• Journal of Preventive Medicine and Public Health
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• v.37 no.2
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• pp.141-149
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• 2004

Objectives : To evaluate the cost and proportion of complementary and alternative medicines (CAM) in the total healthcare costs among the elderly in the last 6 months of life. Methods : The care-giving families of 301 persons older than 65 years, who died between July 1st and December 31st of 2001, and were also registered in Self-Employed Health Insurance Programs in Seoul, were interviewed. Results : The cost of CAM was 1.09 million Won, which as a proportion of the total healthcare cost was 38.1%. The elderly aged between 65 and 69 year-old, male, living with their spouse, Buddhist and having cancers had higher CAM costs in an ANOVA and simple regression analysis. After controlling of various factors, age was the only significant factor associated with the cost of CAM. The elderly above 80 years old, female, bereaved and Buddhist had higher proportional CAM costs, and the elderly having cancers or cardiovascular diseases had lower proportional CAM costs in an ANOVA and simple regression analysis. After adjusting for various factors, the elderly above 85 years old, female and Buddhist had higher proportional CAM costs, and the elderly having cancers had lower proportional CAM costs. Conclusion : The very old and Buddhist, and/or the ill with no clear diagnosis, may depend more on CAM. Further research will be needed on the meaning and impact of CAM and their costs to public health and the total healthcare system.

• Health Policy and Management
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• v.22 no.1
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• pp.65-84
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• 2012

Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.

• Journal of Preventive Medicine and Public Health
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• v.46 no.4
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• pp.201-209
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• 2013

Objectives: The goal of this study was to perform an economic analysis of a primary stenting with drug-eluting stents (DES) compared with bare-metal stents (BMS) in patients with acute myocardial infarction (AMI) admitted through an emergency room (ER) visit in Korea using population-based data. Methods: We employed a cost-minimization method using a decision analytic model with a two-year time period. Model probabilities and costs were obtained from a published systematic review and population-based data from which a retrospective database analysis of the national reimbursement database of Health Insurance Review and Assessment covering 2006 through 2010 was performed. Uncertainty was evaluated using one-way sensitivity analyses and probabilistic sensitivity analyses. Results: Among 513 979 cases with AMI during 2007 and 2008, 24 742 cases underwent stenting procedures and 20 320 patients admitted through an ER visit with primary stenting were identified in the base model. The transition probabilities of DES-to-DES, DES-to-BMS, DES-to-coronary artery bypass graft, and DES-to-balloon were 59.7%, 0.6%, 4.3%, and 35.3%, respectively, among these patients. The average two-year costs of DES and BMS in 2011 Korean won were 11 065 528 won/person and 9 647 647 won/person, respectively. DES resulted in higher costs than BMS by 1 417 882 won/person. The model was highly sensitive to the probability and costs of having no revascularization. Conclusions: Primary stenting with BMS for AMI with an ER visit was shown to be a cost-saving procedure compared with DES in Korea. Caution is needed when applying this finding to patients with a higher level of severity in health status.

• The Journal of Health Technology Assessment
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• v.6 no.2
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• pp.123-132
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• 2018

Objectives: Maternal morbidity and mortality are important healthcare issues. However there have been few studies on cost of illness (COI) from maternal disorders. This study aimed to estimate the COI due to maternal disorders in Korea. Methods: By reviewing previous studies and consulting expert we determined the scope of maternal disorders. We operationally defined maternal disorders as maternal hemorrhage, maternal sepsis, hypertensive disorders of pregnancy, obstructed labor, and abortion for maternal disorders. The reference period of this study is the year 2015. Main source of data were the National Health Insurance Service claims data, cause of death statistics from the Korea National Statistical Office, and the Korea Health Panel study. We classified the total costs into direct and indirect costs. The direct costs cover healthcare costs and non-healthcare costs. The indirect costs consist of productivity losses due to morbidity and premature death. Results: The cost of maternal disorders in 2015 was 229.7 billion won. The direct and indirect costs of maternal disorders were 165.2 billion won and 64.5 billion won respectively. The largest cost item for maternal disorders was healthcare cost (138.3 billion won, 60.2%). By age groups, the COI in 30-39 years old women were the highest (165.1 billion won, 71.9%). Abortion was the disorder with the highest COI among maternal disorders (71.9 billion won, 31.3%). Conclusion: The COI due to maternal disorders in Korea is quite substantial. Economic burden of maternal disorder increased when being compared with the year 2012 data despite the continued low birth rate in Korea. Therefore, it is necessary to continuously monitor the social costs of the maternal disorders in Korea.

