• 한국의료질향상학회지
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• 제25권2호
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• pp.44-55
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• 2019

Purpose: To investigate whether changes in Medical Aid (MA) status are associated with unmet need and catastrophic health expenditure (CHE). Methods: Data from the 2010 to 2014 Korea Health Panel (KHP) were used. The impact of changes in annual MA status ('MA to MA,' 'MA to MA Exit,' 'MA Exit to MA,' and 'MA Exit to MA Exit') on unmet need (all-cause and financial) and CHE (10% and 40% of household capacity to pay) were examined using the generalized estimating equation (GEE) model. Analysis was conducted separately for MA type I and II individuals. Results: In 1,164 Medical Aid type I individuals, compared to the 'MA to MA' group, the 'MA to MA Exit' group had increased likelihoods of all-cause and financial unmet need. This group also showed higher likelihoods of CHE at the 10% standard. The 'MA Exit to MA Exit' group showed increased likelihoods at the 10% and 40% CHE standards. In 852 type II recipients, the 'MA to MA Exit' group had higher likelihoods of CHE at the 10% standard. Conclusions: Type 1 MA exit beneficiaries had higher likelihoods of all-cause and financial unmet need, along CHE at the 10% standard. Type I 'MA Exit to MA Exit' beneficiaries also showed higher likelihoods of CHE at the 10% and 40% standards. In type II recipients, MA exit beneficiaries had higher likelihoods of CHE at the 10% standard. The results infer the importance of monitoring MA exit beneficiaries as they may be vulnerable to unmet need and CHE.

• 한국IT서비스학회지
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• 제11권sup호
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• pp.123-138
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• 2012

Healthcare and wellness industries have become more promising as the interests on healthy living increase. Not only the medical care oriented services for the patients done by medical centers but also the psychological and emotional healthgiving services for the people who are normal have been being stressed. The psychological and emotional healthgiving services should be executed in an agile and timely manner to maximize its effects. This paper aims to propose an emotion healing service spaces which are able to provide the normal people with psychological care services. To achieve the goals, we invented the tripot approach : the ubiquitous computing technology for context-aware and intelligent estimation of psychological index, LED technology to implement emotional atmosphere and wellness healthcare technology. The proposed architecture has been implemented in an actual site.

• 대한예방한의학회지
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• 제7권2호
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• pp.45-64
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• 2003

This study was conducted to examine the recognition level of the people on oriental medical Services and the need for it's improvement. Data were collected from 1174 residents in Daegu metropolitan city and Gyungbuk province. According to the satisfaction level with each items of oriental medical services, the respondents had positive views on efficacy, kindness, and side-effects. They, however, had negative view on the cost of oriental medical services. In regarding to the priority of improvement of oriental medical system, 'expansion of insurance benefit package' ranked first. Followed by 'safety of herbal medicine(heavy metal/pesticides)', 'improvement of scientific methods and diagnostic technique' etc. For the further development of oriental medical services in the consumer - focused and evidenced-based health care environment, much attention to implement relevant health policy reflecting user's need positively should be made.

• 한국병원경영학회지
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• 제28권4호
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• pp.62-72
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• 2023

Based on the basic ideology of health care, this study realized the seriousness of annual unmet medical need and conducted a study to confirm the relationship between the subjective perception of regional healthcare environment and unmet medical needs. The independent variable was classified into attitude 'satisfaction' and 'unsatisfaction' toward regional healthcare, and the dependent variable was classified as whether unmet medical needs occurred annually. Based on previous studies, the control variables were selected as demographic and socioeconomic characteristics that can affect the occurrence of unmet medical care annually and characteristics related to health behavior. Descriptive statistics were conducted for each variable on the extracted sample, and multivariate survey logistic regression analysis was conducted to confirm the association between variables. As a result, more unmet medical needs occurred annually than those who were satisfied with the medical services in the area where they lived. In addition, more unmet medical need occurred annually in "unsatisfied" households compared to households "satisfied" with local medical services. In residential areas, women live in "metropolis" and "rural areas" compared to "urban," women live in men, lower education levels, and poor subjective health levels, and less satisfied with local medical services. As such, the impact of environmental factors in the community on the use of health and medical services is one of the major areas of interest in the field of health science, such as health policy and social dynamics. Therefore, hospitals in each region need to make efforts in terms of hospital management to increase the overall satisfaction of medical services in the region by continuously monitoring the attitude of residents to achieve universal health security, and policymakers should also be interested and propose new policies.

• 지역사회간호학회지
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• 제33권4호
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• pp.357-371
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• 2022

Purpose: This study aims to investigate factors related to long-term length of stay (LOS) of patients with chronic diseases in Korean veterans hospitals. Methods: The subjects were 196 elderly patients with chronic disease staying in the hospital for more than 10 days, Data were collected by the survey of patients with structured questionnaires and medical records review by nurses from July 15 to August 10, 2019. Collected data were analyzed using t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: The present and desired LOS were 37.78±32.66 days and 60.87±45.95 days, respectively. Factors affecting hospital LOS were found to be main disease (genitourinary) (p<.001), assistance in activities of daily living (p<.001), area of hospital (p<.001), payment of medical fees (p=.026), hospital satisfaction (p=.036) and the explanatory power of these variables was 26.4%. The most common health problems that need to be solved after discharge were symptom alleviation and health promotion. These problems can be solved using community-based facility services or visiting medical-welfare services (especially home care nursing). Conclusion: In order to reduce hospital LOS, the following measures are required: personalized self-management education, provision of transportation services for dialysis therapy of inactive patients, linking patients with visiting medical-welfare services including home care nursing and mobile healthcare services, operation of the case management system including the notice of the discharge date at admission, interim check of patient status, and connecting the patient with community resources or transferring the patient to long-term care facilities at discharge.

