• Title/Summary/Keyword: Health Care Cost

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Chronic Physical Comorbidities and Total Medical Costs in Patients with Schizophrenia (조현병 환자의 동반 만성신체질환 현황 및 총 의료비용에 관한 연구)

  • Lee, Sang-Uk;Lee, Ye-rin;Oh, In-Hwan;Ryu, Vin;Goo, Ae-Jin;Kim, You-Seok
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.26-34
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    • 2018
  • Objectives : This study tried to explore the prevalence of chronic physical diseases in patients with schizophrenia and its effects on total medical costs. Methods : The Health Insurance Review and Assessment Service data in 2014-2015 was employed. Only the injuries and diseases, identically diagnosed 3 times or more as a major or minor injury and disease, were classified into chronic physical diseases to improve data accuracy. Total medical costs included out-of-pocket and insurer's costs from health care system perspective. Results : It was shown that 24.5%, 17.3% and 23.4% of schizophrenia patients had one, two and three or more chronic physical diseases, respectively. There was a high prevalence of not only metabolic, but also musculoskeletal, diseases in those patients. The amount of 2015 total medical costs of patients with schizophrenia in 2014 was about 1.08 trillion won. The factors affecting the costs included sex, age, number of chronic physical diseases, and health insurance status. Conclusions : It is considered that clinical practice guidelines based on personal diseases may not sufficiently solve the problems for comorbidities in schizophrenia patients. Accordingly, it should be required to develop models for new types of medical systems capable of treating and caring varied illnesses at the same time.

A Study on the Utilization Level of Traditional Medicine by Residents - On the basis of Use of Folk Medical Techniques - (주민(住民)의 전통의술(傳統醫術) 이용도(利用度) 조사연구(調査硏究) - 민속요법(民俗療法) 이용(利用)을 중심(中心) 으로 -)

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.13 no.1
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    • pp.3-18
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    • 1988
  • The general objective of this research is to study behavioral pattern of health care utilization and to measure the level of utilization of the traditional medicine. The specific objective is to study utilization pattern and content of folk medicine which is the indegenous medical technology recognized part of traditional medicine. This research was under taken to generate valid information that will provide basis data for formulating general direction for health education activities and for designing service package for general population. A social survey method was employed to obtain required information for the research activities, The survey field team consisted of 20 surveyors who all participated is an intensive 2 day training course. A total of 3091 households were visited and interviewed by the field team during the period 7 September to 6 October 1987. The major findings obtained from the information collected by the field survey are as follows ; 1) General characteristics of the study households 2562 households out of 3091 households visited were selected for final data process, 80.2 of the selected households were nuclear families ; 17.4%, extended families ; others 2.4%. Only 4.3 percent of the study population in the urban households indicated "no schooling" whereas 14.2% of the rural household members falls within this category. Study population in the urban areas are more protected against diseases by the national medical insurance system than those in rural areas. In their self appraisal of living standard, those who responded with low group are 39.6% and 50.3% respectively by urban and rural households. 2) Morbidity status Period prevalence rate for all diseases during the preceding 15 days before the date of the household interview v as 243,0 per 1,000 study population. For cases with the illness duration of within 15 days, the initial points of medical entry were diversied ; 56.9%, drug stores ; 30.9%, clinics and hospitals ; 4.6% folk medicine ; 1.7% clinics of Korean oriental medicine. Among the chronic case; with illness duration of over 90 days, 34.6% of these people utilized clinics and hospitals of modern medicine ; 31.6%, drug stores ; 18.6% clinics of Korean oriental medicine ; 6.8% folk medical techniques. Noticeable is the almost ten fold increase from the mere 0.9% in the utilization of Korean oriental medicine, whereas in the utilization of folk medicine, it is short of two-fold increase. 3) Folk medicine and its utilization Households that use folk medicine for relief and care of signs and symptoms commonly encountered in daily life, number 1969 households, which accounts for 76.9% of all the study households. This rather high level use of folk medicine is not different from rural to urban areas. The order of frequency of utilizing folk medicine among the study people are : the highest 14.3% for the relief of indigestion ; 8.6% for burns ; 5.1% for common cold ; 4.7% for hiccough ; and 4.2% for hordeolum. A present various procedures of folk medicine is being used to relieve all kinds of symptoms. 192 symptoms are identified at present. The most frequently used procedures of folk medicine appear to be based either on principles of the Korean oriental medicine or of scientific knowledge. Based on these survey findings, proposals for utilizing folk medicine are as follows First, this survey's findings will be feed back to both on the job training and on the spot guidance of community health practitioners, public health nurses and other peripheral work force in the health field, who are in daily contacts with community. This feed back will assure that the health personnel carry out their health education and information activities that are based on the utilization pattern of folk medicine as found in the survey result. Second, studies will be soon implemented that are designed to measure the efficiency and potency of these procedures and to improve these procedures of folk medicine were most frequently used by the community. Third, studies will continue to systematize medicinal plants and skills of Korean oriental medicine that are easily available at minimal cost in daily life for the prevention of diseases and management of emergency cases.

