• Title/Summary/Keyword: Package of care

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A Study on the Informal Cost Burden of the Patients Admitted to the Hospital (입원환자의 비공식적 의료비용 부담에 관한 연구)

  • Han, Mi-Hyun
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.1
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    • pp.5-14
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    • 2001
  • To estimate total burden of hospital admission over patient of gamily, we need to know the unofficial private expenses in addition to explicit hospital admission fees. This study was conducted from June 29, 2,000 to August 10, 2,000. Subjects were 104 patient at university hospital located at chungnam province. After thorough explanation of purpose and procedures, notebooks are given to each patient or guardian. They are requested to recorded all relevant expenditures occurred during hospital stay. Incomplete records were filled-up by direct personal contact or phones. Datas were summarized and analyzed using SAS statistical package. P-value less than 0.05 was considered significant. The results of the study are as follows: 1. In 96.1% of the patient, guardians stayed at hospital to take care of patients. In 38,8% one of the family members get work-leave or temporary resting from job. Average date of leave was 7.5days. 2. Average informal cost burden per patient was 204,467 won (14,330 won${\sim}$1,594,870 won). Average hospital cost paid by the patient was 1,061,807 won. The ratio of informal cost burden to hospital cost paid by the patient was 0.327. 3. According to the regression analysis, the relevant factors affection informal cost burdens were distance from home to hospital(p=0.018), and duration of hospitalization(p=0.0001). 4. Informal cost burden was composed of expenses for personal expense of care giver (126, 720 won/patient), meal (86,924 won/patient), transportation (77,648 won/patient), necessaries of life (18,789 won/patient), tests and treatments not covered by insurance (17,289 won/patient), medical supplies not covered by insurance (15,280 won/patient), treat for visitors (14,757 won/patient), TV coin (8,247 won/patient), and others (7,582 won/patient). In addition to the hospital cost paid by the patient for hospital admission, the informal cost burdens should be recognised explicitly because it is not small. Significant proportion of informal cost burden is composed of care-giver's personal expense, transportation, meal. It is suggested that some polices are to be devised and implemented enabling that this portion of informal expenses be directed to formal professional nursing care. Thus we can improve the quality of care and decrease discomfort of patient's relatives.

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A Study on Disturbing Behaviors of Demented Elderly Staying at Home (재가 치매노인의 문제행동에 관한 연구)

  • Kang, Young-Sil
    • Research in Community and Public Health Nursing
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    • v.11 no.2
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    • pp.453-469
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    • 2000
  • This study has a purpose to provide information to help develop nursing intervention for demented elderly staying at home. For this purpose I analysed the relationship of patients' disturbing behaviors with their demographic and social characteristics, premorbid personality, and present environmental characteristics through questionnaire survey on their family members. The survey was performed through direct interview, telephone contact. and mail in the regions of Pusan and Gyeongnam. Among family members contacted. 112 ones made an appropriate response to the survey. The statistical package SAS was utilized for descriptive statistics, correlation coefficients, stepwise multiple regression, and cluster analysis. The results of the study were as follows: 1) Demographic and social characteristics of the patients surveyed are female 81.3%, average age 81.4 years, lack of schooling 83.0%, spouse dead 73.2%, having no other disease 58.9%, average duration of dementia 3.8 years, no medical treatment for dementia 84.8%, good married life 40.2%, and primary care given by daughter-in-law 49.1%. 2) Aggressive Psychomotor Behavior(APB) was observed in a way statistically meaningful in case that primary care was given by daughter-in-law, while Nonaggressive Psychomotor Behavior(NPB) was in case of good married life and primary care given by other than daughter-in-law and spouse. Verbally aggressive behavior (VAB) was observed in groups of female, spouse dead, bad married life, and daughter-in-law's primary care. As for Passive Behavior(PB), it was observed in case that patients had educational background of not less high than middle school and that they were having medical treatment. Functionally Impaired Behavior(FIB) was observed in age group of 60-69 and more than 90, in patients' group having no other disease, and in case that the duration of dementia was not less than 5 years. 3) Premobid Neuroticism(N) showed positive correlation with APB and VAB, while Openness (O) did negative correlation with PB. Agreeableness (A) was proved to have positive correlation with PA and FIB, but to have negative correlation with APB and VAB. In addition, Conscientiousness(C) showed negative correlation with APB and VAB. 4) The worse the psychosocial environment was, the more NPB and VAB were observed. 5) APB was explained 24% by C and primary care-giver, while NPB was explained 28% by psychosocial environment, having other disease or not, and married life. VAB was explained 40% by A. sex, and married life. On the other hand PB was explained 33% by O, A. N, and having medical treatment or not. But any significant factor was not found to explain FIB. 6) A cluster analysis was performed on disturbing behaviors of demented elderly staying at home. It enabled to regroup the demented elderly in 5 patterns: high scored in NPB, high scored in FIB. high scored in NPB and VAB, moderately scored in most disturbing behaviors, and low scored in all areas. In conclusion, disturbing behaviors of demented elderly not only reflect their premorbid personality in the past, but also are affected by their present psychosocial environment. Therefore, it is necessary to encourage and respond them with understanding their disturbing behaviors in relation to their past premorbid personality. In addition, it is important to provide them better psychosocial environment in order to reduce their disturbing behaviors.

