• Korean Journal of Clinical Pharmacy
• /
• v.5 no.2
• /
• pp.17-31
• /
• 1995

Pharmacist-managed Anticoagulation Service(ACS) was estabilished and the effectiveness of warfarin monitoring by ACS in maintaining therapeutic INR was evaluated. The primary goal of ACS is to maximize the control of therapy, to maintain therapeutic INR and to decrease morbidity and hospitalization caused by inadequate dosage regimen. Clinical pharmacists performed chartreview, laboratory interpretation, recommendations for warfarin dosage adjustments, physician and patient education, and coordination of follow-up in ACS. Patients receiving warfarin sodium were evaluated via retrospective chart review. Sixty-two patients were referred to ACS by primary physicians were compared with 117 patients in the physician-amtrolled group. The ACS patients maintained $88.6\%$ in the therapeutic range for anticoagulant therapy and the control group maintained $63.7\%$, where the difference was statistically significant.(P<0.001) The ACS improved warfarin dose determination, PT stability, patient compliance and provided improved therapy compared with the control group. ACS offers safe and efficient anticoagulant therapy in the ambulatory setting.

• Health Policy and Management
• /
• v.30 no.1
• /
• pp.62-71
• /
• 2020

Background: The purpose of this study is to analyze the current status and factors of elderly patients' hospitalization for hip replacement, knee replacement, and general spine surgery. Methods: National health insurance data in 2018 was provided by the National Health Insurance Service. We used multiple regression to analyze factors associated with the medical utilization of hip replacement, knee replacement, and general spine surgery in elderly patients over 65 years old. The dependent variables are the length of stay and total health expenditure. The independent variables are the demographic-social factors (sex, age, region, insurance type, income level) and surgery-related factors (institution type, location of the hospital, surgery classification). Results: The most common factor affecting surgery was the location of medical institutions. Compared with the medical institutions located in metropolitan, the length of stay in rural medical institutions was higher and total health expenditure was lower. The lower quartile of income, the higher the length of stay and total health expenditure. In addition, the variables of age, type of health insurance, and type of medical institution were statistically significant. Conclusion: In this study, we confirmed the effect of sociodemographic factors and medical institution factors on the Healthcare Utilization of spinal and joint surgery.

• Health Policy and Management
• /
• v.15 no.3
• /
• pp.79-93
• /
• 2005

The purpose of the study is to identify Ambulatory Care Sensitive Conditions (ACSC) and their potential health insurance applicability in Korea, using the correlation and regression analysis with the empirical data provided by Korean Health Insurance Review Agency(KHIRA). Here, ACSC would be thought of as conditions that when timely and effectively treated in the outpatient medical services can help reduce the risk of hospitalizations. As for ACSC, reducing accessibility for outpatient visit results in increasing hospitalization. In this respect, the ACSC concept is popularly adopted as one of the performance indicators of the national health system. As one of main results, fortifying the accessibility to necessary health care in a way of sharing appropriately the role with private health insurance can lead to the efficiency of national health care delivery systems in view of total health care expense, in particular in a case of ACSC children. Lastly, we would like to strongly suggest that the disease treatment data set reported to KHIRA needs to be opened to private insurance companies only for illness experience investigation.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.11 no.3
• /
• pp.299-308
• /
• 2004

Purpose: This study was done to compare the perceived nursing needs as reported by admitted patients and nurses in a general hospital. Method: The participants were 194 patients and 183 nurses in a general hospital in Seoul. The instruments were constructed based on a prior study review and revised after a pilot study with 3 patients. The questionnaire for nursing needs included questions on physical, therapeutic, emotional, educational and socioeconomic domains. Data were collected between February 29 and March 26 for patients and between February 19 and 26, 2002 for nurses. The data were analyzed with frequencies, percentiles, means and t-test. Results: The results were as follow: 1. The total score for perceived nursing needs by nurses was higher than that reported by patients except for socioeconomic needs. 2. There were significant differences between patients and nurses only in the emotional domain (t=3.50, p=.001). 3. The highest score was for therapeutic needs and the next was for educational needs. 4. Relatively higher scored items were for comfort care, prevention of nosocomial infections, immediate treatment, monitoring health condition, kindness, and explanation of tests and treatments. Conclusion: Nurses generally understand patients' nursing needs but have to be more interested in patients' needs in order to prevent nosocomial infections, to provide care in a good relationship with the doctors and to encourage the patients.

• Research in Community and Public Health Nursing
• /
• v.26 no.1
• /
• pp.31-41
• /
• 2015

Purpose: The purpose of this study was to compare the use of health services and health expenditures between non-exercise and exercise groups of diabetic patients and among three groups divided according to exercise intensity. Methods: Data were obtained from the Korean Health Panel Survey of 2011. The participants of this study were 864 diabetic patients who did exercise (walk, moderate exercise, or vigorous exercise) or not. Data were subsequently analyzed using the SPSS 21 Program. Results: The exercise group showed higher percentages of medication compliance, non-smokers, and regular diet than the non-exercise group. The hospitalization percentage, the number of outpatient hospital visits, and health expenditures were higher in the non-exercise group than in the exercise group. There was no difference among the three groups divided according to exercise intensity in the use of health services and health expenditures. Conclusion: These results show that exercise is a way to reduce diabetic patients' use of health services and their health expenditures.

