• Title/Summary/Keyword: Medical Utilization Rate

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Influencing Factors on Influenza Vaccination among Korean 50~64 Age Adults Living Alone (1인가구 장년 성인(50~64세)의 인플루엔자 백신 접종률에 영향을 미치는 요인)

  • Kim, Kyoung-Ja;Lee, Insook
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.27 no.3
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    • pp.284-293
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    • 2020
  • Purpose: Based on Anderson's model of health service utilization, we investigated the factors that affect the influenza vaccination status in Korean adults aged 50-64 years, who live alone. Methods: Data of 194 Korean adults aged 50-64 years, who live alone were obtained from the Korea National Health and Nutrition Examination Survey 7th Edition (2016-2018). Descriptive statistics and a multiple logistic regression model were used for statistical analysis. Results: The influenza vaccination rate in the study population was 39.3%. Educational status and health behaviors such as smoking habits and regular medical check-up were associated with the influenza vaccination rate in Korean adults aged 50-64 years, who live alone. Multiple logistic regression analysis showed that educational level lower than middle school graduation (odds ratio [OR] 2.02), non-smoking status (OR 1.98), and lack of regular medical check-up (OR 0.62) were significantly associated with the influenza vaccination rate in Korean adults aged 50-64 years, who live alone. Conclusion: The influenza vaccination rate in Korean adults aged 50-64 years, who live alone, is relatively low; therefore, policies should be implemented to improve the influenza vaccination rate in this population. Influenza vaccination in single households was affected by health promotion activities; therefore, interventions are warranted to encourage overall health promotion activities.

Direction of Healthcare Reform for Sustainability (지속 가능한 보건의료의 혁신 방향)

  • Park, Eun-Cheol
    • Health Policy and Management
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    • v.29 no.4
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    • pp.379-381
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    • 2019
  • Korea's healthcare is in great danger of sustainability. In 2020, the baby boomer will begin to be older, and there is no promise that the total fertility rate of 1.0 or less will rebound, and Korea's economic growth rate is predicted to be less than 2%. Together with these phenomena, Plan for Benefit Expansion in Nation Health Insurance (Moon Jae-in Care) will seriously threaten the sustainability of health insurance finance. In addition, health care in Korea has many problems: excessive medical utilization, rapidly increasing elderly medical costs, concentrating patients into big hospitals, low healthcare personnel but many healthcare facilities and equipment, bad quality of primary and mental care, and fast-growing health expenditure. For sustainability, healthcare of Korea should be reformed. The direction of the reform is people-centered and integrated healthcare in the community which is composed of empowering and engaging people, strengthening governance and accountability, reorienting the model of care, coordinating services, and creating an enabling environment.

Developing Innovation Index of Hospital Service Using 6 Sigma and SERVQUAL (6 시그마와 SERVQUAL을 활용한 병원서비스 혁신지표 개발)

  • Oh, Ka-Eun;Bak, Won-Sook;Han, Sang-Sook;Park, Sang-Chan;Lee, Sang-Chul
    • Journal of Korean Society for Quality Management
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    • v.41 no.4
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    • pp.555-566
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    • 2013
  • Purpose: The purpose of this study is to develop innovation index of hospital service integrating 6 sigma and SERVQUAL. Methods: This study used DMA(Define, Measure and Analysis) from 6 sigma and 5 Factors from SEVQUAL. To test data, chi-squire text, association analysis and behavior analysis was conducted. Results: This study indicated the management index through CTQ (Critical to Quality) and Chosen few X using 6 sigma process. Finally, And this study developed 5 Factors; Equipment Utilization in Tangibility, Ratio of Patients/Disease/Behavior/Treatment in Reliability, Survival RAte, Canselation Rate of Reservation, Churn Rate, Interval of Treatment and Confidence in Responsiveness, Frequency of Patients/Disease/Behavior/Treatment in Assurance and Contrast to Best Department/Best Doctor/Best Doctor in Faculty/Average of Mine in Empathy. Conclusion: This study developed innovation index of hospital service. Managing this index, hospital is able to achieve the decline of total treatment cycle, adjustment of patients behavior and increase of equipment utilization. Ultimately, hospital is able to accomplish innovation of healthcare service.