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A study on subjective awareness and expectations of implant patients (임플란트 시술환자의 주관적 인식 및 기대도)

  • Go, Eun-Jeong;Jang, Gye-Won
    • Journal of Korean society of Dental Hygiene
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    • v.10 no.1
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    • pp.107-125
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    • 2010
  • Objectives : The purpose of this study was to examine the subjective awareness and expectations of implant patients. Methods : The subjects in this study were 200 implant patients at three different dental clinics in the region of Busan. Results : Concerning awareness of implant, the patients aged between 41 and 50 were best aware of implant with 2.85(p<0.05). By education, those who received college or higher education were best aware of it with 3.53(p<0.001). By income, those whose income was three million won or more were best aware of it with 2.95(p<0.05). As for expectations for implant, the women expected more from it with 2.89(p<0.01). By age, those aged between 41 and 50 had the biggest expectations with 3.63(p<0.001). By education, the patients whose income ranged between 2 and 2.99 million won had the greatest expectations with 2.91(p<0.05). Education and occupation made no significant differences to that. In regard to correlation among their knowledge, awareness and expectations for implant, there was a positive correlation between their knowledge and awareness(0.439), and their awareness had a negative correlation to their expectations(-0.147). Conclusions : The above-mentioned findings suggested that what patients expect from implant should accurately be grasped when counseling is provided, and that accurate information should be provided to them as well. Their cooperation should be requested during implant treatment, and special post-care programs should be prepared to boost their quality of life after receiving implant treatment. Quality medical services should be offered in proportion to the cost of treatment in order to satisfy their expectations.

A STUDY ON THE SATISFACTION FACTORS OF THE DISABLED WHEN USING DENTAL CARE SERVICES (장애인의 치과의료서비스 이용 시 만족 요인에 관한 연구)

  • Cho, Hye Lim;Kim, Yung Jae;Yoon, Tai Young
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.1
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    • pp.9-21
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    • 2014
  • This study aims to help utilize the dental treatment institutions for the disabled and provide high quality of medical services in the future by identifying the satisfaction factors for the patients of the dental clinics for the disabled. As a study method, surveys were completed 200 patients who visited the dental hospital for the disabled. Among these, the surveys from 187 patients were statistically analyzed. The main findings of this study are as follow. Since the study showed that there were differences in the satisfaction factors between the disabled and non-disabled people, subsequent studies needs to be done to develop measuring tools to accurately accommodate the satisfaction factors of the disabled. In addition, as the low spatial accessibility in terms of distance and location was found in this study, more dental treatment institutions for the disabled are required. In the meantime, the survey results found that the most satisfactory aspect was the lower treatment cost compared to other clinics, and that the most important factor when choosing a clinic was also treatment. In addition, given the fact that the group that took a prosthetic treatment, which was non-insured treatment, showed higher satisfaction compared to the group that did not, it suggests that the economic burden plays an important role for the dental treatment of the disabled.

Considerations for the Migration of Electronic Medical Records to Cloud Based Storage (전자의무기록의 클라우드 기반 저장소 이동시 고려사항)

  • Yi, Myongho
    • Journal of Korean Library and Information Science Society
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    • v.47 no.1
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    • pp.149-173
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    • 2016
  • As cloud computing becomes more and more popular and ubiquitous, many organizations are deciding to move their whole information infrastructure to the cloud. The healthcare industry is one of those that is beginning to utilize cloud-based solutions en masse. Cloud based computing and storage offers numerous benefits including scalability, cost efficiency, and accessibility, which in turn have the potential to streamline hospital operations. Despite the potential benefits of acquiring this system, considerations must still be given to the migration of the massive amounts of personal and highly protected data to a cloud-based solution. Health care organizations must consider all matters of security, reliability, and availability, to ensure that patients' data remains compliant to the Health Insurance Portability and Accountability Act (HIPAA) compliant. This paper will examine the benefits and challenges of such operation to determine the best practices for the utilization of Electronic Medical Record (EMR) cloud based networking and storage for small to mid-sized hospitals.

