• Title/Summary/Keyword: Evidence-based healthcare policy

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Current Practices and Future Directions in Patient Safety Education and Curriculum in Medical Schools (의과대학에서의 환자안전 교육과정 도입을 위한 환자안전 교육현황조사 및 향후 운영방안)

  • Oh, Hae Mi;Lee, Won;Jang, Seung Gyeong;Kim, So Yoon
    • Korean Medical Education Review
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    • v.21 no.3
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    • pp.143-149
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    • 2019
  • In 2018, The Ministry of Health and Welfare announced its first comprehensive plan for patient safety, which included the imperative to develop a patient safety curriculum for students studying to become health professionals. The aim of this study is to assess current patient safety education and points of consideration for introducing new curriculum. An online survey was used to understand the status of patient safety education in medical schools, and key informant interviews and focus group interviews were used to collect qualitative data on the experience of patient safety education. The results of the online survey from 16 out of 40 medical schools (40% response rate) and the qualitative data analysis were integrated and analyzed. Twelve schools (75%) had established courses related to patient safety. The qualitative responses suggest that patient safety education is appropriate both before and after clinical training through a variety of educational methods, and that the topics should be linked with clinical training. The challenge of securing lecture time to address patient safety was mentioned as a realistic obstacle. When patient safety education is integrated in future curriculum, it is necessary to consider it as a priority. Moreover, in the early stages of introducing patient safety education, a step-by-step, policy-based approach is required for seamless adoption and settlement.

Analysis of the Use of Insured Herbal Extracts and Korean Medicinal Treatments in Patients with Allergic Rhinitis : Data from Health Insurance Review and Assessment Service (알레르기 비염 환자의 보험 한약 제제 및 한의 처치 이용 현황 : 건강보험심사평가원 자료 분석)

  • Kim, Jeong-Hun;Ryu, Ji-In;Kang, Chae-Yeong;Hwang, Jin-Seub;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.2
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    • pp.38-52
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    • 2021
  • Objectives : The purpose of this study is to analyze the use of insured herbal extracts and Korean medicinal treatments, which are mainly used to treat allergic rhinitis in Korean medicine. Methods : Among all HIRA(Health Insurance Review and Assessment Service) claims data in 2016, we included all statements that included J30(vasomotor and allergic rhinitis) or a subcategory of J30(J30.0, J30.1, J30.2, J30.3, or J30.4) as the main disease, using the Korean Standard Classification of Diseases(KCD-7). This study analyzed the most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis in Korean medicine. We performed a frequency analysis on subgroups based on treatment type(inpatient or outpatient), sex, age, insurance type, and medical institution type. Results : The result shows the 10 most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis. The total number of insured herbal extracts prescriptions was 82,533, and the most commonly prescribed insured herbal extracts was socheongryong-tang(35,131 prescriptions), followed by hyeonggaeyeongyo-tang(18,157 prescriptions), samsoeum(6,257 prescriptions), and galgeun-tang(4,465 prescriptions). The total number of Korean medicinal treatments prescriptions was 1,878,541, of which the most common Korean medicinal treatments was acupuncture(922,977 prescriptions), followed by moxibustion(372,120 prescriptions), cupping(242,094 prescriptions), and segmental acupuncture(161,553 prescriptions). Conclusions : It is expected that the results of this study can be used as a basis for establishing the priorities of evidence-based clinical research topics in the field of Korean medicine and making health care policy decisions to strengthen coverage in the future.

Prioritizing Themes Using a Delphi Survey on Patient Safety Theme Reports (환자안전 주제별 보고서의 주제 우선순위 설정: 델파이 조사를 통한 분석)