A Study Concerning Health Needs in Rural Korea (농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究))

  • Lee, Sung-Kwan;Kim, Doo-Hie;Jung, Jong-Hak;Chunge, Keuk-Soo;Park, Sang-Bin;Choy, Chung-Hun;Heng, Sun-Ho;Rah, Jin-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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Trend and Forecast of the Medical Care Utilization Rate, the Medical Expense per Case and the Treatment Days per Cage in Medical Insurance Program for Employees by ARIMA Model (ARIMA모델에 의한 피용자(被傭者) 의료보험(醫療保險) 수진율(受診率), 건당진료비(件當診療費) 및 건당진료일수(件當診療日數)의 추이(推移)와 예측(豫測))

  • Jang, Kyu-Pyo;Kam, Sin;Park, Jae-Yong
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.3 s.35
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    • pp.441-458
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    • 1991
  • The objective of this study was to provide basic reference data for stabilization scheme of medical insurance benefits through forecasting of the medical care utilization rate, the medical expence per case, and the treatment days per case in medical insurance program for government employees & private school teachers and for industrial workers. For the achievement of above objective, this study was carried out by Box-Jenkins time series analysis (ARIMA Model), using monthly statistical data from Jan. 1979 to Dec. 1989, of medical insurance program for government employees & private school teachers and for industrial workers. The results are as follows ; ARIMA model of the medical care utilization rate in medical insurance program for government employees & private school teachers was ARIMA (1, 1, 1) and it for outpatient in medical insurance program for industrial workers was ARIMA (1, 1, 1), while it for inpatient in medical insurance program for industrial workers was ARIMA (1, 0, 1). ARIMA model of the medical expense per case in medical insurance program for government employees & private school teachers and for outpatient in medical insurance program for industrial workers were ARIMA (1, 1, 0), while it for inpatient in medical insurance program for industrial workers was ARIMA (1, 0, 1). ARIMA model of the treatment days per case of both medical insurance program for government employees & private school teachers and industrial workers were ARIMA (1, 1, 1). Forecasting value of the medical care utilzation rate for inpatient in medical insurance program for government employees & private school teachers was 0.0061 at dec. 1989, 0.0066 at dec. 1994 and it for outpatient was 0.280 at dec. 1989, 0.294 at dec. 1994, while it for inpatient in medical insurance program for industrial workers was 0.0052 at dec. 1989, 0.0056 at dec. 1994 and it for outpatient was 0.203 at dec. 1989, 0.215 at 1994. Forecasting value of the medical expense per case for inpatient in medical insurance program for government employees & private school teachers was 332,751 at dec. 1989, 354,511 at dec. 1994 and it for outpatient was 11,925 at dec. 1989, 12,904 at dec. 1994, while it for inpatient in medical insurance program for industrial workers was 281,835 at dec. 1989, 293,973 at dec. 1994 and it for outpatient was 11,599 at dec. 1989, 11,585 at 1994. Forecasting value of the treatment days per case for inpatient in medical insurance program for government employees & private school teachers was 13.79 at dec. 1989,13.85 at an. 1994 and in for outpatient was 5.03 at dec. 1989, 5.00 at dec. 1994, while it for inpatient in medical insurance program for industrial workers was 12.23 at dec. 1989, 12.85 at dec. 1994 and it for outpatient was 4.61 at dec. 1989, 4.60 at 1994.

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The trend of Korean Medicine utilization in 2008-2013 (비급여를 포함한 한의 외래의료이용의 최근(2008-2013) 변화추이)

  • Kim, Dongsu;Lim, Byungmook
    • Journal of Society of Preventive Korean Medicine
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    • v.21 no.1
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    • pp.57-66
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    • 2017
  • Objectives : This study aimed to analyze the structure and the trend of utilization and expenditure for Korean Medicine (KM) in Korea. Methods : Data were drawn from the 2008-2013 annual Korea Health Panel (Version 1.2.2), a national representative sample. We combined the data of household members with the data of outpatient KM service use. The volume of KM use was estimated based on the frequency of use and co-payment. Results : The KM utilization rate slightly increased in recent years, and it is presumed to be resulted from the increase of elderly population. Most KM outpatient visits were being concentrated in treating musculoskeletal diseases, and the procedures used frequently were acupuncture, moxibustion, cupping, and physical therapy. The imbalance of KM use between lower income group and higher income group was deepening. Conclusions : To expand restricted disease areas KM covered, the more herbal prescriptions should be insured and the insured form of herbal medicines need to be diversified.

