• 제목/요약/키워드: Health Services Research

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Impact of the Outpatient Prescription Incentive Program on Reduction of Pharmaceutical Costs of Clinics in South Korea

  • Kwon, Seong Hee;Han, Kyu-Tae;Park, Sohee;Moon, Ki Tae;Park, Eun-Cheol
    • 보건행정학회지
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    • 제27권3호
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    • pp.247-255
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    • 2017
  • Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

공공도서관에서 소비자건강정보를 제공하는 것에 대한 사서의 인식 조사연구 (An Analysis of the Librarians' Perception of Providing CHI Services in Public Libraries)

  • 노영희;오상희
    • 한국비블리아학회지
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    • 제22권3호
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    • pp.25-55
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    • 2011
  • 국내 공공도서관의 사서들을 대상으로 설문조사를 함으로써 CHI 서비스 현황을 명확히 파악할 수 있으며, 설문결과를 바탕으로 국내 공공도서관의 CHI 서비스 개발방향을 모색하는데 기여할 수 있다. 본 연구에서는 현재 공공도서관이 CHI 서비스를 제공하고 있는지를 조사하고, CHI 관련 참고서비스 경험 및 제공빈도를 분석하였으며, 국내 공공도서관에 서 CHI서비스를 제공하는 것의 필요성에 대한 인식조사를 수행하였다. 1) 국내 공공도서관은 건강관련 서적이나 의학저널을 구비하고 있는 것 외에 CHI 관련 웹사이트 정보원을 구축하고 있는 도서관의 비율은 5% 정도의 매우 낮은 비율이었다. 2) CHI 참고서비스 제공비율은 조사대상 도서관 중 30%에 지나지 않았다. 3) 국내 공공도서관의 82.1%가 CHI 관련 교육 프로그램을 제공하지 않았다. 4) CHI 관련 취약계층에 대한 서비스를 제공하지 않는 공공도서관의 비율이 82.1%나 되었다. 5) 국내 공공도서관 중 CHI 관련 아웃리치 프로그램 제공비율 및 CHI 관련기관과 협력체계를 구축하고 있는 비율은 약 20% 정도에 지나지 않았다. 본 연구 결과는 국내 공공도서관에서 CHI 서비스를 제공하는 것에 대한 공공도서관 사서들의 관심을 유도하고 관련 연구활동 활성화에 기여할 수 있을 것이다.

취약계층의 방문간호 서비스 요구 특성 (Working with Vulnerable Families: A Nurse Home Visiting Perspective)

  • 이인숙
    • 대한간호학회지
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    • 제34권6호
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    • pp.1025-1034
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    • 2004
  • Purpose: This study defines a vulnerable group in a community that has become the main target of a national health project also, it is descriptive research to suggest an evidence-based direction to meet their deficit health-related needs, Method: This research examined 833 families and 1,835 family members of the financially vulnerable class that was registered in a home visiting program of a public health center. Among them, 892 persons who had health problems, and their family members were examined in detail to find out their characteristics of vulnerability and health needs by assessment during a nurses home visit. Frequency distribution, stepwise-regression and factor analysis were used to analyze the data. Result: The vulnerable group that was defined with social indexes set as standards, involved substantial characteristics of vulnerability. The characteristics of demand showed tendencies of being clustered in 5 factors needs of intensive nursing care, chronic nursing care problems and helplessness, maintenance of family functioning with a disability, deficient problem solving ability, and simple financial fragility. Conclusion: Categorization of needs is an evidence-based estimator of workload in nurse home visiting services, and can be used as a basic resource for direction to meet the deficit needs of a vulnerable group.

응급구조사의 스트레스와 건강과의 관계 연구 (A Study on the Relationship between the Stress and Health of the Emergency Medical Technician)

  • 이강오;정지연
    • 한국응급구조학회지
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    • 제5권1호
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    • pp.23-35
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    • 2001
  • This study was done to examine the relationship between stress and coping methods of 86 emergency medical technicians with the 1st or 2nd grade qualifications who serve at 36 fire stations in Gwangju and Jeonnam region from Aug. 1 to Aug. 31, 2001. Data collection was done by questionnaire. The research instruments used the stress measure tool developed by Cho Hee et al.(1999) and revised and complemented by the researcher to measure firemen's stress, and health instrument revised by Suh Mi Hye et al(1993). Data were analyzed by t-test, ANOVA, and Pearson's correlation using SPSS. The results of this study were as follows : 1. The mean score of perceived stress was 3.4. The mean score of coping methods was 2.11. 2. The levels of stress according to the general characteristics of subjects were significantly different at marital status(t=7.054, p=.009) and in relation with organization(t=3.989, p=.049). 3. The relationship between levels of stress and health status was significantly correlated(r=.325, p=.000), and so the hypothesis of this research, "the less levels of stress, the better health status is." was supported. 4. The relationship between stress and health status was significantly different at crisis status(r=.393, p=.000), relation with organization(r=.348, p=.001), the characteristics of subjects(r=.387, p=.000), special knowledge and technology(r=.337, p=.001), and the roll complication as a professional(r=.343, p=.001).

