• 간호행정학회지
• /
• 제14권3호
• /
• pp.229-240
• /
• 2008

Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

• 한국치위생학회지
• /
• 제23권4호
• /
• pp.245-250
• /
• 2023

Objectives: This study was conducted to analyze the factors related to unmet dental care needs in Korean adults who needed dental treatment. Methods: This study analyzed data from the 7th Korea National Health and Nutrition Examination Survey (2016-2018). Among the adults who participated in the National Health and Nutrition Examination Survey, 2,723 dental treatment who performed oral examinations were the final subjects. General characteristics and oral health characteristics were analyzed with complex sample chi-square test using the IBM SPSS program. Factors related to unmet dental care were analyzed by multiple logistic regression analysis. Results: As for unmet dental care needs related factors, bad oral health was 3.383 times higher, and usually was 1.736 times higher. In the use of dental clinic unmet dental care needs was 0.121 times lower. Unmet dental care needs was high, 1.366 times for those with the experience of tooth pain and 2.736 times for those with chewing difficulty. Conclusions: Based on the above results, it can be seen that oral health status or oral discomfort is related to unmet dental care needs. It is necessary to set goals to improve unmet dental care, recognize that one's oral health condition is very important, and continuously educate about oral health for each life cycle.

• 보건행정학회지
• /
• 제1권1호
• /
• pp.116-135
• /
• 1991

Few studies have been conducted on the detailed routes of medical care utilization under the National Health Insurance. This study was undertaken to identify the utilization patte군 of health care facilities among industrial workers and their dependents. One of the largest health insurance association was purposively chosen for this objective. The association had 345, 757 members as of 31 December, 1990. The study sample of 297, 948 subjects have been drawn from the membership pool on the basis of their continuous membership status during 1 January through 31 December 1990. This study has tried to identify differential utilization patterns between acute and chronic conditions, and among standard income classes. All the diagnoses were recoded in a manner to achieve the objective of this study. As for acute diseases, most age group had used one medical facility as much as by 60% except the age group of 1-4, This young age group had used over three different health facilities as much as by 10.9-15.8%. The finding suggests that some policy measures by sought for remedying the excessive/inappropriate use of services. In addition, mid-income classes(between 17 and 48) were more likely to use multiple sources of care than lower income classes(between 1 and 16) and upper income classes(above 49). This study has revealed that chronic cases are more likely to pursue multiple sources of care, however those with chronic conditions tend to use single health facility more than those with acute conditions(67.9% versus 52.4%). As many as 12.2% have visited more than three health facilities in chronic conditions, but 5.9% for acute conditions. The most likely source of care was primary clinics for both acute and chronic conditions. Compared with the role of general hospital, small-size hospitals found to play a minimal role in the care and referral of patients. This indicates the need of strengthening the function of small-size hospitals. While a minor cross utilization of western medicine and pharmacy was noted, no significant boundary crossing was identified between western medicine and oriental medicine, or between pharmacy and oriental medicine. It is too early to confirm that whether there is substitutability or cross utilization among these alternative sources of care. A further study is needed to identify these relationship.

• 한국학교ㆍ지역보건교육학회지
• /
• 제14권3호
• /
• pp.89-99
• /
• 2013

Objectives: This study was designed to examine the effects of oral health behaviors and use of dental clinics on periodontal diseases in women, the purpose of this study is to provide basic information to develop program for dental health promotion in young women. Methods: We conducted a survey targeting 486 women that agreed with the survey and were going to dental clinic from October 1, 2013 to October 18, 2013. We surveyed them by self-administered questionnaire and analyzed it by SPSS Win 19.0 program. Results: 1. For differences in periodontitis according to general characteristics, if th age is high, ratio of periodontitis is high. Married woman is higher than single one in ratio of periodontitis. Also the more number of birth, the higher ratio of periodontitis is.(p<.05) 2. For differences of periodontitis by dental care behavior, ratio of periodontitis of non-smokers is significantly low. For one that brush one's teeth broadside, the ratio of periodontitis is high.(p<.05) 3. For differences of periodontitis by use of dental clinic service, ratio of periodontitis of one that have more times visit to a dental clinic, more annual average cost for dental care, and regular dental check-ups is relatively low.(p<.05). 4. For determinant factors influencing on periodontitis, ratio of periodontitis of one that is old, have more stress, have a low level of education, and have preventive dental care is high. Ratio of periodontitis of one that have less toothbrushing and brush one's teeth after having lunch or a snack and before sleeping is significantly low. Conclusions: From this study, dental health behavior as the factor influencing on periodontitis of young women is statistically meaningful. Because this dental health behavior has a lot of potential to be improved by government and local community efforts such as education and social support, we think that systematic and various educational program development is needed to strengthen self dental care ability effectively with policy support.

