the difference of average visit day and average medical expenses between non-collaborative group (KM plus WM) and CT were analyzed by the propensity score matching method. Results A Total of 64,333 patients and 365,745 claims were extracted. The number of episodes of WM, KM and CT was 69,383 (92.97%), 3,903 (5.23%), and 1,341 (1.80%) respectively. The frequency of collaborative treatment episode was higher in women and the age of 50s. The most frequently described treatment in CT was acupuncture therapy. As a result of the propensity score matching, the number of visit days and medical expenses in the collaborative treatment group was higher than in the non-collaborative group. Conclusions The analysis of healthcare utilization of Korean-Western collaborative treatment may be used as basic data for establishing medical policies and systematic collaborative treatment model in the future.

Study on Building Smart Home Testbed for Collecting Daily Health Condition based on Internet of Things (사물인터넷 기반의 일상 건강정보 수집을 위한 스마트 홈 테스트베드 구축)

  • Chae, Myungsu;Kim, Yongrok;Kim, Sangsik;Kim, Sangtae;Jung, Sungkwan
    • KIISE Transactions on Computing Practices
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    • v.23 no.5
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    • pp.284-292
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    • 2017
  • With the development of Internet of Things (IoT) technology, the combination of ICT and medical services has been increasing to improve the quality of medical services. Using the IoTs, we can collect personal health information continuously in a patient's everyday life. We expect that this will improve the quality of medical service through analysis. However, the problem of ensuring the protection of personal information within the personal health information has been hampering the research, development, and application of such services. Other problems include lack of IoT devices and lack of user convenience for collecting health information about a patient's everyday life. Therefore, in this study, we construct a daily health information management service that can collect the health related information at any time and store this data in personal storage. This data is then only provided to the healthcare worker when necessary. We built a test bed for an IoT-based smart home platform and are currently conducting user experiments. Based on the results of this study, we are attempting to provide a high quality medical trial service based on daily health information through linkage with medical device manufacturers, medical clinics, insurance companies, etc. We expect the proposed health information management service will contribute to the revitalization of smart health care services via activating various health related IoT devices and analyzing daily health information.

Effects of Community-based Case Management Program for Clients with Hypertension (고혈압 대상자의 지역사회 중심 사례관리 프로그램 효과)

  • So, Ae-Young;Kim, Yun-Mi;Kim, Eun-Young;Kim, Chang-Yup;Kim, Cheol-Hwan;Kim, Hee-Gerl;Shin, Eun-Young;Yoo, Weon-Seob;Yi, Ggod-Me;June, Kyung-Ja
    • Journal of Korean Academy of Nursing
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    • v.38 no.6
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    • pp.822-830
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    • 2008
  • Purpose: The purpose of this study was to analyze effects of a community-based case management program for clients with hypertension living in the community. Methods: The research design was a one group pre and post-test design with 30 participants with hypertension who agreed to participate in the 8-12 week case management program provided by case managers from the National Health Insurance Corporation in 2002. Data were collected three times, before and after the case management services, and 6 months later. Outcomes included changes in blood pressure, knowledge of hypertension and daily life practices, including alcohol consumption, smoking, exercise, and medication adherence. Results: Repeated-measures ANOVA and post-hoc tests of means revealed significant differences before and after service for systolic blood pressure, daily life practices (monitoring body weight and BP, low salt and cholesterol and high vegetable diet, and stress-relief practices), and exercise. The goal for medication adherence was attained after service. Significant improvements from baseline to 6 months after service were observed in measures of salt and vegetables in diet. There were no significant differences on hypertension knowledge, alcohol consumption or smoking behavior between before service and after, and at 6 months. Conclusion: The findings provide preliminary evidence that case management intervention can have positive outcomes on BP control, daily life practices, exercise, and medication adherence for clients with hypertension. However, additional interventions are needed to sustain long-term effects.

