• Health Policy and Management
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• v.20 no.1
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• pp.87-102
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• 2010

The objective of this study were to examine the impact of medicaid coverage expansion policy aimed at improving access to primary care. The case-control study was conducted to compare preventable hospitalization(PH) rate in new medicaid recipients versus national health insurance(NHI) enrollees form 1996 to 2001. Rates of preventable hospitalization associated with ambulatory care sensitive conditions(ACSC) were calculated and standardized by age and sex. Multinomial logit regression model was used to control the confounding factors such as age, gender and charlson comorbidity index Annual PH rates in the new medicaid increased 1.64 times after medicaid expansion, with controling confounding factors. Meanwhile, annual PH rate in the NHI increased 1.68 times during the same period, with adjusting confounding factors. Current findings suggest that the new medicaid PH rate was less likely to rise than NHI PH rate after implementing medicaid expansion. This study is expected to provide policy-relevant evidence of medicaid expansion to include population with low income.

• Journal of Wellbeing Management and Applied Psychology
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• v.7 no.1
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• pp.51-65
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• 2024

Purpose: This study is to propose the establishment and direction of a public health-medical cooperation system for rehabilitation medical services for people with physical and brain disabilities in Gangneung, Korea. Research design, data and methodology: The study focused on 30 individuals with these disabilities registered. Data was collected from December 20, 2021, to December 31, 2021, through structured surveys administered by researchers visiting disability-related facilities, utilizing convenience and random sampling methods. Descriptive statistics and cross-analysis were applied for analysis. Results: Specifically, among respondents with physical disabilities, a total of 20 needs were identified, with 'Visiting health services' (25.0%) and 'Oral health services' (20.0%) ranking highest. The survey results regarding visit-based rehabilitation services for disability support showed a high demand, emphasizing the necessity of service provision tailored to the needs of recipients, focusing on disability prevention, health management, and motor function recovery, rather than solely medical or therapeutic concepts. Conclusions: Gangwon National University Hospital, as the regional referral hospital in Gangwon, should collaborate with Gangwon Province Rehabilitation Hospital to provide prompt acute rehabilitation services. Moreover, cooperation and collaboration with Gangneung Asan Hospital, the tertiary hospital in the region, are essential to ensure continued acute and recovery phase rehabilitation therapy for a certain period in the Gangneung area.

• Journal of Preventive Medicine and Public Health
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• v.43 no.1
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• pp.35-41
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• 2010

Objectives: In Korea, the top 10% of Medical Aid recipients represent nearly 60% of total payment, with the costs for those disabled for over 365 days representing approximately 30% of total payment. The purpose of this study was to compare Medical Aid use of the disabled with non-disabled recipients, and to identify contributing factors to the total payment in the top 2% of recipients identified as Medical Aid overusers. Methods: Subjects (n=2,211) selected were ${\geq}18$-years-of-age and received >1000 days of co-payment-free type I Medical Aid. Case managers (n=200) conducted interviews in December 2006, and collected data from Health Insurance Review & Assessment Service. Amounts over the 9 months from January September 2006 were analyzed descriptively and using Chi-square, ANCOVA, and robust multiple linear regression. Results: Disabled individuals (mean age 61.3 years) composed 36.6% of subjects; 44.8% of the disabled were male. On a monthly basis per capita, the disabled group averaged 10.5 outpatient days, total payment of 523,000 Korean Won(￦), inpatient payment of ￦359,000, and outpatient payment of ￦183,000. All values exceeded the monthly average for non-disabled individuals. Contributing factors were identified as male gender (￦82,000), elementary school or lower educational level (￦64,000), residence in a small city (￦82,000), lack of family support (￦61,000), kidney disability (￦673,000), intellectual disability (￦151,000), and multiple disabilities (￦119,000). Conclusions: The identification of contributing factors to Medical Aid use by those defined as disabled supports the adoption of comprehensive alternative policies such as strengthening of education and consultation services, provision of alternative facilities, and promotion of self-care.

