• The Korean Journal of Emergency Medical Services
• /
• v.22 no.1
• /
• pp.49-59
• /
• 2018

Purpose: The purpose of this study was to develop an assistant device for the promotion of bag-valve-mask ventilation based on a non-equivalent control group pre-test and post-test design. Methods: The experimental tool was a mask assistance device developed by the researchers. Data were analyzed using SPSS 21.0 with the cardiopulmonary resuscitation (CPR) evaluation program from August 18 to 30, 2016. The research tools included general, hand-related, and ventilation-related characteristics. Results: Before and after using the mask assistance device, the tidal volume increased by 64 mL (p<.001) from 461.76 mL to 525.86 mL. The tidal volume for control was 477.86 mL, and there was a statistical difference (p<.05). The ventilation frequency in device users was 10 times per minute for a total of 20 ventilations with before 10.65 after 10 times, and that of the control group was before 10.36 times after 10 times; there was no difference in both groups(p>.05). The accuracy of the assistance device was $81.72{\pm}30.86%$, which was a very high value. However, the accuracy of ventilation in the control group with no assistance device was $18.97{\pm}32.44%$, which was a very low accuracy rate. Conclusion: This study's results suggested utilizing the newly-developed mask assistance device in CPR, and showed increases in tidal volume and accuracy of ventilation using the bag-valve-mask ventilation equipment. The general and hand-related characteristics did not have any effect, so the use of the device proved to increase the efficacy in all users.

• Health Policy and Management
• /
• v.27 no.3
• /
• pp.247-255
• /
• 2017

Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.25 no.4
• /
• pp.295-303
• /
• 1999

Presented in this paper are the experimental results that measure rapid prototyping (RP) errors in 3D medical models. We identified various factors that can cause dimensional errors when producing RP models, specifically in maxillofacial areas. For the experiment, we used a human dry skull. A number of linear measurements based on landmarks were first obtained on the skull. This was followed by CT scanning, 3D model reconstruction, and RP model fabrication. The landmarks were measured again on both the reconstructed models and the physical RP models, and these were compared with those on dry skull. We focused on major sources of errors, such as CT scanning, conversion from CT data to STL models, and RP model fabrication. The results show that the overall error from skull to RP is $0.64{\times}0.36mm(0.71{\times}0.66%)$ in absolute value. This indicates that the RP technology can be acceptable in the real clinical applications. A clinical case that has applied RP models successfully for treatment planning and surgical rehearsal is presented. Although the use of RP models is rare in the medical area yet, we believe RP is promising in that it has a great potential in developing new tools which can aid diagnosis, treatment planning, surgical rehearsal, education, and so on.

• Journal of Korean Public Health Nursing
• /
• v.2 no.2
• /
• pp.21-44
• /
• 1988

In Korea, fee-for service reimbursement has been adopted from the begining of medical insurance system in 1977, and the importance of the relative value unit is currently being investigated. The purpose of this study was to find out the level of propriety of the difference in the fees for different surgical services, and the appropriateness of the classification of the insurance fee schedule. For the purpose of this study, specific subjects and the procedural methodology is shown as follows: 1. The propriety of the Relative Price System(RPS). 1) Choice of sample operations. In this study, sample operations were selected and classified by specialists in general surgery, and the number of items they classified were 32. For the same group of operations the Insurance Fee Schedule(IFS) classified the operations into 24 separate items. In order to investigate the propriety of the RPS, one of the purpose of this study, was to examine the 24 items classified by the IFS. 2) Evaluation of the complexity of surgery. The data used in this study was collected The data used in this study was collected from 94 specialists in general surgery by mail survey from November I to 15, 1986. Several independent variables (age, location, number of bed, university hospital, whether the medical institution adopt residents or not) were also investigated for analysis of the characteristics of surgical complexity. 3) Complexity and time calculations. Time data was collected from the records of the Seoul National University' Hospital, and the cost per operation was calculated through cost finding methods. 4) Analysis of the propriety of the Relative Price System of the Insurance Fee Schedule. The Relative Price System of the sample operation was regressed on the cost, time, comlexity relative ,value system (RVS) separately. The coefficient of determination indicates the degree of variation in the RPS of the Insurance Fee Schedule explained by the cost, time, complexity RVS separately. 2. The appropriateness of the classification of the Insurance Fee Schedule. 1) Choice of sample operations. The items which differed between the classification of the specialist and the classification of medical, Insurance Fee Schedule were chosen. 2) Comparisons of cost, time and complexity between the items were done to evaluate which classification was more appropriate. The findings of the study can be summarized as follows: 1. The coefficient of determination of the regression of the RPS on-cost RVS was 0.58, on time RVS was 0.65, and on complexity RVS was 0.72. This means that the RPS of Insurance Fee Schedule is improper with respect to the cost, time, complexity separately. Thus this indicates that RPS must be re-shaped according to the standard element. In this study, the correlation coefficients of cost, time, complexity Relative Value System were very high, and this suggests that RPS could be reshaped I according to anyone standard element. Considering of measurement, time was thought to be the most I appropriate. 2. The classifications of specialist and of the Insurance Fee Schedule were compared with respect to cost, time, and complexity separately. For complexity, ANOVA was done and the others were compared to the different values of different classifications. The result was that the classification of specialist was more reasonable and that the classification of Insurance Fee Schedule grouped inappropriately several into one price unit.

