• Korean Journal of Health Education and Promotion
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• v.32 no.4
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• pp.59-65
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• 2015

Objectives: Health screening in Korea is very active in both the public and private sector. However, primary prevention for health promotion has not been activated yet. Quaternary prevention is the prevention of unnecessary medical interventions or the prevention of overmedicalization. Methods: Data was collected after a search of the literature focusing on keyword. The curriculum guidelines for family medicine residents were collected from the homepage of the American Academy of Family Physicians. Results: This quaternary prevention is just beginning. The first step to enhance the health promotion services in the community is to identify the barriers pertaining to the delivering of health promotion activities. These barriers are related to the patient, the physician, attitudes, health promotion programs and the healthcare system. The second step is to establish new changes, such as expansion of insurance coverage, improvement of medical payment system, provision of consumer-oriented services, connection and integration of providers, and the service provider education and training. Conclusions: In order to enhance the health promotion services in the community we need to identify the barriers and to establish several changes to overcome them.

• Korean Journal of Clinical Pharmacy
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• v.27 no.3
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• pp.136-142
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• 2017

Background: Dementia is one of important social and economic healthcare issues in the aging age. Therefore, it signifies to analyze the relationship between chronic disease or cardiovascular drug use and the incidence of dementia to establish a basis for increasing or preventing the risk of dementia. The purpose of this study was to investigate the correlation between the prevalence of chronic diseases and the use of cardiovascular drugs in patients diagnosed with dementia. Methods: In this study, we used data from sample of elderly patients from the Health Insurance Review and Assessment Service. We analyzed by logistic regression analysis with age, gender, and medication as covariates. KCD-7 was used to diagnosis of the disease, and drugs were analyzed using ATC codes and Korean standardized drug classification codes. Results: A total of 1,276,331 patients were analyzed in the sample of the elderly population, of which 532,075 (41.7%) were male and 744,256 (58.3%) were female. The patients have the higher risk of dementia in the older, women, and lower socioeconomically status. Cerebral infarction and ischemic heart disease increases risk of dementia. Patients taking statins, angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor antagonists (ARB) showed low incidence of dementia. Conclusion: This study has been shown that ACEI, ARB, and statin drugs may associate with lower incidence of Alzheimer's and other dementia except vascular dementia.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6985-6989
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• 2013

Background: This study aimed to examine out-of-pocket expenditure for cancer treatments of hospitalized patients and to analyze changing patterns over time. Materials and Methods: This study examined data of all cancer patients receiving inpatient care from two tertiary hospitals from January 2003 to December 2010. Medical expenditures per admission were calculated and classified into those covered and uncovered by the Korean National Health Insurance (NHI) and co-payment. Results: The medical expenditure per admission increased slowly from 3,455 thousand Korean won (KRW) to 4,068 thousand KRW. While expenditures covered by the NHI have increased annually, co-payments have generally decreased. The out-of-pocket expenditure ratio, which means the proportion of uncovered expenditure and co-payment among total medical expenditure dropped sharply from 2005 to 2007 and was maintained at a similar level after 2007. Medical expenditures, NHI coverage, and the out-of-pocket expenditure ratio differed across cancer types. Conclusions: It is necessary to continually monitor the expenditure of uncovered services by the NHI, and to provide policies to reduce this economic burden. In addition, an individual approach considering cancer type-specific characteristics and medical utilization should be provided.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.8 no.3
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• pp.314-323
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• 2001

Purpose : Complementary and alternative therapies(CAT) are defined as those treatments and healthcare practices not taught widely in medical schools, not generally used in hospitals, and not usually reimbursed by health care insurance. Recently, CAT have become increasingly popular with health care consumers and health care professionals. This study investigated nurses' perceptions and experiences with CAT. Method: 124 nurses who were working in university hospitals in Seoul and Inchon were randomly selected as participants for this study. They answered open and closed questionnaires on their Perceptions and experiences with CAT. Results: Most of the subjects recognized the existence of CAT (86.3%), and expected a treatment effect from CAT when it is combined with conventional therapy (84.7%). Nurses accepted CAT positively as complement for conventional therapy and useful modalities of psychological support when its effects have been proven scientifically. Forty nurses (32.3%) had learned CAT including soojichim, aroma therapy, relaxation, meditation, music therapy, massage, and acupressure. Eight nurses (6.5%) used CAT with patients including soojichim, hand massage, relaxation, and music therapy. Conclusion: In spite of the nurses' positive perceptions of CAT, the nurses' professional experiences were quite limited. Nurses need authorized training programs and continuing education opportunities in CAT. This would increase their ability to use CAT. But to improve scientific knowledge more evidence based research is.

• Health Policy and Management
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• v.15 no.4
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• pp.1-25
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• 2005

Legislation on pharmaceutical reimbursement decision using economic evaluation results was made in Korea in fm, but has yet to be fully implemented. We evaluated the quality of Korean economic evaluation studies of pharmaceuticals to understand gaps between legislation and implementation. From this evaluation, we propose policy options that might strengthen the research Infrastructure In order to support such studies. We reviewed 23 published studies for drugs conducted between 1996 and 2004. Evaluation criteria included methodological characteristics, healthcare system characteristics, population characteristics, and applicability of results. Large variation in study quality was observed, particularly with study design, outcome data, treatment patterns and interpretation. Korean clinical data used was mostly from observational studies of 1-2 hospitals. Foreign data was extracted from clinical trials that did not Include Asian population and their selection criterion was not clarified. With respect to treatment patterns, medical records and hospital bills were used without adjustment regarding area, hospital type, and others. And next frequent situation relied on expert opinion from academic physicians in specialty practice. preference measures, when used, were not elicited from the Korean population. $78.3\%$ of studies did not clarify the funding source. If the Korean economic evaluation policy is to provide meaningful data for decision makers, the quality of cost-effectiveness studies will need to improve dramatically. This may involve access to or creation of better data, more diverse funding, unproved training of researchers and evaluators, and partnerships with technology manufacturers.

