• 보건행정학회지
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• 제13권3호
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• pp.104-128
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• 2003

Equity in health care has taken priority in the Korean government's policy agenda after the government-led national health insurance achieved universal coverage in 1989 along with the final inclusion of the self-employed as beneficiary. The purpose of this study is to examine the extent to which there exists difference or inequality in the utilization of health care, especially cancer inpatient services among income classes. We analysed the utilization of cancer inpatient services of residents in Jeju Island for a year of 2000, using the national health insurance data for qualification of beneficiaries and utilization of health care. The independent variable are 10 income classes based on the national health insurance fee imposed on each household for a year of 2000. The dependent variables of this study are an amount of cancer inpatient health care utilization measured by cancer admission days and cancer treatment costs. Also, cancer inpatient health care utilization is analysed by three categories divided into utilization in medical care institutions (1) within Jeju Island, (2) outside Jeju Island, and (3) all within and outside Jeju Island. We measured concentration index of cancer inpatient health care utilization. This analysis showed negative concentration index within Jeju Island and positive outside Jeju Island, and positive in all within and outside Jeju Island. This results suggest inequality against the relatively poor income groups in utilization of cancer inpatient health care services. Especially, inequity of cancer inpatient health care would be more serious in Jeju Island of Korea, considering that lower income groups reportedly have higher incidence rates in most of cancer and thus use more health services.

• Journal of Preventive Medicine and Public Health
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• 제44권3호
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• pp.101-110
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• 2011

Objectives: Screening for colorectal cancer is considered cost effective, but is underutilized in the U.S. Information on the efficiency of "tailored interventions" to promote colorectal cancer screening in primary care settings is limited. The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control (CDC) web-based intervention (screen for life) and to a tailored interactive computer-based intervention. Methods: A randomized controlled trial of people 50 and over, was conducted to test the interventions. The sample was 1224 partcipants 50-70 years of age, recruited from Kelsey-Seybold Clinic, a large multi-specialty clinic in Houston, Texas. Screening status was obtained by medical chart review after a 12-month follow-up period. An "intention to treat" analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects. Analysis of statistical uncertainty was conducted using nonparametric bootstrapping. Results: The estimated cost of implementing the web-based intervention was $40 per person and the cost of the tailored intervention was $45 per person. The additional cost per person screened for the web-based intervention compared to no intervention was $2602 and the tailored intervention was no more effective than the web-based strategy. Conclusions: The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion. The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion. Researchers need to continue developing and evaluating the effectiveness and costeffectiveness of interventions to increase colorectal cancer screening.

• 지역사회간호학회지
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• 제14권2호
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• pp.179-189
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• 2003

Objectives: This study described the features of home-bound industrial accident victims and their needs for rehabilitation services. This study was also aimed to find a future direction of development of community rehabilitation programs that are suitable for their needs demands. Methods: This study is a descriptive study, were collected through two phases using structured questionnaire. In the first stage, su were performed via telephone interviews. In the se stage, surveys were performed via home visit Subjects in the first stage included 2203 indu injured victims staying at home, of whom. individuals complaining of post-traumatic complic became the subjects of the second stage. Results: This study showed that the home-bound industrial accident patients were complaining of complications from the injury even after receiving treatment by IACI. However, they were neglecting their health problems without any intervention. Even if they use health care services. the treatment is mainly focused on acute medical care, which may not effective for them. Furthermore, they had unstable employment status and suffered from financial burden for health care costs. The Labor Welfare Organization has established a plan to remove barriers of industrial accident victims in reinstatement, and has been preparing various programs in order to establish an all-embracing service system for industrial accident victims from accident occurrence to reinstatement. However, these rehabilitation services can be truly helpful only when the injured are able to obtain enough information about them. The current restrictive system is also not appropriate for solving health problems of the industrial accident victims. Therefore, it is necessary to develop a plan that can provide industrial accident victims high-quality rehabilitation services so that they can use those services in the community without being dependent on hospitals. This study proposes visit nursing services as a way to provide various health services within community for the industrial accident victims.