• Journal of Preventive Medicine and Public Health
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• v.52 no.1
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• pp.51-59
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• 2019

Objectives: The purpose of this study was to estimate the mediating effect of subjective unmet healthcare needs on poor health. The mediating effect of unmet needs on health outcomes was estimated. Methods: Cross-sectional research method was used to analyze Korea Health Panel data from 2011 to 2015, investigating the mediating effect for each annual dataset and lagged dependent variables. Results: The magnitude of the effect of low income on poor health and the mediating effect of unmet needs were estimated using age, sex, education level, employment status, healthcare insurance status, disability, and chronic disease as control variables and self-rated health as the dependent variable. The mediating effect of unmet needs due to financial reasons was between 14.7% to 32.9% of the total marginal effect, and 7.2% to 18.7% in lagged model. Conclusions: The fixed-effect logit model demonstrated that the existence of unmet needs raised the likelihood of poor self-rated health. However, only a small proportion of the effects of low income on health was mediated by unmet needs, and the results varied annually. Further studies are necessary to search for ways to explain the varying results in the Korea Health Panel data, as well as to consider a time series analysis of the mediating effect. The results of this study present the clear implication that even though it is crucial to address the unmet needs, but it is not enough to tackle the income related health inequalities.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2016.10a
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• pp.755-758
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• 2016

The use of smart phones has had a great impact on the mobile internet business. It shows a lot of growth in the healthcare sector not only commerce, advertising, billing, games, video content, media, amd O2O business. The United States has eased the regulations for healthcare apps smart phone devices in 2015, and China has established a five-year road map to solve shortage of doctors and hospital beds by utilizing mobile devices such as wearable in the same year. The application of wearable devices in the medical field is gradually increasing in Korea too, but there is a security problem as leading challenge. Security incidents in non-ICT sectors such as financial, medical, etc. have increased by using ICT each year. Personal information leakage is also increasing in field likely occurring the potential secondary damages such as financial fraud, illegal promotions, insurance and pharmaceutical companies abuse. In this study, we analyze malwares as the mobile threats, the five risks of mobile smart phone, mobile use cases and the mobile threat countermeasures for healthcare.

• Korean Journal of Social Welfare Studies
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• v.42 no.4
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• pp.61-102
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• 2011

The purpose of this article is to anatomize the political dynamics of South Korea's healthcare policymaking through the integrative analytical framework combining the policy network perspective and the advocacy coalition theory. This framework is expected to be advantageous to the analysis of Korea's turbulent healthcare policy change from a systematic and process-driven point of view. A target of analysis is the two decades of turbulence to transform the health insurance system into a single payer system. Through the analysis, this article tries to illuminate the dynamics of Korea's healthcare policymaking, by connecting environmental context, policy networks, advocacy coalitions, and policy outputs. For a case study, this article classifies the debates to inaugurate a single payer system into four sub-phases and conducts longitudinal comparative research.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.1
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• pp.497-505
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• 2018

