• Title/Summary/Keyword: Medical Fee

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Study on Short Term Smoking Cessation Treatment in Dental Hospitals in Korea (국내 치과대학병원에서 시행한 단기 금연진료에 대한 조사)

  • Song, Je-Il;Lee, Gi-Ho;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.245-258
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    • 2010
  • Smoking has been identified not as a major risk factor for circulatory and respiratory diseases but also as causes of various oral diseases. A number of clinical studies and regional health surveys have found an association between smoking and poor oral health status and between smoking and prognosis of dental treatments. However, there is few studies about status of smoking cessation treatment and policies in dentistry in Korea. The purpose of this study was to investigate the smoking patterns of outpatients and outcomes of short-term smoking cessation treatment in dental hospitals in Korea and, subsequently, to seek further smoking cessation services in dentistry. This study was sponsored by Korean Dental Association (KDA) and department of culture and welfare. 825 dental patients were voluntarily participated in a 4-week smoking cessation program with nicotine patch and 297 participants of them completed on smoking-related questionnaires. All participants were recruited from outpatients of 11 dental university hospitals (primarily in the department of oral medicine, oral surgery and periodontology) in Korea during 3-month period from October 2009 to January 2010. The Questionnaires included demographics, duration of smoking, heavy smoking index (HSI), number of thinking of quit smoking, duration of stop smoking and reasons to smoking, awareness of smoking effects on oral health, and their success rate after 4 weeks of nicotine patch program was investigated. The statistical analysis was carried by SPSS version 18.0 program and Chi-square test. According to the results of this study, male in their 30s to 50s were the most prevalent of all the participants and duration of smoking increased with age. Attempt rate to quit smoking (Quit smoking) was the highest in 30s and 40s with duration of quit smoking ranging 1 to 3 months. Emotional stresswas the most frequently reported reason for smoking, followed by habit and pleasure in order. All age group showed high HIS over 71% and awareness of smoking effects on oral diseases such as oral soft tissue diseases, periodontal diseases and dental caries was found relatively high (50~60%) Periodontal implant was the main reason for participation in the smoking cessation services in dental clinics and the success rate of, 4-week nicotine patch program of all the participants was 29.4%, extremely low compared to that of medical clinics. Systemic education for dentists to be able to provide interventions to quit smoking including counseling with the 5As'and development of available measures for smokers is needed as considered that the low success rate of the smoking cessation services in dentistry could be explained mainly by lack of dentists' strategies, experience and attention. Awareness and attention of dentists should be emphasized and their participation be encouraged by long-term, multidisciplinary policies such as establishment of insurance fee, which would made a considerable progress in preventing smoking-related oral diseases and promoting public oral health.

The Characteristics of Traffic Noise and Its Effects on Inhabitants' Life at an Apartment Area in Taejon City (대전 신도시 일부 아파트지역 교통소음의 특성과 주민생활에 미치는 영향)

  • Park, Chan-Ho;Chang, Seong-Sil
    • Journal of Environmental Health Sciences
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    • v.25 no.3
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    • pp.94-102
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    • 1999
  • To estimate the effects of environmental noise on inhabitants' life in an apartment area at Taejon, noise levels and traffic volume of major roads were measured. 203 housewives were surveyed by questionaires including general factors, noise related factors and three items of life effects: subjective evaluations on the general environment, annoyance, and life disturbance due to environmental noise. At the boundary adjacent to the road with more traffic volume, noise level was higher; according to the time, the amount of noise level was in the morning, in the evening, at noon, and at night in order. Most of boundary noise levels were higher than those of recommended standard environmental noise levels in a residential area. The boundary noise level showed a very significant linear relationship with traffic volume of near roads. Noise level difference in the apartments adjacent to three roads was ranged 2.4~6.7dB between in windows open and close state. The apartments adjacent to 9 lane or 6 lane-road, which were protected by noise prevention wall and 20m or more distance from the roads, showed higher noise level at middle floors and high floors than those of low floors; but the buildings adjacent to 4 lane-road, with no protection, showed higher noise level at low and middle floors than those of high floors. Among 203 housewives, 120(59.1%) participated in this study, and 86(73.2%) of them answered that the most serious environmental noise was traffic noise from near roads. Comparing traffic noise levels with those of before-migration, 67.0% participants found the environmental noise became louder. Fifty eight(49.5%) of the participants wanted noise protection wall and 15(25.9%) of them were willing to charge the fee. Less perception on the present noise comparing to those before-migration, less traffic volume, and lower noise levels in the apartments were related to higher scores of self-evaluation on the environment. Higher susceptibility on the present noise, areas with more traffic volume, higher boundary noise levels, and higher noise levels showed higher scores of annoyance on environmental noise and life disturbance. Considering above all things, it was suggested that traffic noise in this area was the major problem of environmental noise, and its' effect was so serious that inhabitants needed some preventive measures for better life quality.

