• Korea Journal of Hospital Management
• /
• v.26 no.1
• /
• pp.42-54
• /
• 2021

The purpose of this study is to analyze that ICT-based primary health care affects clinical changes of participants in the primary care chronic disease management pilot project using ICT medical care. Customized health information data, provided by National Health Insurance Service, was used for the analysis. The study targeted a total of 676 people that participated in primary care chronic disease management pilot project using ICT medical care from 2017 to 2018. Hierarchical regression was used to test three model. First, there were many subjects who used face-to-face consultation and non-face-to-face consultation(messaging), but less than half of patients using non-face-to-face consultation(telephone). Second, after participating in the pilot project, the fasting blood sugar level decreased. Third, the clinical condition of the subjects appeared to be an important factor in controlling blood sugar levels. Finally, patients using the non-face-to-face consultation(messaging) had reduced blood sugar levels after participating in the project. This results imply that non-face-to-face consultation is effective in reducing fasting blood sugar level with hospital intervention, and there are effects of the primary care chronic disease management project using ICT.

• The Korean Journal of Rehabilitation Nursing
• /
• v.18 no.2
• /
• pp.98-106
• /
• 2015

Purpose: The purpose of this study was to compare the needs of case management between Medical aid beneficiaries with simple and multiple chronic diseases (SCD vs MCD). Methods: The study employed secondary analysis method using a cross-sectional data from 2009 case management service enrollees. Data on 35,862 beneficiaries who have chronic disease(s) were used in the description of chronic disease characteristics, and data on 20,392 beneficiaries, excluding those who have depression and/or disabilities, were used to compare the group differences. Results: Mean age was $68.8{\pm}11.63years$, and 73.3% were females. MCD group showed an older age, had more women than SCD group. Self-care ability and appropriateness of health care utilization were significantly different between the groups, but there was no difference in health-related quality of life. In subscales, there were significant differences in general health status, depression, symptom management, healthy lifestyle, hygiene and vaccination, and appropriateness of health utilization. Conclusion: Different characteristics between patients with simple and multiple chronic diseases indicate that different case management approaches are required for these groups. The study results could be used as a basis for the development of case management model tailored to the characteristics and needs of medical-aid beneficiaries.

• Journal of Korean Academy of Nursing
• /
• v.51 no.5
• /
• pp.617-629
• /
• 2021

Purpose: The aim of this study was to examine the validity and reliability of the Korean version of the self-efficacy for managing chronic disease 6-item scale (SECD-6-K). Methods: The English version of the Self-Efficacy for Managing Chronic Disease 6-item Scale first underwent forward and backward translation procedures. The SECD-6-K was then used to collect data from 350 adults diagnosed with chronic diseases. Content, construct, convergent, discriminant, and criterion validity were all evaluated. Reliability was assessed using Cronbach's α. SPSS 25.0 and the data were analyzed using AMOS 26.0 software. Results: The SECD-6-K consists of six items in two domains: disease management and health behavior. The results for construct, convergent, and discriminant validity were good. Exploratory factor analysis produced eigen values between 2.27 and 3.28, with factors total explained cumulative variance of 91.1%. Confirmatory factor analysis supported goodness of fit and reliability for the modified SECD-6-K model. The criterion validity also showed significant correlation with both the Patient Health Questionnaire and 12-item Short-Form Health Survey version 2. Finally, reliability was found to be excellent. Conclusion: This study identified the high reliability and validity of SECD-6-K. The SECD-6-K is an appropriate tool for determining Korean patients' self-efficacy in managing their chronic conditions. Therefore, this scale may be used in clinical settings as well as in educational and research settings.