A Study on Quality-incorporating Models in Evaluation of Hospital Efficiency with Data Envelopment Analysis - An Analysis on National University Hospitals in Korea - (DEA에 의한 병원 효율성 평가에서 질적 측면 통합 모형에 관한 연구 - 국립대학교병원에 대한 분석을 중심으로 -)

  • Shin, Dong-Wook;Shin, Chong-Gak;Jung, Kee-Taig
    • Korea Journal of Hospital Management
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    • v.13 no.3
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    • pp.69-93
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    • 2008
  • Rising healthcare cost is a global phenomenon that justifies governments' introduction of 'incentive regulation' plan for the improvement of hospital efficiency. A number of previous studies tried to evaluate the efficiency of healthcare organization by using Data Envelopment Analysis(DEA), a common efficiency benchmarking method. However, there is a concern that this kind of efficiency evaluation could induce "quantity-quality trade-off". Moreover, as quality aspect is especially important in terms of 'effectiveness' of health care, it should be considered in efficiency evaluation of healthcare organization. A number of different models were tried so far to incorporate quality aspect into DEA, however, none is universally recognized as a standard. Thus, in this study, previous quality-incorporating DEA models were categorized into 6 types according to the way of incorporating quality aspect, and strengths and limitations of each type were reviewed with a set of artificial data as an example. Based on this review, a new quality-incorporating efficiency evaluation model, named Quality-adjusted output DEA(QAO-DEA), was suggested. As an exploratory empirical analysis, technical efficiency of human resource were measured with different quality-incorporating DEA models, using 2004 data from National University Hospitals. In conclusion, Quality-adjusted output DEA(QAO-DEA) model seems to be one of the most desirable alternatives to incorporate quality aspect in efficiency evaluation of hospital, and deserves the consideration as a policy tool to induce simultaneous improvement of both efficiency and quality.

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Self Management of Pain by Folk Remedies in Patient with Chronic Arthritis (만성 관절염 환자의 민간요법을 이용한 자가통증조절 행태)

  • Kim, Jong-Im;Kang, Hyun-Sook
    • Journal of muscle and joint health
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    • v.6 no.2
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    • pp.242-252
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    • 1999
  • The purpose of this study was to explore self management of pain by folk remedies in patient with chronic arthritis. The participant of this study were 90 volunteers who were visit C hospital and who want to counsel with researcher for their pain control by convenient sampling method. The results of this study were summarized as follows : The subjects were the 90 patients who had been diagnosed rehumatoid arthritis(52.5%)and osteoarthritis(47.8). 93.3% of participants were women. Mean age of participants was 53.7 and duration of arthritis was 7 years. Mean pain score was 5.5cm. Eighty five kinds of folk remedies were used for pain management. The mean cost for folk remedies was 3,723,207 won and the patients with rheumatoid arthritis paid to folk remedies as much as 3 times. The perceived effect score of pain management by folk remedies was 2.932(the range of perceived effect score were 0-10cm). Percentage of discontinue to use folk remedies was 82.8% and the major reason of discontinue to use folk remedies was no effect to pain control(50.4%). Some participants(30.5%) were experienced side effect such as exacerbation of pain(50.5%). In conculusion, chronic arthritis patients have been experienced various kind of folk remedies for the management of their pain. But the effect of pain control was very low. The important weakness of folk remedies were economical waste and loss of opportunity to treatment for arthritis. The nurse who care for arthritis should be teach about weakness of folk remedies for their pain control to the patients with arthritis.

