This was a qualitative study on medical aid patients to understand the cause and process of statistical difference of health service utilization between medical aid and health insurance patients. The main results were the following; 1) There was few overuse of health service in medical aid patients. The reason of heavy utilization was mainly due to the complicated disease. Some of them were considered to overuse physical therapy and oriental acupuncture. 2) In case of medical aid patients, medical cost was paid by their welfare benefit of government or by the support of family or neighbors. They usually could not adequately use the services of uninsured benefit or large hospitals due to the cost. Some patients just endured the pain. There was still discrimination for medical aid patients in some medical institutions. 3) The health officials and institutions did not provide sufficient information to medical aid patients about the policy of medical cost support. 4) Health policies, such as selective clinic system, medial aid case management, approval of extended care, were considered to contribute in preventing unnecessary use of health service. However, this might limit adequate use of medical aid service. In conclusion, there is little evidence of overuse of health service for medical aid patients, which is different from the previous studies. A new plan is necessary, because medical aid patients thought that the necessary health service was not accessible to them.
Journal of agricultural medicine and community health
/
v.33
no.2
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pp.181-192
/
2008
Objective: The use of complementary and alternative medicine (CAM) is common especially among patients with osteoarthritis The aim of this study was to investigate the utilization rate and expenditures of patients who use CAM.
Method: Two hundred seventy four patients with osteoarthritis were interviewed by a telephone survey. A structured questionnaire about sociodemographic features and type, cost, satisfaction and reason of CAM utilization was used
Results: Among 274 patients with osteoarthritis, 251 patients(91.6%) had used at least one type of CAM during six months. There was a significant difference in sex (female), age (70 years), medical security (insurance), educational level between the user and non-user of CAM. Hyperthermia was the most use. The average cost for CAM utilization was 120 thousands won/person during six months and there was no difference in sociodemographic features among the out-of-pocket cost of users. The scores of satisfaction for CAM use were ranged between 60-70.
Conclusions: CAM became a popular source of health care because of elderly and lay referral system. And Korean spent a substantial amount of out-of-pocket money on CAM without benefit. Health care system and professionals should pay more attention to CAM, make a evidence for CAM.
Objective : The purpose of this study is to discuss the role and ways to improve the position and rights of Korean Medicine Doctors (KMDs) working at long-term care hospitals (LTCHs) through survey analysis. Method : (1) The legal and institutional position of KMDs is studied using current law and related papers. (2) The online survey was conducted through KMD community websites, targeted at KMDs working at LTCHs. Results : (1) Whereas there is perceived added benefit for the eight specializations for a specialist of Western medicine at LTCHs, in the case of a specialist of Korean Medicine, their value is not institutionally recognized at all. (2) A Western inpatient's medical fee is more than a Korean inpatient's medical fee, and the individual fee for the same medical treatment is also higher in Western hospitalization. So, Korean medical hospitalization actually cannot be made. Because of that, Korean Medicine Doctors find it difficult to be primary care physicians. (3) Musculoskeletal diseases and the aftereffects of cerebrovascular diseases were the most common chief complaints addressed in Korean medical consultations. Conclusion : This study shows that KMDs working at LTCHs have suffered many kinds of inequality. That is because of the limited medical scope of the current medical system and real constraints from the gap in Korean-Western medical fees by the National Health Insurance Corporation. Therefore, it is necessary to eliminate these variations along with revising the statute with continuous research.
