• Title/Summary/Keyword: National insurance system

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Economic Evaluation of Eastern, Western and Collaborative Treatments for Patients with Frozen Shoulder Pain (견비통의 한${\cdot}$양방 진료 및 협진의 경제성 평가)

  • Jang, Hye-Jung;Hong, Sang-Min;Park, You-Seon;Nam, Dong-Woo;Lim, Doo-Ik;Lee, Jae-Dong;Lee, Yun-Ho;Lim, Sabina
    • The Journal of Korean Medicine
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    • v.28 no.1 s.69
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    • pp.72-86
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    • 2007
  • Objectives : The purpose of this study was to evaluate and compare the cost-effectiveness of Eastern, Western, and collaborative treatments and suggest a cost-effective approach for patients with frozen shoulder pain. Methods : Using the data of fifty-two patients, treatment effectiveness was measured by CSA, SPABI, and ROM scales and changes from the baseline score were evaluated. Data source for cost estimation was based on the national health insurance (NHI) payment system. Because the price in NHI was differentiated by health care institutions, five collaborative types were considered in assessing costs. Cost-effective ratios were computed for economic evaluation. Results : Compared with Eastern treatment, collaborative and Western treatments showed better effects on CSA scale after 4 weeks' treatment. The collaborative approach was also the most effective treatment on SPADI and ROM scales. The direct cost per patient receiving Eastern treatment was less than other treatments. In general, collaborative treatment dominated Eastern and Western treatments in cost-effectiveness an analysis. However, the cost-effectiveness ratio of Eastern treatment resulted in \9,000 compared to \29,000 of collaborative treatment on SPADI. Four different indicators of ROM scales resulted in different approaches as the cost-effective treatment. Conclusions : Considering cost-effectiveness ratios, collaborative treatment was the best treatment on CSh and SPADI scales after 4 weeks' treatment. As for ROM scales, the recommended alternatives were Eastern treatment for patients with abduction and adduction disabilities, Western treatment for those with flexion disability, and collaborative approach fir those with extension disabiliry.

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A Comparative Study of Knowledge, Attitude, and Experience towards Dental Tourism between Indonesian and Korean People (한국과 인도네시아의 치과 의료관광에 대한 지식, 태도, 경험의 비교)

  • Deasy, Rosalina;Kim, Jong-Yeon;Hong, Seong-Ae
    • Journal of Digital Convergence
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    • v.12 no.3
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    • pp.299-308
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    • 2014
  • Nowadays, dental tourism becomes phenomenon because of its cost-effectiveness, improvement of quality and technology, dental infrastructure, and attractive tourism. Korea as one of popular destination country had established dental system. On the other hand, Indonesia with high number of population is potential market for dental tourism. The aim of this study is to compare the knowledge, attitude, and experience towards dental tourism among Indonesian and Korean. Two cross-sectional descriptive surveys were conducted to collect the data. This study was used one questionnaire in two different languages due to nature of the study population. Data from a total 923 of Indonesian from 33 provinces in Indonesia was collected during the period from April through July 2010. On the other hand, during May until August 2010 data from a total of 312 Korean were obtained. It was found that the majority of participants in both countries had never heard about dental tourism. Among those who had heard about dental tourism, the most common source was internet. Ownership of dental insurance had significant relationship with knowledge of dental tourism among Indonesian while level of education and monthly internet usage had it among Korean (p<0.05). Attitudes of Indonesian and Korean people about dental tourism were negative due to assumption that dental services in their home country were satisfactory. 100% of Korean had no experience on dental treatment in other countries while 2.4% of Indonesian had experience with it. In conclusion, regarding all these evidences, comprehensive and positive information about dental tourism is needed to enhance people's knowledge, attitude, and experience.

