• Health Policy and Management
• /
• v.23 no.2
• /
• pp.103-111
• /
• 2013

Seven diagnosis-related groups (DRGs) prospective payment system is going to expand to all hospitals including university hospitals this year. However there are few studies on the change of practice pattern under prospective payment system in the university hospital setting. So This study was intended to predict the practice pattern change after the introduction of 7 DRGs prospective payment system in a university hospital setting. To predict the change of practice pattern, this study used simulation technique. Five hundred and nineteen patients classified as 5 DRGs in a university hospital were selected for simulation. The change of practice pattern were predicted based on clinicians' opinion. We also predicted payment change by service items. Major findings of this study are as follows. First, the total medical payment was reduced by 14.4%. The drug payment change (8.8%) took most of total payment reduction. The followings are the change of treatment material cost (3.2%), the change of laboratory tests cost (1.8%), the change of room charge (0.5%), and other payment change (0.1%), respectively. Second, most of the reduction in total medical payment resulted from the decreased amount of medical services themselves. The transfer of medical services to outpatient setting took up only 4.9% of the total payment reduction. The change of unit price or composition took up 5.5% of the total payment reduction. In this study we found that it is possible to reduce the inpatient services through practice pattern change in university hospital setting. However, it needs to be careful to adjust DRG payment after the reduction of provided services, because most of reduction was not due to service transfer but to service volume reduction. It is desirable to utilize the saving from practice pattern change as incentive to improve quality of care.

• The Journal of Korean Society for School & Community Health Education
• /
• v.20 no.3
• /
• pp.83-90
• /
• 2019

Purpose: This study is a repetitive comparative analysis of a qualitative case study that carried out a home visiting oral health education program. Method: This study conducted an interview survey through medical examination by interview before and after the home visiting oral health education and measured some pathogenic microorganism counts in the denture. Results: There was a positive change in the self oral care ability of the elderly at home after home visiting oral health education, including the behavior of self management of dentures, and some pathogenic microorganism counts in the dentures. Conclusion: The home visiting oral health education of home care service centers can improve oral health care for the elderly at home.

• Korean Journal of Adult Nursing
• /
• v.25 no.3
• /
• pp.241-249
• /
• 2013

Purpose: The aim of the study was to identify the effects of education from using cellular phones and a short messaging service. Methods: Collected data included baseline demographics, blood pressure, abdominal circumference, total cholesterol, body mass index and health behavior index (Dietary Practice Guidelines Score, Physical Activity, Drinking frequency, Stress score, Subjective health status, and Action change stage score). Data were collected at public health centers in Chungcheongnam-do from January to December, 2011. Data obtained from Individual health counseling Programs in Chungcheongnam-do. Analysis was divided into health risk group and Disease management group, using a paired t test. Results: Following the education of using short messaging service of cellular phones Health risk group was a reduction in the systolic blood pressure, diastolic blood pressure, waist circumference. Disease management group was a reduction in the systolic blood pressure and body mass index. In both groups, there were improvement in the Health behavior index; dietary practice guidelines score, physical activity, stress score, subjective health status and action change stage scores. Conclusion: These results indicated that education using short messaging service of cellular phone for Community was effective in improving health behaviors and status. By applying the results, development of customized teaching messages for stable settlement is required.

• Korean Journal of Health Education and Promotion
• /
• v.33 no.4
• /
• pp.89-100
• /
• 2016

Objectives: Life style modification leads to decrease health risk and change of health status for person at health risk. This study aimed to suggest essential components and effective strategies for customized health management service to provide individual and risk group in public and private health care organizations. Methods: To systematic review the essential component of health management service, I performed to collect political legislation, research papers, reports, publication and public release for heath management service from 2008 to 2016. Essential components of heath management service were service scope, service design, organizations and applied technology. Results: Service cope was composed of health risk factors, such as smoking, drinking, nutrition, physical activity and weight control. Main strategies were customized health management services, personalized behavior modification programs, evidence-based service protocol, utilization of information and communications technology (ICT), multi-dimension and multi-level approach, and public and private organizations partnership through health policies and health care system. Conclusions: To make the most of the limited resources, it should require a systematic approach that focuses on continuous monitoring and partnership of health management service.