In Korea, as the elderly population is growing, the quality of life of the rural elderly is becoming a major concern. By the way, social welfare services is less available and accessible to the rural elderly. And we have very limited information about community -oriented welfare services for the elderly. The lack of social welfare services in rural area resulted from mainly geographic isolation and economic deprivation. So, the present research aimed at; 1) to explore what the social welfare service is benefited from governmental or local assembly. 2) to explore what kind of community services is provided for the rural village and elderly. 3) to appear the political propose for the rural elderly. In South Korea, The Rural Development Administration currently operate 'villages which is supported special programs for the improvement of QOL of rural elderly' in 110 villages. It is a model governmental welfare service for rural area. For the purpose, the survey data is gathered from community level data per village (107 villages), individual survey data(881people) who live in the village and qualitative data. Two kinds of quantitative data is combined to form a data. The statistical methods used for data analysis are descriptive statistics, t-test and ANOVA. The major findings of this study were as follows : It was founded that the majority family type of the rural elderly is elderly-only households(75%). In case of poor elderly, they have very limited social insurance benefit and they can not get medical services with satisfaction. The result show that the welfare facilities per village and welfare service for the elderly is extremely low while the needs of welfare service is greate high. A distinctive characteristics in rural villages is that they receive a lot of services from private sectors, like as Women Farmers Union, Adult Union. They operate voluntary welfare services related to food supporting, education for the elderly, free haircut services and so on. In conclusion, the community care services from private sector has specialty in rural area. We conclude it is a distinguishing characteristic of rural community.
Objectives : Most studies about multiple roles and women's health suggested that combining with paid job, being married and having children was more likely to improve health status than in case of single or traditional roles. We investigated whether there was better health outcome in multiple roles among Korean women coinciding with previous studies of other nations. Methods : Data were from the 2005 Korea National Health & Nutritional Examination Survey, a subsample of women aged 25-59 years (N=2,943). Health status was assessed for self-rated poor health, perceived stress and depression, respectively based on one questionnaire item. The age-standardized prevalence of all health outcomes were calculated by role categories and socioeconomic status. Multiple logistic regression was used to assess the association of self rated health, perceived stress, and depression with multiple roles adjusted for age, education, household income, number of children and age of children. Results : Having multiple roles with working role was not associated with better health and psychological wellbeing. Compared to those with traditional roles, employed women more frequently experienced perceived stress, with marital and/or parental roles. Non-working single mothers suffered depression more often than women with traditional roles or other role occupancy. Socioeconomic status indicators were potent independent correlates of self-rated health and perceived stress. Conclusions : Employment of women with other roles did not confer additional health benefit to traditional family responsibility. Juggling of work and family responsibility appeared more stressful than traditional unemployed parental and marital role in Korean women.
Purpose: To develop therapeutic duplication criteria for the drugs used for respiratory diseases. Method: Therapeutic duplication was defined as "more than 2 drug ingredient-usage in which each has the same therapeutic effect and combination therapy does not confer additional therapeutic benefit". Respiratory system drugs approved in Korea were examined for the study. The WHO's Anatomical Therapeutic Chemical Classification System was used for grouping of the corresponding drug ingredients. The principles and recommendations on combination usage or multiple drug regimens were reviewed by using the clinical practice guidelines, textbooks, product labelings, and clinical articles. Clinical expert group consultation was performed and expert opinions were incorporated into the final criteria. Results: Nine hundred sixty two drug products with Korean Food and Drug Administration classification codes of 141, 149, 222, and 229 were evaluated, of which 87 active ingredients were composed. The drug ingredients were classified into 12 groups (antihistamines, oral nasal decongestants, leukotriene receptor antagonists, inhaled anticholinergics, inhaled corticosteroids, oral ${\beta}2$-agonists, long-acting ${\beta}2$-agonists, short-acting ${\beta}2$-agonists, xanthines, antiallergics, mucolytics and cough suppressants). The use of more than 2 drug ingredients including the same group was therapeutic duplication, and thus combination should be recommended not to be used. Conclusion: Twelve drug groups were identified as therapeutic duplication criteria. Combination therapy within each group should not be used otherwise therapeutic benefits outweigh potential risks.
