• Title/Summary/Keyword: Healthcare Utilization

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Development of Case Management System and Analysis of Economic Feasibility under the Fee-For-Service Reimbursement (행위별 수가 지불제도 하에서의 사례관리시스템 개발 및 경제성 분석)

  • Choi, Mi Young;Chae, Young Moon;Tark, Kwan Chul;Kim, In Suk;Chun, Ja Hae
    • Quality Improvement in Health Care
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    • v.11 no.1
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    • pp.46-60
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    • 2004
  • Background : Recently, we have experienced various changes in the healthcare environment. Healthcare organizations are facing a financial crisis due to more competitive relationships among themselves as well with low health insurance fees. The purposes of the current study were: (1) to develop a data warehouse-based system for evaluating and monitoring the case management activities, and (2) to measure and analyze its effects. Methods : In order to collect the data for the study, the database on discharged patients was utilized at a university hospital located in Seoul from June 1, 2002 through December 31, 2002. Initially, a data warehouse was built for the case management system. The case management activities were analyzed using structured methodology to establish the case management system. Results : The findings of this study were as follows: (1) A case management system was developed to make it possible to monitor of healthcare quality and resource utilization. The Case management System included monitoring functions regarding utilization reviews, critical pathways, and clinical indicators. (2) Utilizing the case management system, unplanned readmissions were documented among total discharged patients during two months from November 1, 2002 through December 31, 2002. The unplanned readmission rate was 2.3%(276 patients) in total of 11,960 discharged patients. Among them 81 patients(0.7% of total discharges, 29.3% of unplanned readmission) were readmitted to the same physician in charge under the same diagnosis. No significant differences were found in the demographic variables such as gender and age among the patients. (3) After implementing the case management system, 2.9% of average length of stay reduced. Applying cost-benefit analysis, the 2.9% reduction of length of stay represents net profit of ${\backslash}$ 279,592,000 in the year of 2004. In addition, applying value acceleration analysis, cumulative net benefit of ${\backslash}$ 1,481,000,000 was expected by the year of 2007. Also we were able to expect ${\backslash}$ 247,800,000 of cumulative benefit for the prospective 5 years in value linkage analysis. It represents average ${\backslash}$ 787,700,000 of pure net benefit a year. Conclusion : The value of present study would be not only implementing the knowledge management system into the existing case management activities, but also evaluating its effects and estimating its financial benefits. This study suggested that the case management system would be a supportive tool for monitoring and improving the quality of healthcare, and a cost-effective tool for increment of healthcare organization's financial benefit.

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The Meaning and Tasks of Guidelines for Utilization of Healthcare Data (보건의료 데이터 활용 가이드라인의 의미와 과제)

  • Shin, Tae-Seop
    • The Korean Society of Law and Medicine
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    • v.22 no.3
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    • pp.31-55
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    • 2021
  • The Personal Information Protection Act, one of the revised 3 Data Laws, established a special cases concerning pseudonymous data. As a result, a personal information controller may process pseudonymized information without the consent of data subjects for statistical purposes, scientific research purposes, and archiving purposes in the public interest, etc. In addition, as a follow-up to the revised Personal Information Protection Act, a 'Guidelines for Utilization of Healthcare Data' was prepared, which deals with the pseudonymization in the medical sector. The guidelines are meaningful in that they provide practical criteria for accomplices by defining specific interpretations and examples that take into account the characteristics of healthcare data. However, the guidelines need to clarify the purpose of using pseudonymous data and strengthen the fairness of the composition of the data deliberation committee. The guidelines also require establishing a healthcare data compensation framework and strengthening the protection of rights for vulnerable subjects. In addition, the guidelines need to be adjusted for inconsistency with the Bioethics and Safety Act and the Medical Service Act. It is expected that this study will contribute to the creation of a safe environment for the utilization of healthcare data as well as the improvement of related laws and systems.

Related Factors on Health Service Utilization and Satisfaction of Health Center Clients -Using '2010 Community Health Survey'- (보건기관 이용 현황 및 만족도와 관련 요인 -'2010지역사회건강조사' 자료를 이용하여-)