• 치위생과학회지
• /
• 제15권6호
• /
• pp.775-785
• /
• 2015

본 연구는 KNHANES 제6기 1차 년도(2013년) 자료를 이용하여 성인의 구강위생용품 사용에 영향을 미치는 요인을 파악하고자 하였다. 만 19세 이상 성인 4,839명을 최종 분석대상자로 하여 다음과 같은 결론을 얻을 수 있었다. 교차분석 결과 구강위생용품의 사용(하루 칫솔질 빈도, 치실 사용 여부, 치간칫솔 사용 여부, 구강양치용액 사용 여부)은 성별, 나이, 교육수준, 가구소득, 결혼상태, 치과의료 이용, 치과검진 여부와 통계적으로 유의한 관련성을 나타냈다. 구강위생용품 사용에 미치는 변수를 로지스틱 회귀분석으로 살펴본 결과 성별, 교육수준이 공통적인 영향요인으로 나타났으며, 구강위생용품에서 모두 공통되지는 않았지만 구강건강상태와 치과의료 이용, 최근 1년간 치과검진 여부가 통계적으로 유의한 관련성을 나타냈다. 치과 전문인력인 치과위생사는 구강위생용품을 세분화하여 각 영향 요인을 인식하고 개인의 특성 및 구강상태를 반영한 구강보건교육매체 및 프로그램 개발을 통해 국민구강보건증진에 기여해야 할 것이다.

• 한국엔터테인먼트산업학회논문지
• /
• 제13권3호
• /
• pp.249-258
• /
• 2019

보건의료서비스는 장애인을 포함한 국민의 건강을 위해 제공되는 가장 기초적인 사회제도이다. 그러나 언어장애가 있는 사람 중 언어치료 이용여부에 따른 보건의료서비스의 차이를 알아본 연구는 미흡하였다. 본 연구는 언어장애가 있는 장애인을 대상으로 언어치료 이용여부에 따른 특성과 보건의료서비스의 인식을 비교하고자 하였다. 연구자는 2017년 장애인 실태조사의 원시자료를 이용하여 언어장애를 가진 사람 229명을 선정하였다. 이 중 언어치료를 이용하는 자와 이용하지 않는 자를 구분하여 그들의 특성(사회인구학적 특성, 장애특성)과 보건의료서비스 인식(미충족 의료, 정부 또는 사회에서 강화해야할 보건의료 서비스)을 비교하였다. 229명의 언어장애가 있는 사람 중 언어치료를 이용하고 있는 사람은 37명(16.2%)이었다. 언어치료 이용자는 비이용자와 비교하여 나이가 젊었고, 미취학인 아동이 많았으며, 월평균 총 가구 소득이 높았으며, 장애등록유형에서 지적장애와 자폐성장애가 더 높은 비중을 차지했다. 언어치료 이용자는 비이용자에 비해 미충족 의료 경험의 비율이 낮았다. 미충족 의료 이유에서 언어치료 비이용자 49명의 분포를 살펴보면 '경제적인 이유'와 '의사소통에 어려움'이 13명(6.8%)과 12명(6.3%)로 1순위와 2순위를 차지하였다. 언어치료 비이용자와 이용자 모두는 정부(사회)에서 강화해야 할 보건의료서비스로 '장애관리'를 요구하였다. 본 연구의 결과는 언어장애가 있는 사람의 언어치료 이용의 장벽을 낮추기 위해서 보건의료서비스의 접근성을 증대시킬 필요가 있음을 시사한다.

• 보건교육건강증진학회지
• /
• 제7권2호
• /
• pp.78-88
• /
• 1990

The subject of this study is to review the practical approaches of Home Care Services. Included is a brief overview of its nature, providers of Home Care Services, recent history of Home Care Services, and the impact of the national movement toward cost containment in health care. The data used in this study are obtained from the Elderly Program of the Medical Services and other data on the Home Care Services in Japan. With the growing elderly population in Japan, it is to be expected that the medical care expenditure for this sector will continue to increase. With the aim of keeping expenditure for medical care within reasonable bounds, it is essential that this increasing expenditure on the elderly be used effectively. With the Health and Medical Services Law for the Aged was enforced, therefore, remuneration for medical treatment of the elderly and what is known as the staff placement standard at hospital for the elderly were rationalized. In addition to rationalization from the point of view of medical care supply, it is necessary to guarantee the appropriate treatment within the community and at home for those elderly who are bedridden but not in need of hospital care. For this it is required that Home Care Services, such as health services like visiting guidance by public health nurse in hospital of Health Center. So that the elderly can feel secure in receiving treatment within the community and at home, allowances for guidance on leaving hospital and for intermittent nursing and guidance thereafter are to be newly introduced. Home care Services in one aspect of comprehensive health care, it is comprised of health services provided to individuals and families in their homes. Its purposes include promoting, maintaining and restoring health, specifically maximazing independent functioning and minimizing the disabling effects of illness, including terminal illness. Services appropriate to the needs of clients and their families are planned, coordinated, and delivered by providers organized for the delivery of home health care through the use of contractual arrangement, employed staff, or a combination of the two.