• 농촌의학ㆍ지역보건
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• 제2권1호
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• pp.30-35
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• 1977

Health care conditions in Korea are gradually improving along with the economic and social development. However, the volume of disease is still great, especially in rural areas. This study attempts, therefore, to initiate a comprehensive proposal of rural health care delivery system. The proposal is constructed three parts, problem of health care system, medical cost, medical education system. The proposal consist of the following components: I. The health care system 1. health sub-center is required to be locate in "Myun" the basis administrative unit of local government for delivering primary health care. But, in the viewpoint of medical economics, the primary health care is operated cautiously. 2. Health center is desirable to provide health services in coordinating the health sub-center and other private health institution. 3. The secondary health care is performed in regional combination hospitals, and the attitude that doctors accomodate this system is required. II. The medical cost, Insurance In the expenditure of medical care, the method of a third person's payment is required absolutely. III. The medical education system. 1. The medical education system (process) is changed from the medical education to regional doctor education. 2 In the nurse education system. nursing technical high school is resurrected.

• 품질경영학회지
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• 제27권2호
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• pp.1-19
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• 1999

It is truism to say that today's customers demand high quality products and services; nevertheless, nowhere is this more prevalent than in the medical industry. Korea's globalization has increased it's citizen's awareness of greater life expectancies and medical improvements in other regions of the globe. Therefore, it is universally essential that in order to be successful in the medical industry, vendors must meet the ever increasing demands of better educated customers. The purpose of this study was twofold: 1) The first objective was discover what health care services are in demand and the quality factors related to these services. 2) The second objective was to determine a strategy for improving health care service through quality function deployment(QFD). One hundred and ninety-five respondents were randomly selected and asked to fill out a questionnaire after having undergone treatment at a medical clinic, located in Daejon, South Korea. The questionnaire was designed to obtain information about both he clients' satisfaction with, and their sense of the value of the medical treatment they received. Penalty-reward analysis and QFD were used to interpret the survey results and to deploy the collective voices of the customers. The results of the penalty-reward analysis illustrated that the 'communication' service quality factor was classified into an excitement factor that incurs no penalty if not achieved but adds value if the requirement is exceeded. As a result of the QFD analysis on the 'communication' service quality factor, eleven strategic alternatives were prioritized, and isolated a vital service quality characteristic. This characteristic can be implemented to bring value-added changes for the improvement of health care services.

• Journal of Hospice and Palliative Care
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• 제25권4호
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• pp.198-203
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• 2022

Purpose: To grasp public opinion accurately, we conducted an opinion poll on beliefs and attitudes toward physician-assisted suicide (PAS). Methods: A randomized telephone survey ensuring a representative sample was conducted, 1,007 participants aged 18 years or older (response rate, 9.5%). Results: The main results are as follows: i) 61.1% of participants thought that the current social support system for terminally ill patients and their families is insufficient; ii) 60% of participants did not recognize the term "hospice and palliative care"; iii) 81.7% of participants would not like to receive life-sustaining treatment if there is no possibility of recovery; iv) 58.4% of participants would like to receive hospice and palliative care if they are diagnosed with a terminal illness; v) the priorities for dignified dying were preparing a support system to reduce the burden of care (28.6%), economic support including reduction of medical expenses (26.7%), expansion of hospice and palliative care services (25.4%), and legalization of PAS (13.6%); and vi) 58.3% of participants agreed that the expansion of hospice and palliative care should precede the legalization of PAS. Conclusion: Koreans currently want other efforts, including expansion of hospice and palliative care services, instead of the legalization of PAS.

• 한국치위생학회지
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• 제15권4호
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• pp.565-574
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• 2015

Objectives: The purpose of the study is to investigate the oral health of the elderly people receiving nursing care and home care services in Chungnam. Methods: The subjects were 350 elderly people receiving 21 nursing care and home care services in Chungnam. The direct interview with the elderly people and oral examination was carried out from July, 2012 to December, 2013 after explanation fo the purpose of the study. The subjects consisted of 178 elderly people receiving nursing care services and 172 elderly people receiving home care services. Except incomplete answers, 315 data were analyzed. The questionnaire consisted of general characteristics of the subjects, characteristics by facility, oral condition, oral care behavior, correlation by factors on oral health, influencing factor on dental caries, influencing factor on periodontal disease, and influencing factor on elasticity of gingival muscle. Data were analyzed by frequency analysis, chi-square test, and multiple regression analysis using SPSS 21.0 program. Results: Multivariate analysis of influencing factors on oral health revealed that the elderly people with low education level tended to have higher incidence rate of dental caries. The influencing factors on oral health were the elasticity of gingival muscle, periodontal disease, educational level, and economic level. (p<0.05). The explanation power was 26.2%. Conclusions: Oral Health Promotion should be obligatorily established as one of the medical system and medical fee system to promote oral health condition for the aged.

• 지역사회간호학회지
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• 제10권1호
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• pp.80-92
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• 1999

The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. I t is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(k=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay $10.9{\pm}6.7$ days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.