• Title/Summary/Keyword: Economic Burden

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The Health Belief Model - Is it relevant to Korea?

  • Lee, Mi-Kyung;Colin William Binns;Kim, Kong-Hyun
    • Korean Journal of Health Education and Promotion
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    • v.2 no.1
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    • pp.1-19
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    • 2000
  • With rapid economic development, the emphasis of the public health movement in Korea has shifted towards addressing the burden of chronic disease. With this shift in direction comes a greater focus on health behaviour and the need for planning models to assist in lifestyle modification programs. The Health Belief Model (HBM), which originated in the US, has generated more research than any other theoretical approach to describe and predict the health behaviour of individuals. In recent years it has been applied in many different cultures and modifications have been suggested to accommodate different cultures. Given the centrality of language and culture, any attempts to use models of health behaviour developed in a different culture, must be studied and tested for local applicability. The paper reviews the applicability and suitability of the HBM in Korea, in the context of the Korean language and culture. The HBM has been used in Korea for almost three decades. The predictability of the HBM has varied in Korean studies as in other cultures. Overall, this literature review indicates that the HBM has been found applicable in predicting health and illness behaviours by Korean people. However if the HBM is used in a Korean context, the acquisition of health knowledge is an important consideration. Most new knowledge in the health sciences is originally published in English and less frequently in another foreign language. Most health knowledge in Korea is acquired through the media or from health professionals and its acquisition often involves translation from the original. The selection of articles for translation and the accuracy of translation into language acceptable in the Korean culture become important determinants of health knowledge. As such translation becomes an important part of the context of the HBM. In this paper modifications to the HBM are suggested to accommodate the issues of language and knowledge in Korea.

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Treatment Patterns, Costs, and Survival among Medicare-Enrolled Elderly Patients Diagnosed with Advanced Stage Gastric Cancer: Analysis of a Linked Population-Based Cancer Registry and Administrative Claims Database

  • Karve, Sudeep;Lorenzo, Maria;Liepa, Astra M;Hess, Lisa M;Kaye, James A;Calingaert, Brian
    • Journal of Gastric Cancer
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    • v.15 no.2
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    • pp.87-104
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    • 2015
  • Purpose: To assess real-world treatment patterns, health care utilization, costs, and survival among Medicare enrollees with locally advanced/unresectable or metastatic gastric cancer receiving standard first-line chemotherapy. Materials and Methods: This was a retrospective analysis of the Surveillance, Epidemiology, and End Results-Medicare linked database (2000~2009). The inclusion criteria were as follows: (1) first diagnosed with locally advanced/unresectable or metastatic gastric cancer between July 1, 2000 and December 31, 2007 (first diagnosis defined the index date); (2) ${\geq}65$ years of age at index; (3) continuously enrolled in Medicare Part A and B from 6 months before index through the end of follow-up, defined by death or the database end date (December 31, 2009), whichever occurred first; and (4) received first-line treatment with fluoropyrimidine and/or a platinum chemotherapy agent. Results: In total, 2,583 patients met the inclusion criteria. The mean age at index was $74.8{\pm}6.0years$. Over 90% of patients died during follow-up, with a median survival of 361 days for the overall post-index period and 167 days for the period after the completion of first-line chemotherapy. The mean total gastric cancer-related cost per patient over the entire post-index follow-up period was United States dollar (USD) $70,808{\pm}56,620$. Following the completion of first-line chemotherapy, patients receiving further cancer-directed treatment had USD 25,216 additional disease-related costs versus patients receiving supportive care only (P<0.001). Conclusions: The economic burden of advanced gastric cancer is substantial. Extrapolating based on published incidence estimates and staging distributions, the estimated total disease-related lifetime cost to Medicare for the roughly 22,200 patients expected to be diagnosed with this disease in 2014 approaches USD 300 millions.

