• 보건행정학회지
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• 제21권1호
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• pp.115-131
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• 2011

Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.

• 농촌의학ㆍ지역보건
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• 제32권1호
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• pp.27-39
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• 2007

Objectives: The challenge of an increasing elderly population has coupled with everpresent social concerns in Korea. A major problem in health center for the frail older people is that medical, healthcare, and welfare services are often fragmented in terms of providers and settings without appropriate coordination. The purpose of this study was to investigate the need of health center-based integrated healthcare services and its related factors for the elderly. Methods: A total of 110 elderly people who had visited at a county Health Center were interviewed using a self-administered questionnaire from November to December, 2005. The questionnaire consists of five domains according to the Program of All-inclusive Care for the Elderly. Results: Respondents had high need (total mean score with the 5-point Likert-type sacle: 3.67) of health center-based integrated healthcare services including home visiting service (mean: 4.08), chronic disease care service (mean: 4.06), and transportation service (mean 4.05). According to the results of hierarchical multiple regression analysis, among three regression models the magnititude of the variance of full model that is explained by the need of welfare-domain service was significantly larger than two reduced model. Income was a significant variable in increasing the need of health care and welfare services. Conclusions: This study suggests that the health center-based integrated healthcare services for the elderly must be continuously developed and provided for the health promotion and improved the quality of life of the elderly who live in rural area in Korea.

• 전자공학회논문지
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• 제51권6호
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• pp.162-168
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• 2014

PHR(Personal Health Records : 개인평생건강기록) 은 진료정보를 제공하는 것을 기본서비스로 하며, 환자와 서비스 제공자에게 유용한 서비스를 제공해야 한다. 본 연구는 진료정보의 제공 외 사용자에게 적합한 서비스를 발굴하는데 목적이 있다. 서비스 대상은 암환자로 한정하였고 PHR 서비스 발굴을 위하여 기존 사례 분석, 의료진 인터뷰, 환자 설문을 진행하였다. 그 결과로 발굴된 서비스는 3가지이다. 첫째, 환자에게 치료계획(patient's clinical pathway)을 제공하고 두 번째 온라인 질의응답기능 제공, 세번째 환자 본인의 상태를 입력하는 기능 제공이다. 발굴된 명지 PHR 서비스는 웹과 앱(안드로이드)으로 약 3개월간 파일롯 테스트를 하였고 유용성을 확인하였다. 향후 상업화된 PHR 서비스가 되기 위해서는 치료계획의 등록을 위한 표준화 및 사용자 편의성을 고려한 모델이 되어야 할 것이다.

• Journal of Information Science Theory and Practice
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• 제11권2호
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• pp.82-103
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• 2023

The Zimbabwean healthcare sector faces huge challenges due to increased demands for improved services for a growing number of patients with fewer resources. The use of information and communications technologies, prevalent in many industries, but lacking in Zimbabwean healthcare, could increase productivity and innovation. The adoption of health management information systems (HMISs) can lead to improved patient safety and high-level patient care. These technologies can change delivery methods to be more patient focused by utilising integrated models and allowing for a continuum of care across healthcare providers. However, implementation of these technologies in the health care sector remains low. The purpose of this study is to demonstrate the advantages to be attained by using HMISs in healthcare delivery and to ascertain the factors that influence the uptake of such systems in the public healthcare sector. A conceptual model, extending the technology, organization, and environment framework by means of other adoption models, underpins the study of adoption behavior. A mixed method methodology was used to conduct the study. For the quantitative approach, questionnaires were used to allow for regression analysis. For the qualitative approach, thematic analysis was used to analyse interview data. The results showed that the critical success factors (namely, relative advantage, availability, complexity, compatibility, trialability, observability, management support, information and communication technology expertise, communication processes, government regulation, infrastructure support, organizational readiness, industry and competitive support, external support, perceived ease of use, perceived usefulness, attitude, and intention to use) influenced adoption of HMISs in public hospitals in Zimbabwe.