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방문구강건강관리사업에서 정신적 장애인의 구강건강관리시간에 영향을 미치는 요인 (A STUDY ON FACTORS AFFECTING DENTAL TREATMENT TIME OF PATIENTS WITH MENTAL DISABILITY IN VISITING DENTAL SERVICES)

  • 임경철;이재영;진보형;이교린;김소연;백혜란;김영재
    • 대한장애인치과학회지
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    • 제14권2호
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    • pp.78-87
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    • 2018
  • Patients with mental disability who are classified as dental severely disabled, have poor oral health status and many difficulties in taking health services. The purpose of this study was to investigate factors of influencing in visiting oral health care services. After receiving approval from institutional review board in Seoul National University, 39 participants were recruited and the oral health examination and questionnaire were taken. Data were analyzed using one-way ANOVA, independent t-test, hierarchical linear regression for predicting influence of each participants' characteristics on oral examination time and care time. In regression model, the higher the disability grade and the lower the degree of cooperation, the more oral examination time increased. However possibility of communication was not significantly influenced. Also, the higher the disability grade and the lower the degree of cooperation, the more oral care time increased. However possibility of communication was not significantly influenced. These results are expected to provide objective data for introduction and establishment of visiting dental care.

The Past and Current Status of Dentists in Japan

  • Sugiyama, Masaru;Nishimura, Rumi;Lee, Myung-Jin;Oh, Sang-Hwan
    • 치위생과학회지
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    • 제21권1호
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    • pp.8-18
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    • 2021
  • The purpose of this study is to provide the general history of fostering dentists in Japan and introducing their new roles. This research was conducted based on the government policy report on dentists and the information published by each educational institution. Based on the collected data, the official websites were used to represent the latest statistics of the institutions. The number of dentists in Japan has increased. The government established the National Examination for Dentists to guarantee the quality of dentists. After the standards for developing questions for the national examination were established in 1985, the contents of the examination have been appropriately improved by revising the standards every four years. This improvement has required dental students to study a variety of subjects for six years at dental school. Since dentists in Japan are required to respond to various demands from the nation; the Model Core Curriculum for Dental Education was developed to teach medical ethics and abilities to ensure that dentists conduct themselves professionally. Recently, the roles of dentists have been changing in Japan. When providing dental services to older patients over the age of 65, dentists and other dental professions focus on maintaining oral functions, such as saliva secretion, bite force, tongue movement, and masticatory/swallowing functions. However, oral function-related services for children are different. In addition to providing essential dental services, dental practitioners also provide special treatment, such as oral muscle training, myofunctional therapy, health guidance, and space retainers to the child patients with developmental insufficiency in oral functions. Dentistry in Japan has undergone numerous changes over the years and has continued to offer high-quality dental health services. Thus, information gained from the Japanese experience may be helpful to dental professions in other developed countries for planning oral health measures.

일부 보건소와 일반의원에서의 투약서비스 비교연구 (Difference of Prescription Services between the Health Center and the Private Clinic)

  • 이선희;조공민;손명세;김한중
    • 보건행정학회지
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    • 제2권2호
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    • pp.131-151
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    • 1992
  • The contents of prescription service were comparatively analysed between health centers(HC) and private clinics(PC). Medical chart review was done for 330 otu-patients diagnosed with upper respiratory tract infection(UR) of 120 adults and 90 children, and gastritis or duodenitis of 120 adults. Emphasis on comparison was the prime cost of medication which used in prescription service. The results were as follows; 1. The prime costs fro the medication per visit of HC group were significantly higher than PC group in all three diseases, and the out of pocket payments of patients per visit were significantly lower in the HC group than PC group. 2. The reason for high prime costs of medication per visit of HC in adult case of URI were due to the idverse use of medication and long prescription period per visit. And high medication costs in children cases of URI in HC group were due to the longer prescription day. In cases of gastritis, the prime cost of medication was also higher because of longer prescription period and the higher prime cost of medication. The proportions of medications for injection in the HC and PC groups showed similar features. 3. In depth analysis of the prescription services showed the differences of the contents of medication. In adults cases of URI, the averaged cost of oral medication was significantly lower in HC group, but that of medication for injection was higher in HC group. In children cases of URI, the averaged cost of oral medication and medication for injection was lower in HC group than in PC group. But in the cases of gastritis it was was higher in HC group than in PC group. The prescription periods were longer in HC group than in PC group in all three diseases. As a conclusion prime medication cost and quality of prescription services of HC group were higher than PC group. In terms of health care the cost containment and quality assurance in physician visit for common disease, public sector utilization is good option for those perspectives. But it should not be generalized unless future study about structure and outcome research for quality assurance.