  • Park, Jeong Yun;Shin, Eun-Jung;Kim, Rhieun;Kim, Sukyeong;Park, Choon-Seon;Park, Taezoon;Choi, Yun-Kyoung;Heo, Young-Hee
    • Quality Improvement in Health Care
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    • v.28 no.1
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    • pp.45-54
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    • 2022
  • Purpose: The study aims to identify the theme list and priority criteria of patient safety theme reports in South Korea. Methods: The survey was conducted twice, and the importance of each criterion and theme was measured on a nine-point scale using the Delphi technique by a panel of 19 patient safety experts. The criteria included severity, universality, preventability, and organizational-social impact. Descriptive statistics such as frequency, percentage, mean, standard deviation, median, and interval quartile range were used to analyze the data. Results: The parameters were assigned a weighted average of 35% for severity, 20% for universality, 30% for preventability, and 15% for organizational-social impact, respectively. The final top three rankings were surgery safety, blood transfusion safety, and medication safety. In addition to expert opinion, for the theme that is selected based on the priority ranking, one to five sub-topics can be derived from the theme based on the priority ranking, societal demands, or the yearly priority list of patient safety incidents. Conclusion: It is recommended that the official patient safety center distribute the report in the form of a summary that can be utilized nationwide at medical institutions, government institutions, and other places. Updates, as well as accumulated theme reports, will serve as the baseline data for the proposal of the system and for the policy designed to implement and improve institutions' safety practices as a standard of domestic patient safety practice guidelines.

Fatigue and Fatigue-regulation Behavior in Hemodialysis Patients (혈액투석 환자의 피로와 피로조절행위)

  • Kim, Hye-Won
    • Journal of Digital Convergence
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    • v.10 no.5
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    • pp.301-305
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    • 2012
  • This study was performed to examine the relationship between fatigue and fatigue-regulation behavior in Hemodialysis(HD) patients. Methods: The subjects for this study were 107 patients on HD who were registered in a hospital in Seoul. The data were collected from August 2 to August 14, 2010. The collected data were analyzed by the SPSS WIN 12.0 program. Results: The mean score of fatigue was 77.1 which means their experience of high level fatigue. Frequency of the fatigue-regulation behavior and the mean of efficiency of the fatigue-regulation behavior was 8.8 and 22.8. Positive correlation was found between fatigue and fatigue-regulation behavior (r=.45, p=.000). Conclusion: It is considered that the study emphasizes for the healthcare providers to recognize fatigue as the important nursing issue for HD patients. And it is necessary to develop an evidence-based nursing intervention program for regulating fatigue in HD patients.

A Study on the Policy Implication on the Management of Narcotics Distribution for Medical Use (의료용 마약류 유통 관리에 대한 고찰과 정책적 함의: 유통자료 및 청구자료 분석을 중심으로)

  • Yu, Su-Yeon;Cho, Hyunmin;Kang, Hyeun Ah;Kim, Sukyeong
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.4
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    • pp.280-285
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    • 2015
  • Objectives: To suggest direction for improving policies by understanding current management of narcotics or psychotropic drugs and analyzing their distributions and usage. Method: We conducted a comparison analysis between health insurance claims and the amount supplied to health care institutions for narcotics or psychotropic drugs through health insurance claims data and drug distribution supply data from 2010 to 2012 collected from Korea Pharmaceutical Information Service Center (KPIS). Furthermore, we carried out literature investigation and online search to comprehend the current management of narcotics drugs in Korea. Results: The amount supplied to medical institutions for all drugs in 2012 was 19.4 trillion won, which increased from 19.5 trillion in 2011 by 0.54%. For narcotic drugs, the amount supplied was 318.4 billion won in 2011 and increased to 335.1 billion won by 5.3% in 2012, which exceeded the rate of increase for the amount supplied for all drugs. The proportion of amount claimed in the total amount supplied to medical institutions for all drugs was 60.5% in 2012, whereas the proportion of amount claimed for narcotic drugs was 55.6%, which showed that narcotic drugs were used relatively less within health insurance. Furthermore, management of the current domestic distribution supply data focuses on manufacturing and medical institution supply stages. Conclusion: Hereafter, the management of narcotics or psychotropic drugs needs to be improved by reinforcing active monitoring in optimal prescription and usage in patients by collecting and analyzing information on drug usage of patients.