The characteristics related to the development of pressure ulcers in long term care facilities : the use of 2009 National Patient Sample (요양병원 입원 환자의 욕창 발생 현황과 관련 요인: 2009년 건강보험 환자표본 자료 이용)

  • Moon, Mikyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.7
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    • pp.3390-3399
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    • 2013
  • The purpose of this study was to examine the incidence rates of pressure ulcers depending on the types of healthcare organizations and to determine whether the characteristics of patients and facilities influence on the incidence of pressure ulcers in long term facilities. We analyzed data on 796,857 patients of the 2009 National Patient Sample which was extracted from to claims for medical fees to Health Insurance Review & Assesment Service(HIRA). A total of 3.2% of patients(n=25,339) had at least 1 pressure ulcer during their hospitalization. The pressure ulcer rates were highest in long term care facilities(8.2%, n=11,895) following general hospital(2.7%, n=8,052), hospital(1.7%, n= 5,059). According to logistic regression analysis, urinary incontinence (Odds ratio(OR)=2.462, 95% confidence interval(CI)=2.038-2.974), hypertension(OR=1.456, CI=1.400-1.515), peripheral vessel diseases (OR=1.357, CI=1.200-1.534) were significant predictors of pressure ulcers. As the number of diagnoses, age, and the number of doctors per 100 beds increased, the incidence of pressure ulcers increased. In addition, more number of beds was associated with fewer pressure ulcers.

A Study on the Lived Experiences of Homecare Nurses (가정간호사의 실무체험 연구)

  • 서문자;김소선;신경림;강현숙;김금순;박호란;김혜숙
    • Journal of Korean Academy of Nursing
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    • v.30 no.1
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    • pp.84-97
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    • 2000
  • The Necessity and Purpose of the Study Recently the number of patients with chronic diseases and the aged patients is increasing steadily. Furthermore, due to the expansion of health insurance system, the number of patients hospitalized in the general hospital is increasing at a surprising speed. However, hospitals urge the early discharge of the patients for the efficiencies of hospital administration, and therefore, the number of patients who must be taken care of in their home is also increasing. Homecare nursing is one of the health care service for the patients at home who require continual attention and care, and now increasing attentions are given to it as one of the professional nursing fields. However, it was almost impossible to find a study on the actual experiences of the homecare nurses written by their own language in Korea, that it also posed a great difficulty in understanding their diverse experience. Considering these situation, this study will help understanding of them, and provide the fundamental data on their experiences for making policies to develop homecare nursing. Methods of Research Phenomenological research method was employed to analyze the lived experiences of homecare nurses fundamentally. Data collection Data were collected from August 1998 to December 1998 from ten homecare nurses who worked for patients under the homecare nursing setting as model cases designated by Seoul Nurses Association and who agreed to the purpose of this study after listening to and understanding the explanation completely. The in-depth interview was carried at the time which was convenient both for the researcher and participants for one or two hours, and recovered with the approval participants. The first interview covered diverse and broad areas like the situation of homecare nursing, and their feelings and thoughts over it, and in the second and third interviews, more specific questions are asked. Data Analysis For the phenomenological analysis, contents analysis was employed. The data collected from the participants were analyzed into the following procedures according to Van Manen 's phenomenological analysis. 1) Reserve the preconception of the researcher by restricting it inside parenthesis. 2) Make a thorough observation of the lived experiences by insight process. 3) Analyze the contents (Find out the repetitive factors) 4) Interpret the essence found. 5) State the meaning of the interpretation. Results and discussion 1. Fear and expectation for the first visit. (unfamiliarity, awkwardness, anxiety, shivering) 2. Mingle with the family (feeling friendly with the family, becoming like a family member) 3. Being proud of her own know-how (learning the know-how, organizing alternatives, building up confidence) 4. Pity for the poor. (criticizing the current government, feeling ashamed, feeling anger) 5. Difficulty of constructing cooperative system with physicians (strenuousness, frustration) 6. Helplessness due to the lack of support system (difficulty to get supplies, annoyance, embarrassment by institutional restraints) 7. Anxiousness for heavy traffic and parking (annoyance, hastiness) 8. Ethical conflicts (pity for the patients and family, skepticism about lengthening life maintenance) 9. Burden for the possible accident (pressure, anxiety, conflict, physical exhaustion) 10. Establishment of identity as a professional (fulfillment, worth, joy) 11. Being distressed at other's ignorance

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Oral health of Chinese students in Korea by behavior of oral care (국내 중국인 유학생의 구강건강관리행태에 따른 구강건강 삶의 질)

