• Title/Summary/Keyword: Health care efficiency

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The Design and Implementation of Continuity Health Care Record Management System based on Data Stream System (데이터스트림 처리 시스템에 기반한 연속적인 헬스케어 데이터 관리 시스템 설계)

  • Wu, Zejun;Li, Yan;Shin, Soong-Sun;Kim, Gyoung-Bae;Bae, Hae-Young
    • Proceedings of the Korea Information Processing Society Conference
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    • 2011.04a
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    • pp.1218-1221
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    • 2011
  • The development of the internet and information management has enabled new applications which include: Electronic medical record (EMR), intelligent transportation, environmental monitoring, etc. In this paper, we design and implement the Continuity Care Record(CCR) Data Stream management server that compiled with DSMS and DBMS in EMR system for processing, monitoring the incoming CCR data stream and storing the processed result with high-efficiency. The proposed system enables users not only to query stored CCR information from DBMS, but also enables to execute continue query for the real-time CCR Data Stream. By using of CCR Viewer Application users can view or update their personal health records even compare self health care records with standard health care records in order to monitor the healthy status, and the on line updating information would be minimized and medical error.

Influence of Usual Source of Care on Outpatient Visit and Expense of Hypertension Patients (상용치료원 보유여부가 고혈압 환자의 외래이용횟수 및 외래의료비에 미치는 영향)

  • Yoon, Hyo Jung;Choi, Jae Woo;Lee, Sang Ah;Park, Eun-Cheol
    • Korea Journal of Hospital Management
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    • v.22 no.1
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    • pp.1-9
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    • 2017
  • Purpose : Many studies showed that having a usual source of care improved the efficient access of healthcare service. However in Korea there have been few studies on the usual source of care. So this study aims to find whether having a usual source of care affect the medical utilization and expense. Methodology/Approach : We used the Korean Health Panel data in 2012, 2013 to examine the change of utilization and expenses in ambulatory care affected by having a usual source of care. We selected 1,215 hypertension patients without usual source of care in 2012 and performed linear regression analysis to identify the difference between treatment group(with usual source of care in 2013) and control group(without usual source of care in 2013). Then we performed analysis again separated by the age group. Findings : Among study population, 711(58.5%) reported that they have a usual source of care in 2013. Treatment group reported 1.85 less increase in outpatient visits and 69,234 won less increase in expense than control group with weak significance(visit ${\beta}$ -1.85 p-value 0.0807, expense ${\beta}$ -69,234 p-value 0.0541). People under the age of 65 showed significant change in outpatient visits for tertiary hospital (visit ${\beta}$ -0.78 p-value 0.0154, expense ${\beta}$ -91,462 p-value 0.0168). The analysis which focused outpatient for mild disease showed similar trend. Practical Implications : This study supports the positive effect of having usual source of care which decrease inefficient outpatient utilization. Promoting physician-patient relationships is important for efficiency of healthcare service.

Introducing the Insurance Health Care Delivery System and Its Impact on Patients Distribution of Medical Service Organizations (보험진료체계 개편이 의료기관 종별 환자분포에 미친 영향 분석 -3차 의료기관, 종합병원, 병원, 의원을 중심으로-)

  • 공방환;한동운;장원기;강선희;문옥륜
    • Health Policy and Management
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    • v.5 no.1
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    • pp.31-58
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    • 1995
  • The Korean government achieved the universal coverage of health insurance in July 1989, and concomitantly introduced a new measure of regulated health care delivery system in using medical care. There are three reasons why the government took the new health care delivery system. Firstly, there was ample room for improving the allocative efficiency in the use of medical facilities. And the second one was to constrain the dramatic increase of medical demand under health insurance. Thirdly, and the most important reason was to alleviate the patient crowdedness in big general hospitals, particularly tertiary hospitals. There are essentially two different ways to control the use of health care : one is to cut the demand for health care, and the other to regulate behaviors of providers through the use of incentives/disincentives, demand-side approach or supply-side approach. The objective of this study is to examine whether or not medical care utilization behaviors under health insurance scheme have been changed among medical facilities such as clinic, hospital, general hospital and tertiary hospital in comparison with those before and after the introduction, particularly whether the patient crowdedness in tertiary hospitals has been alleviated or not. In order to conduct this study, the insurance claim data during the period of January 1989 and July 1992 were analyzed by focusing on diagnosis of both inpatients and outpatients, and especially the fifteen most frequent diseases in ambulatory care and the seven most frequent diseases in hospitalizatio. In addition, the same analyses were made on the changes in medical care utilization by specialty department. This was because the five departments, such as family medicine, ENT, eye, dermatology and rehabilitation, were exempted from applying the regulated health care delivery system in tertiary hospitals. The study revealed that a remarkable alleviation effect in the crowdness was noted for tertiary hospitals. This effect was most conspicuous for the most frequent mild diseases of both inpatient and outpatient care. For example, the fifteen most frequent OPD care at tertiary facilities have decreased as much as by 40%, of which 34% belonged to the cut in initial visits. Meanwhile, the proportion of those who used general hospitals and private practitioner's clinics have increased due to the shift of patients. The cases from the five special departments were also decreased, but not so much as other departments. A problem was noted that, as time passed by, the decreasing tendencies of crowdness at tertiary hospitals due to the regulated system became slightly smaller. Therefore, through complementary remedies are needed for the future implementation.