A Case Study of Home Health Care for Postpartum Women and their Newborns (산욕부와 신생아의 가정간호 사례연구)

  • Jun, Eun-Mi
    • 모자간호학회지
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    • v.4 no.1
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    • pp.3-11
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    • 1994
  • Presently there is an increasing demand for home health care services due to changes in the demographic structure as a result of an increasing elderly population, socio-economic improvements, and changes in the family structure, as well as the growing number of people with degenerative diseases. In addition to these reasons, rising medical costs and there a shortage of patient beds space in the hospital, particularly since introduction of national medical insurance. There has been an increasing demand for health care health care services. This study was done to identify the basic data for home health care management. It focused on developing client selection criteria, assessment tools, and recording methods. This was accomplished by the researchers visiting the patients in their homes. The research process included preparation investigation, tool development, training of the project researcher, and visiting the clients in their homes. The research tools are as follows : 1. Record development : a) The selection criteria tool for home health care of postpartum women was a structured tool and consisted of four parts. b) The structured assessment tool consisted of a general items, obstetric history, past medical history, methods of feeding, medications taken before admission, laboratory test results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of postpartum women and their newborns. c) The visit note I consisted of the frequency of visits. Visit note II consisted of the date ; nursing problems ; nursing process including the initial assessment ; nursing goal ; visit plan ; postpartum women and their neonate health status, diagnosis, goal, implementation, evaluation, summary, next plan, for visit revision. d) Problem note consisted of the date, problem numbers, nursing diagnosis, problem appearance date problem resolution date. The research results are as follows : 1. Nursing problems : The nursing problems of the postpartum women and their neonates were evaluated by the number of nursing diagnoses and the change in the pattern of nursing diagnosis related to the number of visits. a) Nursing diagnosis The nursing diagnosis was classified according to physical function, psychosocial function, family system maintained function. b) The changes of nursing diagnosis related to the number of visits. As the type of nursing diagnosis changed related to the number of visits the number of nursing diagnoses decreased. 2. Contents of home health care : The content was categorized according to assessment, direct care, counseling, education, family care, reporting to with the attending doctor. The recommendations based on the research results are as follows : 1. Tool development Replication of this study is needed to test the validity of the assessment tools used. 2. Home visit a) Home health care nurses should be licensed and qualified. A referral form from the attending doctor is needed for legal protection of nurses. b) The first home visit need to be within 24 hours of discharge from the hospital to decrease the anxiety of frightened postpartum women. c) When the changes occur in the newborn's status, home health care nurses should consult a pediatrician. Communication within the home healthcare team is essential and needs to consistent and done smoothly. 3. Home health care A Study is required to develop protocols for education of staff and for operation of all aspects of this program.

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Development of Advanced TB Case Classification Model Using NHI Claims Data (국민건강보험 청구자료 기반의 결핵환자 분류 고도화 모형 개발)

  • Park, Il-Su;Kim, Yoo-Mi;Choi, Youn-Hee;Kim, Sung-Soo;Kim, Eun-Ju;Won, Si-Yeon;Kang, Sung-Hong
    • Journal of Digital Convergence
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    • v.11 no.9
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    • pp.289-299
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    • 2013
  • The aim of this study was to enhance the NHI claims data-based tuberculosis classification rule of KCDC(Korea centers for disease control & prevention) for an effective TB surveillance system. 8,118 cases, 10% samples of 81,199 TB cases from NHI claims data during 2009, were subject to the Medical Record Survey about whether they are real TB patients. The final study population was 7,132 cases whose medical records were surveyed. The decision tree model was evaluated as the most superior TB patients detection model. This model required the main independent variables of age, the number of anti-tuberculosis drugs, types of medical institution, tuberculosis tests, prescription days, types of TB. This model had sensitivity of 90.6%, PPV of 96.1%, and correct classification rate of 93.8%, which was better than KCDC's TB detection model with two or more NHI claims for TB and TB drugs(sensitivity of 82.6%, PPV of 95%, and correct classification rate of 80%).

A Comparative Study on the Civil Aviation Law between South and North Korea. (남.북한 항공법 비교연구)

