• 한국직업건강간호학회지
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• 제17권1호
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• pp.86-95
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• 2008

Purpose: The objectives for this study are to produce the comprehensive management indexes and find their application strategies for appropriate medical care in primary care clinics under workers' compensation insurance. Method: Data of this study was workers' compensation insurance medical fees claim's data from July 2006 to June 2007. Data were analyzed using SAS 9.1 version by applying descriptive statistics and Pearson's correlation. The indexes such as costliness index(CI), standard medical fee were calculated based on the fourth revision of korean classification of diseases(KCD-4.). Results: The CI, visiting index(VI), outliers index(OI), and medical review adjustment percentage were positively correlated in the both inpatient and outpatient medical fees in primary care clinics under workers' compensation insurance. The major medical specialities were neurological surgery, general medicine, general surgery, rehabitational medicine, and orthopedic surgery. The CIs were slightly high in rehabitational medicine among major medical specialities. The CIs were mostly high in diagnosis, test, anesthesia, and rehabitational assistive device fees among major medical specialities. The CIs were slightly high in Kwangju, Daegu, Daejeon, and Busan districts among district management centers of Korea Workers' Compensation and Welfare Service. Conclusions: We suggest the continuous development of appropriate disease classification system and medical care quality indicators to successfully take root the comprehensive management for appropriate medical care under workers' compensation.

• Journal of Preventive Medicine and Public Health
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• 제31권3호
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• pp.460-470
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• 1998

By expanding health insurance, customers will carry a smaller burden of medical costs. As a result, the number of visits to a physician increase and this result in the improvement of medical accessibility. But medical care utilization may be changed not only by insurance status but also by socio-demographic factor, economic status and other factors. The question thus remains, at which level of accessibility and what price of medical care service in health insurance will the customer and the medical care service be satisfied. The price of medical care service ls comprised of the customer's out-of-pocket money and the costs not covered by health insurance. If the price of medical care services in health insurance are appropriate, medical care utilization should not differ because of the difference in income status or the acuteness of illness. But If the price is not adequate, low income groups will receive relatively low medical care utilization, particularly in the case of chronic disease. The purpose of this study is to evaluate the differences in medical care utilization among the various income groups and those with varying acuteness of illness. The major hypotheses to test in this study are : (i) whether there are differences in medical care utilization among different income groups exist, (ii) whether differences in medical care utilization among different income groups exist with the hospital type. (iii) whether differences in medical care utilization among different income groups exist with the acuteness of illness and with age. The data was collected from the JongRo District Health Insurance Society in Seoul. A total of 118,336 persons were selected as the final sample for this study. The major findings of this study were as follows; 1. The volume of ambulatory utilization among users was statistically significant by income level. 2. Among different income groups, the volume of ambulatory utilization was statistically significant by the acuteness of illness. 3. Higher income groups with chronic diseases had a greater volume of ambulatory utilization than other groups.

• 임상간호연구
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• 제24권1호
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• pp.34-43
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• 2018

Purpose: This study was aimed to identify the difference in satisfaction and importance of nursing care between patients in comprehensive nursing care unit (CNCU) and general nursing care unit (GNCU). It also confirms the difference between practice environment of nursing work and nurse's intention to work. Methods: Nursing care satisfaction and importance levels were measured from 202 patients. Practice environment of nursing work and nurse's intention to work were measured from 54 nurses. Results: The satisfaction level was higher in the CNCU in comparison to the GNCU (p<.001). There was no significant difference between the importance and satisfaction level of nursing care for patients at the CNCU (p=.973), whereas in the GNCU, patients' satisfaction level was lower than the importance level (p<.001). The score for practice environment for nursing work was higher in the CNCU than in the GNCU (t=3.34, p=.002). The nurse's intention to work in the CNCU was higher than that of the GNCU, but there was no statistically significant difference. Conclusion: Through the survey, the paper suggests that comprehensive nursing care is a service type that satisfies the nursing demand (importance) that patients consider important. Results from nurses showed no significant differences.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.2107-2111
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• 2013

Objectives: To investigate data agreement of cancer registries and medical records as well as the quality of care and assess their relationship in a 5-year period from 2006 to 2011. Methods: The present cross-sectional, descriptive-analytical study was conducted on 443 cases summarized through census and using a checklist. Data agreement of Nemazi hospital-based cancer registry and the breast cancer prevention center was analyzed according to their corresponding medical records through adjusted and unadjusted Kappa. The process of care quality was also computed and the relationship with data agreement was investigated through chi-square test. Results: Agreement of surgery, radiotherapy, and chemotherapy data between Nemazi hospital-based cancer registry and medical records was 62.9%, 78.5%, and 81%, respectively, while the figures were 93.2%, 87.9%, and 90.8%, respectively, between breast cancer prevention center and medical records. Moreover, quality of mastectomy, lumpectomy, radiotherapy, and chemotherapy services assessed in Nemazi hospital-based cancer registry was 12.6%, 21.2%, 35.2%, and 15.1% different from the corresponding medical records. On the other hand, 7.4%, 1.4%, 22.5%, and 9.6% differences were observed between the quality of the above-mentioned services assessed in the breast cancer prevention center and the corresponding medical records. A significant relationship was found between data agreement and quality assessment. Conclusion: Although the results showed good data agreement, more agreement regarding the cancer stage data elements and the type of the received treatment is required to better assess cancer care quality. Therefore, more structured medical records and stronger cancer registry systems are recommended.

• 보건행정학회지
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• 제32권2호
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• pp.173-179
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• 2022

Background: This study aimed to identify patterns of elderly patients who transferred from long-term care hospitals to emergency rooms and provide the evidence of emergency medical systems to prepare for a super-aged society. Methods: The data source was the National Emergency Department Information System database from January 2014 to December 2019 in Korea. We performed a cross-sectional study among elderly patients (≥65 years) who transferred from a long-term care hospital to an emergency room. Trend analysis was conducted by year. Results: We identified 225,765 elderly patients who were transferred from long-term care hospitals to emergency rooms between January 1, 2014 and December 31, 2019. The proportion of the study population and their mean age were recently increased (p<0.001, respectively). The proportion of elderly patients being re-transferred (p=0.049) and the patients re-transferred to long-term care hospitals is significantly increased (p=0.005). Conclusion: The establishment of efficient emergency medical services for an aging society is important. It is necessary to develop a healthcare network with the government, long-term care hospitals, and medical institutions in the community suitable for preventing disease deterioration.

• 한국IT서비스학회지
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• 제21권6호
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• pp.21-37
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• 2022

Due to the development of technology and medical care following the 4th industrial revolution, the medical paradigm is shifting towards patient-centered medical services. Based on the development of smart home technology, the residential environment is changing into a residential space that cares for and heals the lifestyles and the healthcare of families. As lifestyle changes, the concept of supporting smart home care based on the residential environment is making it possible to build a smart home IoT service design with enhanced accessibility and convenience for medical appointments and well-being lifestyle care. This paper is a study on user-centered health care smart home IoT service design suitable for family members based on the health care, beauty care, exercise care, and customized diet care beyond the conventional concept of health care monitoring. Based on the analysis, this paper proposes a personal care coordinate smart home service design in a human-centered wellness clinic care smart home service design environment. Human-centered wellness clinic smart home IoT service design is meaningful in presenting a vision for research on smart home service design that links hospital-linked and care-linked service industries, which should be considered from the smart home construction planning stage.

• 간호행정학회지
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• 제23권2호
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• pp.211-222
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• 2017

Purpose: To develop staffing levels for nursing personnel (registered nurses and nursing assistants) to provide inpatients with integrated nursing care that includes, in addition to professional nursing care, personal care previously provided by patients' families or private caregivers. Methods: A time & motion study was conducted to observe nursing care activities and the time spent by nursing personnel, families, and private caregivers in 10 medical-surgical units. The Korean Patient Classification System-1 (KPCS-1) was used for the nurse manager survey conducted to measure staffing levels and patient needs for nursing care. Results: Current nurse to patient ratios from the time-motion study and the survey study were 1:10 and 1:11, respectively. Time spent in direct patient care by nursing personnel and family/private caregivers was 51 and 130 minutes per day, respectively. Direct nursing care hours correlated with KPCS-1 scores. Nursing personnel to patient ratio required to provide integrated inpatient care ranged from 1:3.9 to 1:6.1 in tertiary hospitals and from 1:4.4 to 1:6.0 in general hospitals. The functional nursing care delivery system had been implemented in 38.5% of the nursing units. Conclusion: Findings indicate that appropriate nurse staffing and efficient nursing care delivery systems are required to provide integrated inpatient nursing care.