• 여성건강간호학회지
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• 제30권2호
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• pp.101-106
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• 2024

This paper discusses the implications of the birth notification system and the Protected Birth Act in Korea. Aiming to prevent infanticide and abandonment of infants, the law will enter into force on July 19, 2024 in South Korea. The birth notification system mandates that both parents and the head of the medical institution where the birth occurred must report the event. In parallel, the Protected Birth Act will be implemented, allowing pregnant women in crisis who wish to remain anonymous, the option to give birth outside of a hospital setting in a way that safeguards the life and health of the child. However, many issues are being raised in Korean society in advance of the implementation of the Protected Birth Act. There is widespread concern that the Protected Birth Act fails to protect either women or children, especially as it raises issues regarding the need for legislation to protect children with disabilities and to address gaps for migrant women and children. This paper examines the gender and healthcare issues relating to the Protected Birth Act, focusing on women's health and human rights. The Act continues to perpetuate discrimination against out-of-wedlock pregnancies and upholds the ideology of the traditional family model. Furthermore, the legislative process did not address protective measures for the various reasons behind child abandonment. Critical issues such as women's autonomy, safe pregnancy termination, and paternal responsibility in childbirth are also notably absent. However, with the Act set to take effect soon, it is crucial for healthcare providers to comprehend the rationale and procedures associated with birth notification and the Protected Birth Act, and to prepare for its nationwide implementation. The law defines the socially vulnerable as its main beneficiaries, and it is necessary to strengthen social safety nets to improve their access to healthcare, eliminate prejudice and discrimination against out-of-wedlock pregnancies, and embrace the diversity of our society. We eagerly anticipate future discussions on gender and healthcare issues, as well as amendments to the law that reflect real-world circumstances to provide genuine protection for pregnant women in crisis and their infants.

• 보건행정학회지
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• 제23권4호
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• pp.326-342
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• 2013

Background: Engaging and Involving stakeholders who have different interests in changing health care policies are difficult task. As the literature on the governance in Korean health care field is rare, this study aims to provide empirical evidence of 'governing health policy'-the ways health care policy is made, implemented, and evaluated from a political perspective. Methods: The authors of this study conducted interviews with elites in policy and clinical areas, which was considered to be the most effective approach to gather in-depth information about the background of changing payment policy as well as the barriers or contributors for making the policy sustainable. A total of 14 experts (3 government officials, 2 representatives from medical profession, 3 professors form academic field, and 6 healthcare providers from New DRG pilot program hospitals) participated in 2 hour long interviews. Results: There was a perception gap of the feasibility and substantiality of new payment system among elites. The score was higher in government officers than those in scholars or clinical experts. Next, the interviewees indicated that Korean New DRG might not sustain without significant efforts to improving democratic aspects of the governance. It is also notable that all interviewees except healthcare providers provided negative expectation of the contribution of new payment system to increase administration efficiency. For clinical efficiency, every stakeholders perceived there was no increased efficiency after introduction of New DRG payment. Like general perception, there was a wide gap between the perception of stakeholders in quality change after implementing the new payment system. Finally, interview participants negatively assumed about the likelihood of New DRG to remain a case of successful reforms. Conclusion: This study implied the importance of social consensus and the governance of health policy.

• 디지털융복합연구
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• 제14권12호
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• pp.283-292
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• 2016

본 연구는 당뇨병 환자를 대상으로 인슐린 치료에 대한 문화적 관점과 경험을 탐색하기 위해 19명의 제1형과 2형 당뇨병 환자를 대상으로 포커스 그룹 인터뷰를 실시하였다. 인터뷰 내용을 기록하고 녹취한 후 내용분석을 통해 당뇨병 환자들이 경험하는 인슐린 치료에 대한 사전인식요인과 장애요인 및 촉진요인을 목록화하였으며 이들 3가지 목록에 포함되는 주요어를 도출하였다. 그 결과 인슐린에 대한 막연한 두려움이 사전인식요인의 주요어로 확인되었고 장애요인으로는 인슐린과 관련된 걱정(통증, 낮은 지식과 문해력, 자가 주사에 대한 낮은 자신감, 경제적 부담, 저혈당에 대한 두려움)과 의료진에 대한 양가감정, 의지하게 된 삶, 친구, 친척과 가족에 대한 감정, 불편감, 과거에 대한 후회, 부끄러움이 주요어로 도출되었다. 촉진요인으로는 깨달음과 신체적 회복 및 혈당조절에 대한 자신감이 확인되었다. 본 연구결과를 토대로 국내 당뇨병 환자의 인슐린 치료에 대한 경험과 지각에 대한 의료인의 이해가 필요하며 당뇨병 환자의 이러한 경험은 존중되어야 할 것으로 사료된다.