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A Study of Abdominal Syndrome in Shanghanlun (상한론(傷寒論) 조문중(條文中) 상견복증(常見腹證)에 관한 연구(硏究))

  • Shin, Sang Seup;Park, Won Hwan
    • The Journal of Dong Guk Oriental Medicine
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    • v.7 no.2
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    • pp.47-67
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    • 1999
  • The subject of Abdominal syndrome in the field of Shanghanlun takes a quarter of the whole research quantity, and has greatly contributed to the development of diagnoses due to the well-growth of syndrome differentiation through the differentiation of symptoms and signs based on prescription-centered abdominal syndrome. Since then, while the diagnostic has been developed mainly in the field of pulse fee ling and the inspection of the tongue, application of the abdominal diagnostic has not been continuously improved because of special historical and social environments. Recently, since interest in the differentiation of symptoms and signs based on abdominal syndrome has been raised by emphasis of Oriental diagnostic methods and medical treatment which have led to the study of Abdominal Syndrome in Shanghanlun. The following is the results of the study. 1. Shanghanlun abdominal syndrome is categorized into all abdominal symptoms. Epigastric symptoms, Hypochondrium symptoms, and Lower abdomen symptoms. 2. Subjective symptoms and Objective symptoms have been found in Abdominal syn drome, and Subjective symptoms have been more often than Objective symptoms. Both of the symptoms have been found more to co-exist in abdominal syndromes. 3. more cases of fullness of abdomen symptoms in All abdominal symptoms, a smaller number of cases in Taiyang disease, Yangming disease, disease, disease involving all three yang, Tayin disease and Jueyin disease have been found, but there have not been found in shaoyin disease. 4. More cases of Epigastric fullness and rigidity in Epigastric symptoms, Epigastric throbs in Palpitation symptoms, and sense of fullness-in-chest in Abdominal syndrome of chest and hypochondrium have been recognized. 5. Any regularity caused by abdominal symptoms has not been identified. 6. Diagnosis of the abdomen caused by abdominal symptoms has been identified in Epigastric fullness, Epigastric pain, Epigastric procrastination, Epigastric throb, fullness of abdomen and distension of lower abdomen.

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Survey on the Discharge Planning of Occupational Therapists (국내 작업치료사의 퇴원계획 개입에 대한 실태 조사연구)

  • Hwang, Na-Kyoung;Yoo, Eun-Young
    • Therapeutic Science for Rehabilitation
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    • v.9 no.2
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    • pp.55-71
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    • 2020
  • Objective : The purpose of this study was to investigate the necessity of occupational therapist's involvement in patient discharge planning, the areas that should be considered for discharge screening and planning, and to provide the basic data required for the development of a discharge assessment tool. Methods : We conducted an online questionnaire survey of 60 occupational therapists who were working at medical institutions and had agreed to participate in the study. The questionnaire was composed of 36 questions regarding the general characteristics of the current discharge planning process and the necessity of discharge assessment and planning. Descriptive statistics, an independent t-test, and a one-way ANOVA were conducted using SPSS 20.0. As for the post-hoc test, Scheffe's test was used. Results : The awareness of occupational therapist's role in discharge planning and the necessity of a discharge assessment tool were high, but the occupational therapist's awareness of discharge-related knowledge was low. The difficulties in discharge planning showed high response rate in the absence of adequate fee-for-service in the patient interview and assessment and the lack of team approach and appropriate assessment tools for discharge planning. The high-needs areas for evaluation during discharge were fall risk and BADL, and the low-needs areas were well-being and functional level prior to onset. Conclusion : This study is expected to provide preliminary information necessary for the development of a discharge assessment tool for effective discharge planning.

What Can Koreans Learn from the Dutch Experiences in Reforming the Health Insurance System? (한국의료보험제도(韓國醫療保險制度)의 개혁필요성(改革必要性)과 네덜란드의 경험(經驗)이 주는 교훈(敎訓))

  • Kwon, Soon-won;Sunwoo, Duk
    • KDI Journal of Economic Policy
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    • v.12 no.3
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    • pp.47-69
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    • 1990
  • The measures taken to reform the Dutch health insurance system hold valuable lessons for countries such as Korea, where there has been increased concern regarding the efficiency and effectiveness of the health services provided. The growing literature on comparative health insurance policies suggests that nations can learn from each other. In addition, Korean policymakers have shown great interest in the health insurance systems of foreign countries, particularly in Japan. The development of Korea's health insurance scheme during the past 12 years has made a significant contribution to the increased accessibility of health care services. Although the insurance coverage is universal, the health insurance system today in Korea is by no means a product of systematic and planned efforts. Moreover, it lacks due considerations of insured's needs as well as the long-term objectives of the social security health care system. There are growing gaps in premium burdens and benefits between the rural health insurance program and the employee's health insurance programs. Furthermore, the regional health insurance program is experiencing financial difficulties in spite of the fact that the amount of the government subsidy has been sharply increased in recent years. Under the present payment method solely based on the fee-for-service schedule, both consumers and providers are encouraged to utilize and prescribe more services. The combination of the utilization-inducing reimbursement system and continuous pushes for expanding health insurance has played a crucial role in raising the country's medical bills. Current trends in Korea's health care sector and those anticipated in the near future necessitate changes in the structure and funding of health care. As indicated in the above, there are various shortcomings in this context, the health policy authority in Korea can draw valuable lessons from the Dutch experiences in reforming their health insurance system. The main elements of the Dutch reform measures are a restructuring of the insurance system and a greater role for market forces in the health care system. On this basis a new system will be created which reflects the social nature of health care while at the same time containing sufficient mechanisms to allow the health care sector to operate in a cost-effective and efficient manner.

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Determination of Nursing Activities for Estimation of Nursing Fees Based on 9 KDRGs (Korean Diagnosis-Related Groups) (한국형 진단명 기준 환자군(KDRG)별 간호수가 산정을 위한 간호행위 규명;9개 질환군을 대상으로)

  • Lee, Eun-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.3
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    • pp.547-561
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    • 1999
  • The purpose of this study was to determine which nursing activities are performed for patients in each of the nine KDRGs and to examine common nursing activities between patients with the nine KDRGs and special nursing activities which were not common to patients with the nine KDRGs. The study will provide basic data for estimation of nursing fees. The nine KDRGs in model project are Lens procedures, tonsillectomy, &/or adenoidectomy, appendectomy &/or not complicate principal diagnosis, vaginal delivery, cesarean section, anal & stomal procedures, inguinal & femoral hernia, uterine & adneza procedure for nonmalignancy, and simple pneumonia & pleurisy. To determine the nursing activities for each of the nine KDRG, checklists of nursing activities in each nine KDRG were developed from the literature and a total of 115 records of patients 'who were diagnosed and discharged between January and April, 1999 from a tertiary medical center. Nursing activities for each of the nine KDRG were verified through two consecutive content analyses. The results of study are followed as: 1. The checklists of nursing activities developed included direct and indirect nursing activities, for a total of 241 nursing activities. Direct nursing consisted of physical, educational, emotional-socioecomomic-spiritual nursing in 17 areas. Indirect nursing had four areas. 2. Through the two consecutive content analyses, 197 nursing activities were selected, having item CVIs of .83 or more. Those included 81 nursing activities for Lens procedures, 95 for Tonsillectomy &/or Adenoidectomy. 93 in Appendectomy &/or not complicated principal diagnosis, 155 for vaginal delivery, 172 for cesarean section, 89 for anal & stomal procedures, 93 for inguinal & femoral hernia, 108 for uterine & adneza procedures for non-malignancy, and 68 for simple pneumonia & pleurisy. 3. Nursing activities for each of the nine KDRG were compared. Activities with 80% or higher commonality within the nine KDRGs consisted of 86 of 197 nursing activities for the total designated common nursing activities, 30 common nursing activities for patients in the operation group, 45 common activities for patients in the delivery Group. Special nursing activities not common within the nine KDRGs were : 3 for Lens procedures, 1 for Tonsillectomy &/or Adenoidectomy. 2 for Appendectomy &/or not complicated principal diagnosis, 27 for vaginal delivery, 21 for Cesarean section, 6 for anal & stomal procedures, 3 for inguinal & femoral hernia, 16 for uterine & adneza procedure for non-malignancy, 8 for simple pneumonia & pleurisy. In this study, nursing activities for each of the nine KDRGs verified through two consecutive content analyses are those that are performed in the hospital. And, nursing activities for each of the nine KDRGs included all nursing activities from hospital admission to discharge. So. the checklists consisted of nursing activities that allow for an estimation of nursing fees under PPS. The classification of nursing activities in the study will provide a reference for the development of a nursing activity classification.

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A Study on Elderly People's Needs in Daycare Centers in the Next Generation (낮보호 시설에 대한 차세대 노인들의 인식에 관한 연구)

  • Chung, Yeoun-Kang;Yeoum, Soon-Gyo;Kwon, Hye-Jin;Kim, Kyung-Hee;Kim, In-Kook
    • Research in Community and Public Health Nursing
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    • v.9 no.2
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    • pp.324-335
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    • 1998
  • This study describes the extent of recognition of problems to the aged in a future society, the recognition and necessity of day care facilities, and the service contents and patterns preferred as a method of mediation for nursing the aged and increasing their quality of life. It also tries to certify the relations between those subjects. The result of the study is as follows: 1. Concerning problems of the aged of social significance the aged of the next generation consider the difficulties in nursing the aged to be the most important at 63.6%. 2. Concerning the nursing of parents, 49.4% of those answered 'children should take care of their parents and live together', while 46.7% answered that 'it is enough for children to provide an economic support, not necessarily living together. 3. Concerning information of day care facilities, 66.9% answered that they have no information. 4. Concerning the use of day care facilities, 54.6% answered that 'they would under certain circumstances', and 21.0% that 'they had better use them in the future'. 5. Concerning the feelings of the aged using day care facilities, 46.6% say 'they do not look poor', and 33.4% said that 'they look a little poor'. 6. Concerning the reasons for using day care facilities, 56.1% answered' because children do not proride care', and 48.5% answered 'because their economic ability is not sufficient'. 7. Concerning the programs potentially needed, food supply, medical services and physical therapy were ranked in that order. 8. Concerning social facilities necessary for the aged, centers that specialize in dementia, free day care facilities, home care services, and fee - based day care centers were ranked in that order. 9. Concerning institutions providing day care, welfare centers for the aged, those centers auxiliary to hospitals, asylums, and individuals were ranked in that order. 10. Concerning the responsibity running day care facilities, social workers, doctors/nursing assistants, nurses, and entrusted visitors were ranked in that order. Based on the results of this study, the study proposes that the study of applied cases of therapy in day care facilities for the aged continue.

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Comparison between Tissue Adhesive and Suture by Using Modified Hollander Score for Facial Wounds Treated in the Emergency Department (응급실 얼굴 열상 환자에서 Modified Hollander 점수에 의한 조직 접착제 사용과 봉합사를 이용한 봉합 후 결과 비교)

  • Hong, Suk-Ho;Yang, Young-Mo;Lee, Jang-Young;Lee, Won-Suk;Bark, Koung-Nam;Yang, Hee-Bum
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.143-150
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    • 2011
  • Purpose: The object of this study is to compare the patient satisfaction in the view of scarring, cost, and hospital stay between the conventional suture method and a method using Histoacryl$^{(R)}$ (2-N-butylcyanoacrylate) adhesive for treating facial lacerations in the emergency department. Method: This study is a randomized prospective trial, which was conducted from December 2009 to January 2010. The participants include 109 patients who visited the emergency room in Deajon Eulji Medical Center. The ages ranged from 1 to 59 (mean age of 18.7), and all had facial lacerations of less than 3 cm. In order to treat the facial lacerations, an emergency medicine doctor used tissue adhesive (2-N-butylcyanoacrylate, Histoacryl$^{(R)}$) for 41 patients in the experimental group, and a plastic surgeon performed conventional suturing for 68 patients in the control group. The ER-stay and the primary treatment fee were compared in the two groups, and the scarring was evaluated 10 to 11 months from suturing by using the Modified Hollander Method and the 10-cm scaled VAS (visual analogue scale: score 0=no scar, score 10=very severe scar) Result: The ER stay was 76 minutes for the experimental group and 107 minutes for the control group, showing that statistically significantly less time of 31 minutes was taken in the experimental group. The cost of the experimental group was 40000 won (50.1%) more expensive than the control group, with an average cost of 121900 won for the experimental group and 81200 won for the control group. As for scar evaluation, 10.56 months after suturing, the experimental group showed a better result with a score of 2.6 compared to a score of 3.4 in the control group; however, this difference was not statistically significant ($p$ <0.05). As to a detailed evaluation of scar characteristics, the experimental group had a statistically significantly better result in scar elevation, with a score of 0.6 compared to a score of 1.65 for the control group. Conclusion: If appropriate patients are selected, the method using tissue adhesive directly applied by an EM doctor not only decreases ER stay but also creates similar patients satisfaction, with statistically better result in scar elevation, compared to the conventional suture method; thus, ultimately general patient satisfaction is increased.

Optimal Nursing Workforce and Financial Cost to Provide Comprehensive Nursing Service in the National Health Insurance System (국민건강보험 간호·간병통합서비스의 전면 도입을 위한 간호인력 및 재정비용 추계)

  • Kim, Jinhyun;Kim, Sung-jae;Lee, Eunhee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.6
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    • pp.119-128
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    • 2017
  • This study estimated the optimal nursing workforce and financial costs of providing comprehensive nursing services at hospitals under the national health insurance system. Data on registered nurses, nursing aids, medical institutions, and number of patients were obtained from the Health Insurance Review and Assessment Service. The optimal size of the nursing workforce was calculated using the workload model. A bottom-up approach was used to estimate the annual total financial cost of comprehensive nursing services. The number of registered nurses and nursing aids would need to be increased by 81.75% and 83.23%, respectively, in order to fully apply comprehensive nursing care on a national scale. The additional financial costs for comprehensive nursing services at all hospitals was estimated to be as much as 110.39% of the current cost. For the comprehensive nursing service, nurses with a career and newcomers need to be retained at their hospitals, and the validity of the nurse-patient ratio should be continuously checked. The financial shock to the national health insurance system could be minimized by gradually extending the system to all hospitals.

The Service Features Influencing the Acceptance of Telecommunication-Broadcasting Bundling in Convergence Environment (컨버전스 환경 하에서 통신.방송 결합상품 수용의도에영향을 미치는 서비스 특성 연구)

  • Sim, Jin-Bo
    • Journal of Technology Innovation
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    • v.18 no.2
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    • pp.59-89
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    • 2010
  • One of the key words that represent the culture and social phenomena in this 21st century is 'Digital Convergence'. Presently our society is going through the second evolving phase of the convergence, integration between industries. Integration between industries refers to the phenomenon of integrating various industrial areas such as broadcasting, communication, finance, automobile, and medical treatment as the range of IT utilization becomes extended. The telecommunication-broadcasting bundling is a typical example of integration between industries. This study analyzed the effect of the service features of the bundling on the customer's acceptance intention by applying the innovative technology product acceptance model, TAM, in the process of accepting the telecommunication-broadcasting bundling. This study suggests three independent variables, the 'low cost(discount)', 'service integrity', and 'selectability', which affect perceived usefulness, perceived ease of use, and perceived risk, and figures out the actual influence as follows. In conclusion, these results suggest that in order to accept and spread the telecommunication-broadcasting bundling, it is necessary to establish (1) the cost discounting strategy realize (price strategy), (2) the fee noticing system, payment system, call-service system, and systemic integration including installation and A/S system integration, and develop (service strategy), (3) the bundling or related options that can provide users with selectability (product strategy).

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