• 농촌의학ㆍ지역보건
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• 제33권2호
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• pp.181-192
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• 2008

Objective: The use of complementary and alternative medicine (CAM) is common especially among patients with osteoarthritis The aim of this study was to investigate the utilization rate and expenditures of patients who use CAM. Method: Two hundred seventy four patients with osteoarthritis were interviewed by a telephone survey. A structured questionnaire about sociodemographic features and type, cost, satisfaction and reason of CAM utilization was used Results: Among 274 patients with osteoarthritis, 251 patients(91.6%) had used at least one type of CAM during six months. There was a significant difference in sex (female), age (70 years), medical security (insurance), educational level between the user and non-user of CAM. Hyperthermia was the most use. The average cost for CAM utilization was 120 thousands won/person during six months and there was no difference in sociodemographic features among the out-of-pocket cost of users. The scores of satisfaction for CAM use were ranged between 60-70. Conclusions: CAM became a popular source of health care because of elderly and lay referral system. And Korean spent a substantial amount of out-of-pocket money on CAM without benefit. Health care system and professionals should pay more attention to CAM, make a evidence for CAM.

• 한국콘텐츠학회논문지
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• 제13권11호
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• pp.187-197
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• 2013

2007년 8월부터 건강보험 보장성 확대 정책의 일환으로 6세 미만 어린이 외래환자에 대한 본인부담금 경감제도가 시행되었다. 본 연구는 본인부담금 경감제도가 시행된 2007년 8월을 기준으로 제도 시행 전인 2006년 8월부터 2007년 7월까지와 제도 시행 후인 2007년 8월부터 2008년 7월까지 전후 1년 동안 외래진료 민감질환으로 외래를 방문한 6세 미만 환자들의 의료이용 변화를 분석하였다. 의료이용 변화는 제도 시행전후 외래 환자 수 증감율, 외래방문일수, 방문당 평균 진료비로 파악하였는데, 6~10세 환자를 대조군으로 설정하여 이중차이방법을 적용한 다중 회귀분석을 적용하였다. 제도 시행 후 외래진료 민감질환으로 외래를 방문한 환자는 대상군과 대조군 모두 증가하였는데, 특히 대상군에서 증가율이 높았다. 그러나, 대상군은 대조군에 비해 제도 시행에 따른 외래방문일수와 방문당 외래진료비의 증감율은 일정한 양상을 보이지 않고 그 차이 또한 적었다. 6세 미만 어린이 외래 본인부담 경감제도는 외래환자 수 증가라는 의료이용 변화를 가져왔으나, 실질적인 의료 접근성을 나타내는 외래방문일수, 방문당 평균 진료비는 큰 차이가 없었다. 따라서, 제도의 궁극적인 목표인 의료 접근성 향상을 달성하기 위하여 적극적인 제도홍보와 함께 소득계층별로 본인부담률을 상이하게 설계하는 등의 의료 취약계층에 초점을 둔 정책이 요구된다.

• Journal of Preventive Medicine and Public Health
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• 제29권4호
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• pp.831-842
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• 1996

Demand for high quality medical care has recently been increasing in step with high level of income and education. Patients prefer the use of large general hospitals to small community hospitals. Large hospitals, usually located at urban area, expand their capacities to cope with the increasing demand, therefore, they easily secure revenue necessary for growth and development of hospitals. However, small community hospitals are facing with serious financial difficulties caused from the reduction of patients in one hand and the inflation of cost in another. If small rural hospitals were closed, the closure would have negative impacts on local economies in addition to the decrease in access to medical care. Community leaders should have an insight on the contribution of community hospitals to local economies. They could make a rational decision on the hospital closure only with the understanding of hospital's contribution to the community. This study is designed to develop an economic model to estimate the contribution of rural hospital to local economies, and also to apply this model with a specific hospital. The contribution of a hospital to local economies consists of two elements, direct effect and multiplier effects. The direct impacts include hospital's local purchasing power, employee's local purchasing power, and the consumption of patients coming from outside the community. The direct impact induces multiplication effect in the local economy. The seed money invested to other industries grows through economic activities in the region. This study estimated the direct effect with the data of expenditure of the case hospital. The total effect was calculated by multiplied the direct effect with a multiplier. The multiplier was drown from the ratio of marginal propensity of income and expenditure. Beside the estimation of the total impacts, the economic effect from the external resources was also analyzed by the use of the ratio of patients coming outside the region. The results are as follows. 1. The direct economic contribution of the hospital to the local economy is 1,104 million won. 2. The value of multiplier in the region is 2.976. 3. The total economic effect is 3,286 million won, and the multiplication effect is 2,182 million won. 4. The economic contribution from the external resources is 245 million won which is 7.5% of the total economic effect.

