• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.2
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• pp.649-656
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• 2016

This study was a retrospective examination to identify the association of postoperative delirium of the prognosis on following femur fracture surgery in elderly patients. Data was collected from the medical records of elderly patients (aged 65 years or older), who underwent femur fracture surgery from July 2010 to January 2014, following on 3-years in one university hospital. A total of 68 patients were involved. There were 31 cases (45.6%) with delirium and 37 cases (54.4%) without delirium. The participant's average age was 80.8 (patients with delirium), and 81.8 (delirium without patients) years of age, respectively, and most of them were female. There was no significant difference between the two groups. Taking five or more medications, serum creatinine level, and the total medical costs were significantly different in the delirium group and non-delirium group. In addition, the proportional hazard model of Cox to determine the predictors for the major clinical outcome occurring after surgery revealed delirium, five or more multi-drug use, and an experience of transfusion to be significant predictors. In conclusion, postoperative delirium in the elderly undergoing femur fracture surgery can have a negative clinical outcome in patients and caregivers. Therefore, a preoperative evaluation and management of the risk factors will be necessary.

• Journal of Life Science
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• v.33 no.7
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• pp.574-585
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• 2023

Sarcopenia is a leading cause of increased medical and nursing care costs among the elderly. In Korea, preventive measures for sarcopenia are mostly targeted toward the general elderly population without specific diseases. However, it is also necessary to implement measures for elderly individuals living in nursing homes and hospitals, where the prevalence of sarcopenia is high. Currently, computed tomography and/or magnetic resonance imaging are considered standard diagnostic tools. However, their complexity and time-consuming nature make them unsuitable for clinical use. The exact pathophysiological mechanisms of sarcopenia are unclear, as they involve various molecular biological pathways, including decreased exercise, protein and nutrient intake, changes in testosterone and growth hormone, and inflammation. Sarcopenia symptoms can lead to several diseases, such as osteoporosis, fractures, dementia, diabetes, and cardiovascular disease. Vitamin B deficiency is a significant factor in sarcopenia induction, with B vitamins being directly involved in energy and protein metabolism and nerve function. Vitamin B deficiency can lead to neuromuscular and neurogenic disorders, which often overlap with sarcopenia. Suboptimal intake of B vitamins, malabsorption, and anorexia are common among the elderly. This study aims to provide information on the role of water-soluble B vitamins in preventing and controlling muscle mass loss and deterioration among the elderly with sarcopenia. In addition, we discuss the potential of myokines from the B vitamin family in modulating sarcopenia.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.11
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• pp.6746-6755
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• 2014

This study examined the effect of long-term care utilization on the health care utilization of Medicaid elderly. The subjects were 5,834 long-term care insurance with the level 1 Medicaid elders, who received either service or non-service. This study examined the impact of long-term care service on the probability of health care utilization and the costs of health care utilization. The total medical cost and inpatient day between 2009-2007 were significant factors affecting long-term care utilization (${\beta}=.29$, p< .001, ${\beta}=.33$, p< .001 ) and this variable explained 22.6% of the total medical cost and 22.4% of the inpatient day. The results showed that non-service in long-term care was associated with an increase in health care utilization. The current long-term care insurance system should place higher priority and more resource allocation on long-term care utilization to increase the efficiency of the insurance system.

• The Journal of the Korea Contents Association
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• v.16 no.5
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• pp.113-123
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• 2016

Purpose: The purpose of this study was to evaluate how the cost perception and the cost attitude of nurses have effect on cost management behavior. Methods: Participants were 150 nurses who had worked for more than 1 year in general hospitals. Data were collected from November 16 to December 11, 2015, using self-recorded questionnaires. Collected data were analyzed using descriptive statistics and multiple regression methods. Results: Cost management behavior was positively correlated with cost perception and cost attitude. Cost attitude was revealed as the variable having effect on cost management behavior. Positive cost attitude can induce desirable cost management. Conclusion: It is necessary to develop effective and systematic Cost Education Program for nurses. Our result is useful to develop cost Education program of clinical nurses, and can be expandable for a variety of fields in programs for nursing students, and nurse managers.

• Korean Journal of Health Education and Promotion
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• v.31 no.4
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• pp.63-72
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• 2014

Objectives: The current study reviews the implementation and evaluation of the Chronic Disease Self-Management Program (CDSMP) in the United States (U.S.) to illustrate the program's potential contribution to improving health among Korean adults with chronic conditions while saving healthcare costs. Methods: This study examines existing literature on the history, theoretical background, essential elements, and delivery outcomes of CDSMP with special focus on the successes and challenges to be faced in the implementation of CDSMP to Koreans with chronic conditions. Results: CDSMP is designed to empower people with chronic conditions to develop skills necessary for medical, social role, and emotional management of chronic conditions. Recent studies show the utility of CDSMP in achieving the Triple Aim health reform goals (i.e., better care, better health, better value). Lessons learned from the U.S. experience emphasize the importance of establishing evidence-based studies, collaborating with community partners, and diversifying funding sources to make CDSMP more sustainable. Conclusion: The current study demonstrates the replicability of CDSMP and potential for expansion in Korea. More concerted efforts among academia, government, and communities are needed to deliver CDSMP to Korean adults and identify its effectiveness within the Korean context in terms of meeting the Triple Aim goals of better care, better health, and better value.

