• Title/Summary/Keyword: Fees, medical

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A Study on the Energy Usage Prediction and Energy Demand Shift Model to Increase Energy Efficiency (에너지 효율 증대를 위한 에너지 사용량 예측과 에너지 수요이전 모델 연구)

  • JaeHwan Kim;SeMo Yang;KangYoon Lee
    • Journal of Internet Computing and Services
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    • v.24 no.2
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    • pp.57-66
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    • 2023
  • Currently, a new energy system is emerging that implements consumption reduction by improving energy efficiency. Accordingly, as smart grids spread, the rate system by timing is expanding. The rate system by timing is a rate system that applies different rates by season/hour to pay according to usage. In this study, external factors such as temperature/day/time/season are considered and the time series prediction model, LSTM, is used to predict energy power usage data. Based on this energy usage prediction model, energy usage charges are reduced by analyzing usage patterns for each device and transferring power energy from the maximum load time to the light load time. In order to analyze the usage pattern for each device, a clustering technique is used to learn and classify the usage pattern of the device by time. In summary, this study predicts usage and usage fees based on the user's power data usage, analyzes usage patterns by device, and provides customized demand transfer services based on analysis, resulting in cost reduction for users.

Searching for Ways to Improve Visiting Oral Health Care Services in Korea through Comparison with Japanese System in Long-Term Care Insurance

  • Sang-Hwan Oh;Rumi Nishimura;Soo-Jeong Hwang
    • Journal of dental hygiene science
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    • v.23 no.2
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    • pp.154-168
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    • 2023
  • Background: Legal regulations and fees have been established in Korea to provide visiting oral health care services to individuals with long-term care insurance (LTCI). However, beneficiaries of this service are very limited. Therefore, to improve the Korean system we propose a comparative analysis with the Japanese system. Methods: This study is a descriptive analysis based on secondary data, such as statistics, laws, and service record forms from Korea and Japan. The most recent institutional documents were obtained through a Google search. The variables investigated were financial resources of LTCI, co-payment structure, monthly limit of LTCI benefits, care levels of LTCI, service providers, service costs, contents of service, and the number of cases of service. Results: In both Korea and Japan, LTCI is financed through a combination of taxes and insurance premiums. However, the monthly limit for receiving LTCI services in Japan is about 2.4 times higher than in Korea. Visiting medical and dental treatment is also possible in Japan. Furthermore, nursing staff can provide daily oral health care services according to dental hygienists' instruction unlike Korea. Oral health care services in Korea are focused on oral hygiene and prevention of oral diseases, while Japan additionally provides oral function screening, patient education for oral health management, and training for nursing staff to enhance oral function, eating, and swallowing of the patients. Conclusion: We concluded that the possibility of visiting dental treatment, differences in monthly limit of LTCI benefits, oral function assessment and guidance, as well as collaboration with other healthcare professionals contributed to the difference in the frequency of utilization of visiting oral health care services between Korea and Japan.

Analysis of Hospital Foodservice Management and Health Insurance Coverage of Inpatient Meals in Seoul (서울지역 의료기관의 급식서비스 및 환자식 급여화 현황 분석)

  • Kim, Hye-Jin;Kim, Eun-Mi;Lee, Geum-Ju;Lee, Jung-Joo;Lim, Jung-Hyun;Lee, Jung-Min;Jeon, Hyun-Jung;Lee, Hae-Young
    • Journal of the Korean Dietetic Association
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    • v.16 no.4
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    • pp.378-396
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    • 2010
  • The objectives of this study were to explore hospital foodservice management and to investigate conditions related to health insurance coverage of inpatient meals. A questionnaire was distributed to the nutrition departments of 44 hospitals in Seoul on July 2009. The average kitchen area was 0.5 $m^2$, and centralized distribution systems were in place. Partition walls from contamination zones, separate work tables to prevent cross-contamination, exclusive areas for preparing tube feeding, and split carts with refrigerated and convection heat settings were largely used in tertiary hospitals. Most dietitians did meal rounds (93.2%) and surveyed for patient satisfaction (86.4%). The major theme of QI (Quality Improvement) was menu management (31.8%). The health insurance fees for meals were (won)4,938.9 for a general diet, (won)5,199.8 for a therapeutic diet, (won)4,067.0 for tube feeding, (won)9,950.0 for sterilized diet, and (won)18,383.4 for diets not covered by health insurance. The prices for general and therapeutic diets were significantly lower in hospitals compared to tertiary or general hospitals (P<0.001). The cost composed of 48.3% food, 44.0% labor and 7.7% overhead for general diets and 47.9%, 44.5% and 7.6% for therapeutic diets. In the case of health insurance coverage for patient meals, the number of items applied to general diets averaged 2.8 out of 4 and for therapeutic diets it averaged 1.9 out of 3. To reform the health insurance coverage system for patient meals, it is urgent that the qualified level of patient meals is presented from a national viewpoint, and monitoring should be performed consistently by developing the evaluation tools.

