• Journal of the Korean Dietetic Association
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• v.28 no.2
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• pp.67-84
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• 2022

This study aimed to explore the status of food service outsourcing behavior of long-term care institutions (LTCIs) through a cross-sectional survey using a questionnaire administered between July 16th and August 7th, 2020. The survey respondents were either dietitians or facility managers, who worked at 731 nursing homes, 477 group homes, and 673 day-care centers. Approximately 25.9% of nursing homes, 11.7% of group homes, and 33.1% of day-care centers used a managed-services company to operate their food service units. The main reason for outsourcing food service by nursing homes was related to the staffing of dietitians and cooks, whereas group homes and day-care centers outsourced food services due to factors relating to meal costs and the cooking process. Almost all the LTCIs entered into private contracts for outsourced food services. Only a few food service contracts included the types of meals, nutrition standards such as protein and calories per meal, and the parameter or ratio of food cost. Of the respondents, 84.5% from nursing homes, 87.5% from group homes, and 87.1% from day-care centers agreed that the quality of outsourced food services of the LTCIs should be regulated. Meals are essential for maintaining the health and functional status of LTCI users. As more LTCIs outsource their food services, we suggest the following: (1) Increasing the minimum dietitian staffing standards for LTCIs as per the Welfare of Senior Citizens Act and requiring at least one dietitian for every nursing home, (2) Making it mandatory to use a standard food service contract template when drafting food service contract, and (3) Developing realistic standards for food service operations considering the size and operation type of the LTCIs.

• Journal of Preventive Medicine and Public Health
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• v.14 no.1
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• pp.3-12
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• 1981

To identify the changes in professional care patterns after the introduction of medical insurance in Korea, professional care in hospitals and clinics of two succeeding years were compared. The hospitals and clinics selected for this study were those which located in Seoul city. Hospitals were classified into 3 categories: university hospital, general hospital and hospital. The diseases selected for this study were acute appendicitis and normal delivery. They were selected because their disease courses are considered to be fairly stable. The variables used for this study were length of stay, total hospital costs, costs of each components of cares. The information used for this study was obtained from the official forms requested by the medical facilities to the Korea Medical Insurance Corporation. The two periods studied were 3 months of each year from March 1st to May 31st in 1979 and 1980, The total number of normal delivery studied was 289 in 1979, 301 in 1980 respectively and the acute appendicitis was 92 and 111 respectively. In order to compare the quantity of medical care between 2 study periods the insurance price scores of 1979 were converted to prices of 1980. For statistical test of difference between 2 periods T-test and Welch's test were used. The result of the study were briefly summarized in below. 1. No significant difference was observed in the average length of stay of both disease between two study periods in all types of hospitals. 2. No significant difference was observed in the average total hospital costs of both diseases in all types of hospital, but in the private clinic the average clinic costs was rather decreased significantly in 1980. 3. More cost decrease were seen than cost increase in 1980 in all types of facilities, More cost changes by items were seen in acute appendicitis than in normal delivery between two study periods. The total hospital costs can be devided into 2 portions: charges for drug and material and for physician. In normal delivery, costs for physician's charges was significantly decreased in almost all the hospitals and costs for drug and material were not changed significantly in all the hospitals in 1980. In the university hospitals, however, the costs for drug and material were increased significantly in 1980. The cost decrease for physician's charge were mainly due to the decrease in the costs of laboratory test, treatment and physical therapy. The increase in the costs for the drug and material in the university hospitals was mainly due to the increase in the cost for drugs for oral administration and injection. 4. The proportion of components of medical care in the hospital has not been changed significantly, however, the cost for injection in normal delivery was characteristically increased in 1980 in all hospitals studied. In general the proportion of the costs for drug and material was tended to increase and the costs for physician was tended to decrease in 1980. The increase in the costs for drug and material were considered to be due to increase in the cost for drugs for oral administration and injection. The decrease in the costs for physician were due to decrease in the costs of laboratory test, treatment and physical therapy. Above mentioned changes in hospital and clinic care patterns are considered to be mostly influenced by the review criteria set by the K.I.C. for the assessment of the fee request made by clinics and hospitals.

• Health Policy and Management
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• v.6 no.2
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• pp.14-42
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• 1996

On rationale for government intervention is the failure of competition in the market. Health care markets are characterized by such unique aspects as information asymmetry, prevalence of insurance, and cost-increasing competition based on the adoption of costly medical technology. Therefore, government policy to guarantee a sufficient number of providers in markets may not lead to socially beneficisal outcomes such as higher quantity and lower price. This paper examines the unique nature of health services and its implications for competition, the evidence that competition may not reduce health care ex[enditures, and policy tools that government can use to encourage competition which contributes to supporting a sustainable health care system.