Comparison of Multiple Chronic Obstructive Pulmonary Disease (COPD) Indices in Chinese COPD Patients

  • Zhang, Jinsong;Miller, Anastasia;Li, Yongxia;Lan, Qinqin;Zhang, Ning;Chai, Yanling;Hai, Bing
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.2
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    • pp.116-122
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    • 2018
  • Background: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations. Methods: Toward this end, this study compared the relative effectiveness of six indices in predicting patient healthcare utilization, cost of care, and patient health outcome. The six assessment systems evaluated included the three multidimensional Body mass index, Obstruction, Dyspnea, Exercise capacity index, Dyspnea, Obstruction, Smoking, Exacerbation (DOSE) index, and COPD Assessment Test index, or the unidimensional measures that best predict the future of patient healthcare utilization, cost of care, and patient health outcome among Chinese COPD patients. Results: Multiple linear regression models were created for each healthcare utilization, cost, and outcome including a single COPD index and the same group of demographic variables for each of the outcomes. Conclusion: We conclude that the DOSE index facilitates the prediction of patient healthcare utilization, disease expenditure, and negative clinical outcomes. Our study indicates that the DOSE index has a potential role beyond clinical predictions.

Blindness Experience of Family of Persons with Unilateral Acquired Blindness (일측 중도시각장애인과 가족의 체험연구)

  • Kim, Kyung Ran
    • Korean Parent-Child Health Journal
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    • v.18 no.2
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    • pp.47-57
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    • 2015
  • Purpose: The purpose of this study is to discover the nature from the life experience of a person with unilateral acquired blindness and his/her family after losing the eyesight and adapting in the environment and to find the meaning of life and how to solve the problem in psychosocial aspect. Methods: This study uses one of the qualitative research methods which explains how families with the unilateral acquired blind perceive blindness after experiencing it and observes how they signify it. starts with interest in lifestyles of individuals and their families and tries to understand the subjective existences of participants in accessible ways and draw the experiences after becoming one-side blind. It cyclically uses deductive verification process through inductive method and establishing hypothesis using materials. Results: According to the results of this study, unilateral acquired blindness studies, due to shattered life, they did not know what to do. Also, discomfort from struggling in a big tunnel and even will to live were found. trying to go out to the world, seeing the new world, and trying to encourage myself, strong attachment to life was shown to by saying, appeared. Each includes sub-topics such as feeling abandoned after confirmed the blindness, feeling disappointed to doctors, family, and friends, trying to live with hope, struggling in a tunnel with thinking how to live, closing the mind from the world, seeing outside the world in the midst of struggling, trying to forget the past with the will of life, having hope to live with care of family, and trying to keep the rest vision. Conclusion: Firstly, in nursing aspect for their adaptation, programs for disable people and nursing intervention focused on their families should be developed. Secondly, since it can be economic and psychological burden for their families and acquaintances, it is necessary to support the blind so that they can find fitted rehabilitation programs and come back to society. Thirdly, active participation of health care providers may influence social interest the improvement of national welfare policy for the unilateral acquired blind.

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Factors Related to the Unmet Dental Care Needs of Adults with Dental Pain (구강 통증을 경험한 성인의 미충족 치과의료 관련 요인)

  • Ahn, Eunsuk;Shin, Myong-Suk
    • Journal of dental hygiene science
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    • v.16 no.5
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    • pp.355-360
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    • 2016
  • The purpose of this study was to examine unmet dental care needs and related factors among adults in Korea. The study included a nationally representative sample of Koreans (Korea National Health and Nutrition Examination Survey 2104). The dependent variable was unmet dental care need and the independent variables were socioeconomic status and oral health status. The chi-square test and logistic regression analysis were performed to identify the associations between explanatory variables and unmet dental care needs. The major causes of unmet dental care needs included economic burden, work life, and academic reasons; in addition, dental treatment was considered to have lower priority. The factors that had statistically significant relationships with unmet dental care needs were sex, age, self-rated oral health status, and difficulty in mastication. The findings of the study, suggest a need for lower dental insurance copayments in keeping with the policies and principles aimed at strengthening the national health insurance system. In addition, groups with limited access to dental services should be identified, and effective health care policies and services should be established for these individuals.

