• 한국치위생학회지
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• 제12권3호
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• pp.503-511
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• 2012

Objectives : This research seeks to present the data needed for the development of coping strategy, following medical market opening by identifying dental hygienists' perspective and coping measures towards the opening. Methods : One hundred eighty-eight dental hygienists were targeted to identify their level of perception towards medical market opening, attitude towards medical market opening, question of whether they agree or not with the opening and reasons, and coping measures and benefits of the medical market opening. t-test, chi-square test and cross-tabulation analysis were used for the analysis Results : First, team leaders are more aware of the medical market opening and hold greater sense of crisis towards opening compared to the rank and file. Second, the reasons cited for agreeing with the medical market opening included improvement of medical services' quality and diversification of services. As for the reasons for disagreeing, they cited the increase medical expenses paid by public. Third, limitation of the hospital management technique was cited the most when it comes to the scope of Korean hospitals' management crisis, followed by the limitations of the diagnosis procedure, limitations of the medical services, limitations of the medical techniques and increase in the number of large hospitals, in the order cited. Fourth, team leaders perceive greater need to seek coping measures from the aspect of realizing medical insurance fee from the policy development, service and system level aspects when it comes to the coping measures depending on their ranks. Conclusions : Therefore, Dental Hygienist has a comparatively low awareness of medical market opening, coping measures need to be explored to cope with the medical market opening by ensuring the dissemination of accurate knowledge through the education on the fees for dental hygienist and seminars in relation to the medical market opening.

• 대한한방내과학회지
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• 제35권3호
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• pp.309-316
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• 2014

Objectives: This study aimed to analyze the status of Kampo medicine services in Japan. Methods: We surveyed the literature or reports regarding health insurance, clinics for Kampo medicine, human resources and medical fees for Kampo medicine services. Results: The Japanese government abolished the system of the Oriental doctor in 1874, but Kampo medicine has been maintained and developed continuously. The national health insurance covers Kampo medicine services including acupuncture and moxibustion, and 674 products of 149 herbal drugs are now involved in items for health insurance. A total of 78 university medical schools or hospitals have Kampo clinics. As of 2012, 1,775 Kampo specialists, 100,881 acupuncturists and 99,118 moxibustion therapists provide Kampo medical services. Conclusions: Japan has a unique system of Kampo medicine which is much different from Korean medicine or traditional Chinese medicine. This study provides basic information about Kampo medicine, and can be useful to establish a globalization-strategy for Korean medicine for Japan.

• Journal of Preventive Medicine and Public Health
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• 제36권4호
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• pp.325-331
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• 2003

Objectives : To analyze medical service utilization and trends among the elderly in the last year of life. Method : The subjects of this study were People that had died at the age sixty-five and above between January $1^{st}$ and June $30^{th}$ 2000 The names of the deceased and their dates of death were collected from the data of the funeral-expenses-receivers of the National Health Insurance Corporation (NHIC). This data was merged with that of the individual medical expenses of the NHIC. Results : In the first half of 2000, 84.2% of the funeral-expenses-receivers (53,063) utilized medical services during the year prior to their death; 51.0% (27,042) were female and 49.0% (26,021) male. In the last twelve months of life, the medical fees, the number of days receiving medical services and the number of days receiving medicine were 3,107,935 Won, 47.88 and 153.21, respectively, for each person. As the age of the groups increased, the level of medical service utilization decreased; the change was more obvious in female group. The level of medical service utilization during the twelve months prior to death drastically increased around the time of death. Conclusions : This study, from an analysis of the level of medical service utilization prior to death, shows a concentrated volume of medical services during a certain time period prior to death.

• 근관절건강학회지
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• 제3권2호
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• pp.166-176
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• 1996