• Archives of Craniofacial Surgery
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• v.17 no.2
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• pp.68-76
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• 2016

Background: In scalp allotransplantation, the scalp from a brain-dead donor, including hair, is transferred to a recipient with scalp defects. Opinions differ on the appropriateness of scalp allotransplantation. In order to maintain graft function and cosmetic outcomes, scalp transplantation recipients would need to receive lifelong immunosuppression treatments. The risks of this immunosuppression have to be balanced against the fact that receiving a scalp allotransplant does not extend lifespan or restore a physical function. Therefore, the present study aimed to investigate risk acceptance and expectations regarding scalp allotransplantation in different populations. Methods: A questionnaire survey study was conducted. A total of 300 subjects participated; survey was conducted amongst the general public (n=100), kidney transplantation recipients (n=50), a group of patient who required scalp reconstruction due to tumor or trauma (n=50), and physicians (n=100). The survey was modified by using the Korean version of the Louisville instrument for transplantation questionnaire. Results: Risk acceptance and expectations for scalp transplantation varied widely across the groups. Kidney transplantation recipients revealed the highest risk acceptance and expectations, whereas the physicians were most resistant to the risks of scalp transplantation. Conclusion: Our study demonstrates that, in specific groups, scalp allotransplantation and the need for immunosuppression carries an acceptable risk despite the lack of lifeextending benefits. Our results suggest that scalp allotransplantation can be an acceptable alternative to existing scalp reconstruction surgeries in patients with pre-existing need for immunosuppression.

• Journal of Korean Academy of Nursing
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• v.28 no.1
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• pp.26-36
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• 1998

This primary study was done to develop an ethical guideline for organ transplantation, a life-saving treatment which helps improve the quality of life. This study tried to identify the current situation in Korea, in terms of ethical considerations in organ transplantations. This study collected basic data in organ transplantations, in the hope that procedure of organ transplantations could be developed that would be fair to both organ donors and recipients. The immediate goals of this study were : 1)to identify staff in charge of organ transplantations and their jobs in the hospital, 2)to survey whether there exists a Hospital Ethics Committee(HEC), 3)to research what consideration are formally taken in selecting recipients, and 4)to accumulate data on how consent from donors are currently obtained. The study used a survey questionnaire and received responses from 31 hospitals out of 45 hospitals where organ transplantation are being done. Organ transplantation coordinators were found in 16 hospitals, but the job description varied among hospitals. The survey showed that all 16 hospitals with an HEC that health care personnel unnecessarily dominate the committee. The study notes that HECs should be vitalized by recruiting, as members, ethicists, theologians, patients, guardians, as well as the general public outside of the hospital. The study revealed that in selecting recipients the hospital take into account ABO blood type, histocompatibility, age, waiting time. and level of patient compliance. Finally, it was shown that in the cases of living donors the transplanting hospitals seek a formal consent, whereas there are no common consenting practice established for cadaveric donors. The study concludes with three proposals. First, a nationwide institution responsible exclusively for procurement and distribution of cadaveric organs for transplantation should be established. Second. we should rebuild the national health insurance system so that have costly organ transplantation expenses are substantially covered. Last, but certainly not least. there is a need to emphasize the HEC's committment to prepare a proper ethical guideline for organ transplantation in general.

• Health Policy and Management
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• v.23 no.1
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• pp.59-65
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• 2013

Background: The purpose of this study was to analyze the related factors which decide the percentage of health care expenditure of the total fiscal expenditure of local governments and to provide the basic data to contribute for the efficient allotment of healthcare budget. Methods: This study was conducted by the percentage of health care expenditure for 3 years by classifying a total of 230 local governments into the metropolitan cities (gu, 69), the counties (si, 75), and the boroughs (gun, 86) all over the country. With the collected data, the general characteristics of independent variables and the dependent variable were analysed using SPSS ver. 18.0, The correlation analysis and multivariate regression analysis were conducted for the characteristics of variables according to regions by year. Results: In correlation between health care expenditure by year and other variables, there was a significant positive correlation with unemployment rate, metropolitan cities (gu) and other regions, the percentage of health center personnel, health care expenditure in last year as a independent factors. On the other hand there was no correlation with social assistance recipients and the percentage of aging population, financial self-reliance, industrialization rate, suicide rate, cardiac disease mortality, cerebrovascular mortality on health care expenditure. Conclusion: The study clearly shows that health care expenditure of local governance was not correlated with health care need factors comparing social welfare expenditure.

• Journal of Korean society of Dental Hygiene
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• v.14 no.3
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• pp.353-362
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• 2014

Objectives : The purpose of the study is to investigate the xerostomia in the chronic severe psychiatric patients in Korea because there were few reports on xerostomia in the psychiatric patients. Methods : The subjects were 61 psychiatric patients in the mental hospital by convenience cluster sampling. A self-reported symptom questionnaire was filled out by the three researchers on the basis of medical records by the informed consent. The stimulated salivary flow rate of the patients was measured by saliva sampling. Results : The subjects consisted of 45.9% of male and 54.1% of female. High school graduation accounted for 40.0% and 20.0% did not attend the school. The majority of the patients were medicaid recipients. Schizophrenia accounted for 86.9% and most patients were long term care recipients. A total of 68.9% of the patients suffered from salivary dysfunction. The medication in schizophrenia seemed to decrease the stimulated salivary flow rate and made the patients difficult in chewing and swallowing due to xerostomia and low saliva secretion(p<0.05). Conclusions : Medication in schizophrenic patients caused the salivary dysfunction. So the collaboration between the psychiatry doctors and dental hygienists is very important to improve the salivary secretion in the schizophrenic patients. The continuous and long term care of the xerostomia will help the patients maintain the good oral hygiene.