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The Seosan County Family Planning/Maternal & Child Health Service Research Project, Korea -Project Design and Findings of the Baseline Survey- (가족계획(家族計劃) 및 모자보건사업(母子保健事業)의 효율적 통합방안(統合方案)에 관한 연구(硏究)(서산군(瑞山郡)) -기초조사보고(基礎調査報告)-)

  • Bang, S.;Cho, T.H.;Lee, S.J.;Han, S.H.;Lim, K.J.;Ahn, M.Y.
    • Journal of Preventive Medicine and Public Health
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    • v.16 no.1
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    • pp.163-192
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    • 1983
  • In order to facilitate the Korean government's efforts in integrating family planning and maternal & child health at the primary health care level (or township level), the Soon Chun Hyang College of Medicine, with the financial and technical assistance of WHO, has under-taken a service research project. The project has employed a quasi-experimental study design introducing interventions tat provide crucial factors lacking in the ongoing government programs such as midwives and qualified referral physicians. The study is being conducted in three locations, one control area and two study areas. Before introducing trained Nurse/Midewives into the study areas, a baseline prevalence survey was undertaken from 15 July 1981 to 10 August 1981 in selelcted townships of Seosan County. In this sample survey of bath the study and control areas, 2,484 eligible women (97% reponse rate) were interviewed to obtain benchmark data on basic evaluation indicators related to family planning and maternal and child health. The salients results were summarized as follows.: 1. CONTACT RATES WITH HEALTH WORKERS; During the year preceding the survey, 12% of women were visited by government health workers. The primary reason for such visits by health workers was family planning (45% of the visits). About 34% of the women visited the health centers during the year. The primary reason for visiting health centers was immunizations for their children (45% of the visits). 3. FAMILY PLANNING USE RATE; The baseline data showed little difference between women in the study area and the control area on contraceptive use. Approximately 59% were currently using some methods. However, among those current users, almost half were practicing less effective methods of birth control such as rhythm or withdrawal. Among other methods, the tubectomy was the most popular (16%), while use of the IUD, oral pill and condom together reached only 14%. 3. PRENATAL CARE RATE; About 75% of the women reported no prenatal care for their last births (the youngest child of each women), Additionally, among women received prenatal care, over half had only one visit. 4. ATTENDANCE AT DELIVERY; Most of the women surveyed (over 80%) were attended by a non-medical person during their last delivery. These figures are somewhat comparable to the national figure of 84% for remote areas. 5. POSTNATAL CARE; The proportion of women reporting postnatal care was only 4.5%, and postnatal care was not received by the majority of women surveyed. 6. CHILD HEALTH CARE: In contrast to the low rate of maternity care for women themselves, most women reported obtaining immunization care for their children. About 75% of the women obtained Polio and/or DPT, 58% BCG, and 44% Measles vaccine for their children. However, in terms of illness care, while 35% of the women stated that their youngest child had been sick during the month preceding the survey, only 28% of these women took their child to the clinic for treatment. 7. COMPLICATIONS OF PREGNANCY AND DELIVERY AND ABNORMALITIES IN THE NEWBORN; Among all last deliveries, 18% of the women had pregnancy complications and 9% of the women had complications during delivery About 5% of the women reported abnormality in their most recent newborn. 8. REPRODUCTION EFFICIENCY; PERINATAL MORTALITY AND INFANT MORTALITY Based on data from the pregnancy history in this survey, reproduction efficiency was estimated. Out of the 11,154 pregnancies reported by all women surveyed, foetal loss was 21% (almost 16% were induced abortions) and infant deaths before reaching one year old were 3.1%. The reproduction efficiency was, therefore, reduced to 76%. In terms of perinatal and infant mortality rates, the former was 40.2 per 1,000 total births and the latter was 39.3 per 1,000 live births. Both rates described J shaped relationships with age of mothers and parity, and they were also correlated with birth interval and mother's education. In summary, this baseline survey data indicated a need for (1) improving contraceptive practices with more effective methods to prevent unwanted pregnancies and (2) providing better services for maternal and child care to protect wanted pregancies. In the Korean rural setting. the author believes that the latter is more important as the value of each child has increased as a result of the family planning campaign for the past two decades. This calls for more effective integration of Family Planning and MCH programmes to meet the needs of the family in each stage of the child bearing and rearing period with deploying more qualified personnel than the current government program personnel.