This is a study through survey with the purpose of analysing of treatment cost for arthritis. Treatment cost can be devided Into two characteristics, one is the direct cost and the other is the indirect cost. Direct cost contains fees of medical treatment Including cost of self treatment & purchsing price of herb durg. On the other hand indirect cost means the using money of tansportation, lodging charge & labor-losing-time cost. For the succession of medical treatment of chronic diseases patients have to control themselves to go shopping around for the cure remeadies. And also it is important that the cost for unefficient or probably hamful folk remeadies should be reduced in order to distribute appropriatively the limited financial resources. As the result of this study, the fees for self treatment & herb drug are two times as much as those of regural medical treatment. Within the direct cost, there are the mean cost of regural medical treatment 59,630 won/mon., self-treatment 42,790 won/mon., and herb drug 78,380won/mon. therefore total mean direct cost is 180,800won per month. Moreover patients intermittently pay the cost of prostheses If folk remedies, these are added to the direct cost as above mentioned. Attributes of folk remedies are various from cure & analgesics to nutrients and their virtues as medicine are not clear in view of scientific knowledge. But 56% of arthritis patients have ever been experienced folk remedies. the cost for these remedies has wide ranges from 40,000 won to 1,000,000won. Total mean indirect cost including the transfortation fee, lodging charge & labor-losing-time cost has the range from 82,825won/month to 106,150won/month. Among these cost, labor-losing-time cost has a mojority because the waiting times are too long for seeing a doctor. In conclusion those patients having arthritis have a large burden against the treatment cost for continuous care. Therefore health professional should make effort to guide the patient to determine themselves informed choice about the treatment process.

• 한국병원경영학회지
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• 제23권1호
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• pp.28-40
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• 2018

Purpose: The purpose is to understand the perception of medical providers at tertiary hospitals in Seoul on the importance-performance of the reform on a doctor-designation system, and to provide the policy suggestion of the perception on such a system. Methodology: To achieve the purpose, this study utilized structured survey tools to conduct a questionnaire survey of nursing, administrative and medical technology professionals at six tertiary hospitals in Seoul. An importance-performance analysis was utilized for an analysis that showed the perception of the reform on a doctor-designation system. Findings: First, it was identified that those medical providers had the highest perception of the importance about the performance of the reform on a doctor-designation system. Second, according to the result of action grid of an importance-performance analysis (IPA), it can be identified that in the 2nd stage of 'Concentrate here' included are the items as to design and effect of medical care quality and subsidies & patient infection and safety and control fees, effect of income security of the method for compensating for loss established by the government and offering sufficient information on general medical services and doctor-designation medical services. In the 1st stage of 'Keep up the Good Work', and the 2nd stage of 'Concentrate here' included is the item as to the performance of patients of the reform on a doctor designation system. Practical Implications: There could be identified the effect of the reform bill on the perception of medical providers. It is expected that a better environment would be provided for patients to use a hospital and for medical providers to offer medical services, if the goverment makes efforts to improve methods for compensating for loss and continuous monitoring of the performance of patients.

• 농촌의학ㆍ지역보건
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• 제18권2호
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• pp.121-129
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• 1993

This study was conducted to investigate the incidence and related factors of farming tool-machinery injuries developed in the Chonnam rural area in 1992. A total of 9,068 persons (4,571men and 4,497women)were selected in a stratified cluster sampling manner, and interviewed individually to complete a structured questionnaire covering farmer characteristics, duration of farm working, annual income, kind of farming tools and machinery, type of injuries and medical care. The results were as follows : 1. The incidence rate of farming tool-machinery injuries was 63 per 1,000 persons over all, 73 in males and 54 in females. The age standardized incidence rate was 69 per 1,000 persons over all, 83 in males and 65 in females. 2. The associated factors with farming tool-machinery injuries in univariate analysis were sex, age, duration of farming and monthly income. The occurrence of injuries was higher in men than in woman, and the higher in high-income group than in the low-income group. 3. More men than woman were involved in trunk injuries and treated at the large scale medical care units such as hospitals, and they paid much higher medical fees. 4. The complaint rates for each item of farmers' syndrome in the injured group were higher than those of the non injured group in 'shoulder stiffness', 'sleeplessness', 'dizziness', and 'gastric fullness'. 5. When multiple logistic regression was applied to farming tool-machinery injuries, the significant variables were farmer's syndrome, age, and duration of farming in both males and females.