The Past, Present and Future Strategies of Korean Social Work in Hospice and Palliative Care (한국 호스피스.완화의료 사회복지의 과거, 현재 그리고 미래 전략)

  • Lee, Young Sook
    • Journal of Hospice and Palliative Care
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    • v.16 no.2
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    • pp.65-73
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    • 2013
  • The objective of this paper is to suggest future goals and strategies for social work in hospice and palliative care in Korea by understanding its historical background. Both literature review and participant observation were performed to examine historical data relating to social work in hospice and palliative care in Korea. Also reviewed were the current trends with a focus on the roles of social workers in the said arena, qualifications, education, research and medical insurance policy. First of all, the roles of social workers do not appear to be clearly defined in the field of hospice and palliative care, which seems to lead to the lack of recognition as professional workers. The qualification standard for social workers in hospice and palliative care remains inadequate. Second, there seems to be insufficient professional social worker training resources, in terms of both the number of educators and training programs. Third, social workers in Korea produce significantly less publications than those in other professions. There is also a dearth of qualified evidence-based research that is needed to prove benefits of intervention and ultimately for policy implications. Last, the current medical insurance policy needs to be revised to secure fees for social work services and dedicated full-time social workers in hospice and palliative care. Korea needs to approach social work in hospice and palliative care with specific goals to develop future strategies. Related infrastructure and an executive structure should be established via networking and partnership with academic societies, associations and schools.

Study on the Efficient Integration of Long-term Care Facilities and Geriatric Hospitals by Using NHIC Survey Data (실태조사를 통한 장기요양시설과 요양병원의 효율적 연계방안)

  • Choi, in-duck;Lee, eun-mi
    • 한국노년학
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    • v.30 no.3
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    • pp.855-869
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    • 2010
  • The purpose of this study is to identify how to efficiently integrate long-term care facilities into geriatric hospitals. We conducted a survey on the current operations of facilities and medical services of 2009 of 192 long-term facilities and 168 geriatric hospitals in Korea between October and November. Technical statistics and chi-square test were conducted on the collected data using the SPSS 13.0/Win program. There was a difference between the two facility types in terms of the co-payment levels of the food services. Both types selected the budget deficit as their major management problem. Ease of access and the surrounding environment were critical factors used to select the location of both types of facilities. Facility users benefited from the discounted co-payments of both facility types. However, facility users wanted more frequent visits and support from their family members during their stay at the facilities. It was discovered that users in the long-term care facilities stayed longer, that is until they died, compared to their counterparts in geriatric hospitals. The two types of facilities provided their services totally separately to users. Users of the two types of facilities are poorly supported and cared for by their families. This study suggests that setting reasonable service fees, paying caretakers, introducing an integrated facility, strengthening facility assessment standards, introducing the family doctor system, and introducing the handling of long-term care insurance by geriatric hospitals would allow the integration between long- term care facilities and geriatric hospitals to be beneficial.

A Study on Appropriate Nurse Staffing Levels in Intensive Care Units and Improvement of the Critical Care Nursing Fee Schedules (중환자실 적정 간호사 배치수준과 간호관리료 차등제 개선 연구)