• The Korean Society of Law and Medicine
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• v.10 no.2
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• pp.287-307
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• 2009

A person is injured in car accident caused by his/her slight negligence except he / she causes accident by his / her willfulness or gross negligence. Because the National Health Insurance Corporation (hereinafter called "Corporation") shall not provide any insurance benefit "when he has intentionally or through gross negligence caused a criminal conduct or intentionally contributed to the occurrence of an accident" referred to in Article 48 (1) 1 of the National Health Insurance Act. So, if he / she is insured by his / her own bodily injury coverage, he / she can be compensated for his / her medical expenses. The injured have the rights to file either National Health Insurance claim and Automobile Insurance claim but there is no clear and definite adjustment clause. The claim disputes between National Health Insurance (hereinafter called "NHI") and Automobile Insurance (hereinafter called "AI") in the own bodily injury coverage makes some problems. Firstly, there are some differences in co-payments which he / she chooses between NHI and AI. Profit per a patient is higher in the NHI than in the AI. Secondly, it can provoke criticism that people shall unnecessarily pay double contributions. Lastly, it can raise moral hazards. For example, if he / she can cover the compensations when the insured receives the compensations from his / her insurer, the Corporation can be claimed by medical care institution payment of the health care benefit costs. In conclusion, first of all, to improve the national health and preserve the insured's rights the Corporation shall keep notice these facts.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.8
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• pp.5430-5441
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• 2015

The purpose of this study is to investigate the effect of Medicaid case management (CM) performed by Medicaid case managers on health management and to examine the overall health care utilization with high risk Medicaid beneficiaries. The subjects involved in this research were 113 Medicaid beneficiaries who were recipients CM in Y-gu between October 1st, 2012 and March 31th, 2013. The results show that there were significant differences in 'recognition of own disease', 'understanding of Medicaid policy', 'medication' and 'healthy lifestyle'. Also there were significant differences in 'appropriateness of health utilization', 'number of medical institutions', 'level of social isolation' and 'general health status'. In addition, significant differences were found in Medicaid days, outpatient days, medication days and Medicaid costs. It was found that the Medicaid CM had a positive effect on health care utilization. The study suggests the need of strengthening and diversifying Medicaid CM as well as supporting the management and monitoring after the termination of Medicaid CM.

• Korea Journal of Hospital Management
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• v.21 no.2
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• pp.37-49
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• 2016

The purpose of this study is to investigate the level of competition between Public Health Centers (PHCs) and private clinics (PCs) by examining the number of patients that used PHCs vs. PCs, estimating the total amount of revenue generated from outpatient services at both PHCs and PCs, thereby analyzing the financial impacts on PCs derived from the PHCs. We utilized 2011 National Inpatient Sample data (NIS). Using the 20 table containing general information on each individual claims, we integrate it with the 40 table which contains all the diagnostic codes for each claim. Then, we disaggregate the bundled claims into the original individual claims. Overall, 3.1% of outpatient visits are made at PHCs while the rest was made at the PCs (96.9%). Among the total claim costs of 6.34 billion USD (as of 2011), PHCs occupy 2.0% (124 million USD), and 98.0% are contributed to PCs (6.21 billion USD). The estimated economic losses of PCs due to PHCs are summarized as follow; the maximum potential loss is estimated at 198 million USD in total and 7,099 USD per clinic when we include all patient types; the minimum loss is estimated at 71 million USD in total and 2,540 USD per clinic where Medical Aid recipients and the elderly (aged 65 and over) are excluded. Our results confirm the potential economic effect on PCs due to PHCs providing outpatient services. PCs and PHCs are the most important players providing primary care in Korea. Unnecessary competition between PCs and PHCs is not desirable. Health authorities should carefully examine the healthcare services currently provided by PHCs and their impacts on PCs.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.11
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• pp.7463-7473
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• 2015

This study aims to analyze the effect of long-term care utilization on health care utilization of the national health insurance elderly. This study is a secondary data analysis of the long-term care insurance data that comprised of total 21,213 long-term care insurance with the level 1 elders who received either service or non-service. This study evaluated the impact of long-term care service on the probability of health care utilization experience and costs of health care utilization. The total medical cost, geriatric hospital's medical cost, inpatient day and geriatric hospital's inpatient day by 2007-2009 were significant factor influencing the long-term care utilization. This study suggests long term care system should proper medical service linkage system. The current long-term care insurance system should more resource allocation on long-term care utilization to increase the efficiency of insurance system.

• Journal of Korean Academy of Oral Health
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• v.42 no.4
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• pp.204-209
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• 2018

Objectives: This study was conducted to identify the demand and willingness to pay for oral hygiene services among elderly people with long-term care insurance. Methods: Our study was a cross-sectional analysis. Subjects comprised 126 elderly individuals from long-term home-care centers. A total of 28 centers were selected through convenience sampling from among 78 centers in ${\bigcirc}{\bigcirc}$. For analysis, semi-structured questionnaires that required about 20-30 minutes to complete were used. Analysis was performed using SPSS 23.0 software. Results: The overall demand for oral hygiene services was 44.4%, and willingness to pay was 31.0%. Thirty-three people (58.9%) of elderly those who have demand for an oral hygiene service were willing to pay for the service, and 64 people (91.4%) who did not have a demand were not willing to pay for it. Among those with partial dependence on brushing, 65.6% had demand for oral hygiene services and 50.0% were willing to pay costs. Among basic livelihood beneficiaries, 69.6% were willing to pay for oral hygiene services; general subjects and relievers were less willing to pay. Conclusions: The overall demand for oral hygiene services among elderly people was 44.4%, and the willingness to pay was as low as 31.0%.