• Korean Journal of Adult Nursing
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• v.23 no.6
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• pp.554-563
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• 2011

Purpose: The purpose of this study was to investigate factors associated with drug misuse behaviors among polypharmacy elderly. Methods: This was a cross-sectional survey. Participants consisted of 116 polypharmacy elderly who were taking 5 or more medications each day. Data were collected via face to face interviews. Data were analyzed using the PASW 18.0 program. Data concerning predisposing factor (knowledge, benefit), enabling factor (communication with health care provider), and need factor (perceived health status, number of disease) were collected. Results: The total mean score of drug misuse behaviors among polypharmacy elderly was 3.04 out of 10 points. Communication with health care provider, perceived health status, and knowledge were found to be significantly correlated with drug misuse behaviors. In stepwise multiple regression analysis, a total of 42% of the variance in drug misuse behaviors was accounted for communication with health care provider, perceived health status, and knowledge. Conclusion: Therefore, education program for improving communication with health care provider, and knowledge should be designed and provided for polypharmacy elderly.

• Health Policy and Management
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• v.26 no.1
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• pp.63-70
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• 2016

Background: Selective health benefit was introduced for decreasing economic burden of patients. Medical devices with economic uncertainty have been covered as selective health benefit by National Health Insurance since December 2013. We aimed to analyze impact of selective health benefit to medical expenditure and provider behavior focused on electrosurgery (ultrasonic shears, electrothermal bipolar vessel sealers) for gastric cancer patients covered since December 2014. Methods: We used the National Health Insurance claims data of 2,698 patients underwent gastric cancer surgery between August 2014 and March 2015. Medical cost and patient sharing per inpatient day were analyzed to verify that covering electrosurgery increased medical expenditure and changed provider behavior from open surgery to endoscopic or laparoscopic surgery. Additionally, we analyzed the claim rate of medical device or goods relating gastric endoscopic and laparoscopic surgery. Results: Medical cost and patient sharing per inpatient day were increased after covering electosurgery as selective health benefit (39,724/1,421 won). However, there were no medical expenditure increases after adjusting claim of electosurgery and patient sharing was decreased 1,057 won especially. The coverage of selective health benefit did not increase the claim rate of medical device or goods related endoscopic or laparoscopic surgery, either. Conclusion: Covering electosurgery decreased patient economic burden and did not change of provider behavior. Expanding selective health benefit is needed to decrease economic burden of severe patients. Further study should evaluate the long term effect with accumulated data.

• Journal of Korean Clinical Health Science
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• v.1 no.3
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• pp.21-31
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• 2013

Purpose. The purpose of this study was to explore the meaning of BLS-Provider Certification Course experienced by nursing students. Methods. The phenomenological method developed by Giorgi was used for this study. The participants were 7 students who had experienced BLS-Provider Certification Course. The data were collected between February, 2013 and May, 2013 by face to face interview. The interview was recorded and then transcribed. Results. The constituents associated with the meaning of the Nursing students's experiences on BLS-Provider Certification Course were as followings 'To obtain the information', 'Complicated preparation process', 'Unfamiliar education', 'Fear on the BLS ', 'Satisfaction after getting of BLS-Provider Certification ' Conclusions. The result of this study may contribute to a deeper understanding of the meaning of the BLS-Provider Certification Course experienced by nursing students. The highlights of this study are that, although the students had much inconvenience on the preparation process of BLS-P and fear on the BLS-Provider Certification Course, they were satisfied much after getting the BLS-Provider Certificate. It can give the better quality of BLS-Provider Certification Course if these results are provided in the program.

• Korean Journal of Community Nutrition
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• v.5 no.3
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• pp.529-536
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• 2000

The major purpose of this study was to identify the differences in priorities of nutrition service needs between the service provider and consumers (general population). Identification of the personal characteristics which influence the priorities of nutrition service needs among the general population was also examined. An interview survey using a questionnaire was conducted to collect the data required for analysis. The questionnaire included the priorities of various nutrition service needs as well as the personal characteristics of the study subjects. The study subjects were 300 residents over 40 years of age, and 15 health workers representing health center service personnel in Kyounggi province. Wilcoxon Rank Sums test were adopted to analize the differences in priority between the service providers and consumers. The results showed that priority of nutrition service needs for provider were significantly different from that of consumer. Gender, age, family type, and education levels of the population were the significant factors affecting the differences in priorities for nutrition service needs among consumers (general population). Out of the results, it could be suggested that consumers need should be considered in developing nutrition services to promote nutrition services utilization in health centers. The results may also suggest that one of the causes for the low utilization rate of nutrition services in health centers was the provider oriented program development regardless of the needs of consumers.

• Health Policy and Management
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• v.24 no.4
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• pp.304-311
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• 2014

This manuscript treats a new paradigm for the Korean health care system. We give an account of innovative health care delivery and payment models widely discussed in the contemporary US accountable care organization and coordinated care organization. In doing so, we explore a new health care model amenable to foreseeable changes to the health care system. We propose creating an integrated health care system in which the network of health care providers delivers coordinated and comprehensive care for enrolled patients residing within the geographic boundaries served by the provider network; providers may participate voluntarily in one or more networks and assume shared responsibility for patient care and cost; provider networks compete with each other based on cost and quality; and consumers are allowed to choose a network. We expect that the new paradigm will create a financially-sustainable system that assures quality of care and improves patient experience, minimizing the existing system-wide inefficiency through cross-network competition and within-network care coordination.