Study on the Current Utilization and the Reason of Ceasing Korean Medicine Treatment among Children with Cerebral Palsy (뇌성마비 아동의 한방치료 이용실태와 중단원인 연구)

  • Park, Byungwook;Park, Yohan;Yu, Sunae;Hur, Youngjin;Kim, Sungchul;Yun, Youngju
    • Journal of Society of Preventive Korean Medicine
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    • v.20 no.1
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    • pp.89-97
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    • 2016
  • Objectives : The purpose of this study was to investigate the real status of the utilization of Korean medicine (KM) treatment among children with cerebral palsy (CP). Methods : In a prospective observational multicenter study for children with CP aged from 6 months to 78 months, we analyzed 69 questionnaires of children currently receiving or have received KM treatment such as acupuncture and Korean herbal medicine for CP. Results : Of all the 170 participants, 32 children was currently getting KM treatment and they were getting acupuncture therapy 2.5 times per week on average. The mean expenditure per month for acupuncture and herbal medicine was respectively 32,000won and 501,000won. 37 children have discontinued KM treatment. The most frequent reason for quitting acupuncture therapy was 'inconvenience' (40.7%), followed by 'suffering of children' (33.3%). The average duration of taking Korean herbal medicine was 3.78 months and the highest reason of stopping medicine was 'rejection of children' (32.3%), followed by the 'cost burden' (22.6%). 75% of currently KM using group answered they have experienced positive effect of KM and the rate was 48.6% among the group who have ceased KM. There was a significant difference between the two groups(p=0.025). Conclusions : Further study will be required to increase the therapeutic effect and utilization of KM among the children with CP. More efforts should be made to develop less invasive acupuncture method and various shape of KM herbal medicine and to expand the insurance coverage of KM for children with CP.

The Effect of Korean Prospective Drug Utilization Review Program on the Prescription Rate of Drug-Drug Interactions (의약품 처방·조제지원서비스(Drug Utilization Review)사업이 병용금기 처방률에 미치는 영향)

  • Kim, Dong-Sook;Park, Juhee;Jeon, Ha-Rim;Park, Chanmi;Kang, Hyeun Ah
    • Health Policy and Management
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    • v.24 no.2
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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.

Determinants of Welfare Service Utilization among the Single and the Married Couples Elderly (남녀 독거노인가구와 부부노인가구의 복지서비스 이용의 영향요인)

  • Lee, Yoon-Jung
    • 한국노년학
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    • v.32 no.4
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    • pp.1119-1135
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    • 2012
  • The single and the married couples elderly are rapidly increasing in the next twenty years. Due to the size of these group, their level of living, life satisfaction, income and medical security and welfare services utilization have been a social issue in Korea. For these reasons, the purpose of this study was to analyze the determinants of welfare services utilization by the single and the married couples elderly. Their analyses were composed of a cross-tabulations and t-test, analysis of variance, duncan test, multiple regression analysis using 5'th Wave Korea Welfare Panel(2010). Data were collected from a survey of 2,716. The results showed that the elderly single women had the lowest level of income and health, the elderly single men needed the help about the emotional support for improvement of family and social relations. The married couples elderly are young and the participation rate of job opportunities for the elderly is high, relatively. The results of the multiple regression analysis indicated that the level of income and medical security and the satisfaction of family relationships were important factors as related to the welfare services utilization.

Reversible and High-Capacity Data Hiding in High Quality Medical Images

  • Huang, Li-Chin;Hwang, Min-Shiang;Tseng, Lin-Yu
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.7 no.1
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    • pp.132-148
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    • 2013
  • Via the Internet, the information infrastructure of modern health care has already established medical information systems to share electronic health records among patients and health care providers. Data hiding plays an important role to protect medical images. Because modern medical devices have improved, high resolutions of medical images are provided to detect early diseases. The high quality medical images are used to recognize complicated anatomical structures such as soft tissues, muscles, and internal organs to support diagnosis of diseases. For instance, 16-bit depth medical images will provide 65,536 discrete levels to show more details of anatomical structures. In general, the feature of low utilization rate of intensity in 16-bit depth will be utilized to handle overflow/underflow problem. Nowadays, most of data hiding algorithms are still experimenting on 8-bit depth medical images. We proposed a novel reversible data hiding scheme testing on 16-bit depth CT and MRI medical image. And the peak point and zero point of a histogram are applied to embed secret message k bits without salt-and-pepper.