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Performance Evaluation of Nurses in a General Ward Using Data Envelopment Analysis (DEA) (자료포락분석을 활용한 일 병동 간호사의 성과평가 방안)

  • Park, Yeon Hong;Lim, Ji Young
    • Journal of Home Health Care Nursing
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    • v.25 no.1
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    • pp.67-77
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    • 2018
  • Purpose: The purpose of this study was to compare the efficiency of general ward nurses in hospitals using Data Envelopment Analysis (DEA). Methods: Participants were 30 nurses working at a general ward. Input variables were labor cost and time of direct nursing. Output variables were prevention rate of medication error and bedsores, and patient satisfaction. These variables were extracted using literature review and CVI of an expert group. Data were collected from September 18 to October 7, 2017. Data were analyzed using EMS 3.1 program for DEA and descriptive statistics. Results: The average efficiency score of 30 nurses was 0.986, which was very high over all. In the super-efficiency analysis of 11 nurses, their efficiency ranged from 1.0 to 1.047. In addition, when the current output was fixed, the labor cost of nurses did not affect efficiency. Conclusion: This study attempted a new approach concerning performance evaluation of nurses using DEA. This method was useful during appraisal of nurses. We suggest that various input and output variables that were not considered in this study should be added to develop a integrative performance analysis model for nurses.

Study on efficient financial income elderly long-term care facilities size

  • Jeong, Seong-Bae
    • Journal of the Korea Society of Computer and Information
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    • v.21 no.10
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    • pp.157-166
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    • 2016
  • The aims of this study are to contribute to efficient revenue management by analysis of the scale in elderly long-term care facilities. The data was used for input of the elderly long-term care costs Scale, and calculated the staffing standards and social welfare facilities workers with living wage guidelines in the Department of Health and Human Services. Revenue efficiency is the highest order of size are as follows. I8(98 people) \43,517,010, H6(86 people) \36,568,332, G8(78 people) \29,426,532, F8(68 people) \23,227,532, E8(58 people) \19,701,254, D8(48 people) \19,155,187, C6( 36) \14,389,109, B8(28 people) \9,920,031, A8(18 people) \3,721,031. It seems that its revenue efficiency even higher than the larger the scale. Meanwhile, The researchers focused on C6 (36 patients) model. Suggestion of this study are following; First, the arrangement can be provided based on needs of the elderly care facility staffing standards. Secondly, an elderly care facility selected wage guidelines. Thirdly, the elderly efficiency guidelines established by the size of a nursing facility. This study and other financial income factor are not the applicable limits.

Evaluation of Chromium and Manganese Exposure in Welders and Establishment of Efficient Preventive Measures for Fume Exposure (철강용접자의 크롬 및 망간 노출평가와 산업위생관리 대책에 관한 연구)

  • Lee, Young-Sei;Yoon, Chong-Guk;Park, Jong-An;Lee, Song-Kwon;Chae, Jong-Hong;Kim, Ek-Soo
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.10 no.1
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    • pp.45-57
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    • 2000
  • Results of environmental monitoring for 35 steel industry welders exposed to manganese and chromium fume were evaluated. Efficiency of respiratory protectors, welding face shields and local exhaust ventilation were also evaluated to establish more efficient preventive measures that can protect welders from occupational disease as related to welding fume. The results are as follows; 1. Total fume from $CO_2$ arc welding with mild steel occurred 1.5 to 2.2 times more than that from shielded metal arc welding. Chromium and nickel fume from welding with stainless steel occurred 27 to 59 times and 18 to 30 times, respectively, than those with mild steel. 2. Proportions of water-soluble chromium(VI) and insoluble chromium(VI) Compare to total chromium occurring from $CO_2$ arc welding with stainless steel were 10.5% and 8.7%, respectively, while those with mild steel were 57.1 to 63.2% and 31.6 to 38.1%, respectively. 3. The efficiencies of 4 types of respiratory protectors to reduce welding fume exposure were evaluated as 54.4 to 64.4%. 4. The reducing effect of head type welding face shield was 67.6%, and that of hand type welding face shield was 58.5%. The highest reducing effect was shown in air supply welding face shield as 99.2%, although it is not convenient to wear. 5. When welding face shield and respiratory protectors were worn together, the reducing efficiency increased to 79.0 to 87.5%. 6. When local exhaust ventilation was installed in workplace, the reducing efficiencies varied from 31.5 to 73.1% according to the types of welding.