• Health Policy and Management
• /
• v.23 no.1
• /
• pp.3-18
• /
• 2013

This paper investigates the possibility of expanding pay-for-performance (P4P) program as a provider payment system, in terms of financial, economical, and political sustainability. In order to expand the sustainable P4P, P4P should have usefulness in terms of economic value as well as efficiency in the financial aspects of health care. More importantly, the P4P would be politically sustainable only when both providers and consumers can accept. Korea's healthcare system seems to have logical ground for the P4P program financially and economically. However, how well the P4P can work remains to be proven in its implementation. After 43 tertiary hospitals applied the P4P program for acute myocardial infarction (AMI) and C-section in 2007, the number of hospitals adopting the P4P program for AMI and C-section has increased to 316 in 2011, and an incentive for hospitals applying the P4P has risen to 2% from 1% of health insurance benefits. This shows that the P4P program introduced by Health Insurance Review and Assessment Service is quite successful. In addition, people are aware of the need for improved P4P program and policy alternatives have been already made. Therefore, it is very important to come up with politically supportable strategies that can make providers and consumers accept the P4P program while maintaining the governance of the existing health insurance policy. To this end, there are some tasks to be considered. First, the expansion of the P4P program should be placed on the agenda of the Health Insurance Policy Review Committee, the highest decision-making body, and a separate agency for P4P planning should be established. Second, for more efficient P4P program, the processes of review and assessment, currently carried out separately, should be integrated into a single process. Third, infrastructure to measure the quality of medical services should be sharply expanded. Fourth, the current paradigm for the assessment should be changed. Lastly, a P4P program for consumers should be considered. Given that the consumers in Korea can use medical services freely, the National Health Insurance Corporation could initiate the P4P program for consumers as a means of controlling excessive use of medical services and adjusting consumer's moral hazard.

• Journal of Digital Policy
• /
• v.1 no.2
• /
• pp.71-77
• /
• 2022

The purpose of this study is to analyze the job satisfaction of hospital workers according to the type of hospital and to provide basic data for successful hospital management. For data analysis, frequency analysis and chi-square analysis are performed for general characteristics, and Kendall's tau correlation analysis is performed to see the correlation between statistically significant factors among job environment, value realization, organizational characteristics, and individual ability factors. did A total of 241 people working at primary, secondary, and tertiary medical institutions were surveyed. Among the value realization factors in the research results, self-esteem and rewarding (p<0.05), autonomy and creativity (p<0.05), and among personal competencies factors, workload (p<0.05) were statistically A significant difference was seen. Value realization and personal competence factors were found to influence job satisfaction (p<0.001). In conclusion, the most basic for the qualitative and quantitative growth of the hospital should be the job satisfaction of the internal members, on the basis of which positive medical services should be provided to the patients.