• 의학교육논단
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• 제24권1호
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• pp.10-17
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• 2022

South Korea is not a wasteland of publicly funded health care-instead, it has a good medical social security system known as the national health insurance (NHI). The NHI of Korea has three unique features; (1) low premiums, low insurance fees, and low coverage; (2) obligatory designation of medical institutions; (3) and allowance of non-benefit services. These features have made hospitals and doctors interested in profit-seeking. However, the commercialization of medical institutions has taken place in both private- and public-established sectors. A basic problem of commercialization is the co-existence of the obligatory designation of medical institutions and non-benefit services. The problem became worse in the Kim Dae-Jung government because it officially permitted non-benefit services. Since 2000, the Korean government has consistently pursued benefit extension policies, but the coverage rates of the NHI have stagnated. In addition, premiums and current medical expenses have markedly increased because policy-makers have emphasized accessibility to the NHI, while ignoring important principles of medical social security such as a needs-based approach and patient-referral system. In order to resolve the commercialization problem, the obligatory designation of medical institutions to the NHI should be changed to a contract system, and non-benefit services should be prohibited at NHI institutions. We must re-establish the patient-referral system via a needs-based approach. We also need to build a primary healthcare system and public health policies. We should make a long-term plan for healthcare reform.

• 간호행정학회지
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• 제18권2호
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• pp.137-145
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• 2012

Purpose: This study was performed to identify the key elements for the improvement of healthcare services for foreigners in Korea. Method: Delphi technique was used for this study. As the members of an expert panel for this study, 32 healthcare professionals, who were physicians, nurses, administrators, and care coordinators, with at least 6 months of experiences in international clinics and healthcare services in five metropolitan areas in Korea participated. Data collections were conducted three times from August to October, 2009. The priority and the importance were analyzed using descriptive statistics in SPSS Win 15.0. Result: The key element selected most frequently by the experts was the 'Healthcare providers' abilities for foreign languages' followed by 'Guidelines for facing medical accidences and disputes', 'Information and guide for healthcare services written in English', 'Informed consent preventing medical disputes', 'System of healthcare service fees for foreigners'. Conclusions: The key elements for the improvement of healthcare services for foreigners in Korea were mostly the requirements for effective communication with the foreign clients and the systemic support. The key elements identified in this study can be applied usefully for the development of strategies to improve the quality of healthcare services for foreigners.

• 대한예방한의학회지
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• 제19권3호
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• pp.77-90
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• 2015

Objective : The purpose of this study is to discuss the role and ways to improve the position and rights of Korean Medicine Doctors (KMDs) working at long-term care hospitals (LTCHs) through survey analysis. Method : (1) The legal and institutional position of KMDs is studied using current law and related papers. (2) The online survey was conducted through KMD community websites, targeted at KMDs working at LTCHs. Results : (1) Whereas there is perceived added benefit for the eight specializations for a specialist of Western medicine at LTCHs, in the case of a specialist of Korean Medicine, their value is not institutionally recognized at all. (2) A Western inpatient's medical fee is more than a Korean inpatient's medical fee, and the individual fee for the same medical treatment is also higher in Western hospitalization. So, Korean medical hospitalization actually cannot be made. Because of that, Korean Medicine Doctors find it difficult to be primary care physicians. (3) Musculoskeletal diseases and the aftereffects of cerebrovascular diseases were the most common chief complaints addressed in Korean medical consultations. Conclusion : This study shows that KMDs working at LTCHs have suffered many kinds of inequality. That is because of the limited medical scope of the current medical system and real constraints from the gap in Korean-Western medical fees by the National Health Insurance Corporation. Therefore, it is necessary to eliminate these variations along with revising the statute with continuous research.

• 한국응급구조학회지
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• 제27권3호
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• pp.47-58
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• 2023

Purpose: The purpose of this study was to analyze the characteristics of patients who canceled their ED visits and to determine the factors that influence ED cancellation. Methods: Retrospective study that analyzed data from the electronic medical records(EMR) and Prehospital Care Reports(PCRs) of 305 patients who cancelled their appointments at a single emergency medical center over a six-month period from October 12, 2022, to April 12, 2023. Results: ED cancellations were 2.287 times higher if the patient presented to the ambulance after outpatient hours(09:00~17:00) (p=.007), and ED cancellations were 3.712 times higher if the patient presented to the ambulance under the influence of alcohol(p=.011). For patients' symptoms, medical diseases were associated with a 1.965 times increase in cancelled ED visits compared to other modes of transport (p=.005), while mental and chronic diseases were associated with a 67.3% decrease in cancelled ED visits compared to other modes of transport (OR=0.327, CI=[0.130-0.822], p=.018). symptomatic improvement was associated with a 2.482 times increase in presentations to a 119 ambulance compared to delayed waiting time(p=.022). Conclusion: Emergency medical centers should consider improving the legal system, such as increasing emergency medical care fees, to reduce the number of patients who cancel their appointments.