Multiple-life policies pay a benefit on the first death or the last death among the group of lives. In practice, the future lifetime random variable of policy holders has been considered to be independent, but it is more rational to take into account the correlations among the policy holders. In this paper, the Gaussian copula is applied to re ect the correlations among policy holders and then to diversify the common shock of the multiple life policies which follows an exponential distribution. Five case studies demonstrate its usefulness of using copula in calculating the premiums of the multiple-life policies including the common shock.
Many plant species have two modes of reproduction: sexual and asexual. Both modes of reproduction have often been viewed as adaptations to temporally or spatially variable environments. The plant should adjust partitioning to match changes in the estimated success of the two reproductive modes. Perennial plants showed that favorable habitats in soil nutrients or water content tend to promote clonal growth over sexual reproduction. In contrast, under high light-quantity conditions, clonal plants tend to allocate more biomass to sexual reproduction and less to clonal propagation. On the other hand, plants with chasmogamous and cleistogamous flowers provides with a greater tendency of the opportunity to ensure some seed set in any stressful environmental conditions such as low light, low soil nutrients, or low soil moisture. It is considered that vegetative reproduction has high competitive ability and is the major means to expand established population of perennial plants, whereas cleistogamous reproduction is insurance to persist in stressful sites due to being strong. Chasmogamous reproduction mainly enhances established and new population. Therefore, the functions of sexual and asexual propagules of perennial or annual plants differ from each other. These traits of propagule thus determine its success at a particular region of any environmental gradients. Eventually, if environmental resources or stress levels change in either space or time, species composition will probably also change. The reason based on which the plants differ with respect to favored reproduction modes in each environmental condition, may be involved in their specific realized niche.
Shin, Sangjin;Kim, Youn Hee;Hwang, Jin Sub;Lee, Yoon Jae;Lee, Sang Moo;Ahn, Jeonghoon
Asian Pacific Journal of Cancer Prevention
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v.15
no.8
/
pp.3383-3389
/
2014
Background: Prostate cancer is rapidly increasing in Korea and professional societies have requested adding prostate specific antigen (PSA) testing to the National Cancer Screening Program (NCSP), but this started a controversy in Korea and neutral evidence on this issue is required more than ever. The purpose of this study was to provide economic evidence to the decision makers of the NCSP. Materials and Methods: A cost-utility analysis was performed on the adoption of PSA screening program among men aged 50-74-years in Korea from the healthcare system perspective. Several data sources were used for the cost-utility analysis, including general health screening data, the Korea Central Cancer Registry, national insurance claims data, and cause of mortality from the National Statistical Office. To solicit the utility index of prostate cancer, a face-to-face interview for typical men aged 40 to 69 was conducted using a Time-Trade Off method. Results: As a result, the increase of effectiveness was estimated to be very low, when adopting PSA screening, and the incremental cost effectiveness ratio (ICER) was analyzed as about 94 million KRW. Sensitivity analyses were performed on the incidence rate, screening rate, cancer stage distribution, utility index, and treatment costs but the results were consistent with the base analysis. Conclusions: Under Korean circumstances with a relatively low incidence rate of prostate cancer, PSA screening is not cost-effective. Therefore, we conclude that adopting national prostate cancer screening would not be beneficial until further evidence is provided in the future.
Journal of the Korea Institute of Information and Communication Engineering
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v.20
no.8
/
pp.1460-1465
/
2016
Lots of costs threaten the sustainability of the national health-guarantee system. Despite research by the national center for disease control and prevention on health care dynamics with its auditing systems, there are still restrictions of time limitation, sample limitation, and, target diseases limitation. Against this backdrop, using huge volume of total data, many technologies could be fully adopted to the preliminary forecasting and its target-disease expanding of health. With structured data from the national health insurance and unstructured data from the social network service, we attempted to design a model to predict disease. The model can enhance national health and maximize social benefit by providing a health warning service. Also, the model can reduce the advent increase of national health cost and predict timely disease occurrence based on Big Data analysis. We researched related medical prediction cases and performed an experiment with a pilot project so as to verify the proposed model.
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