  • Kim, Hye-Sook;Park, Young-Hee
    • The Korean Journal of Health Service Management
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    • v.7 no.3
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    • pp.95-109
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    • 2013
  • The objective of this study is to assess the utilization and satisfactions about public health centers in Korea. For the analysis, the study utilize the nationwide data of 229,229 person on '2010 Community Health Survey' of Ministry of Health & Welfare. The statistical methodology used in the study is ${\chi}^2$, ANOVA, logistic regression model and multiple regression model. This study have four major findings. First, the significant affecting socio-demographic factors in utilizing public health center were gender, age, region, national basic living secured, married, income, education, job, state of health, chronic disease, unmet medical needs and utilization reason. Second, the most serviced category of health center user was vaccination both city and rural area and the next was certificate, primary care, health screening, other use, the mother and child in city area, primary care, health screening, certificate, home visiting health in rural area. Third, the significant affecting socio-demographic factors in satisfaction degree on health center service were age, region, national basic living secured, income, education, job, state of health, utilization degree and reason. Fourth, the most satisfied service of health service center was home visiting health in city area and mental health service in rural area and the next was nutritive control and the lowest satisfied service was user of certificate. The utilization and satisfaction on health center service were identified as different with residental area and user's characteristics. The politic effort are needed to support socially disadvantaged class and to narrow regional gap.

Analysis of Local Community Spaces Bringing Empty Homes Back into Use in Japan - Focused on Empty Home Utilization Model Project of Kyoto City - (일본의 빈집을 활용한 지역사회 커뮤니티 거점공간 분석 - 교토시 「빈집활용 & 마을만들기」 모델 프로젝트를 중심으로 -)

  • Park, Hae-sun;Eun, Nan-Soon
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.24 no.2
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    • pp.65-77
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    • 2018
  • Purpose: By identifying the contents of the "Empty Home Utilization & Community Revitalization Model Project" which is a pilot project of empty homes back into use in Kyoto City and analyzing the characteristics of the case housing, the purpose of this study is to find out implications and suggest improvements for the domestic empty home utilization project. Methods: The scope of the survey covers seven project sites in the period from 2014 to 2016. The research method is to derive the physical and operational characteristics of the project, through the literature reviews related to bringing empty homes back into use in Kyoto City and the field survey including the space measurement and the operator interview. Results: First, in order to succeed in bringing empty homes back into use for community revitalization, the selection process of the project and the role of the public in and after supporting the project are important. Second, the important features that are required as a physical characteristic of the project are an advantage in location and an interactive space that is available at all time like a community cafe at the entrance. Third, as an operational characteristic of the empty home utilization project, it is advantageous for the local residents to participate as a business actor or an operator, and it is the continuous use of residents and outsiders by implementing an operating program that is suitable for the characteristics of the local community. Implications: The physical and operational activation factors to bring empty homes back into use need to be included as the project screening standards. And it is necessary for the public to develop the Intermediate Support Organization and to participate in linking with residents in order to carry out the empty homes utilization project effectively.

A Study on the Delivery Planning of Nursing Homes in Korea (한국 노인요양시설의 공급계획에 관한 연구)

  • Kwon, Soon-Jung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.5 no.9
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    • pp.47-59
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    • 1999
  • With the unparalleled rate of aging and rapid modernization, Korean society faces the situation in which it has to increase the supply of elderly care services dramatically in the near future. Among these services, nursing homes are considered as an essential alternative provision because Korea can no longer rely on traditional familism nor medical facilities for the care of her older population. It is necessary, therefore, to prepare a future plan for the delivery of nursing homes in Korea. This paper has identified elderly care context and analyzed elderly care facilities of Korea in the point of supply and utilization rate of nursing homes according to the region and type of facilities. On the bases of this analysis, the delivery planning of nursing homes in Korea has been proposed in order to increase welfare status of older people and efficient utilization of health care resources.

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Effects of Supplemental Insurance on Health Care Utilization and Expenditures among Cancer Patients in Korea (암 보험이 암 환자의 의료이용 및 의료비에 미친 영향)

  • Kang, Sung-Wook;Kwon, Young-Dae;You, Chang-Hoon
    • Health Policy and Management
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    • v.15 no.4
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    • pp.65-80
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    • 2005
  • This study examines the effects of supplemental insurance on health care utilization and expenditures among cancer patients, who were hospitalized in a general hospital in Korea 2003. We find that those who purchase the supplemental insurance in addition to the social health insurance use more health care services and pay more than those who do not, suggesting insurance effects. This paper, however, cannot distinguish the moral effects of the health insurance from the selection effects due to adverse selection.

A Study on the Program and Utilization of the Multipurpose Senior Center in Deajeon (대전시 노인종합복지관의 운영프로그램 및 이용실태에 관한 연구)

  • Jeon, Young Hoon;Chai, Choul-Gyun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.14 no.3
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    • pp.35-42
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    • 2008
  • The purpose of this study is to provide the fundamental materials for architectural planning of the Multipurpose Senior Center according to regional characteristics, and to analyze the Multipurpose Senior Center at the view of the program and utilization. For the analysis of the actual condition are surveyed 164 respondents und programs in four facilities in Deajeon. The results of this study are as follows; 1. the characteristics, problems and demands of the section of social education, the counseling, the medical rehabilitation, the sports education, etc. 2. the consideration factors for the planning of the program and volume of the Multipurpose Senior Center on the basic of the rate of increase in population of the Elderly in regions.