• 대한한방내과학회지
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• 제31권4호
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• pp.722-730
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• 2010

Objectives : While the proportion of clinical trials is increasing in oriental medical research, no studies in recruitment strategies exist. This study was conducted to investigate which recruitment strategy was efficient to increase the number of potential subject and to reduce cost. Methods : Data from 179 callers in a single-center between June 22 and August 12, 2010 were analyzed. Results : We found that daily newspaper and free newspaper advertisement collected maximal participants. Advertisements in the hospital and on the Internet were considered as the most cost-effective methods. Conclusions : Intensive multiple overlapping recruitment strategies might be effective in success of participant registration in a clinical trial.

• 대한의용생체공학회:의공학회지
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• 제26권5호
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• pp.343-349
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• 2005

Continuously motivating people to exercise regularly is more important than finding a way out of barriers such as lack of time, cost of equipment, lack of nearby facilities, and poor weather. Our proposed system presents practicable methods of motivation through a diverse exercise aid system. The Health Improvement and Management System (all-in-one system which saves space and maintenance costs) measures and evaluates a diverse body shape analysis and physical fitness test and directs users to automated personalized exercise prescription which is prescribed by the expert system of three types of exercise templates: aerobics, anaerobics, and leisure sports. Automated personalized exercise prescriptions are built into XML based documents because the data needs to be in the form of flexible, expansible, and convertible structures in order to process various exercise templates, BIOFIT, a digital exercise trainer, monitors and provides feedback on the physiological parameters while users are working out in the gymnasium. If these parameters do not range within the prescribed target zone, the device will alarm users to control the exercise and make the exercise trainer adjust systemically the proper exercise level. Numeric health information such as the report of the physical fitness test and the exercise prescription makes people stay interested in exercising. In addition, this service can be delivered through the Internet.

• 한국식생활문화학회지
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• 제33권4호
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• pp.299-306
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• 2018

Pork is a popular meat consumed in Korea. However, the consumption pattern has typically focused on preferred parts, like pork belly, which is usually broiled. This consumption pattern has increased both stocks of low fat parts and medical costs, and has thereby disturbed pork industry growth and the national health welfare. Changing the consumption patterns of preferred parts and encouraging consumption of low fat parts will improve consumers' quality of life and also increase their benefits. Thus, this study estimated WTP (Willingness To Pay) for health funds among consumers who eat pork meat, considering the health benefits gained by consuming low fat parts and changes in preferred part consumption. The results of this study show that WTP is higher when consumers have a smaller family and a higher income; these consumers plan to increase intake of pork meat in the future and think that the promotion of low fat pork meat consumption is more important. The WTP for health funds is estimated to be 49won to 287won through Logit Model. The health benefits of low fat consumption were estimated to be 92 billion won to 539 billion won per year. Therefore, reforming low fat pork consumption not only changes the traditional consumption pattern focused on preferred parts but also leads to a variety of benefits for consumers, including health benefits.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2317-2322
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• 2015

Background: Despite the increasing number of screening examinations performed for cervical cancer utilizing the Papanicolaou smear test (Pap test), few studies have examined whether this strategy is cost-effective in Korea. Objective: This study was conducted to evaluate the cost-effectiveness of cervical cancer screening strategies incorporating the Pap test based on age at the start and end of screening as well as screening interval. Materials and Methods: We designed four alternative screening strategies based on patient age when screening was started (20 or 30 years) and discontinued (lifetime, 79 years). Each strategy was assessed at screening intervals of 1, 2, 3, or 5 years. A Markov model was developed to determine the cost-effectiveness of the 16 possible cervical cancer screening strategies, and this was evaluated from a societal perspective. The main outcome measures were average lifetime cost, incremental quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). Results: Compared with various strategies comprising younger starting age, discontinuation age, and longer screening intervals, strategies employing annual screening for cervical cancer starting at a target age of 30 years and above were the most cost-effective, with an ICER of 21,012.98 dollars per QALY gained (with a Korean threshold of 30,000,000 KRW or US$27,272). Conclusions: We found that annual screening for cervical cancer beginning at a target age of 30 years and above is most cost-effective screening strategy. Considering the potential economic advantages, more intense screening policies for cervical cancer might be favorable among countries with high rates of cervical cancer and relatively low screening costs.