• 한국관광식음료학회지:관광식음료경영연구
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• 제10권
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• pp.219-238
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• 1999

Obestity, characterized by an excess accumulation of fat, is a detriment to good health and wellbeing. It is easy for individuals to take on excess fat as soon as enough food and leisure are available in a society, causing an imbalance between energy intake and energy expenditure. Although there has been disagreement as to which side of this energy equation is more important in th epidemic of obesity, both sides are certainly involved. I think the prevalence of obesity begins with infancy. It seems to be relatively constant throughout childhood. Some retrospective studies have suggested that there is a direct progression from a fat chile to a fat adult. Obesity has been associated with excess mortality in many studies. The effect of obesity on cardiovascular disease has not always been an independent one, but has generally been through exacerbation of other rish factors such as hypertention, diabetes, hyperlipedmia, galbladder disease, gout and cancer of the grease and endometrium. The weights of identical twins raised in separate homes have been reported to be similar, thereby suggesting that heredity contributes significantly to weight. Overweight and obesity are by far greater health problems for many people in our society. Therefore in this paper we consider the relationship between body energy balance and problems of obesity. Whatever the weight of the person, the goal of the nutritionist and health care workers is to find solutions that will allow persons to feel better about themselves.

• 한국학교보건학회지
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• 제13권2호
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• pp.341-347
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• 2000

Background : One-quarter of Koreans are either students or school employeeS. Therefore, school health programs for them have high levels of cost-benefit. School health programs, though, are focused on services such as vaccination and physical examination according to administrational regulations without systemic planning. Futhermore, college health programs run autonomously, not under the supervision of the Ministry of Education. It is my intention to analyse the current status of college school health service centers and use the basic data so generated to model how they might operate at an optimal level of efficiency. Methods : I intended to investigate all 29 colleges in Seoul except some specialized colleges such as theological schools in the two-month period of August and September, 1999. I used the telephone interview method to ask questions relating to personal composition, medical equipment in use, annual expenditure and the provision of school health services. School health services were composed of three items; health servies, health education and a healthy school environment. Results : 27 college health service centers were surveyed. The median number of medical personal in each center was 2, the range was 1-31. 7 centers(25.9%) have only nurses with no doctors. Annual expenditures of 11 centers(50.1%) was less than 10 million won, 19 center(70.4%) were maintained by support from their college. Thirteen centers(48.1%) provided doctor's examinations, 6 centers(22.2%) provided dental care services, laboratory services were provided by seven centers(25.9%). Some 81.5% of the centers had vaccination programs and 44.5% had health education programs. There was no school environment program except insecticide provisions. College health service centers with school doctors differed from centers without school doctors in terms of medical equipment range, annual expenditures and annual case loads. Conclusion : The structure and function of college health service centers in Seoul are diverse. However, no center has a well-organized school health plan.

• 한국임상약학회지
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• 제23권2호
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• pp.89-96
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• 2013

This article aimed to introduce 'risk sharing' schemes for pharmaceuticals between drug manufacturers and healthcare payer. Published literature review was undertaken to summarize risk sharing concepts and collect information on existing scheme examples in other countries focusing on new anticancer drugs. Risk sharing schemes could be categorized into health outcomes-based and non-outcomes (financial) based ones. Outcome-based schemes could be broken down into performance-linked reimbursement and conditional coverage. Performance-linked reimbursement can be further broken into outcomes guarantee and pattern or process of care and conditional coverage included coverage with evidence development and conditional treatment continuation schemes. Non-outcome based schemes included market share and price volume at population level, and utilization caps and manufacturer funded treatment initiation at patient level. We reviewed the fifteen examples for anticancer drugs that risk sharing agreements in response to the inherent uncertainties and increased costs of eleven anticancer drugs. Of them, eight cases were coverage with evidence development schemes. The anticancer drugs except bevacizumab and cetuximab were all listed on the national health insurance formulary in Korea, with reimbursement criteria defined on the basis of approved indications and administrations. Risk sharing approach may be a useful tool to ensure values for drug expenditure, but there are a number of concerns such as high administration costs, lack of transparency and conflicts of interest, especially for performance-based health outcomes reimbursement schemes.