• International journal of advanced smart convergence
• /
• v.8 no.4
• /
• pp.154-160
• /
• 2019

In this paper, we propose the miniaturization size of wearable Range of Motion(ROM) and a system that can be connected with smart devices in real-time to measure the joint movement range dynamically. Currently, the ROM of the joint is directly measured by a person using a goniometer. Conventional methods are different depending on the measurement method and location of the measurement person, which makes it difficult to measure consistently and may cause errors. Also, it is impossible to measure the ROM of joints in real-life situations. Therefore, the wearable sensor is attached to the joint to be measured to develop a miniaturize size ROM device that can measure the range of motion of the joint in real-time. The sensor measured the resistance value changed according to the movement of the joint using a load cell. Also, the sensed analog values were converted to digital values using an Analog to Digital Converter(ADC). The converted amount can be transmitted wireless to the smart device through the wearable sensor node. As a result, the developed device can be measured more consistently than the measurement using the goniometer, communication with IoT-based smart devices, and wearable enables dynamic observation. The developed wearable sensor node will be able to monitor the dynamic state of rehabilitation patients in real-time and improve the rapid change of treatment method and customized treatment.

• Health Policy and Management
• /
• v.6 no.1
• /
• pp.59-84
• /
• 1996

It is generally believed that the medical profession in Korea is an well-paid field along with legal profession. In this vein, the nursing is regarded one of well-paid profession. The actual data, however, reveals that nurses belong to low income bracket. We carefully compare the nurse's earnings with those of other professions. We selected 58 professions, which are similar in vocational characteristics and education background to nurses and conduct a regression analysis to estimate earning functions. Using the estimated coefficients, we project an optimum salary level for nurse, and compare it with the actual salary level. The estimated results show that the nurses are underpaid : their actual salary is less than the optimum level. We provide several explanations for this phenomenon : a tradition based on Confucian value, wage discrimination for women, and wage inequality among hospitals. Undercompensation will result either ratard professional development, or block the motivation for high quality of nursing care. If the current underpaying situation is not improved, a shortage of nurses along with an noticeable decline in the quality of medical services are expected. Therefore an adequate compensation for nurses must be properly assessed and addresed not only be health care authorities but also by legislators. Further research is needed to explain why there is such as wide salary inequality among nurses, and to find what cause it.

• Journal of The Korea Institute of Healthcare Architecture
• /
• v.22 no.4
• /
• pp.105-115
• /
• 2016

Purpose: This study is a case study of a small-mid sized hospital to promote a full-scale remodeling to ensure the quality and competitiveness of the medical services and trying to arrange the remodeling characteristics of small-mid sized hospital which is suffering from aging facilities as well as chronic congestion and lack of spaces. Methods: Research was conducted by consultation with hospital executives and each department operators, and on-site investigation, Results: The result of this study can be summarized into two points. The first one is that existing statistical value like area per bed, in the remodeling of the small-mid hospitals may not mean much. planners have to verify the necessary room space areas in close consultation with the department operators. And after confirming layout possibilities, they have to create the program. The second one is that remodeling planning can be a realistic plan with structural and installation diagnosis at the same time. If so, it is advisable to proceed architectural design from the beginning for cost and time savings. Implications: This results can be applied to small-mid hospitals to apply to the medical law revision and others.

• Journal of the Korean Society of Physical Medicine
• /
• v.5 no.2
• /
• pp.173-182
• /
• 2010

Purpose : This study aims to figure out problems in Korea's physical therapy, how to improve it, and the need for it by examining the nation's physical therapy charges. Methods : This study was performed based on materials from the National Health Insurance Corporation, Korean academic theses, and domestic medical charge system. Results : The number of patients with physical therapy stood at around 17,764,428 in 2008, and then has gradually rose to 3 out of 100,000 citizens. The National Health Insurance Charge System based on relative values, which has been applied since 2001, is not desirable in that it is increasing patients' financial burden. Also, in deciding the amount of work carried out by physical therapists, their amount of input time, efforts, labor, and stress from their patients were not considered and the false relative value system has made patients pay more. Conclusion : Korean medical insurance charges and the overall system should be improved, so that physical therapists can perform specialized services of global physical therapy and service receiving patients do not incur losses.