• 간호행정학회지
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• 제9권1호
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• pp.129-139
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• 2003

Purpose : The purpose of this study is to investigate the actual condition and recognition about social service activity(SSA) of nurses. Methods : This is a descriptive study. The data were collected by a structured questionare from July 15 to 31, 2002. The questionares were sent to 711 nurses of 38 hospitals, and 664 cases were returned. The answer rate is 93.4%. The data were analyzed by SPSS 11.0. Results : 1. 71.0% nurses had a SSA experience during university, but only 14.2% nurses are participated in SSA now. 2. In the case of having an experience, 56.0% nurses participated in SSA under 1 year, 69.5% nurses didn't support the service costs. 3. In the case of not having experience, the main reason why they didn't participate in is to lack of opportunity. 4. 91.1% nurses recognize the necessity of SSA and 99.5% nurses agree with the necessity of operation system. 82.9% nurses approve the cooperation system among the regions. 87.2% nurses have an intension to participate in SSA when the cooperation system is set up. Conclusion : It need to set up the social service operating system among the regions, and encourage nurse to participate in the SSA.

• 보건교육건강증진학회지
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• 제31권4호
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• pp.63-72
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• 2014

Objectives: The current study reviews the implementation and evaluation of the Chronic Disease Self-Management Program (CDSMP) in the United States (U.S.) to illustrate the program's potential contribution to improving health among Korean adults with chronic conditions while saving healthcare costs. Methods: This study examines existing literature on the history, theoretical background, essential elements, and delivery outcomes of CDSMP with special focus on the successes and challenges to be faced in the implementation of CDSMP to Koreans with chronic conditions. Results: CDSMP is designed to empower people with chronic conditions to develop skills necessary for medical, social role, and emotional management of chronic conditions. Recent studies show the utility of CDSMP in achieving the Triple Aim health reform goals (i.e., better care, better health, better value). Lessons learned from the U.S. experience emphasize the importance of establishing evidence-based studies, collaborating with community partners, and diversifying funding sources to make CDSMP more sustainable. Conclusion: The current study demonstrates the replicability of CDSMP and potential for expansion in Korea. More concerted efforts among academia, government, and communities are needed to deliver CDSMP to Korean adults and identify its effectiveness within the Korean context in terms of meeting the Triple Aim goals of better care, better health, and better value.

• 한국간호교육학회지
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• 제5권1호
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• pp.7-19
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• 1999

The purpose of this study was to examine nursing college students' knowledge of and attitudes toward brain death, organ donation and organ transplantation. The research design utilized in this study was a descriptive research design. The data were collected from September 7 to 14, 1998, by means of strutted questionnaire. To measure students' knowledge of brain death, organ donation and organ transplantation, Joo's(1995) instrument was used. The questionnaire was composed of 22 items. To measure students' attitudes toward organ donation and organ transplantation, s(1995) Instrument was used. The questionnaire was composed of 22 items. The data were analyzed by frequency, t-test, ANOVA, and Pearson's Correlation Coefficient using the SAS program. The results were as follows : 1. Students' knowledge of brain death, organ donation and organ transplantation was 9-20. The mean score was 15.36, with 22, the highest possible score. There was statistically significant difference between students' knowledge and approval on the brain death recognition group(t=9.75, p=0.002). 2. Students' altitudes toward organ do nation and organ transplantation showed is mean score of 3.61 on a 5 attitudes points Liken scale. More than 80% of respondents agreed that organ transplantation can offer a high quality of life to the recipient and is an acceptable form of medical treatment. The health care costs associated with organ transplantation are worth itif another's life can be saved. Students felt it important to help others who are very ill. Also, by donating organs, students felt a part of their own body would continue to live by making it possible for someone else to live. Only 2.9% of students objected to organ donation for religious reasons. There was statistically significant difference among students' attitudes, experienced blood donor group(t=17.04, p=0.000), approval on the brain death recognition group (t=21.06, p=0.000), organ donation agreement group(t=46.13, p=0.000).