• Health Policy and Management
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• v.33 no.3
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• pp.295-310
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• 2023

Background: The long-term care (LTC) group has higher rates of chronic disease and disability registration compared to the general older people population. There is a need to provide integrated medical services and care for LTC group. Consequently, this study aimed to identify medical usage patterns based on the ratings of LTC and the characteristics of benefits usage in the LTC group. Methods: This study employed the National Health Insurance Service Database to analyze the effects of demographic and LTC-related characteristics on medical usage from 2015 to 2019 using a repeated measures analysis. A longitudinal logit model was applied to binary data, while a linear mixed model was utilized for continuous data. Results: In the case of LTC ratings, a positive correlation was observed with overall medical usage. In terms of LTC benefit usage characteristics, a higher overall level of medical usage was found in the group using home care benefits. Detailed analysis by medical institution classification revealed a maintained correlation between care ratings and the volume of medical usage. However, medical usage by classification varied based on the characteristics of LTC benefit usage. Conclusion: This study identified a complex interaction between LTC characteristics and medical usage. Predicting the requisite medical services based on the LTC rating presented a challenge. Consequently, it becomes essential for the LTC group to continuously monitor medical and care needs, even after admission into the LTC system. To facilitate this, it is crucial to devise an LTC rating system that accurately reflects medical needs and to broaden the implementation of integrated medical-care policies.

• Journal of Korean Public Health Nursing
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• v.24 no.2
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• pp.211-225
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• 2010

Purpose: This comparative study analyzed information systems including manpower, contents of service, clients, and costs among four nations. Methods: A literature review of relevant publications from Korea, United States, Japan, and Germany supported the use of several plans to activate home nursing care services under the long-term care insurance system in Korea. Results: Korean home nursing care services require quality improvements. The results indicated that a rule is necessary that rations simple visiting service and home nursing care services under the long-term care insurance system, that an integrated management system for elderly care is required, and that the revised delivery of services needs to establish and reflect on various factors to estimate the value in a home visiting nursing care cost system. Conclusion: The data should be valuable in establishment of home nursing care services under the long-term insurance system in Korea.

• Quality Improvement in Health Care
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• v.24 no.1
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• pp.30-39
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• 2018

Objectives: In Korea, there are many kinds of evaluations for medical institutions. However, evaluations are increasingly burdensome for medical institutions because evaluation agencies, evaluation timing, and evaluation methods are different. The purpose of this study is to improve the efficiency of evaluation for medical institutions and ultimately to provide quality medical services to patients. Methods: In this study, 2,310 indicators of 19 kinds of evaluation for medical institutions were analyzed. Results: 1,424 indicators were available for on-site surveys and 886 indicators were not available for on-site surveys. There were 4 kinds of evaluation that can be integrated in total, 12 kinds of evaluation that can be integrated partially, and 3 kinds of evaluation that need to maintain the current evaluation system. Conclusion: In order to provide patient-centered quality medical services through reduction of burden due to the evaluation for medical institutions, it is necessary to deeply discuss the efficiency of evaluation integration and result utilization.

• Journal of Digital Convergence
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• v.12 no.2
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• pp.237-242
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• 2014

Integrated health care system, which is one of the developing solution technologies of IT, BT and NT, could give us new medical environments in future. Health care is one of the most concerned fields in convergence environments. Many studies on the development and application related with health care industry in recent years has been actively. Therefore, in this paper, we described current integrated medical system trends and future works.

• Tuberculosis and Respiratory Diseases
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• v.72 no.5
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• pp.401-408
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• 2012

Cardiopulmonary resuscitation (CPR) is a series of life-saving actions that improve the chances of survival, following cardiac arrest. Successful resuscitation, following cardiac arrest, requires an integrated set of coordinated actions represented by the links in the Chain of Survival. The links include the following: immediate recognition of cardiac arrest and activation of the emergency response system, early CPR with an emphasis on chest compressions, rapid defibrillation, effective advanced life support, and integrated post-cardiac arrest care. The newest development in the CPR guideline is a change in the basic life support sequence of steps from "A-B-C" (Airway, Breathing, Chest compressions) to "C-A-B" (Chest compressions, Airway, Breathing) for adults. Also, "Hands-Only (compression only) CPR" is emphasized for the untrained lay rescuer. On the basis of the strength of the available evidence, there was unanimous support for continuous emphasis on high-quality CPR with compressions of adequate rate and depth, which allows for complete chest recoil, minimizing interruptions in chest compressions and avoiding excessive ventilation. High-quality CPR is the cornerstone of a system of care that can optimize outcomes beyond return of spontaneous circulation (ROSC). There is an increased emphasis on physiologic monitoring to optimize CPR quality, and to detect ROSC. A comprehensive, structured, integrated, multidisciplinary system of care should be implemented in a consistent manner for the treatment of post-cardiac arrest care patients. The return to a prior quality and functional state of health is the ultimate goal of a resuscitation system of care.

• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.1
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• pp.9-15
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• 2014

Recently, interest in traditional medicine has increased steadily. Nations having traditional medicine system have been attempting to change it institutionally for the purpose of public application boost in use of traditional medicine. But there are not too many countries which have established the modern system of education and licensing system for traditional medicine with it maintained as a part of a national health care system. The best known examples of nations utilizing traditional medicine are the People's Republic of China, Republic of Korea, Japan, and Taiwan. These countries follow different patterns in the relationship with western medicine according to different social and historical backgrounds. Taiwan has dual medical system as Korean. In this study, we looked through history and the current state of affairs of national health care system in Taiwan, and also found out the licensing system, the educational system, and the curriculum in several universities. thoroughly. Furthermore, we looked into the direction of the policy of Taiwanese health care system which has been becoming an integrated medical system between traditional Chinese medicine and western medicine. With findings based on this study, we deduced implications of a future policy line about the integrated medical system in Korea to minimize conflicts between the concerned parties.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.24 no.2
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• pp.181-188
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• 2017

Purpose: The aim of this study was to compare between performance and requirements of visiting nursing care in long-term care insurance using the OMAHA system. Methods: The subjects were 72 nurses who had worked in a visiting nursing care center in long-term care insurance. Data were collected from December 5, 2016 to January 31, 2017 using self-recorded questionnaires. The collected data were analyzed using descriptive statistics and paired t-tests. Results: Four dimensions of the OMAHA system showed statistically significant differences between performance and requirements of visiting nursing care in long-term care insurance. The requirements of visiting nursing care were higher than was performance on all 40 items of the OMAHA system. The greatest difference was in environmental domain and then the psychosocial domain. Conclusion: Based on the results, we found that the environmental and psychosocial domains were the largest gap areas. Therefore, with the reality of elderly people living alone and the increase in elderly couples, active intervention connected with the community is needed in residential areas. Further, we suggest that the OMAHA system can be utilized as an integrated conceptual framework for developing and enhancing visiting nursing care in long-term care insurance.

• Journal of agricultural medicine and community health
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• v.19 no.2
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• pp.159-173
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• 1994

Since the establishment of health centers in the 1960s, the centers have been played an important role in providing basic health care for the people. Although the health centers made a great effect to prevent diseases and promote the health status of the people for the last three decades, the function of health centers should be strengthened to meet the health care need of individual, family and community. Over the last ten years, there have been great changes and developments in health related environments, such as population size and age, rapid urbanization, up-grading of the educational level, increase of income, health care demand for promotive health care measures and practical measures for chronic diseases and also practicing healthy life. According to the great changes in health related environments, the health centers should be reformed. The following policy options are recommended as a summary; First, the function of health centers should be converted from providing basic health services into promotive and preventive health care services, to meet changing needs of people. Second, the health center personnel should be reinforced for their competency to provide a qualitative services to people and also the operation of health center should be reactivated. Third, a close linkage of health centers with the private sector is an essential requirement for the operation of the health care delivery system within a health district in order to improve the health status of people. Fourth, type of manpower mix, scope of organization and health care program should be varied, based on the health care needs of people, geographical characteristics and size of population etc. Fifth, a comprehensive health care delivery system should be developed, for maintaining healthy life style of people and also the health and welfare services should be integrated in order n ensure an effective service.

• Korea Journal of Hospital Management
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• v.9 no.3
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• pp.18-48
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• 2004

Health policies in many countries have come under critical scrutiny in recent years. This is because of increasing national health expenditures. Also many persons in health sector have been the perception that resources allocated to health services are not always deployed in an optimal fashion. And they believe that the scope of resources in health services is limited, there is need to search for ways of using existing resources more efficiently. A further concern has been the desire to ensure access to healthcare of various groups on an equitable basis. In some European countries this has been linked to a wish to enhance patient choice and to make service providers more responsive to consumers, while Korea integrated health insurance funds into single fund in 2000. Many European countries are under considerable pressure to review and restructure their health care systems. There are several reasons of pressure to reform. There are demographic changes, pattern of disease change, advances in medical sciences will also give rise to new demands within the health services, public expectations of health services are rising as those who use services demand higher standards of care. These circumstances require the change of health care delivery system based on hierarchical regionalism, which was basis of health care delivery since 1920s. Korea is also under similarly pressure to restructure our own health care systems. We will have good learning from OECD experiences. In this paper we reviewed and compared among OECD countries' various experiences.

• Health Policy and Management
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• v.21 no.1
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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.