• Journal of Korean Public Health Nursing
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• v.13 no.2
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• pp.202-214
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• 1999

This study was conducted to provide the data for the improvement of home health nursing services through the investigation of burden and satisfaction felt by family caregivers under home health nursing care. The study subjects consisted of 200 family caregivers who were enrolled m six university hospital home care services. Data were collected by using constructed questionnaires through mail from March to April of 1999. and analyzed by using t-test. ANOVA, Duncan-test. and Pearson Correlation Coefficients. The results were as follows: 1. The mean score of burden was 2.24. Among the SIX burden dimensions. the highest score was marked in time-dependence dimension. Caregivers were found to have greater burden in the low income families living in flats. In relation to the characteristics of patients. higher scores were shown in the male patients with cerebrospinal diseases. who also revealed higher score of dependency in the Activities of Daily Living. As a whole. there was no significant difference between home nursing care and clinical nursing care in terms of family caregivers' burden. The burden of time-dependence dimension in home nursing care was significantly higher than that of clinical nursing care while the burdens of physical. social. and financial dimensions were significantly lower than those of the clinical nursing care. 2. The mean score of satisfaction was 3.14. Among the six items. the highest score was marked in the nursing care and treatment skill. while the lowest score was marked in the cost containment. Family caregivers with higher academic background and higher income showed higher satisfaction score. The mean score of home care nursmg was significantly higher than that of clinical nursing care.

• Health Policy and Management
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• v.20 no.1
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• pp.37-63
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• 2010

Public expenditures on long-term care are a matter of concern for Korea as in many other countries. The expenditure is expected to accelerate and to put pressure on public budgets, adding to that arising from insufficient retirement schemes and other forms of social spending. This study tried to foresee how much health care spending could increase in the future considering demographic and non-demographic factors as the drivers of expenditure. Previous projections of future long-term expenditure were mainly based on a given relation between spending and age structure. However, although demographic factors will surely put upward pressure on long-term care costs, other non-demographic factors, such as labor cost increase and availability of informal care, should be taken into account as well. Also, the possibility of dynamic link between health status and longevity gains needs to be considered. The model in this study is cell-base and consists of three main parts. The first part estimated the numbers of elderly people with different levels of health status by age group, gender, household type. The second part estimated the levels of long-term care services required, by attaching a probability of receiving long-term care services to each cell using from the sample from current year. The third part of the model estimated long-term care expenditure, along the demographic and non-demographic factors' change in various scenarios. Public spending on long-term care could rise from the current level of 0.2~0.3% of GDP to around 0.44~2.30% by 2040.

• Journal of Preventive Medicine and Public Health
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• v.42 no.4
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• pp.243-250
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• 2009

Objectives : The purposes of this study is to estimate the cost of cancer care after its diagnosis and to identify factors that can influence the cost of cancer care. Methods : The study subjects were patients with an initial diagnosis one of four selected tumors and had their first two-years of cancer care at a national cancer center. The data were obtained from medical records and patient surveys. We classified cancer care costs into medical and nonmedical costs, and each cost was analyzed for burden type, medical service, and cancer stage according to cancer types. Factors affecting cancer care costs for the initial phase included demographic variables, socioeconomic status and clinical variables. Results : Cancer care costs for the initial year following diagnosis were higher than the costs for the following successive year after diagnosis. Lung cancer (25,648,000 won) had higher costs than the other three cancer types. Of the total costs, patent burden was more than 50% and medical costs accounted for more than 60%. Inpatient costs accounted for more than 60% of the medical costs for stomach and liver cancer in the initial phase. Care for latestage cancer was more expensive than care for early-stage cancer. Nonmedical costs were estimated to be between 4,500,000 to 6,000,000 won with expenses for the caregiver being the highest. The factors affecting cancer care costs were treatment type and cancer stage. Conclusions : The cancer care costs after diagnosis are substantial and vary by cancer site, cancer stage and treatment type. It is useful for policy makers and researchers to identify tumor-specific medical and nonmedical costs. The effort to reduce cancer costs and early detection for cancer can reduce the burden to society and improve quality of life for the cancer patients.

• Proceedings of the Korea Contents Association Conference
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• 2017.05a
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• pp.33-34
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• 2017

In 2015, Ministry of Health and Welfare of Korea announced a research and development plan of using Korean healthcare data to support decision making, reduce cost and enhance a better treatment. This project relies on the adoption of BigData technology such as Apache Hadoop, Apache Spark to store and process HealthCare Data from various institution. Here we present an approach a design and implementation of OLAP server in Korean HealthCare BigData platform. This approach is used to establish a basis for promoting personalized healthcare research for decision making, forecasting disease and developing customized diagnosis and treatment.