A Study on the Analysis of Nurses' Perception of the Fourth Industrial Revolution and the Importance and Performance of Future Core Nursing Competencies in a Tertiary Hospital (일 상급종합병원 간호사의 4차 산업혁명에 대한 인식 및 미래핵심간호역량 중요도-실행도 분석)

  • Kwon, Chi Hye;Kim, Mi Soon
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.1
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    • pp.95-106
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    • 2023
  • Purpose: This study is descriptive survey research on the analysis of nurses' perception of the 4th industrial revolution and the importance and performance of future core nursing competencies in a tertiary hospital located in Seoul. Methods: Data were collected from 149 nurses with more than a year of work experience and analyzed using descriptive statistics, t-test, one-way ANOVA, and Importance Performance Analysis(IPA) with the IBM SPSS/WIN 25.0 program. Results: The nurses' perception of the 4th industrial revolution was 3.23±0.71 out of 5 points. The importance of future core nursing competencies was 4.31±0.48, and the performance of it was 3.47±0.54. The analysis results of IPA showed that A (area of continuous maintenance) included critical thinking, problem-solving skills, teamwork and collaboration, evidence-based practice, communication, quality improvement and safety, professionalism, self-regulation and self-management, and personal literacy. The specific competencies were not included in B (area of priority improvement). Creativity, informatics, healthcare policy, leadership, research ability, and continuing education were included in C (area of progressive improvement). Knowledge and patient-centered care, ability to manage resources as well as professional, legal, and ethical responsibility were included in D (area of overinvestment). Conclusion: The nurses seemed not to be fully prepared for the 4th industrial revolution. However, they were well aware of the importance of the future core nursing competencies. Therefore, if nurses increase the performance of core competencies in order of priority according to the IPA results, they will be able to independently lead the changing nursing field.

Estimation of Supply and Demand for Cardiologists in Korea

  • Mira Kim;Kyunghee Chae;Ju Mee Wang;Arum Choi;Jang-Whan Bae;Keon-Woong Moon;Sukil Kim
    • Korean Circulation Journal
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    • v.54 no.1
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    • pp.1-12
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    • 2024
  • Background and Objectives: The objective of this study was to estimate the supply and demand for cardiologists in Korea and provide evidence for healthcare policy to ensure a stable and adequate workforce for optimal cardiovascular disease management. Methods: Past trends of inflow and outflow of cardiologists were used to make crude projections, which were then adjusted based on demands of services to obtain final projections. Inflow of cardiologists was estimated using second-order polynomial regression and demand for cardiology care was estimated using linear regression. Results: There were 1,139 active cardiologists who were under the age of 65 in clinical practice in Korea. The estimated number of cardiologists from 2022 to 2040 showed that the number of cardiologists would peak at 1,344 in 2032 and gradually decrease thereafter. We also estimated an increase of 947,811 cases of heart-related procedures annually from 2023 to 2032. The number of heart-related procedures per cardiologist would increase 1.4 times from 12,964 in 2023 to 17,862 in 2032. The estimated number of emergency patients per cardiologist under 50 years old would almost double from 544 in 2022 to 987 in 2032. Conclusions: We expect significant shortage of cardiologists in Korea within the next 10 years. The number of emergency patients per cardiologist will increase by nearly 50%, leading to high individual workload for cardiologists. To prevent this imbalance between supply and demand, an organized and collective approach by the specialty of cardiology is imperative to produce a balanced workforce.

A Study on the Spacial Environment Satisfaction for Evidence Based Design of Rehabilitative Health-Care Facilities -convergent approach for patient-centered rehabilitative healthcare service (근거중심 재활 공간 디자인을 위한 공간 환경 만족도 연구 -환자 중심 재활의료서비스를 위한 융복합적 접근)

  • Lee, Nakyung;Suh, Dasom;Song, Kyungeun
    • Journal of Digital Convergence
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    • v.15 no.10
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    • pp.327-337
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    • 2017
  • The purpose of this study is to investigate patient satisfaction for the spacial environment of the rehabilitative facilities, and by this to examine areas of patients' needs to develop patient-friendly improvement in spacial environment. 308 patients were surveyed at physical therapy centers of 6 hospitals or rehabilitative institutions in Daejeon with patient satisfaction questionnaire. The spatial environment satisfaction was categorized into 7 constructs and the data were statistically analyzed and compared by t-test and ANOVA according to the patient characteristics. As a result, inter-floor transfer was found to be the area with the least satisfaction, especially in the in-patient group. Locating floor level was the second lowest satisfied construct. Comfort was relatively highly satisfied construct overall, but patients with neurological disease had less satisfaction than with musculoskeletal disease. Patients in 20's were less satisfied in wayfinding than 60's. Satisfaction for interior design was lower in subject in 50's than 70's. These findings can be used as evidences to improve spacial environment design for rehabilitative facilities to the better patient satisfaction.