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Evaluation of outcome in nursing practice (간호실무에서의 결과평가)

  • Lee, Byoung-Sook;Kwon, Young-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.2 no.2
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    • pp.59-71
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    • 1996
  • Today, quality management is appearing as a critical issue in the field of health care service, partly because of increasing cost of health care. And qualified health care is also accepted as the right of clients, and the responsibility of health professions. So nursing profession can survive and develop only through the quality management of nursing practice like other health professions. Recently, Consumers of nursing service require the effectiveness and the efficiency of nursing practice. Effectiveness and efficiency of nursing practice can be accomplished by outcome evaluation. The focus of outcome evaluation in nurisng practice is on the change which occures in patient's health status with nurisng intervention. Evaluation of outcome is difficult because of some related problems which should be solved, or managed. These problems could be classified as problems of measurement, and attribution. To solve the problems and to evaluate the outcome in nursing practice more accurately, following tasks were suggested. 1) Outcome indicators, and outcome measurement tools should be developed. For these purpose, outcome variables that nursing interventions can contribute primarily should be found out. Also, outcome variables which are driven from nursing theories should be developed. 2) Outcome researches which can explain the effect of nursing care to patient outcomes should be performed. The outcome researches are the methods which can increase the power of nursing profession. 3) Models which can be used for the systematic and scientific quality management in nursing practice should be developed. The models should include outcome variables, and be able to explain the relationship between structure, process, and outcome aspects of quality management. 4) The method which can make patients participate in the evaluation process of quality of nursing practice should be devised. Because outcome evaluation is client-focused evaluation, the perspectives of patients should be emphasized, and reflected in the process of evaluation.

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Relation of the Medical staffs' Perception about Nutrition with a Performance of Dietitians' Nutrition Care (의료진의 인식정도와 병원 영양사의 업무 수행의 관련성)

  • Eom, Yeong-Ram;Kim, Yeong-Ok
    • Journal of the Korean Dietetic Association
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    • v.2 no.2
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    • pp.112-122
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    • 1996
  • This study was designed to provide data useful for the efficiency of dietitians' nutrition care by evaluating medical staffs' perception of nutrition in a hospital. The datas were collected through a questionnaire survey conducted upon 874 medical staffs at 50 general hospitals , each one with more than 100 beds, in Seoul and Pusan. A logistic regression analysis was used to determine the influential factors of medical staffs' perception about nutrition among the selected variables. As a result, most medical staffs(96.9%) had positive perceptions about the importance of nutrition as a medical therapy. However, more than half of the respondents(69.1%) said that the dietary department plays the auxilliary role of producing patients' meals according to diet prescriptions. 271% of the medical staffs perceived that the dietary department as contributor to patient's health care through involvement in medical nutrition therapy, while 4% of the medical staffs misunderstood the dietary department as part of the hospital administration. The results of logistic regression analysis showed that factors related to hospital size and dietitian manpower( Total No. of beds, No. of beds per dietitian) have more influence upon medical staffs' perception about nutrition than their personal and occupational characteristics(P (0.001). In case where medical staffs' perceptions were more positive, the efficiency of dietitians performing nutrition care was higher. Results of this study suggests optimal dietetics staffing as a way to increase the efficiency of nutrition care in a hospital.

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Bio-vector Generation Framework for Smart Healthcare

  • Shin, Yoon-Hwan
    • Journal of the Korea Society of Computer and Information
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    • v.21 no.1
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    • pp.107-113
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    • 2016
  • In this paper, by managing the biometric data is changed with the passage of time, a systematic and scientifically propose a framework to increase the bio-vector generation efficiency of the smart health care. Increasing the development of human life as a medicine and has emerged smart health care according to this. Organic and efficient health management becomes possible to generate a vector when the biological domain to the wireless communication infrastructure based on the measurement of the health status and to take action in accordance with the change of the physical condition. In this paper, we propose a framework to create a bio-vector that contains information about the current state of health of the person. In the proposed framework, Bio vectors may be generated by collecting the biometric data such as blood pressure, pulse, body weight. Biometric data is the raw data from the bio-vector. The scope of the primary data can be set to active. As the collecting biometric data from multiple items of the bio-recognition vectors may increase. The resulting bio-vector is used as a measure to determine the current health of the person. Bio-vector generating the proposed framework, it can aid in the efficiency and systemic health of healthcare for the individual.