• 대한예방한의학회지
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• 제21권1호
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• pp.57-66
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• 2017

Objectives : This study aimed to analyze the structure and the trend of utilization and expenditure for Korean Medicine (KM) in Korea. Methods : Data were drawn from the 2008-2013 annual Korea Health Panel (Version 1.2.2), a national representative sample. We combined the data of household members with the data of outpatient KM service use. The volume of KM use was estimated based on the frequency of use and co-payment. Results : The KM utilization rate slightly increased in recent years, and it is presumed to be resulted from the increase of elderly population. Most KM outpatient visits were being concentrated in treating musculoskeletal diseases, and the procedures used frequently were acupuncture, moxibustion, cupping, and physical therapy. The imbalance of KM use between lower income group and higher income group was deepening. Conclusions : To expand restricted disease areas KM covered, the more herbal prescriptions should be insured and the insured form of herbal medicines need to be diversified.

• 보건의료산업학회지
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• 제6권2호
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• pp.101-109
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• 2012

This study purposed to analyze the differences of cost, length of stay, and number of visits between patients who referred from clinics to a general hospital and patients who directly visit a general hospital. Study sample included 402 patients (177 patients who were not referred from clinics, 225 patients who referred from clinics) who visited the Dept. of Gastroenterology in a university hospital in Daejeon from January to June in 2007. Cost and patients' information were collected from Hospital Information System and medical record. SPSS v.12.0 was used for the statistical analysis. Multiple regression analysis found that for inpatients, location variables and malignant tumors of digestive organs had a significant influence on cost variable. For outpatients, a referring hospital type and visiting month had significant influences on total cost, and sex and visiting month (February) had significant relationship with number of visit. The study results help to understand the differences of patient care depending on whether they were referred from clinics or not. Hospital managements could use the results for marketing purposes, and it could provide valuable information for increasing the competitiveness of hospital in a given market.

• 농촌의학ㆍ지역보건
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• 제25권2호
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• pp.217-230
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• 2000

For the longest time, our government has played an inconsiderable role in the public health services of Korea, especially as it relates to their investment. Voices have cried out against increases in national health expenditure and for more establishment of public medical facilities. In light of this, the necessity and importance of public medical facilities have come into focus amidst the recent medical crisis. When public medical facilities filled in the gap created by the suspension or closure of private hospitals and clinics as a result of this national crisis and acted as a safety net, the demand for more establishment of such facilities increased. Although patient diagnosis and treatment are the first priority of public medical facilities, they must also deal with scopes that private medical facilities do not deal with, dislike, or have difficulty with. In this respect, the closure or privatization of public hospitals to reduce their number just because of their low profits or financial burdens that must be carried by the government is to ignore their innate importance and social role; therefore, we must do all we can to block such efforts and further empower these public health facilities according to demands of the time. The improvement of public health services can be realized by redefining its goals and roles, increasing government funding, strengthening of existing public health facilities and reorganizing the public health services system. Even if public health facilities were to increase their medical services and be reinforced, they cannot take on all the services related to public health services, Therefore, in a country like ours where public health services come second to private health services in the health care system, the health of citizens can be safeguarded only when private and public facilities cooperate and private medical facilities share the social responsibilities. Only the show of interest and effort by government, politicians, health professionals, professional organizations and public can initiate the improvement that is sought.

• 대한물리치료과학회지
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• 제13권3호
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• pp.7-14
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• 2006

Despite well-known benefits of physical activity for older adults, most older adults remain significantly underactive. The purpose of this study was to examine the effects of a physical activity on blood cholesterol in older adults with an inclusive, choice-based physical activity promotion program to increase lifetime physical activity levels of seniors. A six-month comparison-group trial was conducted with 14 older adults(experimental group = 8, control group = 6) in community senior center. Changes in self-reported physical activity and blood cholesterol were evaluated using paired t-test. The intervention group increased estimated caloric expenditure by 858 calories/week in physical activities of any intensity (p=.050), total cholesterol(p=0.049), high density lipoprotein cholesterol(p=0.045). Control group changes were also negligible. The program led to meaningful physical activity increase. Individually tailored programs to encourage lifestyle changes in seniors may be effective and applicable to health care and community settings.