  • Shim, Jae-Suk;Lee, Mi-Ra;Kang, Yoon-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.343-350
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    • 2016
  • To prepare a method for improving the oral health-related quality of life for Chinese foreign students by examining the oral health care behavior affecting the oral health-related quality of life, a self-administered survey was conducted with 236 Chinese foreign students at an university located in Jeonbuk during April 2 -May 5, 2013. The results showed that 65.3% had not visited the dentist within one year, 82.6% had not received scaling within one year, and 68.2% had not received oral health education. In regards to the OHIP-14 according to the general characteristics, there was a significant difference in the school year, health insurance enrollment status and overseas study life satisfaction (p<0.05). In regards to the OHIP-14 according to the oral health care behavior, there was a significant difference in the subjective oral health condition, the experience of having visited a dentist within one year and an experience of having received scaling (p<0.05). As for the influencing factors on the oral health-related quality of life, they were found to be the subjective oral health condition and the experience of having received scaling within one year (p<0.05). For the purpose of helping Chinese foreign students to conveniently use medical institutions when oral health-related problems arise, there is a need for a translated version of the guidebook in their native language, the availability of medical professional interpreters, the availability of a university level oral health service center, and practical oral health education to enhance oral health.

Study on the Early Detection of Mental Health Problems in the Elderly and the Utilization of Related Services (노인의 정신건강 문제의 발견과 관련서비스 이용에 관한 연구)

  • Park, Kyungsoon;Park, Yeong-Ran;Son, Duksoon;Yum, Yoosik
    • The Journal of the Korea Contents Association
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    • v.19 no.9
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    • pp.308-320
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    • 2019
  • This study aims at investigating the major symptoms that help family carers detect mental illness in elderly patients. Another purpose of this study is to empirically verify the major factors determining the utilization of mental health services with a focus on family carers. The results of this study are as follows. First, the most commonly detected symptoms that caused the family carers to suspect mental illness in the elderly patients were memory decline and other forms of cognitive function decline. Second, the determinants of the elderly's utilization of mental health services included the patient's long-term care insurance level, the age of the family carer, the period of care, the level stress associated with the provision of care felt by the carer, his understanding of geriatric mental illness, and the level of perception about community mental health services. Based on these findings, this study suggests policies and practical implications for the early detection of and response to elderly mental health problems and the utilization of related services from the viewpoint of the family carers of the elderly.

Regional Analysis on the Incidence of Preterm and Low Birth Weight Infant and the Current Situation on the Neonatal Intensive Care Units in Korea, 2009 (2009년 한국 시도별 미숙아, 저체중출생아의 빈도 및 신생아중환자실의 현황)

  • Kang, Byung-Ho;Jung, Kyung-A;Hahn, Won-Ho;Shim, Kye-Shik;Chang, Ji-Young;Bae, Chong-Woo
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.70-75
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    • 2011
  • Purpose: Recently, the incidence of preterm and low birth weight infants (LBWI) is increasing, even though the birth rate is continuously low in Korea. Despite that change, there continues to be a deficit of beds in the neonatal intensive care unit (NICU). This study is based on the 2009 Korean Statistical Information Service that examined the development of a Korean NICU service and the survival rate of preterm infants by regionally analyzing the rate of total live births, preterm infants, LBWI, and NICU beds in Korea. Methods: Data were obtained from the Korean Health Insurance Review and Assessment Service and Korean Statistical Information Service. We confirmed the regional total live birth rate, number of LBWI, and preterm infants and NICU numbers, and all of the results were compared to the average value to determine deficient areas of NICU beds. Results: There were 25,374 (5.7%) preterm infants and 21,954 (4.9%) LBWI in the total number of live births (444,849) in 2009, and regions of high proportion compared to the mean value were Busan, Daegu, and Ulsan. Total NICU beds totaled 1,284, and regions of high rates preterm infants and LBWI per 1 NICU bed compared to the mean value were Incheon, Daegu, Ulsan, etc. The NICU holding rate was 87.5% (1,284/1,468), which was increased from 2005. However, there were still shortages of 184 NICU beds (12.5%), especially in Gyeonggi-do, which lacked 157 beds. Conclusion: High risk neonates difficult to transfer, and they need immediate and continuous treatment. As a result, a foundation of well-balanced, national NICU regionalization is necessary. This study suggested that more NICU facilities must be implemented, and clinicians should realize the continuing deficiency of NICU beds in cities and provinces.