• 한국주거학회:학술대회논문집
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• 한국주거학회 2005년도 추계학술대회 논문집
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• pp.367-370
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• 2005

Offer of medical treatment service for recovery or preservation of physical spiritual function of elderly people by sudden population graying developing is essential. Therefore, according to increase of elderly's medical treatment demand, medical treatment service request is augmented. Number of medical treatment service utilization wishes to grope medical treatment service support way for elderly residing cloth elevation laying stress on elderly's Aging in Place in increase trend in this research. If decide, is as following : First, national hospital and public health center were concentrated most on Seoul and kyonggi, and there were many hospitals to south of a river nine, Songpagu, Seochogu, and public health center was expose that is one by one to each nine. Second, in the case of Seoul, elderly population ratio was expose that comparatively high Yeongdeungpo, Chongno, Yongsan, west passage nine is few hospital number relatively in elderly's residential area. Third, need that establish elderly full text clinic on part of general hospital or university hospital equipment. Fourth, must do so that can use access as is easy little more in local community to all elderly who need medical treatment service of visit nursing, visit medical examination and treatment etc.. that consist in present public health center.

• 한국병원경영학회지
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• 제12권4호
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• pp.1-21
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• 2007

The relaxation of the regulation in selection of medical institution allows patients to use their own judgement in choosing proper institution for their diseases. Since the change of the regulation, there should have been many changes in medical institution selection behavior. The analysis of the change in disease specific selection pattern is critical because there be an optimal selection criteria that ensure the efficient and effective utilization of medical resources. This study analysis the institution selection factors by comparing the choice among the cases of acute diseases, the cases of chronic diseases, inpatient services, outpatient services, and emergency medical service. The comparisons performed in terms of size, class and other characteristics of medical institutions. For the study the nationally surveyed database was used and the data were analyzed using logistic regression procedure. The results indicates that the primary care facilities were not properly utilized. This study speculates that the reason for the undesirable pattern of utilization is that the roles of primary care facilities in the healthcare delivery system was not clearly defined. Based on the results, the medical policy implications are discussed.

• 간호행정학회지
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• 제14권3호
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• pp.229-240
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• 2008

Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

• 보건행정학회지
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• 제24권2호
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• pp.120-127
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• 2014

Background: Since December 2010, online computerized prospective drug utilization review (pDUR) has been implemented in Korea. pDUR involves the review of each prescription before the medication is dispensed to the individual patient. The pDUR is performed electronically by Health Insurance Review & Assessment Service (HIRA), which is a Korean governmental agency, and then HIRA provides medical institutions and pharmacies with information that can be helpful to them in preventing potential drug problems such as drug/drug interactions or ingredient duplication. The aim of this study was to assess the impact of the Korean pDUR implementation on the proportion of drug-drug interactions (DDIs) using claims data from HIRA. Methods: A before-after comparison of the prevalence of DDIs between prescription was conducted, using HIRA administrative claims data of medical institution from January 2010 to December 2011. The analysis unit was the prescription issued and pairs before and after. The main outcome measures were the proportion of DDIs within- (control group) or between- physician encounters. To examine the difference, a paired t-test was applied. Results: We found that DDIs proportion between prescription decreased significantly (t=3.04, p=0.0026) after the implementation of pDUR, whereas there is no significant reduction within prescription (t=1.15, p=0.2518). With respect to the prevalence of DDIs between drug groups, the most dramatic reduction was occurred between 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors and anti-fungal agents. Conclusion: It seems effective that giving a direct feedback to prescribers by a prospective DUR. Further research is needed to assess the impact of DUR to final outcomes such as hospitalization.

• 대한예방한의학회지
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• 제28권2호
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• pp.67-83
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• 2024

Background : Coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted all aspects of life, from disease prevalence to the utilization of medical services. In Republic of Korea, there exists both a duty and a right for Korean Medicine to treat epidemic diseases. However, no studies have been conducted to examine changes in the utilization of Korean Medicine during the pandemic. This study aims to identify the differences in the utilization of Korean Medicine before and after COVID-19. Method : This study analyzed data from the Health Insurance Statistics of the National Health Insurance Service and the Health Insurance Review & Assessment Service from 2016 to 2022. To compare the utilization of Korean Medicine with Western medicine, the analysis was limited to the clinic level. Results : The top 10 most frequently treated conditions in Korean Medicine from 2016 to 2022 remained consistent, primarily involving musculoskeletal diseases, with the exception of functional dyspepsia. Visits to Korean Medicine clinics have declined, while visits to Western Medicine clinics recovered. Despite the overall decline in visits, certain Korean Medicine services increased in frequency, especially in precipitator-simulated acupuncture, indirect moxibustion (moxa burner), pricking cupping (two areas), warming meridian sinew, and complex Chuna therapy (80% as out-of-pocket expenses). Although the relative value units in Korean Medicine services varied, the fees for all services, except for precipitator-simulated acupuncture, increased. Conclusion : These findings indicate that COVID-19 has affected the utilization of Korean Medicine. Further studies are needed to explore the broader impact of epidemics on medical services and to develop policies to address these changes.