• Journal of the Korean Dietetic Association
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• v.28 no.1
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• pp.30-44
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• 2022

This study analyzed results of the rounding guidance by applying the nutrition management check list at of the Center for Children's Foodservice Management (CCFM). Totally, 271 foodservices for children (65 institutional foodservices, 53 small scale foodservices, 153 family child care homes) were examined to identify the necessity of implementing a nutrition management strategy, and subsequently creating a priority list for nutrition management improvement measures. Of the 13 items examined in the nutrition management check list for children's foodservices from the Ministry of Food and Drug Safety, 8 performed well, with an overall performance rate of 90% or more. Improvement plans were required for items (all belonging to the menu area) such as 'Post menu on noticeboard at children's foodservice' (62.0%), 'Use the menu planned by dietician' (64.9%), 'Use menu suitable for recipients in children's foodservice' (76.8%), and 'Provide menu to parents' (79.0%)'. In the analysis of service size, the performance rate for 'Use menu suitable for recipients in children's foodservice' revealed a substantially lower result (P<0.01) for institutional foodservices (64.6%), as compared to small scale foodservices (71.7%) and family child care homes (83.7%). Since other check list items, did not show much differences by the service size, we ascertained it pointless to establish separate strategies based on different foodservice sizes.

• Anxiety and mood
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• v.19 no.2
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• pp.37-47
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• 2023

This review article explores the psychological characteristics, comorbid mental disorders, and psychosocial assessments throughout the solid organ transplant journey, spanning the pre-transplant, peri-transplant, and post-transplant phases for transplant recipients. The psychological burden and anxiety in the pre-transplant phase are high for organ failure patients with complex physical difficulties who are deciding to undergo transplantation and are on the waiting list. The pre-transplant psychosocial evaluation covers various aspects, including the patient's readiness, awareness of, and commitment to transplant treatment, medical compliance, psychopathological conditions such as cognitive function and personality disorders, lifestyle factors, including substance abuse, as well as various psychosocial factors like social support. During the peri-transplant phase, mental health problems such as postoperative delirium should be carefully recognized and addressed. After transplantation, it is essential to assist patients in coping with the various stressful experiences they encounter, manage psychiatric symptoms such as depression, anxiety, and insomnia, and improve treatment adherence and quality of life during long-term care for the transplanted organ. Managing psychiatric problems in post-transplant patients requires a deep understanding of immunosuppressant medications and a keen awareness of associated risks, including adverse effects and potential drug interactions. This comprehensive review emphasizes the significance of proactive mental health care and psychosocial evaluation, highlighting the necessity of a multidisciplinary approach to enhance the quality of life and overall success of transplant patients throughout all phases of transplantation.

• Korean Journal of Social Welfare
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• v.46
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• pp.60-88
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• 2001

This paper examined the impacts of the welfare reform program, California Work Pays Demonstration Program(CWPDP), implemented in 1992. CWPDP was designed to move welfare recipients into the labor market by reducing the amount of AFDC grants and one-third earned income disregard. The evaluation of the policy impacts on the welfare recipients was conducted in two areas: employment and earnings. This study used a subset of a database created by the California Department of Social Services, and University of California Data Archive and Technical Assistance. The subset is composed of 3,936 AFDC-FG cases selected in LA County: 1,311 control cases and 2,625 experimental cases. The control group was kept on the AFDC rules as of September 1992, while the experimental group was subject to AFDC rule changes implemented under CWPDP. The analyses of the employment and earnings using the random effects probit model and the random effects regression model, respectively, indicated that CWPDP did not effectively encourage female heads to participate in the labor market. It also revealed that CWPDP did not significantly increase the earnings of female heads. The findings imply that the disincentive structure of the public assistance program is not the main barrier preventing female heads from getting jobs and leaving the welfare rolls. Rather, participation in the labor market and exit from welfare is mainly determined by their own demographic characteristics and the economic cycle. Based on the findings, policy implications are suggested on the National Minimum Protection Program in Korea. Those include a flexible exemption rate for the earned income of beneficiaries, affordable child care services, and guaranteed public jobs.