• Journal of Korean Clinical Nursing Research
• /
• v.19 no.3
• /
• pp.321-332
• /
• 2013

Purpose: Korean health insurance extended application of the Diagnosis Related Groups (DRG) payment system to tertiary and general hospitals from July, 2013. This study was done to develop a DRG fee adjustment mechanism applied to levels of nurse staffing to assure quality nursing service. Methods: Nurse stafffing grades among hospitals in Korea were analyzed. Differences and ratio of inpatient costs by nurse staffing grades in DRG fees and differences of DRG fee between tertiary and general hospitals were compared. Results: In 2013, nurse staffing grades in tertiary and general hospitals had improved, but other hospital nurse staffing grades remained at the 2001 level. Gaps of inpatient costs between first and seventh nurse staffing grades were over 10% in 4 out of 7 DRG diagnosis; However differences of DRG fee between tertiary and general hospitals were only 4.51% and 4.72% respectively. A DRG fee adjustment mechanism was developed that included nurse staffing grades and hospitalization days as factors of the formula. Conclusion: Current DRG fees motivate hospitals to decrease nurse staffing grades because cost reduction is bigger than compensation. This DRG fee adjustment mechanism reflects nurse staffing supply to motivate hospitals to hire more nurses as a reasonable compensation system.

• Korean Journal of Clinical Pharmacy
• /
• v.12 no.2
• /
• pp.76-84
• /
• 2002

The purpose of this study was to evaluate the patient education provided by the pharmacist for cancer patients receiving chemotherapy in the hospital. One time patient medication teaching including verbal instruction and written materials were provided by a pharmacist for cancer patients receiving chemotherapy on the first or second day of hospitalization. After providing medication teaching by a pharmacist a written survey was performed in order to measure the patient's satisfaction with the medication teaching and to evaluate the effectiveness of the patient medication teaching. This one-time patient medication teaching by a pharmacist was provided for 44 solid and hematological cancer patients (23 male, 21 female). The results of 27 written surveys completed by the cancer patients revealed that almost all cancer patients $(96.3\%)$ felt that medication teaching is a must in order to understand and accept the chemotherapy by cancer patients. In addition, almost all patients $(92.6\%)$ stated that they were extremely satisfied with the medication teaching provided by the pharmacist. The levels of understandings on the chemotherapy.

• Journal of health informatics and statistics
• /
• v.43 no.4
• /
• pp.318-328
• /
• 2018

Objectives: People are living longer, but often with diseases or chronic conditions. As a consequence, interest in resolving insurance blind spots is growing. This study provides substandard risk-relevant statistics to help substandard risks who are likely to fall in insurance blind spots obtain insurance coverage, such as the reimbursement of medical costs, as well as to stimulate insurance product development. Methods: This study uses National Health Insurance Service (NHIS) cohort data to determine the relevant statistics. The incidence rates of severe diseases are derived and compared against standard risks to establish a set of relative risk factors. These incidence rates of standard and substandard risks are then compared. Results: Currently, an individual's cancer history is used in the underwriting process for simplified issue insurance. However, underwriting focusing on hospitalization and procedures related to serious illnesses could lower premiums for substandard risks. Moreover, the statistical results could be used to expand the coverage of health insurance products. Conclusions: This study's relative risk factors can be used to derive simplified issue premium rates for substandard risks. They can also be used to implement discount and loading schemes for medical reimbursement insurance and help insurance companies implement proactive risk management.

• Quality Improvement in Health Care
• /
• v.28 no.2
• /
• pp.50-60
• /
• 2022

Purpose: To examine the degree of recognition regarding the concept of patient safety, as perceived by the patient, using a focus group discussion. Methods: A focus group discussion was conducted with a patient group comprising seven patients. Results: When the participants heard the term "patient safety" they seemed to understand it to be related to the hospital environment or satisfaction with the overall hospitalization experience. The participants emphasized communication between the medical staff and the patients in relation to the explanation of treatments, as well as the provision of information regarding prevention, experience, and the treatment of incidents with patient safety. They agreed on the need for indicators reported by patients. However, they emphasized that additional items and a questionnaire method that considers the patients' point of view are needed. Conclusion: It is necessary to establish and implement various strategies that can raise the awareness of patient safety using patient safety indicators and increase participation in patient safety activities.

• Health Policy and Management
• /
• v.19 no.1
• /
• pp.49-61
• /
• 2009

Background: The appropriate management of diabetes mellitus(DM) can help reduce its relapse and economic burden, but the level of management of DM in Korea is reported to be insufficient. This study aims to identify the management level of DM by figuring out the HbA1c examination performance rate of the diabetics and analyzing the variation according to the characteristic of a diabetic. Methods: This study used the Korean National Health Insurance Database which includes E10-14(ICD-10 code) as a primary or secondary disease as of 2006. Study population is 1,892,062 diabetics excluding 393,784 patients with the first attack of DM in 2006, 33,440 diabetics who died in 2006, and 21,299 patients with DM having no record of ambulatory care among the 2,340,585 DM patients in total. Results: The HbA1c examination performance rate of all DM patients in our country is estimated to be 41.5% as of 2006 and shows variation according to the characteristic of individual DM patients. The highest performance odds was shown by the patients who were below 19 of age, insured for health insurance, attended more than 3 ambulatory care providers, made ambulatory care visits more than 10 times annually, attended a specialized general hospital as their main attending medical institution, had a record of hospitalization or had co-morbidity. Conclusion: This study propose that is necessary to make politic preparations for the appropriate management of diabetes at a national level, and particularly, the patients with advanced age, the ones dependent on Medical Aid, and the ones using hospitals or clinics, whose appropriate management seems vulnerable, demand a careful management.