ICT-based Smart Farm Design (ICT 기반의 스마트팜 설계)

  • Shin, Bong-Hi;Jeon, Hye-Kyoung
    • Journal of Convergence for Information Technology
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    • v.10 no.2
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    • pp.15-20
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    • 2020
  • In this paper, we propose an ICT-based smart farm design. At present, the decrease in rural population is naturally inevitable due to the decrease of the total population. The economic burden on each farm grows with increasing labor costs. As a solution to this, the necessity of spreading smart farms using computing resources is emerging. The proposed system utilizes the ICT technology emerging from the Fourth Industrial Revolution. We will use big data analysis to collect a large amount of data and propose a platform for managing collected data and providing efficient services. The proposed platform consists of SOA service layer, middleware layer, resource pool layer and physical resource layer. ICT-based smart farm service can reduce costs and be easy to install and manage because ICT-based smart farm service provides only necessary functions from the user's point of view.

A Literary Review of Day- Hospital for Psychiatric Patients (낮병원에 관한 문헌적 고찰 - 정신질환 환자를 위한 -)

  • 유숙자
    • Journal of Korean Academy of Nursing
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    • v.7 no.1
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    • pp.55-62
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    • 1977
  • Varieties of literatures were reviewed in regard to the fundamental concept of day hospital, historical trends, the recipient of its care, facilities and personnel, therapeutic programmes and the follow-up care plans. Through the research the advantages of day hospital were highlighted in order to provide the reference for those who consider planning such health care institution. Since the introduction of the concept of day hospital and its implementation in 1930, many psychiatric patients world over are treated and cared. Patients with specific health problems ; alcoholism, acute or serious psychiatric disease, tendencies of humidor suicidal attempts, and with serious physical problems were excluded from the general recipient. Day hospital were annexed to the psychiatric hospitals in most in instances ; facilities, personnel, except nursing personnel, were shared. All therapeutic care were planned in daley, weekly programmes, and were focussed on socialization. The follow-up care were provided for those participating post- therapy club activities which were planned and introduced ahead. Many advantages of day-hospital care in contrast to the traditional hospitalization care were found: 1. The abrupt discontinuity of his family and other social role is prevented. 2. Therapeutic progress is faster. 3. Lessened economic burden to the family. 4. Behavioral regression is lessened and the lessened fear of hospitalization. 5. Less injury to the patients, self- respect, through lessened anxiety of hospitalization. 6. Incidents of secondary crisis believed to be existing in long term cases are decreased. 7. Therapeutic care implemented in freer atmosphere, better Patient-personnel relationships are created. 8. Varieties of group activities are Induced which enable faster recovery. 9. Patients could engage himself with social activities including getting job on part-time basis. 10. Rehabilitation of patient could be implemented.

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Consumer Satisfaction with Paid Caregiving in General Hospitals According to Type of Paid Caregiver (종합병원 유료간병인 이용행태에 따른 의료소비자의 만족도)