• The Korean Journal of Health Service Management
• /
• v.13 no.1
• /
• pp.31-42
• /
• 2019

Objectives: The purpose of this study is to analyze the relationship between the change gap in the perception of subjective hierarchy and medical expenditure and the factors influencing medical expenditure. Methods: An analysis based on the the data extracted from the Panel Study of Korea Health Panel for 2012-2013 (n=9,359) is conducted. Further in this study, data analysis included a chi-square test and logistic regression using SPSS version. 22.0 to analyze the factors influencing the turnover intention of industrial workers. Results: Model I showed decreases in medical expenditure by 1.247, 1.391, and 1.441 times in social classes one, two, and Model II showed an increase in medical expenditure by age, spouse, number of family members living together, insurance type, income class, economic activities, subjective health status, chronic illness and change on subjective recognition of social class. Conclusions: The study concludes that the state and community require psychological, social, and cultural support, in addition to individual efforts, to reduce medical expenditure.

• The Korean Journal of Health Service Management
• /
• v.8 no.1
• /
• pp.51-64
• /
• 2014

The purpose of this study was to investigate the relationship among staffing, occupancy rate, upward level change of long-term care need, and evaluation grade of facility. Data were obtained from National Health Insurance Corporation Database. Occupancy rate and evaluation grade were highest in National/public operating facilities, while they were worst in individual operating facilities. The percents of A or B grade in evaluation grade (by newly enforced law) is highest in National/public operating facilities. Multiple regression analysis showed that upward level change of care needs was very weakly associated with the number of doctors. Evaluation grade showed a weak and significant association with occupancy ratey(by old-version law)(r=.20, p<.01), upward level change of care need in group home(r=.23, p<.01) Staffing in facility did not show significantly consistent association with upward level change of care needs, evaluation grade, and occupancy rate.

• Journal of The Korea Institute of Healthcare Architecture
• /
• v.16 no.2
• /
• pp.55-64
• /
• 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.

• Korea Journal of Hospital Management
• /
• v.12 no.3
• /
• pp.99-119
• /
• 2007

In recent years, many of medical institution have reinforced educations for their employees aiming to secure competitiveness and to achieve higher performances. In an effort to actively response to the fast changing environment in the medical industry, the Ministry of Health and Welfare has implemented "Innovation and Service promotion" educations for employees of 34 regional medical institutions and 6 Red Cross hospitals. In this regards, the effect of the educations to change employees' mind for innovation and services and its results need to be evaluated. This study conducted surveys asking participants of the 2006 Education for Innovation of Regional Public Hospital Employees and Service Promotion and synthetically analyzes the effect of the education on their mind for services compare to their mind before the education. As a result, more them 92% of participants say that they are satisfied with the education, and many more participants agreed the effect of the education to change their mind for services. Under this circumstance, after the educations participants change more positively on "their mind for innovative services" and "their service skills in practice".

• Korea Journal of Hospital Management
• /
• v.1 no.1
• /
• pp.170-187
• /
• 1996

This paper proposes a change process model for organization development in health care organizations and provide an OD case exemplar of nursing service unit at Virtual Hospital. This case exemplar was written in a narrative form rather than in an argumentative form as an embodiment of organization development process as is viewed from the cultural/interpretive perspective rather than from the technical/rational one. This case exemplar illustrates the change process which consists of four interrelated components: change intervention, organizational target variables, individual organizational member, and organizational outcomes. It also demonstrates the applicability of the narrative rationality which involves narrative probability and narrative fidelity to the story where the learning organization, shared governance, and empowerment are fully emplotted and enlivened. The implications for organization development in health care organizations are discussed.

• Health Policy and Management
• /
• v.2 no.1
• /
• pp.147-166
• /
• 1992

The purpose of this study is to analyze the effects of the health center hospital on the health service utilization pattern of the rural population in a county. Two field studies had been conducted in Yonchon County, Kyunggi Province, on February 1989 and on August 1991 before and after the establishment of the Yonchon health center hospital. This study revealed that Yonchon health center hospital occupied 7.3% of total outpatient visits and 16.8% of hospitalization of the county population and the self-sufficient rate of the outpatient visit and hospitalization of Yonchon County between two field studies increased by 1.7% and 20.9% each. Yonchon health center hospital contributed to the growth of the public health sector but it weakened the role of health sub-centers. For the efficient health service utilization of the population in that County, more investment to health center hospital would be needed and the primary health activities of the health subcenter should be enforced.