  • Lee, Hyo Jin;Cho, Sung-Hyun;Shim, Mi Young;Kim, Jung Yeon;Song, Yu Gil;Kim, Jin;Kim, Young Sam
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.3
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    • pp.312-326
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    • 2023
  • Purpose: This study attempted to analyze the staffing level and critical care nursing fees of intensive care units at tertiary and general hospitals and to provide a professional judgment-based recommendation on staffing level and critical care nursing fee schedules. Methods: Staffing grades and critical care nursing fee schedules for the first quarter of 2017~2020 and the fourth quarter of 2020~2022 were analyzed. A survey was conducted on nursing managers and nurses about the current and appropriate staffing levels. A total of 77 nurse managers and 708 nurses working in Intensive Care Unit(ICU)s at tertiary and general hospitals participated in the study. Results: Grade 1 staffing increased from 25.6% in 2017 to 92.1% in 2022 at tertiary hospitals and from 0.8% in 2017 to 28.4% in 2022 at general hospitals. The current staffing ratios of tertiary and general hospitals were 1:2.21 and 1:2.77, respectively. The appropriate staffing ratio according to nurse managers and nurses was 1:1.00 in patients with more than a ventilator application and 1:2.00 in patients without any ventilator application in tertiary hospitals, and it was 1:1.25 in patients with more than a ventilator application and 1:2.00 in patients without any ventilator application in general hospitals, respectively. Conclusion: The appropriate staffing level was suggested from 1:1.0 to 1:2.0. The new nursing fee schedules were suggested from 1:1.0 (Grade 1) to 1:3.0 (Grade 5) and recommended to be paid based on the staffing grade, minimum number of nurses, and standard annual working days. It is expected to increase staffing levels and provide a better nursing work environment.

Innovative approaches to the health problems of rural Korea (한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案))

  • Loh, In-Kyu
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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A Survey on the Perception of the Counterplans of Medical Accident and Dispute of Dental Hygienist (의료사고 및 의료분쟁에 대한 치위생사의 인식도 조사)

  • Oh, Jin-Ho;Kwon, Jeong-Seung;Ahn, Hyoung-Joon;Kang, Jin-Kyu;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.32 no.1
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    • pp.9-33
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    • 2007
  • In the field of dentistry, there existed relatively few emergency patients or patients who need intensive care and thus had low medical dispute rates. However, these days, there is a general tendency of increased medical disputes. Although many medical disputes are caused by medical accidents of the dentists, because dental assistants are also lawfully involved in practicing dentistry, there is a possibility of medical disputes or medical accidents caused by dental assistants. Therefore, the role of the dental assistants cannot be ignored. This study consists of a survey given to dental hygienists currently working in general hospitals, dental hospitals and private dental clinics. Following is the results of the analysis of 275 respondents' backgrounds, medical disputes rates including patients' complaints, their understanding of medical regulations and their general understanding of overall dental practice and medical disputes. 1. 251 of 274(91.6%) respondents doubted the risk of medical accident and dispute. 2. 81(29.5%) dental hygienist experienced complaint from patients. They have been working in the private dental clinic, the rate of this experience was high. 3. 349 case of 1805(19.3%) the complaints by patients, highest percentage among its category, were those regarding dental fees and poor service. 4. 129 case of 1805(7.1%) patients' complaints, highest percentage among it's subcategory, were those regarding the absence of explanations of precautions or request of agreements before dental treatment. 5. 252 of 267 (94.4%) dental hygienists chart after a scaling treatment. However, only 55(20.7%) dental hygienists chart the fact of explaining the precautions. 6. 6(2.2%) dental hygienists do not inspect patients' medical history, if patients don't mention it. 7. 104 of 274(38.0%) dental hygienists responded to be capable of administering first aid treatment. 8. 115(41.8%) dental hygienists have a first aid kit and equipment. 9. In case of medical dispute, 268(97.8%) dental hygienists respond that, charting plays a big role in resolving the dispute. 10. In case of medical dispute, 272(93.3%) dental hygienists respond that, explanation and agreement before treatment have an important role in settlement of dispute 11. Only 160(58.4%) dental hygienists responded correct answer that the duration of keeping medical records is 10 years. 12. 124(45.3%) respondents thought that it is legal for a dental hygienist to take a panoramic dental X-ray, 71(25.9%) respondents thought that it is legal practice cervical resin treatment by dental hygienist, and 37(13.5%) respondents thought that it is legal extract primary teeth by dental hygienist. 13. 24(18.76%) respondents thought that it doesn't matter to tell patient's state to others 14. 272(99.27%) responded that receiving education for the prevention of medical disputes was needed and of them, 61.0% thought it was urgent. 15. 186(64.2%) has never had classes regarding the prevention of medical disputes while in school and 212(77.4%) has not had the same type of classes after graduating from school. 16. 256(93.4%) responded that there will be even more of an increased number of medical disputes. Among them, 83.3% of respondents though that due to the increased opportunity of acquiring information through the internet and mass media. The study shows that 29.5 percentage of dental hygienists have experienced the medical disputes and complaints and they are lack of recognition of medical regulations and dental hygienist's official duty. So, there is a big potential of the percentage to increase. Therefore, the correct understanding of explaining precautions and requesting agreement before dental treatments and performing them are mandatory. Moreover, classes regarding the prevention and counterplans of medical disputes need to be widely offered.