• 대한한의학회지
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• 제43권1호
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• pp.73-86
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• 2022

Objectives: In the health care industry, the influence of online reviews is growing. As medical services are provided mainly by providers, those services have been managed by hospitals and clinics. However, direct promotions of medical services by providers are legally forbidden. Due to this reason, consumers, like patients and clients, search a lot of reviews on the Internet to get any information about hospitals, treatments, prices, etc. It can be determined that online reviews indicate the quality of hospitals, and that analysis should be done for sustainable hospital marketing. Method: Using a Python-based crawler, we collected reviews, written by real patients, who had experienced Korean medicine, about more than 14,000 reviews. To extract the most representative words, reviews were divided by positive and negative; after that reviews were pre-processed to get only nouns and adjectives to get TF(Term Frequency), DF(Document Frequency), and TF-IDF(Term Frequency - Inverse Document Frequency). Finally, to get some topics about reviews, aggregations of extracted words were analyzed by using LDA(Latent Dirichlet Allocation) methods. To avoid overlap, the number of topics is set by Davis visualization. Results and Conclusions: 6 and 3 topics extracted in each positive/negative review, analyzed by LDA Topic Model. The main factors, consisting of topics were 1) Response to patients and customers. 2) Customized treatment (consultation) and management. 3) Hospital/Clinic's environments.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권5호
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• pp.277-283
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• 2023

Purpose: Cow's milk protein allergy (CMPA) is a common condition in infants, but little is known about healthcare providers' clinical experience treating infants with CMPA. To address this gap, we analyzed prospectively collected data from healthcare providers (HCPs) who treated infants under six months old with suspected CMPA using hypoallergenic formulas. The study focused on a commercial extensively hydrolyzed formula containing Lactobacillus rhamnosus GG (ATCC53103) (eHF-LGG) or a commercial amino acid formula (AAF). Methods: In this secondary analysis of prospectively collected survey data, 52 HCPs treated 329 infants under six months old with suspected CMPA using hypoallergenic formulas. A series of two de-identified surveys per patient were collected by HCPs to assess short-term symptom relief in the patients and HCP's satisfaction with the management strategies. The initial survey was completed at the initiation of treatment of CMPA, and the second survey was completed at a follow-up visit. Results: The majority of HCPs (87%) in the study were general pediatricians, and most saw 2 to 10 CMPA patients weekly. Results showed that clinicians reported satisfaction with treatment in 95% of patients in the EHF cohort and 97% of patients in the AAF cohort and achieved expected clinical results in 93% and 97% of patients using eHF and AAF, respectively. Furthermore, few patients were switched from the hypoallergenic formula once initiated. Conclusion: The study provides new insights into HCP perspectives on treating infants with CMPA and supports using hypoallergenic formulas to manage this condition. However, additional prospective controlled studies are needed to confirm these initial findings.

• Journal of Hospice and Palliative Care
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• 제25권2호
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• pp.85-97
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• 2022

Purpose: This study aimed to describe nurses' perceived needs and barriers to pediatric palliative care (PPC). Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through open-ended questions and analyzed with topic modeling techniques. Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: "children and adolescents," "families," "PPC management system," and "community-based PPC." Meanwhile, PPC barriers were divided into 3 categories: "healthcare delivery system," "healthcare provider," and "client." The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. Conclusion: In this study, by using mixed-methods, items of nurses' perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.