• Health Policy and Management
• /
• v.24 no.4
• /
• pp.312-321
• /
• 2014

Background: To evaluate the quality of chronic care provided by public health centers located in a South Korean metropolitan city using a modified Assessment of Chronic Illness Care (ACIC). Methods: We conducted self-evaluation surveys and collected data using a modified ACIC from twenty five public health centers. Cultural validity of the original ACIC was examined by the public health and nursing science experts. Based on expert reviews, cognitive interviews, pre-test results, five items of the original ACIC that were not relevant were deleted. The response scale was changed from twelve-point Likert scale to Guttman scale but its scoring system was maintained. Results: Eighty eight percent of public health centers in this study reported that their overall quality of chronic care was at a limited or basic level. About 68% of the centers reported that the organization was as reasonably good or fully developed to provide chronic care. On the other hand, 96% of the public health centers reported that the clinical information system was at a very limited or basic support level. The decision support, the integration of Chronic Care Model components, the delivery system design, the community linkages, and the self-management support were evaluated as limited or basic level of support by more than half of the public health centers, respectively. Conclusion: In a metropolitan area of South Korea, quality of chronic care in public health centers was not found to reach acceptable levels of services. It is critical to enhance the quality of chronic care in public health centers.

• Korean Journal of Health Education and Promotion
• /
• v.31 no.4
• /
• pp.25-36
• /
• 2014

Objectives: The self-management of chronic diseases is currently receiving much attention. This study applied an extended technology acceptance model (ETAM) to analyze the factors influencing acceptance of a healthcare smartphone application. Methods: Three hundred people living in Seoul and Gyeonggi who used smartphones were quota sampled. A telephone survey was conducted using a structured questionnaire based on ETAM. A path analysis was carried out using the AMOS 17.0 program, and the model was verified. Results: The analysis revealed significant factors of perceived usefulness (.374, p < .001), enjoyment (.210, p < .001), subjective norms (.168, p < .001), perceived costs (.146, p < .001), and innovativeness (.138, p < .001). Cost directly influenced intention to use health applications; self-efficacy and perceived ease of use indirectly affected intention through innovation and perceived usefulness. Conclusions: This study helped to identify the main factors that influence usage intention of smartphone applications. These findings could contribute to promoting the self-management of chronic disease through future health applications using smartphones.

• Health Policy and Management
• /
• v.26 no.3
• /
• pp.185-194
• /
• 2016

Background: The purpose of this study is to forecast changes in the prevalence of chronic diseases and health expenditure by age group. Methods: Based on the Future Elderly Model, this study projects the size of Korean population, the prevalence of chronic diseases, and health expenditure over the 2014-2040 period using two waves (2012, 2013) of the Korea Health Panel and National Health Insurance Service database. Results: First, the prevalence of chronic diseases increases by 2040. The population with hypertension increases 2.04 times; the diabetes increases 2.43 times; and the cancer increases 3.38 times. Second, health expenditure on chronic diseases increases as well. Health expenditure on hypertension increases 4.33 times (1,098,753 million won in 2014 to 4,760,811 million won in 2040); diabetes increases 5.34 times (792,444 million won in 2014 to 4,232,714 million won in 2040); and cancer increases 6.09 times (4,396,223 million won in 2014 to 26,776,724 million won in 2040). Third, men and women who belong to the early middle-aged group (44-55 years old) as of 2014, have the highest increase rate in health spending. Conclusion: Most Korean literature on health expenditure estimation employs a macro-simulation approach and does not fully take into account personal characteristics and behaviors. Thus, this study aims to benefit medical administrators and policy makers to frame effective and targeted health policies by analyzing personal-level data with a microsimulation model and providing health expenditure projections by age group.

• Proceedings of the Korean Society of Computer Information Conference
• /
• 2020.01a
• /
• pp.271-272
• /
• 2020

Data mining is known useful in medical area when no availability of evidence favoring a particular treatment option is found. Huge volume of structured/unstructured data is collected by the healthcare field in order to find unknown information or knowledge for effective diagnosis and clinical decision making. The data of 5,179 records considered for analysis has been collected from Korean National Health and Nutrition Examination Survey(KHANES) during 2-years. Data splitting, referred as the training and test sets, was applied to predict to fit the model. We analyzed to predict chronic kidney disease (CKD) using data mining method such as naive Bayes, logistic regression, CART and artificial neural network(ANN). This result present to select significant features and data mining techniques for the lifestyle factors related CKD.