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A Study on the Occurrences of Accidents among Children in Nursery School and Kindergartens (도시지역 어린이집 및 유치원 어린이의 안전사고 발생 실태)

  • Lee Eun Suk;Kim Chungnam
    • Journal of Korean Public Health Nursing
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    • v.17 no.1
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    • pp.96-112
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    • 2003
  • The purpose of this study was to determine how often toddlers and preschoolers in kindergartens have accidents and what factors affect the accident rate. The study population consisted of 150 children who were attending at nursery schools and 150 children who were attending at kindergartens. The data was collected from ten nursery schools and five kindergartens from five districts in Daegu. The questionnaires were distributed to teachers of participating nursery schools and kindergartens to be completed using nursing care records in the institutions and by interviewing children's parents about all of the accidents happened in a previous year. Data were collected during the period of August 1 through 31, 2002. The results of the study are as follow: 1. Among 300 children, 282 had 506 accidental injuries during the study period. 2. The month, the day and the time with the highest accident rate were April. Monday, and between 2 and 4 o'clock in the afternoon, respectively. 3. Locations where the injury took place most included nursery schools or kindergartens, around the homes of the children, and inside the home. 4. Most accidents were occurred due to lack of carefulness of the children, and the most prevalent forms of injury was abrasions. 5. Most frequently injured part of the body was legs of the children. 6. Most injuries were healed within three days and required first aid measures to disinfect the wound. Mostly, these were performed by family members at home. Some children go to the hospital to suture the open wound. Most frequent type of complication was scar formation and the cost of the treatment ranged from 9,000 to 30,000 won. 7. Children's age. sex, birth order. personality. type of family composition. type of residency. father's occupation, father's age, and mother's age were significantly related to the frequency of injury among children. Children who were in nursery schools and kindergartens need their assessment for accident involving condition according to seasons, time. place. This study provided a very useful and important data to prepare accident prevention education program and accident prevention strategies, and to develop Injury Surveillance System.

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Cytomorphologic Patterns of Breast Lesions in Sudanese Patients: Lessons Learned from Fine Needle Aspiration Cytology

  • Almobarak, Ahmed Omer;Elhassan, Taiseer Mohamed;Elhoweris, Mohamed Hassan;Awadalla, Heitham Mohammed;Elmadhoun, Wadie Mohamed Yasin;Ahmed, Mohamed Hassan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3411-3413
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    • 2014
  • Background: Cytology for breast lesions is a safe, rapid and cost-effective with a high specificity and sensitivity. Objective: To determine the cytomorphologic patterns of breast lesions identified among a group of Sudanese patients. Materials and Methods: This study included 759 patients undergoing either a fine needle aspiration FNA, nipple discharge (ND) smears or breast skin scraping (SS) at a cytology clinic in Khartoum. Clinical and demographic data were reviewed. Stained smears were categorized into: inadequate sample, normal breast, benign lesion, suspicious, or malignant neoplasm. Results: Of the 759 cases, 734 (96.71%) were FNA, 18 (2.37%) ND and 7 cases (0.92%) SS. For 28 cases, FNA was done under ultrasound guidance. Females were 720 (94.86%). Benign lesions were 423 (55.75%) and 248 (32.67%) were malignant and 77 (10.14%) of smears were normal without any detected abnormality. Ten (1.31%) cases were suspicious for malignancy, and only one case (0.13%) was reported as inadequate. Most lesions were observed among the age group 30 years and above. Conclusions: Most patients investigated have benign lesions, one third of cytological smears were malignant. FNAC is a useful tool for investigating breast lesions in limited-resource settings.

Awareness and satisfaction on dental implant treatment (임플란트 시술에 대한 인지도 및 만족도)

  • Kim, Soo-Kyung;Kim, Sun-Yi;Jeon, Hee-Young;Lee, Kyeong-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.13 no.3
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    • pp.395-401
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    • 2013
  • Objectives : The purpose of this research was to investigate the awareness of an adult on implants and the relevant factors which affect the satisfaction of a patient after an implant treatment. Methods : This study was conducted to 407 adult subjects in Seoul and Gyeonggi. A total of 384 data were analyzed except the questionnaires having poor responses or errors. Results : The acquaintance route of implant was TV advertisements, self-knowledge, internet, news, and newspapers. Dentist's ability to practice implant was the most important factor in patient's choice. The responents answered the expected lifespan of an implant was more than 5 years to 10 years. In terms of dental health management behavior on implants, the average response of the highest 4.07 points of 5 Likert scale. Generally women are more concerned with implant than men(p<0.01). The highly educated and elderly patients had tendency to receive more treatment(p<0.0001). Patients were more satisfactory after receiving regular checkups after treatment(p<0.05). The low expenses of implant satisfied the patients(p<0.05). Conclusions : As implant technology advances, the concern of patients on implants also increase. So reduction of cost can make the patients have access to the dentist and the patients' oral health must be improved through continuous dental care.