• Health Policy and Management
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• v.19 no.3
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• pp.125-141
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• 2009

The purpose of this study was to examine the role of provider practice patterns in the difference in health expenditure between the two types of patients: Health Insurance and Medical Aid type 1. The study used the outpatient claim data for all Medicaid and health insurance patients of hypertension who received medical services from 8,454 primary care physicians during the first half of 2006. The data were stratified by patient's gender and age for the two groups of patients who received care from the same physician. The dependent variables were the differences in medical expenditure per case, patient days per case and medical expenditure per patient day between Medicaid patients and health insurance patients. Empirical results showed that physician characteristics, such as physicians under age 50, greater proportion of pediatric Medicaid patients, lower proportion of new Medicaid patients and the greater number of comorbidity of Medicaid patients are associated with the greater difference between the two types of patients (i.e., greater expenditure of Medicaid patients relative to health insurance patients). This study shows that factors associated with provider practice patterns need to be taken into account in Medicaid policy.

• Journal of Korean Academy of Nursing
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• v.34 no.8
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• pp.1460-1467
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• 2004

Purpose. This study examined the predictive factors enabling access to children's oral health care at the level of financial barriers, beliefs, and the provider. Methods. In-depth interviews were conducted with 320 immigrant mothers of low-income families regarding their use of oral health services for children aged four to eight years old. Access to oral health care was measured with frequency of planned dental visits, continuity of care, and age at first visit to dentist. Results. The mother took her child to the dentist at a younger age if she received referrals to a dentist from pediatrician. Regular dental visits were significantly related to household income, provider availability on week-ends, and insurance coverage. The extended clinic hours in the evenings, and the belief in the importance of the child's regular dentist visits increased the likelihood of continuing care. The mothers perceiving a cost burden for the child's dental care were also less likely to return to the dentist. Conclusion. The available care delivery system, coordinated medical care, and health beliefs were among important predictors of the health service use. The study findings suggest need for culturally competent dental health interventions to enhance access to oral health care among particularly vulnerable populations such as low-income children in Korean communities.

• Journal of Korean Society for Quality Management
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• v.41 no.4
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• pp.527-539
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• 2013

Purpose: Methods for increasing health-care service quality are considered for a women-centered hospital located on a local city. A walk-through audit is applied to uncover areas for improvement. Methods: A survey questionnaire with 25 questions is constructed based on a service blueprint for a walk-through audit, and a survey is conducted both to patients and service providers to assess a health-care service quality. Frequency analysis, statistical tests and customer-provider analysis are used to analyze surveyed data. Results: According to customer-provider analysis, 6 attributes belong to 'problem unawareness' zone in which they are rated high by service providers but low by patients, and another 6 attributes belong to 'problem awareness' zone in which they are rated low by both groups. These attributes are considered to be improved with priority. Conclusion: Both patient group and service provider group have lots of different perceptions on most attributes that are examined, and the hospital to be studied is, in general, competitive in technical quality and less competitive in functional quality.

• Health Policy and Management
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• v.20 no.4
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• pp.45-57
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• 2010

Background : If different cost efficiency indexes were informed to the same clinic depending on the inclusion or exclusion of pharmacy cost, it may impair the reliability of provider-profiling system. This study aimed to investigate whether the omission of pharmacy cost affects cost-efficiency rankings in medical clinics. Methods : Data for ambulatory care cost at 23,112 medical clinics were collected from the claims database, which was constructed after review by the Health Insurance Review and Assessment Service (HIRA) of Korea in April 2007. We calculated two types of cost efficiency indexes by inclusion or exclusion of pharmacy cost for a medical clinic. The agreement between the decile rankings of the two indexes was also assessed using the weighted kappa statistic of Landis and Koch. Results : When the cost efficiency index for total cost including pharmacy cost was compared with the index for total cost excluding it, the agreement between the two indexes was only 55%. The agreements between the two indexes were relatively low within specialties which have larger pharmacy volume of total cost and lower correlation between total cost with or without pharmacy cost included than the average level of all the specialties. Conclusion : These results suggest that the omission of pharmacy cost may result in contradictory outcomes that may be confusing to a medical institution and may impair the reliability of provider-profiling systems. It is very important to standardize profiling criteria for the reliability of provider profiling system.

• The Journal of the Korea Contents Association
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• v.15 no.9
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• pp.541-554
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• 2015

In this paper, first, we examined the factors which would affect users's intention for accepting Smart Healthcare Service. Second, we analyzed weather the types(health care provider vs. health care recipient) of the users would modulate the factors's influences. The independent variables of the research model are novelty-seeking, self-efficacy, facilitating conditions and security. The mediating variables are the perceived ease of use and the perceived usefulness. The dependent variable is the acceptance intention and the moderating variable is the user type which contains health care provider and health care recipient. As the results of the analysis, we recognized that the self-efficacy of the users would affect the perceived ease of use and the perceived usefulness in the smart healthcare services, but the user types(health care provider vs. health care recipient) did not modulate the factors's influences. We also recognized that the facilitating conditions would affect the perceived ease of use and the perceived usefulness in the smart healthcare services, in particular, the user types modulated the influences in the ease of use. We also recognized that the security would affect the perceived ease of use and the influence was more sensitive in the case of the health care provider. At last, we recognized that the ease of use and usefulness would affect the acceptance intentions. The influence of the ease was more sensitive in the case of the health care recipient. The influence of the usefulness was more sensitive in the case of the health care provider.