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Prenatal care utilization and expenditure among pregnant women (임부의 산전진찰 의료이용양상 및 진료비 분석)

  • Kim, Kyung-Ha;Hwang, Rah-Il;Yoon, Ji-Won;Kim, Jin-Soo
    • Health Policy and Management
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    • v.19 no.4
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    • pp.53-65
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    • 2009
  • Purpose: This study was conducted to identify the prenatal heath care utilization and expenditure among pregnant women. Method: This was a 5-month follow-up study using a stratified sampling and the data were drawn from the "nationwide claim database of Korean National Health Insurance Corporation". Result: This study found that pregnant women were first diagnosed with pregnancy when they were 7.1 weeks pregnant, received 12.7 times of prenatal examinations and 10.6 times of ultrasonogram. It was revealed that 67.5% of the subjects continued to receive prenatal care at the same medical institutions from the diagnosis of pregnancy to the delivery. The study also showed that the total expenditure of prenatal care per pregnant woman was 700,000 Korean Won (KRW) on average and the insurance coverage rate stood at only 20%. Pregnant women living in metropolitan area spent more on prenatal healthcare expenditure than those who living in medium-sized city or rural area. Conclusion: The results of this study implies that the government needs to provide pregnant women with continuous support by increasing health insurance coverage for prenatal care. Especially, it is considered to provide more support to the pregnant women residing in medically underserved areas.

The Effect of Private Health Insurance on Health Care Utilization: Evidence from Korea Health Panel (2008~2010) (민간의료보험이 의료 이용에 미치는 영향: 한국의료패널(2008-2010)을 이용한 Two-Stage 분석)

  • You, Chang-Hoon;Kang, Sung-Wook;Choi, Ji-Heon;Oh, Eun-Hwan;Kwon, Young-Dae
    • The Korean Journal of Health Service Management
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    • v.8 no.2
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    • pp.101-113
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    • 2014
  • This paper examined the effects of private health insurance(PHI) on the health care utilization among the Korean. The used data was the three waves of Korea Health Panel (2008, 2009, 2010), and the number of subjects was 13,951 persons. Authors employed two-stage least square panel model where the instrument variables for controlling for endogeneity of PHI were number of insurance planner per 100,000 in resident area and whether subject worked on financial profession. The results showed that healthcare expenditure of outpatients who purchasing PHI was higher than that of outpatients without PHI, and there was no difference in admission between the two groups. This article recommended the Korean government to monitor the effects of PHI on the health care utilization in order to improve the efficiency of health care finance.

A Study on the Management and Utilization of Sub-Health Center in Rural area, Paraguay [1] - Focused on Limpio, Paraguay (파라과이 농촌지역 보건지소의 시설 관리 및 이용실태에 관한 연구[1] - 파라과이 림삐오시를 중심으로)

  • Kim, Ji Eon;Kim, Min Kyu;Nam, Eun Woo
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.26 no.2
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    • pp.7-17
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    • 2020
  • Purpose: The purpose of this study is to identify the operational status and current management of Sub-Health Centers in Limpio, Paraguay. Second, understanding the use of Sub-Health Centers and Perceptions of Sub-Health Centers in Limpio, Paraguay. Third, Providing policy implications for strengthening the Health Delivery System in Paraguay. Methods: The survey of the current status of sub-health centers in Limpio was conducted with observation and interview. Utilization of Sub-Health centers was analyzed in the 2018 Paraguay Community Health Survey. A face to face interview was conducted to complete a questionnaire and 831 samples were collected for the study. Results: In order to perform the normal function of the sub-health center, it will be necessary to allocate manpower that meets the standard. A common problem with sub-health centers in Limpio is that they have an environment vulnerable to rain. Currently, there are no health promotion and communicable disease management programs in sub-health center. Satisfaction of users about treatment, equipment, medicines and cleanleness of rooms. Implications: First, it is necessary to allocate human resources and organize spaces according to the standard. Second, there was a problem caused by moisture, and continuous maintenance and repair are required. Third, water and sewage related facilities must be safely improved to prevent contamination of groundwater. Forth, it is necessary to implement a program that fits the role of the sub-health center. Fifth, it is necessary to form a health delivery system considering the accessibility of residents. Finally, it is necessary to discuss the location of sub-health center considering travel time of Limpio residents.