• The Korean Journal of Health Service Management
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• v.5 no.4
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• pp.161-175
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• 2011

The purpose of this study was to expand the home-based rehabilitation services in the long term care insurance. This study was reviewed on the home-based physical therapy in the OECD. The way of this study was literature search and review. This was to reviewed Proquest, Sciencedirect, SpingerLink, Pubmed. Kew word is "home-based therapy". This was collected 71 articles and final analyzed article was 49. The results were as follows; The article number is seven in Canada, fifteen in USA, five in UK, six in Australia, three in Sweden, five in New Zealand, two in Netherlands, one in Turkey, South Korea, Japan, France, Spain, Italy respectively. Randomized controlled trial is fifty, case-control study is eleven, interview is three, literature review is two, and case report, cost-analysis, cost-effectiveness, pilot study, single blinded parallel design, demonstrative study, survey is one respectively. Physical therapist played an important role in home-based rehabilitation among OECD than nurse. Therefore, we must introduce home-based physical therapy in long term care insurance in South Korea.

• Korean Journal of Adult Nursing
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• v.29 no.3
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• pp.278-289
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• 2017

Purpose: This study was designed to investigate whether there were differences among three oral care protocols on participants' oral health status (oral status, dry mouth, halitosis, saliva pH, microorganism growth in oral cavity) and tooth stain. The three protocols were: 1) oral solution of 4% normal saline, 2) 0.1% Chlorhexidine and 3) Tantum. Methods: A nonequivalent control group pretest-posttest design was utilized. A total of 55 elderly patients residing at long-term care facilities(19 in the 4% normal saline group, 17 in the 0.1% Chlorhexidine group, 19 in the Tantum group) received oral care daily for four weeks. Data were analyzed using SPSS/WIN 22.0 program. Results: The halitosis (${\chi}^2=10.71$, p=.005) and saliva pH (${\chi}^2=6.84$, p=.033) scores were significantly improved after the oral care with 4% normal saline. Conclusion: These findings indicate that if elderly patients in long-term care facilities have complaint of the discomfort of using Chlorhexidine or Tantum, 4% normal saline is as effective at the other two. This can also be cost effective as there were no differences among the protocols in oral status, dry mouth, tooth stain or microorganism growth in oral cavity.

• Journal of agricultural medicine and community health
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• v.20 no.1
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• pp.51-60
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• 1995

This study was to examine the awareness of health and the utilization of primary health care in rural areas. The data were obtained from self-administered questionnaire conducted 450 parents of Mi Gum md Su Dong middle school students in Nam yang Ju city, Kyung Gi-Do, Korea, from December 15 to 20 in 1993. The results were as follows : 1) Among the causes of disease, 'insufficient health care' was the highest(39.1%), and 'bad environment'(28.9%), 'complexity of life style'(17.8%) in next order. 2) In the priority between 'daily farm work' and 'primary health care', only 45.6% of respondents answered that primary health care is more important than the daily farm work. The 29.8% of respondents answered 'daily farm work', and the 23.1% answered 'the equal of the both'. 3) The 63.6% of the respondents recognized correctly, the meaning of primary health care. And the rate of information source in primary health care were 'TV and Radio'(42.2%), 'medical facilities'(23.3%), and 'newspaper and magazine'(11.3%) in order. 4) In the choice rate of medical facilities for primary health care, 'drug store' was the highest(34.9%), and 'local private clinic'(34.7%), 'health (sub)center'(15.8%), 'hospital'(10.2%) in next order. 5) The 53.5% of the respondents had experienced to visit the health (sub)center more than once. And the disfavorite reasons of health (sub)center were 'insufficient equipment'(36.7%), 'inavailable time to visit'(26.9%), and 'poor treatment'(9.1%). 6) Among the preference of the physicians for primary health care, 'specialist' was the highest rate of the respondents(54.2%), and 'general practitioner'(32.4%), and 'family doctor'(9.8%) in next order. The major obstacles in utilizing the medical facilities for primary health care were 'daily farm work'(41.6%), 'distance'(21.1%) and 'medical cost'(10.4%) in order. 7) The weakened reasons in health (sub)center function were 'insufficient medical equipment'(44.4%), 'the lack of resident's understanding for health (sub)center'(21.8%), and 'short thought of duty in health (sub)center personnel'(16.9%) in order.