• 보건행정학회지
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• 제26권4호
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• pp.390-398
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• 2016

Background: This study aims to analyze the impact of levels of health care coverage on the trajectory of self-rated health, comparing the near-poor which tends to be excluded in traditional health care systems with the upper middle class. Methods: The study participants were 3,687 people who sincerely responded questions regarding health care expenditures, unmet medical needs, and self-rated health in the Korea Health Panel data in 2009-2012. Results: The higher health care expenditures and the presence of unmet medical needs were significantly associated with the lower level of self-rated health. However, both factors did not significantly predict the steeper decline in the self-rated health. The results from multiple group analyses showed that health care expenditures and unmet medical needs had greater impact on the near-poor compared to their higher income counterparts. Conclusion: Public health care coverages need to be enhanced as well as reducing health care expenditures and unmet medical needs.

• Journal of Preventive Medicine and Public Health
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• 제25권3호
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• pp.303-311
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• 1992

It is very important to estimate the future medical care expenditure, because medical care expenditure escalation is a big problem not only in the health industry but also in the Korean economy today. This study was designed to project the medical care expenditure in view of population age change. The data of this study were the population projection data based on National Census Data(1990) of the National Statistical Office and the Statistical Reports of the Korea Medical Insurance Corporation. The future medical care expenditure was eatimated by the regression model and the optional simulation model. The significant results are as follows : 1. The future medical care expenditure will be 3,963 billion Won in the year 2000, 4,483 billion Won in 2010, and 4,826 billion Won in 2020, based on the 1990 market price considering only the population age change. 2. The proportion of the total medical care expenditure in the elderly over 65 will be 10.4% in 2000, 13.5% in 2010, and 16.9% in 2020. 3. The future medical care expenditure will be 4,306 billion Won in the year 2000, 5,101 billion Won in 2010, and 5,699 billion Won in 2020 based on the 1990 market price considering the age structure change and the change of the case-cost estimated by the regression model. 4. When we consider the age-structure change and inflation compared with the preceding year, the future medical care expenditurein 2020 will be 21 trillion Won based on a 5% inflation rate, 42 trillion Won based on a 7.5% inflation rate, and 84 trillion Won based on a 10% inflation rate. Consideration of the aged(65 years old and over) will be essential to understand the acute increase of medical care expenditure due to changes in age structure of the population. Therefore, alternative policies and programs for the caring of the aged should be further studied.

• 한국의료질향상학회지
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• 제3권2호
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• pp.60-68
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• 1997

Background : Medical records are used to assess clinical performance of physicians and quality of care. The contents which are written in medical records are considered as the objective evidences to know what the doctors think about the patient's problems. But the problem to use medical records as the assessment tools is the incompleteness of medical recording. The purpose of this study is to know if the completeness of medical recording is correlated to quality of care for inpattients and it can predict physicians's quality of care. Method : 32 clinical physicians reviewed 200 patients' medical records who were selected randomly from the inpatients who were admitted to the university hospital during July, 1995 and June, 1996. The reviewers used the structured evaluation questionnaires which were composed of two part. One part evaluated the completeness of the medical recording and the other evaluating appropriateness of diagnosis and treatment processes. We summated the scores of each items and calculated percentile scores. Results : The mean percentile score of completeness of the medical recording was 67.9% in 1995 and 79.8% in 1996. The mean percentile score of appropriateness was 52.2% in 1995 and 69.5% in 1996. This change between 1995 and 1996 was statistically significant. In non-surgical patients, the percentile scores of the completeness and those of the appropriateness were correlated positively and this correlation was statistically significant(p<0.05). In surgical patients, the positve correlation between the completeness and the appropriateness was also statistically significant(p<0.05). Discussion : In conclusion, the completeness of medical recording is considered as the good predictor of the quality of care for inpatients.