• Journal of Hospice and Palliative Care
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• v.19 no.2
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• pp.99-108
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• 2016

Hospice palliative care (HPC) in Korea has developed steadily since its introduction in 1965. Currently, HPC in Korea is targeted only towards terminal cancer patients and their families, and the national health insurance scheme covers only inpatient hospice care for said patients. In recent years, healthcare professionals and policy makers began to recognize the need for HPC services in diverse settings including outside hospital boundaries, and for all terminally-ill patients. A law on HPC passed in January 2016 allows terminally-ill patients to refuse life-sustaining treatments, and will likely facilitate further development of HPC services. It is critical for the government and all interested parties in the medical, academic and social sectors to collaborate to ensure its success once it takes effect in 2017. This article will briefly review the half-century history of HPC in Korea, and discuss how to prepare for and cope with death and, thereby, improve the quality of death.

• Health Policy and Management
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• v.28 no.3
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• pp.272-279
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• 2018

Since the introduction of new health technology assessment in 2007, benefit coverage process of health insurance related to new health technology has become an upgraded system through the evidence-based decisions. As a result of enforcing this system for 10 years, however, there have been several rising concerns. It needs to support the insufficient evidence of medical technologies, introduce reassessment system for post management of market entry technologies, and improve evaluation methods and process. In addition, there is the possibility of emerging an unheard-of medical technology, fused various categories like artificial intelligence, robot, information technology, physics and life science in the fourth industrial revolution. Now, new updated system introduced to improve new technology assessment, such as 'limited health technology assessment system,' 'system for postponement of new health technology assessment,' 'one-stop service system,' and 'integrated operation of approval for medical devices and new health technology assessment.' Therefore it needs to prepare the improvement plan for new health technology assessment to be established more advanced system, and we have to resolve concerns by communication with various healthcare experts and patients now and for ever.

• Health Policy and Management
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• v.18 no.2
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• pp.67-85
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• 2008

This study evaluated the specialization status of Korean hospitals by applying index measures that were developed to determine how hospitals are specialized. In addition, multivariate regression analysis was applied to assess how the measures responded to the internal and external factors of hospitals. National Health Insurance claims for 2004 were used to calculate the information theory index, internal Herfindahl index, number of distinct diagnosis-related groups (DRGs) treated, and percent of the five most common DRGs. Data from the Ministry of Health and Welfare and Korean Hospital Association were used to determine the size, ownership, teaching status, organization type, and location of the hospitals. The four indexes analyzed showed that there were significant differences in the specialization status of providers, depending on the provider size, organization type, and location. Hospitals that were smaller and located in metropolitan areas tended to provide specialized services; this is considered to constitute a competitive strategy for hospitals. It is expected that specialized hospitals will increase given the current market structure. Therefore, policy makers will need an index for measuring how hospital services are specialized. Information from such an index could provide a picture of how hospital services are mixed and change over time.

• The Korean Journal of Health Service Management
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• v.14 no.1
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• pp.67-78
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• 2020

Objectives: Using data from the 1styear of the 7th National Health and Nutrition Survey, this study administered a questionnaire to patients with oral damage and examined the type of medical care used based on the nature of the injury, further characterized by age group and sex. Methods: Of the 8,150 respondents, this study selected those who participated in the health survey and oral exam survey, excluding surveys with missing values, and set 7,681 people as the research participants. This study used SPSS Windows version 23.0(SPSS Inc. IL, USA) as the statistics program and applied the chi-square test (p) based on a complex sample and logistic regression analysis. Results: In the analysis of the type of tooth damage, there was a significant difference (p<.001) in the number of male patients who were injured due to exercise, violence, and safety accidents compared to females. However, there was no significant difference in their type of medical security and whether or not they visited a dental clinic. The patients with private insurance showed relatively high use for tooth extraction and oral surgery (p<.001). Conclusions: The best way to prevent tooth damage is to prevent the accident. For sports or exercises which may cause tooth damage, protective gear, such as a mouthpiece, should be used to prevent tooth damage.

• Korea Journal of Hospital Management
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• v.15 no.2
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• pp.15-26
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• 2010

Stroke is a high-risk disease. The future of the medical environment is that the proportion of elderly population is increasing, the average life expectancy is being increased, while the fatal rate of stroke will be low. These situation will due to the financial burden on medical insurance. The most important factor that affects on the medical costs of stroke patients is the length of stay. In this study the mean length of hospital for stroke stay was 21.81days(37.97days for intracerebral hemorrhage, 18.89 days for cerebral infarction). The payment per case of stroke was 6.86 million won(12.6 million won for intracerebral hemorrhage, 5.72 million won for cerebral infarction). The payment per case of intracerebral hemorrhage was 2.2 times more than that of cerebral infarction. The payment in the day of hospitalization was the highest and until the second day medical costs was high. After the third day medical costs tended to decline, after that seemed to show an almost constant level. The length of hospital stay was found to be the most important determinant of inpatient charges for stroke. Accordingly rational management of the length of stay will be beneficial to health care consumers, providers, states.