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A Study on the Improvement Method for Health Management of Seafares (상선 승무원들의 건강관리 개선방안 연구)

  • Kim, Jae-Ho
    • Journal of Navigation and Port Research
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    • v.37 no.1
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    • pp.29-34
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    • 2013
  • In this study, the corelation among the knowledge of and attitude to health care and the actual health protective practices of seafarers was surveyed and analyzed in order to provide the management method for improving seafarers' health care. The subjects of this study were 516 seafarers who took refresh training courses in Korea Institute of Maritime and Fisheries Technology. The questionnaire was constructed under the Guidelines for National Health of the Ministry of Health and Welfare and modified for studying seafarers' health state. The collected data were analyzed by SPSS package. The results were as follows: 1) The older, married, religion believer, higher ranker, the man who have longer career have the higher degree of knowledge, attitude, and practice-degree(p<0.05). 2) The degree of knowledge, attitude, and practice are $4.24{\pm}0.35$, $3.45{\pm}0.41$, and $3.39{\pm}0.22$ in mean by 5-score scale, respectably. 3) The corelation among the degree of knowledge, attitude, and practice was significant(r=0.33~0.63, p<0.05).

Utilization Patterns and Determinants of Oriental Medical Services : Focused on the Residents of Taegu City (한방의료의 이용행태 및 이용결정요인 분석 - 일부 대도시 지역주민을 중심으로 -)

  • Yoo Wang-Keun;Ryu Kyung-A
    • Journal of Society of Preventive Korean Medicine
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    • v.4 no.2
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    • pp.1-24
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    • 2000
  • This study was conducted to examine utilization patterns and determinants of oriental medical services. Data were collected from 545 residents in Taegu city The results of this study are summarized as follows 1) 37.8% of subjects used oriental medical services in the past year. Especially, the female, the ages of 50 and 60 over, the single. low-educated. high-income class, white-collar class, medical insured tended to use more oriental medical services than another groups. 2) 46.7% of users of oriental medical services reported that number of visits in the past year was 2 - 5 times 37 1% of them was 1 times, and 4.5% over 10 times. 3) According to the reasons to choose the oriental medical facilities, most was 'on their own judgement'(48.8%) and 'by the advice of relatives and friends'(42.0%) Regarding to the objectives of using oriental medicine, 68.3% was 'treatment', 31.7% 'health counselling and promotion'. And among diseases of users, diseases of musculo-skeletal system was the highest(54.5%). 4) 57.9% of oriental medical services users had experience of utilizing western medicine on the same diseases. Among peoples with experiencing western medicine on the same diseases. 54.4% received oriental medical services 'in addition to western medicine', 45.6%'in place of western medicine 'And 41.2% of using both services reported that they had difficulty in deciding to choose the type of services -oriental medical services or western medicine-for their diseases. 37.3% of them answered that 'providing relevant information' was the most desirable measure to solve this problem, 27.3% 'establishment of effective referral system between oriental and western medical facilities '23.6% 'cooperative medical treatment systems in the same facilities', 11.8%'integration of oriental medicine into western medicine 5) 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. 6) In regarding to the priority of improvement of oriental medical system,'expansion of insurance benefit package 'ranked first. 'expansion of insurance benefit Package 'ranked second, 'improvement of scientific methods and diagnostic technique 'third, and 'safety of herbal medicine' fourth in order. 7) The significant factors influencing the utilization of oriental medical services were kindness of oriental medical practitioners, efficacy , travel time, age To be brief, utilization rate of oriental medical services in urban area generally tends to be high. There, however, have been various barriers to limit oriental medical services, such as incomplete benefit package of oriental medical insurance and lack of coordination and referral system between oriental and western medical services, lack of scientific diagnostic procedures, high price etc . For the development of oriental medical services, Much attention to remove these limiting factors should be placed. In addition, kindness of oriental medical practitioners , which is expected to be more important factor in the consumer - focused health care environment than ever, should be kept high consistently. Since this study was conducted for specific residents of an urban city. further research including more sampling in different urban areas should be required to generalize the results of the study.

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A Study on the Knowledge, Attitude and Practice about Industrial Health Care Services of workers -Kwang-ju City and Chonnam Province- (근로자의 산업보건관리에 대한 지식, 태도, 실천 조사연구 -광주, 전남지역-)

  • Kang, He-Young;Park, In-He;Oh, Mi-Sung;Choi, Young-Ae;You, Su-Ok;Choi, