• Title/Summary/Keyword: Medical Insurance

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Current Status and Future Prospects of the Population Control Policy in Korea (출산조절정책의 현황과 전망)

  • 조남훈
    • Korea journal of population studies
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    • v.11 no.1
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    • pp.14-31
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    • 1988
  • The national family planning program in Korea, which was instituted as an integral part of the nation's economic development plans since 1962, has contributed greatly to a reduction in the fertility and population growth rate. The total fertility rate dipped from 6.0 births per women in 1960 to 2.0 in 1985, and the population growth rate rom 2.84 percent per year to 1.25 percent during the same period, while the contraceptive practice rate for the 15-44 married women increased from 9 percent in 1965 to 70 percent in 1985. Study findings indicate that the fertility reduction in the past 26 years is largely attributed to the virgorous implementation of the national family planning program, rising age at marriage, wide-spread use of induced abortion, and the changes in attitude regarding the value of children that came into being in the wake of the rapid socio-economic development over the period. Among the strengths of the national family planning program are the following : 1) a pluralistic system of program manageent with active participation of various government and voluntary organizations, 2) utilization of a large corps of family planning field workers to conduct face-to-face communication and motivation activities, 3) use of private physicians with government support to provide contraceptive services, 4) a systematic program management system including program planning of traget allocation, evaluation, and supervision with a broad MIS and award system, 5) numerous incentive and disincentive schemes for stimulating the small family norm and contraceptive use, and 6) strong commitments to the family planning program by political leaders. The new demographic targets during the Sixth Five-Year Economic and Social Development plan period(1987-91) have been set for a further reduction in the population growth rate to 1.0 percent by 1993, assuming that the TFR will decline to 1.75 level in 1995. This target is, however, not easy to achieve due to anticipated unfavorable factors like the strong boy preference, high discontinuation rates of reversible contraceptive methods, fertility termination-oriented contraceptive use, a plateau level of contraceptive practice rate that has mostly accounted for a sterilization, shortened length of birth intervals, and the changing patterns of contraceptive mix. The recent changes in contraceptive and fertility behaviors clearly indicate that the past quantity-oriented management system of the national program should be redirected toward a quality-oriented approach. Particularly, program efforts should be expanded to recruit new contraceptive users in the 20s of younger age groups, both for birth spacing and controlling their fertility since the women aged 20 to 29 account for more than 80 percent of the total annual births in recent years. In addition, the current contraceptive fee system of the national family planning program should be gradually shifted from free contraceptive services to a acceptor's charge system, and the provision of contraceptive services through the medical insurance system, which will cover the entire population by 1989, should be accelerated as a means of integration of family planning program with other health programs.

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Investigation of Ultrasound Examination by Radiological Technologist (방사선사의 초음파검사업무 실태조사)

  • Jeong, Bong-Jae;Ji, Tae-Jeong
    • Journal of the Korean Society of Radiology
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    • v.15 no.7
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    • pp.1031-1040
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    • 2021
  • In this study, the actual condition of ultrasound examination was conducted for radiological technologist working across the country. The measuring tool of the study was a questionnaire, and it was targeted to radiological technologist engaged in ultrasound examination at medical institutions located across the country from February 01 to July 31, 2021. In consideration of the COVID-19 situation, 431 questionnaires suitable for research were analyzed using the SPSS/PC Ver 18.0 program using email and SNS in a non-face-to-face manner. The general characteristics of study subjects, ultrasound examination job characteristics, and job satisfaction factors were analyzed using descriptive statistics. As a result of analyzing the job characteristics of radiological technologist who perform ultrasound examination as overall job satisfaction, the overall job satisfaction was 3.30 ± 0.56. The job satisfaction level of radiological technologist performing ultrasound examinations was higher than the average of 3.0 points, indicating a higher job satisfaction level than the average. Since insurance coverage for ultrasound examinations started, many radiological technologists have been very interested in ultrasound examination work. Therefore, the Korean radiological technologists of Association and radiological technolgists engaged in ultrasound examination more attention and effort should be put into strengthening professionalism.

Increased Readmission Risk and Healthcare Cost for Delirium Patients without Immediate Hospitalization in the Emergency Department

  • Ma, I Chun;Chen, Kao Chin;Chen, Wei Tseng;Tsai, Hsin Chun;Su, Chien-Chou;Lu, Ru-Band;Chen, Po See;Chang, Wei Hung;Yang, Yen Kuang
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.398-406
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    • 2018
  • Objective: Hospitalization of patients with delirium after visiting the emergency department (ED) is often required. However, the readmission risk after discharge from the ED should also be considered. This study aimed to explore whether (i) immediate hospitalization influences the readmission risk of patients with delirium; (ii) the readmission risk is affected by various risk factors; and (iii) the healthcare cost differs between groups within 28 days of the first ED visit. Methods: Using the National Health Insurance Research Database, the data of 2,780 subjects presenting with delirium at an ED visit from 2000 to 2008 were examined. The readmission risks of the groups of patients (i.e., patients who were and were not admitted within 24 hours of an ED visit) within 28 days were compared, and the effects of the severities of different comorbidities (using Charlson's comorbidity index, CCI), age, gender, diagnosis and differences in medical healthcare cost were analyzed. Results: Patients without immediate hospitalization had a higher risk of readmission within 3, 7, 14, or 28 days of discharge from the ED, especially subjects with more severe comorbidities ($CCI{\geq}3$) or older patients (${\geq}65years$). Subjects with more severe comorbidities or older subjects who were not admitted immediately also incurred a greater healthcare cost for re-hospitalization within the 28-day follow-up period. Conclusion: Patients with delirium with a higher CCI or of a greater age should be carefully considered for immediate hospitalization from ED for further examination in order to reduce the risk of re-hospitalization and cost of healthcare.

A Meta-analysis of the Difference in Job Satisfaction Levels by Type of Employee (근로자의 고용형태별 직무만족도 차이에 대한 메타분석)

  • Kim, Young-Heung;Na, Seung-Il;Kim, Ji-Hyeon;Park, Yong-Jin
    • Journal of vocational education research
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    • v.37 no.1
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    • pp.101-118
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    • 2018
  • The purpose of this study was to investigate the effect size of the difference of job satisfaction by type of employment by combining data from previous studies. For this purpose, the total of 95 articles analyzed. For the analysis of data, CMA(Comprehensive Meta-Analysis) 2.0 program was used and statistical significance was set at 5%(${\alpha}=0.05$). The main conclusions of this study are as follows. First, regular workers have higher job satisfaction than non-regular workers and the effect size of employment type is medium. Second, among five constituents of job satisfaction, the difference of wage and promotion satisfaction is greater than the difference of satisfaction in human relations, work and working environment satisfaction. Third, the job satisfaction of regular and non-regular workers differs according to the occupation areas. Fourth, there is a big difference in job satisfaction in financial, insurance, food and service occupation areas, and regular workers have higher job satisfaction than non - regular workers. On the other hand, non-regular workers have higher job satisfaction than regular workers in health, medical, social occupation areas.

Whiplash Injury Conditions of Rear-End Collisions at Low-Speed (저속 추돌사고에서 목 상해 조건에 대한 연구)

  • Kim, Myeongju;Yun, Ilsoo
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.18 no.2
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    • pp.58-76
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    • 2019
  • As the number of reported injuries has tended to increase over time, large hospitalization expenditure from excessive medical treatments and hospitalization, and insurance frauds associated with moral hazard in minor collisions have caused a global societal problem. Many occupants of rear-ended vehicles involved in rear-end collisions complain of whiplash injury, which is also known as neck injury, without any anatomical and radiological evidence. With only clinical symptoms, stating that a whiplash injury is a type of injury defined by the Abbreviated Injury Scale would be difficult. Therefore, this study focuses on minor rear-end collisions, where the rear-ender vehicle collides with the rear-ended vehicle at rest. The mathematics dynamic model is employed to simulate a total of 100 rear-end collision scenarios based on various weights and collision speeds and identify how the weights and speeds of both vehicles influence the risk of whiplash injury in occupants involved in minor rear-end collisions. The possibility of an injury is very high when the same-weight vehicles are involved in accidents at collision speeds of 15 km/h or higher. The possibilities are 36% and 84% with collision speeds of 15 km/h and 20 km/h, respectively, if weights are disregarded.

Endovascular Treatments Performed Collaboratively by the Society of Korean Endovascular Neurosurgeons Members : A Nationwide Multicenter Survey

  • Kim, Tae Gon;Kwon, Oki;Shin, Yong Sam;Sung, Jae Hoon;Koh, Jun Seok;Kim, Bum-Tae
    • Journal of Korean Neurosurgical Society
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    • v.62 no.5
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    • pp.502-518
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    • 2019
  • Objective : Since less invasive endovascular treatment was introduced to South Korea in 1994, a considerable proportion of endovascular treatments have been performed by neuroradiology doctors, and endovascular treatments by vascular neurosurgeons have recently increased. However, few specific statistics are known regarding how many endovascular treatments are performed by neurosurgeons. Thus, authors compared endovascular treatments collaboratively performed by vascular neurosurgeons with all cases throughout South Korea from 2013 to 2017 to elucidate the role of neurosurgeons in the field of endovascular treatment in South Korea. Methods : The Society of Korean Endovascular Neurosurgeons (SKEN) has issued annual reports every year since 2014. These reports cover statistics on endovascular treatments collaboratively or individually performed by SKEN members from 2013 to 2017. The data was requested and collected from vascular neurosurgeons in various hospitals. The study involved 77 hospitals in its first year, and 100 in its last. National statistics on endovascular treatment from all over South Korea were obtained from the Healthcare Bigdata Hub website of the Health Insurance Review & Assessment Service based on the Electronic Data Interchange (EDI) codes (in the case of intra-arterial (IA) thrombolysis, however, statistics were based on a combination of the EDI and I63 codes, a cerebral infarction disease code) from 2013 to 2017. These two data sets were directly compared and the ratios were obtained. Results : Regionally, during the entire study period, endovascular treatments by SKEN members were most common in Gyeonggido, followed by Seoul and Busan. Among the endovascular treatments, conventional cerebral angiography was the most common, followed by cerebral aneurysmal coiling, endovascular treatments for ischemic stroke, and finally endovascular treatments for vascular malformation and tumor embolization. The number of endovascular treatments performed by SKEN members increased every year. Conclusion : The SKEN members have been responsible for the major role of endovascular treatments in South Korea for the recent 5 years. This was achieved through the perseverance of senior members who started out in the midst of hardship, the establishment of standards for the training/certification of endovascular neurosurgery, and the enthusiasm of current SKEN members who followed. To provide better treatment to patients, we will have to make further progress in SKEN.

Factors Affecting Basilar Artery Pulsatility Index on Transcranial Doppler (뇌혈류 초음파 검사에서 기저동맥 박동지수에 영향을 미치는 인자)

  • Jeong, Ho Tae;Kim, Dae Sik;Kang, Kun Woo;Nam, Yun Teak;Oh, Ji Eun;Cho, Eun Kyung
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.4
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    • pp.477-483
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    • 2018
  • Transcranial doppler is a non-invasive method that measures the blood flow velocity and the direction of cerebral blood vessels through the doppler principle. The pulsatility index is an index for measuring the transcranial doppler that reflects the distal vascular resistance and is used as an index for the presence and diffusion of cerebral small vessel diseases. The purpose of this study was to evaluate the risk factors affecting the basilar artery pulsatility index in ischemic stroke patients. From January 2014 to May 2015, 422 patients were selected by measuring the transcranial doppler pulsatility index, considering their basilar artery pulsatility index. Univariate analysis was performed using the basilar artery pulsatility index as a dependent variable. Multiple regression analysis was performed considering the factors affecting the pulsatility index as variables. Univariate analysis revealed age, presence of hypertension, presence of diabetes mellitus, presence of hyperlipidemia, and hematocrit (P<0.1) as factors. Multiple regression analysis showed statistically significant results with age (P<0.001), presence of diabetes (P=0.004), and presence of hyperlipidemia (P=0.041). The risk factors affecting the basilar artery pulsatility index of transcranial doppler were age, diabetes, and hyperlipidemia. Further research will be needed to increase the cerebral pulsatility index as a surrogate marker of the elderly, diabetes, and hyperlipidemia.

Utility of Computed Tomography in a Differential Diagnosis for the Patients with an Initial Diagnosis of Chronic Obstructive Pulmonary Disease Exacerbation

  • Park, Hyung Jun;Kim, Soo Han;Kim, Ho-Cheol;Lee, Bo Young;Lee, Sei Won;Lee, Jae Seung;Lee, Sang-Do;Seo, Joon Beom;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.3
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    • pp.234-241
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    • 2019
  • Background: The utility of computed tomography (CT) in the differential diagnosis of patients with chronic obstructive pulmonary disease (COPD) exacerbation remains uncertain. However, due to the low cost associated with CT scan along with the impact of Koreas' health insurance system, there has been a rise in the number of CT scans in the patients with initial diagnosis of COPD exacerbations. Therefore, the utility of CT in the differential diagnosis was investigated to determine whether performing CT scans affect the clinical outcomes of the patients with an initial diagnosis of COPD exacerbation. Methods: This study involved 202 COPD patients hospitalized with an initial diagnosis of COPD exacerbation. We evaluated the change in diagnosis or treatment after performing a CT scan, and compared the clinical outcomes of patient groups with vs. without performing CT (non-CT group vs. CT group). Results: After performing CT, the diagnosis was changed for two (3.0%) while additional diagnoses were made for 27 of the 64 patients (42.1%). However, the treatment changed for only one (1.5%), and six patients (9.3%) received supplementary medication. There were no difference in the median length of hospital stay (8 [6-13] days vs. 8 [6-12] days, p=0.786) and intensive care unit care (14 [10.1%] vs. 11 [16.7%], p=0.236) between the CT and non-CT groups, respectively. These findings remained consistent even after the propensity score matching. Conclusion: Utility of CT in patients with acute COPD exacerbation might not be helpful; therefore, we do not recommend chest CT scan as a routine initial diagnostic tool.

Psychological Systematic Consideration of Breast Cancer Radiotherapy (유방암 방사선 치료 환자의 심리의 체계적 분석)

  • Yang, Eun-Ju;Kim, Young-Jae
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.629-635
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    • 2019
  • In term of the factors affecting psychosocial adjustment of breast cancer patients, their quality of life after surgical operation, radiation, and chemotherapy were systematically meta-analyzed. As a result, their qualities of life of the patients that had radiation therapy was the lowest right after the therapy, and gradually increased after the end of the therapy. However, after six months, their quality of life failed to reach the same level before the therapy. They had depression and side effects the most right after the therapy, and somewhat reduced them after the end of the therapy. In case of surgical operation, the more they were educated, the more they had psychosocial adjustment, and the more they had a medical examination and took out an insurance policy, the more they had psychosocial adjustment. In case of chemotherapy, their cognitive function is influenced so that they have impairments in memory, learning, and thinking stages. Since subjective cognitive impairment has a relationship with depression, it is necessary to monitor depression of chemotherapy patients. Given the results of this systematic meta-analysis, when three types of therapies (surgical operation, radiation therapy, and chemotherapy) are applied to patients with breast cancer, it is necessary to recognize their psychosocial adjustment, depression, anxiety, and quality of life in the nursing and radiation therapy fields and thereby to introduce an intervention program for a holistic approach.

The Effects of PM10 on the Hospital Admission of Patients with Respiratory Disease in Seoul, Korea (서울지역 미세먼지가 호흡기계 질환으로 입원한 환자에 미치는 영향)

  • Pak, Hae-Yong;Pak, Yun-Suk
    • Journal of Convergence for Information Technology
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    • v.9 no.6
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    • pp.194-201
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    • 2019
  • This cohort study aimed to identify the effects of daily PM10 exposure on the hospital admission of patients with respiratory diseases, during the nine-year period (2002-2010), in Seoul, Korea. The research subjects were 13,974 patients who had been hospitalized with respiratory diseases, including chronic obstructive pulmonary disease (COPD), asthma, and pneumonia. During the follow-up period, an increase of 10 ug/m3 in PM10 under the threshold of 50 ug/m3 of PM10 led to hospital admission in 1.38% of the age group younger than 15 years, 1.62% in those 65 years or older, 2.87% in patients 75 years or older and in 1.50% of pneumonia patients, 1.51% of COPD patients, and 1.55% of pneumonia and asthma patients. Under the threshold of 80 ug/m3 of PM10, there was a 3.71% increase in new patients admitted in the age group 65 years or older and 4.25% in those at least 75 years old. Our study found that high PM10 was associated with increased risk of admission of respiratory patients, especially in the elderly. People who already have a respiratory disease should refrain from exposure to particulate matter when there is a high concentration of PM10, especially older patients.