• 한국임상보건과학회지
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• 제1권1호
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• pp.9-17
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• 2013

Purpose. This study is to find the degree of variations and trends of hospital services utilization for hypertensive disease, and have done the comparative analysis of the factors affecting occurring some variations. For this, this study uses the data for patients-survey and health-survey of a regional society by Korea Institute for Heath and Social Affairs in 2008; The regional units are classified into 160 of medium size medical service areas. Methods. I understand the level of variation by using index of Extremal Quotient(EQ) and Coefficient Variation(CV), and analyze critical factors influencing some differences in hospital services utilization by using multi-regression model. Results. The main results are followed:The first, in case of rate of hospital services utilization according to standarization of sex and age by small area, I find the variations of EQ 5.3 and CV 0.3; In Ho-nam, especially, the variation of high rank of 10 of age shows higher distribution. The second, the results analyzing the factors influencing on hospital services utilization by multi regression model are that a number of bed hospitals is significant positive relationship and EQ-5D of health behavior is significant negative one. Conclusions. To increase equity of hospital services utilization for hypertensive disease, this study requests the appropriate supply management of bed hospitals by region, efficient allocation of resources, and revitalization of the health promotion program.

• 보건행정학회지
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• 제30권1호
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• pp.62-71
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• 2020

Background: The purpose of this study is to analyze the current status and factors of elderly patients' hospitalization for hip replacement, knee replacement, and general spine surgery. Methods: National health insurance data in 2018 was provided by the National Health Insurance Service. We used multiple regression to analyze factors associated with the medical utilization of hip replacement, knee replacement, and general spine surgery in elderly patients over 65 years old. The dependent variables are the length of stay and total health expenditure. The independent variables are the demographic-social factors (sex, age, region, insurance type, income level) and surgery-related factors (institution type, location of the hospital, surgery classification). Results: The most common factor affecting surgery was the location of medical institutions. Compared with the medical institutions located in metropolitan, the length of stay in rural medical institutions was higher and total health expenditure was lower. The lower quartile of income, the higher the length of stay and total health expenditure. In addition, the variables of age, type of health insurance, and type of medical institution were statistically significant. Conclusion: In this study, we confirmed the effect of sociodemographic factors and medical institution factors on the Healthcare Utilization of spinal and joint surgery.

• 대한한의진단학회지
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• 제18권1호
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• pp.25-31
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• 2014

Objective This study aims to understand the actual utilization of the oriental rehabilitation medicine center of the initial interdisciplinary medical care at the National Rehabilitation Center and to arrange proper development plans for more effective interdisciplinary medical services for future activation of interdisciplinary medical care. Method: The interdisciplinary patient status, composition of patient care, and major disease-related status were studied and analyzed for oriental rehabilitation medication relating to interdisciplinary medical care at the National Rehabilitation Center. Furthermore, the interdisciplinary status and its operating conditions were evaluated to devise a development plan for the National Rehabilitation Center. Results: As a result of the analysis of oriental rehabilitation medical care diagnosing status utilization at the National Rehabilitation Center regarding interdisciplinary medical care, the ratio of the number of those receiving interdisciplinary oriental rehabilitation medical care was less than half of the total receiving interdisciplinary care. As the major disease status from the patients of interdisciplinary care, stroke patients covered the large majority, and musculoskeletal pain patients covered the majority of outpatients. The establishment of additional oriental medication departments and assigning of interdisciplinary coordinators were presented as the goals of a development plan for the manpower and structural side of interdisciplinary medical care at the National Rehabilitation Center. On the institutional and systematic side, improvement in the interdisciplinary hierarchy and interdisciplinary model development based on the number of patients per disease was proposed. In addition, operation on ward bedding and construction of interdisciplinary EMR medical care is necessary on the medical and administration service side. Conclusion: To understand the actual utilization and to arrange development plans aimed at constructing a safe and effective interdisciplinary hierarchy for interdisciplinary medical care at the National Rehabilitation Center, patient-centered care needs to be implemented.

• 한국문헌정보학회지
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• 제27권
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• pp.183-214
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• 1994

The purpose of this study is to suggest the schemes to enhance information service functions by the utilization of CD-ROM in medical school libraries. The results of the study are summarized as follows : 1. The selection and evaluation of CD-ROM database are necessary steps in the planning of a CD-ROM. Before the CD-ROM is selected, therefore, medical libraries must make a practical evaluation criteria in important order of information services environment, characteristics of hardware/software, service requirements, price and cost, etc. 2. If possible, CD-ROM MEDLINE must be suited for the information services environment. 3. In case of the popular core journals, full-text CD-ROM should be gradually purchased. 4. In order to reduce the time required from search of bibliographic informations to receipt of original articles, CD-NET system and library holding administration program must be built up and developed. And channel of information search and order/receipt of original article should be varied. 5. Search education program for medical librarians and users should be enforced, and librarians must play an important role in CD-ROM retrieval consultant and intermediator.

• 대한치과기공학회지
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• 제28권1호
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• pp.67-81
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• 2006

This research has been attempt to examine closely factors that high cost and value to overall satisfaction state for dental implant prosthesis, re-utilization intention, inducement intention of the general hospital dental service user and provide basis data necessary to establish competitive general hospital dentistry management strategy. Collected data using own recording way questionnaire from April 17, 2004 to May 15, 2004 choosing 142 people that agree on this research and question of 361 people that dental implant prosthetic treatment finished from March 1, 1999 to March 1, 2004 for this. Major analyzation consequences are as follows : First, general satisfaction, re-utilization intention, inducement intention for implant prosthesis that highly correlation variables are kindness, explanation, medical treatment level and appreciation of the aesthetic. Second, correlation is high relatively between re-utilization intention, inducement intention in the 3 variables such as general satisfaction re-utilization intention, inducement intention. Third, the result of multiple regression analysis showed that most significant effective factors are satisfaction with explanation of dental implant prosthesis between the 3 dependant variables such as general satisfaction, re-utilization intention, inducement intention. In looking into these consequence, how to improve that raise satisfaction about dental implant prosthetic treatment and to establish patient focused care service system for dental implant prosthesis, it is consider that explain enough about implant prosthesis and raise quality of medical examination and treatment level, including satisfied with fabrication of good esthetic dental implant prosthesis.