Factors Associated with the Non-Use of Beneficiaries of Long-Term Care Insurance Service: The Case of Jeollanam-do Province (노인장기요양보험 인정자의 미이용 관련요인 분석: 전남지역을 대상으로)

  • Kuk, Kyung-Nam;Kim, Roeul;Lim, Seungji;Park, Chong-Yon;Kim, Jaeyeun;Chung, Woojin
    • Health Policy and Management
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    • v.24 no.4
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    • pp.349-356
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    • 2014
  • Background: This study aimed to explore factors associated with the non-use of beneficiaries of long-term care insurance services for the elderly in Jeollanam-do Province by analyzing a dataset obtained from National Health Insurance Service. Methods: The study sample consists of 1,663 individuals who were evaluated as eligible for long-term care insurance services in Jeollanam-do Province during the period of July 1, 2008 through June 30, 2009. As a dependent variable, the non-use of the service was defined as one when a beneficiary had used it once or more times during one year after he or she was evaluated as eligible and as zero otherwise. A proportion analysis was conducted to describe characteristics of study sample. Chi-square tests were used to compare general characteristics between beneficiaries who had used the services and those who had not used them. Multiple logistic regressions were performed by three models including additional sets of explanatory variables such as socio-demographic characteristics, health conditions, and economic status. Results: Main results are summarized as follows. The proportion of beneficiaries who had not used the service was 14.5% of all beneficiaries. According to the results from the model using all explanatory variables, the factors associated with the non-use of the services were residence location, dwelling place, type of desired service, level of care needs, and instrumental activities of daily life limitations. Conclusion: In particular, regarding the type of desired service, the cash benefit showed a high likelihood of the non-use of the service; it had an odds ratio (OR) of 50.212 (95% confidence interval [CI], 24.00-105.04) compared with home service. In case of dwelling place, a hospital showed also a high likelihood of the non-use with an OR of 20.71 (95% CI, 10.12-42.44) compared with home.

The cost of end-of-life care in South Korea (사망자의 생애말기 진료비의 양상 - 건강보험자료를 이용한 접근 -)

  • Shin, Hyun-Chul;Choi, Mi-Young;Tchoe, Byong-Ho
    • Health Policy and Management
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    • v.22 no.1
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    • pp.29-48
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    • 2012
  • The purpose of this study is to analyze medical expenses by decedents in their last year of life and compare them with those by survivors during the year 2008. This study is conducted firstly in Korea, except some studies focusing on medical cost of decedents from specific diseases. To study this, national health insurance(NHI) claims data was used with medicaid claims data. The study group(decedents) was selected from the insurance entitlement file who were dropped out from January to December of 2008. The control group(survivors) was selected from the entitlement file by stratified sampling with keeping age-sex composition of the study group. The medical expenses of decedents during one year before death were measured and compared with those of survivors by sex and age. And the medical expenses were analyzed by causes of death, and also the expenses were examined by each item of medical services. On average, the medical expense amounted to 11 million Korean Won per decedent during their last year of life in 2008. The medical expense per decedent was 9.3 higher than that of survivor. The death-related expense of under the age 35 was about 16 million Won, compared with 4 million Won in the case of over the age 95, in average. The death-related expense is higher in younger ages. This means that more medical resources are put in to save life in younger ages. Total death-related expenditure took 8.3 percent in total NHI expenditures. Of the death-related medical expenses, the largest one was injection-related cost which shares twenty five percent, and the second largest one was hospitalization charges, and then the third one was surgery cost. The results of this study suggested that we should pay attention to the medical expenses in the last of year of life when we study health care expenditure in Korea. In addition, we have to deliberate health care policy to cope with medical expenditures before death in more efficient way.