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보육시설을 이용하는 장애아동의 건강문제와 건강관리 현황 (Health Issues and Management for Children with Disabilities attending Daycare Centers)

  • 김지수
    • Child Health Nursing Research
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    • 제18권3호
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    • pp.127-134
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    • 2012
  • Purpose: This study was conducted to investigate health issues of children with disabilities attending daycare centers, and to identify the way of teachers' management on child health. Methods: A cross-sectional descriptive study design was performed with a convenience sampling of 127 teachers from 19 daycare centers for children with disabilities and 175 teachers from 17 general daycare centers. A survey questionnaire was used to collect data, and the data were analyzed using the SPSS 17.0 program. Results: For the last one month, about 90% of the teachers working in daycare centers for children with disabilities had to care for sick children. When a child is sick, 50% of the teachers tended to contact with the parents of the child. The majority of the teachers caring for sick children experienced difficulties with no one available to give expert health care advice. Conclusion: The results of the study indicate that there are many health issues in daycare centers for children with disabilities and therefore health professionals need to be available to the centers. Specifically, health management services and programs need to be developed and provided for children with disabilities.

장애인 건강권 향유를 위한 디지털 헬스 적용 방향 고찰 (Examination of the Application Directions of Digital Health for the Enjoyment of Healthcare Rights by People with Disabilities)

  • 정희영
    • 한국IT서비스학회지
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    • 제22권6호
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    • pp.115-132
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    • 2023
  • This study aimed to propose application directions for South Korea's digital health policy by conducting a literature review, data analysis, and examining foreign cases. The objective was to enhance the healthcare rights of individuals with disabilities, considering the potential expansion of the digital health policy. The findings indicate that digital health holds significant promise in improving mobility and accessibility for the healthcare rights of disabled individuals in Korea. However, addressing the digital gap is crucial for achieving smooth utilization. To ensure seamless use of the digital health system, it is imperative to attain digital inclusion, encompassing digital technology, connectivity, and accessibility. Additionally, establishing governance for digital health and expanding infrastructure for affordable access to high-quality internet are essential. Despite the study's limitations arising from relying on literature research, it is anticipated that the findings can serve as foundational data for preemptive responses and provide insights into the direction of the government's digital health policy to enhance the healthcare rights of individuals with disabilities.

노인장기요양보험 이용지원 상담 대상자 선정모형 개발 (A Target Selection Model for the Counseling Services in Long-Term Care Insurance)

  • 한은정;김동건
    • 응용통계연구
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    • 제28권6호
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    • pp.1063-1073
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    • 2015
  • 우리나라 노인장기요양보험에서는 수급자와 그 가족부양자가 수급자의 심신기능 상태와 욕구에 따라 불이익이나 불편함이 없이 비용-효과적으로 장기요양 급여를 이용할 수 있도록 지원하고자 이용지원 상담을 제공하고 있다. 본 연구는 재가급여 이용자의 이용지원 정기상담 대상자 선정시 상담 대상자의 욕구를 반영하지 않아 이용지원 상담의 만족도와 효율성이 낮은 문제를 통계학적 모형을 활용하여 해결하고자 수행되었다. 모형 개발을 위해 2013년 3월 장기요양 재가급여를 이용한 수급자와 가족부양자를 대상으로 이용지원 상담에 대한 욕구와 관련 변수를 조사하였으며, 2,000명이 조사를 완료하였다. 조사 자료를 바탕으로 이용지원 상담 대상자 선정모형을 다양한 데이터마이닝 기법(로지스틱 회귀모형, 의사결정 나무모형, Lasso 모형, 자동 신경망모형, 그래디언트 부스팅, 앙상블 모형)을 통해 개발하였고, 이중 가장 안정적이고 현장 적용이 쉽고 성능이 좋은 Lasso 모형 결과를 최종모형으로 선정하였다. 본 연구가 이용지원 상담의 만족도를 높이고 업무를 효율화 하는데 기여할 것으로 기대된다.