• The Journal of the Korea Contents Association
• /
• v.11 no.8
• /
• pp.23-32
• /
• 2011

U-health services have been progressed as treatment and management for specific diseases and prevention services for providing the behavior management to customers according to the increase in chronic patients. The conventional U-health services provide required services and bio-information monitoring only through remote diagnoses and counsels and that represent limitations in preventing and managing metabolic syndrome patients like chronic patients. Thus, in this study a multi platform based U-health service model for managing the health of chronic patients is proposed. The multi-platform based U-health service model can provide continuous health information, diet, and exercise services regardless of the location of customers through PCs and smart phones. In addition, it is able to provide prescription services to doctors and nurses using a CDS (Clinical Decision Support) module based on clinical information. Doctors can identify the life pattern of patients through a behavior modification program and provide customized services to patients. The U-health service model provides effective services in multi-platform environments to customers and that will improve the health of chronic patients.

• Health Policy and Management
• /
• v.19 no.3
• /
• pp.92-108
• /
• 2009

This study suggests a model for continuing and comprehensive management of hypertension or Type 2 diabetes mellitus (T2DM) in Korea. Moreover, this paper computed the contribution cost of hypertension or T2DM management using the healthcare medical cost, which could have occurred from stroke, myocardial infarction (MI), and end-stage renal disease (ESRD) that were successfully prevented from the effective hypertension or T2DM management. Additionally, these costs were compared with the cost of implementing the hypertension or T2DM management model suggested in this study. This study used the medical fee summary of the health insurance claims submitted to National Health Insurance Corporation by medical facilities for services provided during the period from January 1st 1999 to December 31st 2006. The prevalence rate with treatment referred to cases in which patients submitted their medical claims at least once during the period, along with an accordant diagnosis. The incidence rate with treatment referred to cases in which patients who never submitted claims for the accordant disease during the five years from 1999 to 2003 submitted claims for the accordant disease in 2004 and 2005. The relative risk of the occurrence of stroke, MI and ESRD was 11.0, 13.6, and 30.3, respectively. The attributable risk of hypertension or T2DM for stroke was 0.730, and that for MI and ESRD were 0.773 and 0.888, respectively. Based on these, the contribution cost of hypertension or T2DM is estimated to be 986.3 billion Korean Won(KRW) for stroke patients, 330.5 billion KRW for MI patients, and 561.7 billion KRW for ESRD patients as in 2005. Hence, the total contribution cost of hypertension or T2DM to stroke, MI, and ESRD is 1.878 trillion KRW. The estimate for operational costs included an annual expenditure of 50,000 KRW per each recipient and an annual subsidy of 0.22 million KRW per person for the 1.6 million low.income individuals with hypertension or T2DM to cover their out.of.pocket medical expenses. Under this assumption, it took approximately 0.6 trillion KRW to manage 5 million high.risk patients in the low. and mid.income range, coverings up to 50% of costs. In conclusion, considering the potential benefits of preventing stroke, MI, and ESRD, the costs seems to be reasonable.

• The Korean Journal of Health Service Management
• /
• v.10 no.2
• /
• pp.83-97
• /
• 2016

Objectives : This study analyzed the factors that determine the use and type of medical examination services (MES) to develop a model explaining the use behavior of MES which could consequently contribute to policy implications for medical examinations. Methods : Based on Anderson's healthcare utilization model, the MES utilization model was developed by including the perceived needs for MES. The data were collected from an online survey of a population aged 20-39 years and from a telephone survey of a population aged 40 years or older, respectively. Chi-Square tests and hierarchical logistic regression analyses were done with SAS version 9.3. Results : Generally, as health status became lower, the use of MES increased. However, patients with two or more chronic diseases were less likely to use private MES compared to patients with one chronic disease. The perceived needs for MES were only related to the use of service and not to the choice of the MES type. Conclusions : There were different results for the significant determinants between the use of the MES and the choice of the MES type. The healthcare industry needs to aware of consumer needs to provide MES based on empirical findings.