The characteristics related to the development of pressure ulcers in long term care facilities : the use of 2009 National Patient Sample (요양병원 입원 환자의 욕창 발생 현황과 관련 요인: 2009년 건강보험 환자표본 자료 이용)

  • Moon, Mikyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.7
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    • pp.3390-3399
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    • 2013
  • The purpose of this study was to examine the incidence rates of pressure ulcers depending on the types of healthcare organizations and to determine whether the characteristics of patients and facilities influence on the incidence of pressure ulcers in long term facilities. We analyzed data on 796,857 patients of the 2009 National Patient Sample which was extracted from to claims for medical fees to Health Insurance Review & Assesment Service(HIRA). A total of 3.2% of patients(n=25,339) had at least 1 pressure ulcer during their hospitalization. The pressure ulcer rates were highest in long term care facilities(8.2%, n=11,895) following general hospital(2.7%, n=8,052), hospital(1.7%, n= 5,059). According to logistic regression analysis, urinary incontinence (Odds ratio(OR)=2.462, 95% confidence interval(CI)=2.038-2.974), hypertension(OR=1.456, CI=1.400-1.515), peripheral vessel diseases (OR=1.357, CI=1.200-1.534) were significant predictors of pressure ulcers. As the number of diagnoses, age, and the number of doctors per 100 beds increased, the incidence of pressure ulcers increased. In addition, more number of beds was associated with fewer pressure ulcers.

A Study on the Informal Cost Burden of the Patients Admitted to the Hospital (입원환자의 비공식적 의료비용 부담에 관한 연구)

  • Han, Mi-Hyun
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.1
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    • pp.5-14
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    • 2001
  • To estimate total burden of hospital admission over patient of gamily, we need to know the unofficial private expenses in addition to explicit hospital admission fees. This study was conducted from June 29, 2,000 to August 10, 2,000. Subjects were 104 patient at university hospital located at chungnam province. After thorough explanation of purpose and procedures, notebooks are given to each patient or guardian. They are requested to recorded all relevant expenditures occurred during hospital stay. Incomplete records were filled-up by direct personal contact or phones. Datas were summarized and analyzed using SAS statistical package. P-value less than 0.05 was considered significant. The results of the study are as follows: 1. In 96.1% of the patient, guardians stayed at hospital to take care of patients. In 38,8% one of the family members get work-leave or temporary resting from job. Average date of leave was 7.5days. 2. Average informal cost burden per patient was 204,467 won (14,330 won${\sim}$1,594,870 won). Average hospital cost paid by the patient was 1,061,807 won. The ratio of informal cost burden to hospital cost paid by the patient was 0.327. 3. According to the regression analysis, the relevant factors affection informal cost burdens were distance from home to hospital(p=0.018), and duration of hospitalization(p=0.0001). 4. Informal cost burden was composed of expenses for personal expense of care giver (126, 720 won/patient), meal (86,924 won/patient), transportation (77,648 won/patient), necessaries of life (18,789 won/patient), tests and treatments not covered by insurance (17,289 won/patient), medical supplies not covered by insurance (15,280 won/patient), treat for visitors (14,757 won/patient), TV coin (8,247 won/patient), and others (7,582 won/patient). In addition to the hospital cost paid by the patient for hospital admission, the informal cost burdens should be recognised explicitly because it is not small. Significant proportion of informal cost burden is composed of care-giver's personal expense, transportation, meal. It is suggested that some polices are to be devised and implemented enabling that this portion of informal expenses be directed to formal professional nursing care. Thus we can improve the quality of care and decrease discomfort of patient's relatives.

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