• 보건행정학회지
• /
• 제2권1호
• /
• pp.115-147
• /
• 1992

The purposes of this paper are twofold : to identify what pathway insured patients are seeking medical care services through, and then, to provide the basis for the prediction and evaluation of the effects of a new policy intervention. To change the patient flow across different types of medical care facilities, this intervention has been enforced since July 1, 1989. It is mainly aimed at discouraging the use of the tertiary hospitals by imposing some restrictions on the patient's choice. The data for analysis were obtained from the claims to the insurance for govermment and school employees. The sample was drawn from the claims for about 1% of the enrollees using medical care facilities during 2 years since January 1, 1985. The sample included 91, 483 for 1985 and 81,914 for 1986, among them the number of patients to initiate the use of medical care service were 66,757 and 59,498 respectively. This paper analysed what types of and how many medical care facilities the patient with same disease had used.

• 보건행정학회지
• /
• 제24권4호
• /
• pp.349-356
• /
• 2014

Background: This study aimed to explore factors associated with the non-use of beneficiaries of long-term care insurance services for the elderly in Jeollanam-do Province by analyzing a dataset obtained from National Health Insurance Service. Methods: The study sample consists of 1,663 individuals who were evaluated as eligible for long-term care insurance services in Jeollanam-do Province during the period of July 1, 2008 through June 30, 2009. As a dependent variable, the non-use of the service was defined as one when a beneficiary had used it once or more times during one year after he or she was evaluated as eligible and as zero otherwise. A proportion analysis was conducted to describe characteristics of study sample. Chi-square tests were used to compare general characteristics between beneficiaries who had used the services and those who had not used them. Multiple logistic regressions were performed by three models including additional sets of explanatory variables such as socio-demographic characteristics, health conditions, and economic status. Results: Main results are summarized as follows. The proportion of beneficiaries who had not used the service was 14.5% of all beneficiaries. According to the results from the model using all explanatory variables, the factors associated with the non-use of the services were residence location, dwelling place, type of desired service, level of care needs, and instrumental activities of daily life limitations. Conclusion: In particular, regarding the type of desired service, the cash benefit showed a high likelihood of the non-use of the service; it had an odds ratio (OR) of 50.212 (95% confidence interval [CI], 24.00-105.04) compared with home service. In case of dwelling place, a hospital showed also a high likelihood of the non-use with an OR of 20.71 (95% CI, 10.12-42.44) compared with home.

• 한국치위생학회지
• /
• 제19권5호
• /
• pp.743-752
• /
• 2019

Objectives: Grip strength is a measure for assessing overall muscle strength, muscle mass, and nutritional status, and is a useful tool for early examination of a person's general health. Thus, this study analyzed the association between oral health-related factors and grip strength, using the 6th Korea National Health and Nutrition Examination Survey (KNHANES) data. Methods: Data were analyzed using the IBM SPSS version 25.0 (IBM Co., Armonk, NY, USA) software with a complex sampling analysis of stratified and clustered variables, all with weighted values, applied for every analysis conducted. From the 6th KNHANES data, a total of 26,101 people were selected as the study population. A complex sample generalized linear model analysis was performed for participants' sociodemographic characteristics, health status, use of oral care products, and factors such as adult mastication and speaking habits. Results: Grip strength was found to be higher among men compared to women. Grip strength was the highest in the 20-39 year old group. Furthermore, grip strength was statistically significantly higher among married and employed individuals, and in the right hand (p<0.001). Grip strength was statistically significantly higher among people who perceived themselves to have good health and among those who did not have health-related problems in the past two weeks (p<0.001). It was also higher among those who used interdental brushes and electronic toothbrushes (p<0.001), but decreased with greater discomfort in mastication and speaking among adults (p<0.05). Conclusions: Grip strength was found to be associated with oral health-related factors and therefore, these could be helpful tools in evaluating both general and subjective health statuses. In general, oral care products are small in size with oral care involving the use of hands and certain precise motions and actions to remove foreign substances in the oral cavity. As shown in the findings, grip strength declines with increased age and as a result, the use of oral care products should be strongly recommended in order to promote better general health.