  • Kim, Maeng-Sern;Lee, Si-Hwang
    • The Korean Journal of Air & Space Law and Policy
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    • v.21 no.2
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    • pp.97-121
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    • 2006
  • Inter-Korean exchanges using civil aviation has been continuing since the temporary direct air route from Pyongyang to Seoul was opened on June 15th, 2000 for the summit meeting with North Korea. In this paper, I analyze the North Korea Aviation law by focusing on the differences with South Korean Aviation law. While South Korean Aviation law is modeled on the Pandect system, North Korean Aviation law can only be understood by looking at North Korea's socialist ideology. Therefore, North Korean Aviation law has some expressions which can hardly be understood. With respect to the source of aviation law, both South and North Korea are in compliance with the Convention on International Civil Aviation (Signed at Chicago, on 7 December, 1944). Thus, they established the aviation law based on the standards and recommendations provided by ICAO. For this reason, they have similar legal systems and composition. From this analysis, a few differences are also derived regarding aircraft ownership, airports, airline liability, aircraft accident investigation organization and aviation insurance. It is important to note that this paper has a particular limitation. Not only is the information about North Korean law very limited, but North Korea also does not provide easy access to its national legal codes. This paper describes the legal comparison of South and North Korea by focusing on the formation and framework of North Korean aviation law.

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The clinical utilization of radiation therapy in Korea between 2009 and 2013

  • Kang, Jin-Kyu;Kim, Mi-Sook;Jang, Won-Il;Seo, Young Seok;Kim, Hee Jin;Cho, Chul Koo;Yoo, Hyung Jun;Paik, Eun Kyung;Cha, Yu Jin;Song, Hyun Jin
    • Radiation Oncology Journal
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    • v.34 no.2
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    • pp.88-95
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    • 2016
  • Purpose: The purpose of this study was to estimate the clinical utilization of radiation therapy (RT) in Korea between 2009 and 2013. Materials and Methods: We analyzed open claims data from the Health Insurance Review and Assessment Service. The subjects were patients who had diagnostic codes C00-C97 or D00-D48 according to the 10th revision of the International Classification of Diseases, with procedure codes indicating RT treatment. Results: The total number of patients who received RT in 2009, 2010, 2011, 2012, and 2013 were 45,571, 49,593, 54,671, 59,172, and 61,485, respectively. Among them, the total numbers of male and female patients were 20,780/24,791 in 2009, 22,711/26,882 in 2010, 24,872/29,799 in 2011, 27,101/32,071 in 2012, and 27,941/33,544 in 2013. The five cancers that were most frequently treated with RT between 2009 and 2012 were breast, lung, colorectal, liver, and uterine cervical cancers. However, the fifth most common cancer treated with RT that replaced uterine cervical cancer in 2013 was prostate cancer. The three leading types of cancer among the male patients were lung, colorectal, and liver cancers, whereas in female patients, they were breast, uterine cervical, and lung cancers. The type of cancer most commonly treated by RT was cancer of the central nervous system in patients aged 20 years or less, breast cancer in patients aged 30-50 years, and lung cancer in patients aged 60 years or more. Conclusion: Data from this study provided the clinical utilization of RT in Korea between 2009 and 2013.

Etiological Classification and Developmental Outcomes in Floppy Infants: A Single Tertiary Center Experience (늘어지는 영아 증후군의 진단적 분류와 발달 예후: 단일 3차 병원에서의 연구)

  • Park, Jung Min;Choi, Young Ha;Lee, Ha Neul;Chung, Hee Jung
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.189-196
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    • 2018
  • Purpose: Floppy infants or congenital hypotonia indicates decreased muscle tone in infants secondary to abnormalities of the central or the peripheral nervous system, or both. Previous literature classified its causes as those attributable to a central vs. peripheral origin; however, recent studies have introduced a newer classification describing a combined origin. We invenstigated floppy infants by applying the new etiological classification and reviewed the most common etiologies based on the age of presentation. We additionally reviewed the clinical characteristics, diagnoses, and the developmental outcomes in these infants. Methods: We retrospectively reviewed the electronic medical charts and recruited 116 infants diagnosed with floppy infant syndrome between January 2005 and December 2016 at Severance Children's Hospital. Among these infants, 66 with a confirmed diagnosis were reviewed for the etiological classification. Information regarding developmental outcomes was obtained via phone interviews with the infants' families. Results: Based on the new etiological classification, among 69 infants with a confirmed diagnosis, in 40 (34.5%) this syndrome was of central origin, in 19 (16.4%) of peripheral origin, and in 10 (8.6%) of combined origin. Prader-Willi syndrome, myotonic dystrophy, and spinal muscular atrophy were the most common disorders observed and combined hypotonia showed the poorest developmental outcome. Conclusion: The study states the importance of proper evaluation of etiological diagnosis and optimal intervention for developmental prognosis. The introduction of a new etiological group of combined hypotonia especially emphasizes regular monitoring and timely rehabilitative intervention in patients for the better quality of life in them as well as their caregivers.