  • Chung, Kyung-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.10 no.3
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    • pp.375-386
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    • 2004
  • The purpose of this study was to identify the present use of caregiver services, to evaluate the degree of satisfaction with the services according to type of caregiver service, private or public, and to provide data for the development of a plan which will provide good quality service with less economic and psychological burden to the patients and their families. Survey data were collected from 130 patients in 4 general hospitals in Seoul, and their families. Data were collected during April, 2004, using a questionnaire which included the patient satisfaction scale developed by Jun (2001). Data were analyzed using frequencies, percentages, means and standard deviations, $X^2$ analysis, t-test. The SPSS computer program was used to facilitate analysis. The results of this study are summarized as follows; The total score for satisfaction was high for both groups. For the private caregiver group it was $52.38{\pm}11.08$, and for the public caregiver group, $58.14{\pm}9.64$. This difference was significant(t=-3.391, p=.001). In all of areas, the scores for satisfaction of the public caregiver service group were higher than private caregiver service group, ie. caregivers' attitude, role, confidence, performance, and service charge, and all the differences were significant. In conclusion, it was found that long-term hospitalization of older patients with high dependence resulted in more caregiver service. There were more severe patients in the public caregiver group, but the service charges, additional costs and paid holidays were less. Based on these results, patients and their families were significantly more satisfied with public caregiver service because it was not only less expensive but also had a high quality of service. Thus, caregiver services should be systemized so that patients and their families will get the best quality caregiver service

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A Scheme of Compensation System for Farmers' Accidents through the Example of Germany (독일의 사례를 통해 본 농업인재해 보장체계 구축 방안)

  • Min, Byeong-Wook;Kim, Hyo-Chel;Lee, Kyung-Suk
    • Journal of Agricultural Extension & Community Development
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    • v.18 no.3
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    • pp.351-384
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    • 2011
  • The purpose of this study is to look at the case of the German compensation system for farmers' accidents and to build a basic scheme in our country's compensation system for farmers' accidents. When you view examples of Germany, the social insurance scheme for farmers accidents in korea should be design as an independent institution from the existing industrial accident insurance, and it comes to relationships with other social insurance system, preferably with complementary personalities. A general rule of the compensation system applies to all farmers in principle but the coverage limits part-time farmers. Financial burden consists of the mix of insurance premium and state aid. The type and level of benefits is similar to the current industrial accident insurance, which give priority to places on economic security for keeping farmworks, such as cost for using temporary farmers, rather than income loss. In terms of financial system, pay-as-you-go system would be better because of immediate payment with the introduction of the compensation system. The compensation system might be managed and administrated by the existing nationwide organization. Of course, for operating of system review and further research on the technical details such as premium issues and funding problems of government support, the exact classification of the target coverage, premiums based on estimated income for the farmers' estimation, the exact statistical data on the accumulation of agricultural disaster is needed.

Factors Affecting the Need for and Utilization of Medical Care In Urban Areas (도시지역 의료요구와 의료이용에 미친 제요인 분석)

  • 송건용;김홍숙
    • Korea journal of population studies
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    • v.5 no.1
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    • pp.167-186
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    • 1982
  • Financial barrier is well known as a determinant of the perceived need for and utilization of medical care in urban areas. This study aims to; a) estimate the levels of the perceived need for and utilization of medical care, b) analyze the reasons for not receiving medical care, and c) determine factors affecting the levels of need and utilization, and major reasons for not receiving medical care. The data of household interview survey in urban areas collected for a National Survey on Reorganization of Nationwide Health Care Delivery Network is used. An interview was conducted with a total of 2, 538 households in urban areas during a 28 day period of October through November, 1981, giving an overall response rate of 99 percent. The results show a factor of third-party payer is most influential to utilization (physician visits by patient), and living standard is a determinant to explain the variance of major reasons for not receiving medical care. Therefore, financial burden is still a major determent in utilization of medical care in urban areas. Improved level of living standard and expanded coverage of the third-party payer such as health insurance and public medical assistance will increase both an overall levels of utilization of and the need for medical care in urban areas in the future. The major statistics are as follows; a) rate of the need for medical care during a 15 day period per 100 persons was 33 percent: the differential rates appeared in sex, age, living standard, and third- party payer variables, b) percent of treatment employed per 100 persons who are wanting medical care was 82: the percents were high in young ages, high levels of living standard and education, and persons covered by third-party payer, and c) economic reasons for not receiving medical care per 100 persons who are wanting medical care were occupied with 60 percent: the rates are high in old ages, low levels of living standard and persons not covered by third-party payer.

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