This study was conducted to investigate the characteristics of private health insurance subscribers and non-subscribers as they relate to severely ill patients, and to identify the factors of participation. The study was conducted using the National Health and Nutrition Examination Survey for 2015, and data were analyzed using SPSS ver. 23.0. The subjects were 417 patients with severe disease (cancer, heart disease, cerebrovascular disease) over 19 years of age. Crossover analysis was employed to identify differences between the state of private health insurance participation, while binary logistic regression analysis was used to confirm the factors affecting private health insurance subscription. Analysis of the effects of the subjects on the private health insurance participation rate revealed that the social and demographic characteristics were higher in younger individuals regardless of sex, residence, or marital status. Moreover, higher household income, regardless of the education level, was associated with a higher participation rate of health insurance target individuals compared to medical benefit target individuals. The private health insurance participation rate was low and the explaining power was 51.7%, regardless of subjective health awareness and walking practice. Therefore, efforts should be made to improve the living environment and support local governmental programs for the elderly, low income households, socially vulnerable groups with limited activities and groups with limited health behavior. It is also necessary to consider various health policies, such as providing government health education or programs to prevent severe illness.

• Journal of The Korea Institute of Healthcare Architecture
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• v.20 no.4
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• pp.67-80
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• 2014

Purpose : Long-term Care Insurance sets up facility standard and installation standard of aged care facilities and decides the presence of minimum number of rooms and its size in care facilities by using systematic instruments. Therefore, most aged care facilities had renovation in expansion and reconstruction following the revised regulations and even facility space structure and space composition are continuously improving. The study is to determine the purpose and trend by comparing before and after space composition of facilities which followed the implementation of Long-term Care Insurance and also to suggest hierarchical space composition suitable for aged care facilities through derived problems and to provide basic materials to plan the most appropriate facility for the aged. Methods : J-graph based on Space Syntax Theory will be schematized through in-site facility survey and before and after facility floor plan. Space composition trend will be analyzed by comparing indexes through S3 program. Results : As a result of 5 cases analysis, the following results were found; the average of whole space depth is increasing due to the Extension, the number of volunteers is decreasing and rooms for geriatric care helpers are being created due to the geriatric care helper introduction duty. Also, there are solariums being created to improve the health of the aged and dispensaries are being placed on every floor with the increase of documentary work for geriatric care helpers. With the policy implementation, care facility space composition and structure are changing with facility standard and it was analyzed that facilities were mostly put under the control of limited number of people in care room and total ground area per person. It was also found that there is increase in care space integration through before and after comparison of whole integration value. This is considered as the important result not only in facility standard satisfaction, but also in care support of geriatric care helpers and the aged, its main users. Implication : In order for elderly care facilities to have quality improvement and to develop as suitable facilities for characteristics of the aged, independent environmental facility standard preparation of elderly care facilities is needed through mutual cooperation of construction fields with regulation and policy related researches.

• Journal of Service Research and Studies
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• v.9 no.3
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• pp.87-99
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• 2019

Healthcare and data science are often linked through finances as the industry attempts to reduce its expenses with the help of large amounts of data. Data science and medicine are rapidly developing, and it is important that they advance together. Data science is a driving force in transition of healthcare systems from treatment-oriented to preventive care in healthcare 3.0 era. It enables customized precision-based medicine that current healthcare systems cannot facilitate, and discovers more cost-effective treatment. Currently, healthcare big data is in the reality of medical institution, public health, medical academia, pharmaceutical sector as well as insurance agency. With this motivation, the medical college of Soonchunhyang university has performed a 'healthcare data science initiative(HDSI)' since 2014. Most of domestic HDSI programs focus on short-term contents such as mentoring and sharing cases for data science. Therefore, it is difficult to provide education tailored to the level of skills and job competency required at the practical site. Soonchunhyang HDSI implemented specialized strategies for improving resilience and response to changes in the IT education of current healthcare with the emphasis on the need for systematic activation of the practical HDSI. The HDSI has been performed as a part of on industry-academic link program in CK-1. Through quantitative and qualitative analysis, this paper discussed the HDSI process, performance, achievement, and implications.