Influence and Change of Healthcare Expenditure on Household Income Inequality (보건의료비 지출이 가구소득불평등에 미치는 영향과 변화)

  • Lee, Yong-Jae;Lee, Hyun-Ok
    • The Journal of the Korea Contents Association
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    • v.19 no.5
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    • pp.331-341
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    • 2019
  • The purpose of this analysis is to examine the effects of health expenditure on income inequality on household income after the financial crisis by using the household income survey form 1996 to 2016. The main results are as follows. First, after the financial crisis, the gross income inequality of households has been changing steadily, though there has been a slight change in each year. Second, high-income earners spend more on health care expenditure by income level. Therefore, unequal levels are maintained. Third, the Gini coefficient of income excluding health care expenditure was calculated. The results of the analysis are larger than the Gini coefficient of total income. Income inequality is intensified by the expenditure of health care expenditure of households. The inequality of household income due to health care expenditure has been increasing steadily since the financial crisis. Efforts such as strengthening the protection of health insurance have been continuously carried out for the purpose of reducing the burden of the national medical expenses. However, it does not contribute to resolving income inequality. In the future, it will be necessary to provide a more selective medical support system to reduce the medical expenditure of the low income class.

Literature Review on Empirical Studies of the Impact of Marketization on Quality of Care in Long-Term Care Sectors (장기요양서비스 시장화가 서비스 질에 미치는 영향에 대한 국내외 경험적 연구 리뷰(review))

  • Lee, Mi Jin;Joo, Eun-Sun
    • 한국노년학
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    • v.40 no.3
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    • pp.485-509
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    • 2020
  • This study reviews empirical studies that investigated the impact of marketization of long-term care services on quality of care in Korea, England, Sweden, United States, and Japan. The trend and characteristics of marketization and regulatory system in those countries were compared. Since 2008 when long-term care insurance was introduced in Korea, we selected and reviewed empirical studies which were listed in the National Research Foundation, PubMed and Web of Science and examined the relationship between marketization and quality of care. Seven Korean, three English, two Swedish, seven American studies and one Japan study were identified and there was little evidence supporting that marketization would lead to better quality of care. Specifically, competition had no consistent relationship with quality of care while there was little evidence supporting that for-profit nursing homes tended to exhibit greater quality of care compared to non-for-profit nursing homes. The chains of for-profit nursing homes were revealed to have greater deficiencies. The findings of this review imply that improvement of quality of care may not be achieved by making for-profit nursing homes have chains. Reconstruction of nursing home markets should be needed, and the number and the proportion of public and non-for-profit nursing homes should be increased.

Understanding Factors Associated with Unmet Need for Outreach Community Health Service among Older Adults in Seoul (노인 방문건강관리 서비스 미충족 영향요인: 서울시 찾아가는 동주민센터 사업을 중심으로)

  • Shon, Changwoo;Lee, Seungjae;Hwang, Jongnam
    • 한국노년학
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    • v.39 no.2
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    • pp.213-229
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    • 2019
  • The purpose of this study was to examine various factors influencing the needs of Seoul's newly implemented outreach community services for older adults, and to suggest the direction of the outreach community health services in Seoul. A multi-level regression was conducted using data collected by face-to-face interviews from 1,000 individuals aged 65 and 70 in 17 districts, where participated in the Seoul's outreach community services. The results demonstrated that socioeconomic status (higher income and living alone), health status (having multiple chronic conditions and depression, lower health literacy), limited experience of the outreach community services, and low government trust at the individual level were associated with higher unmet need for the community outreach services. In addition, shorter participation period of the outreach services and financial independency at the district level were associated with higher unmet need for the services. The findings from this study implies the need for improving the quality of services by focusing on vulnerable groups such as individuals with lower income and worse health status. In addition, the outreach community health services may need to target individuals aged 66 to increasing efficiency of the services through utilizing results of life-cycle health checkup by the National Health Insurance Corporation.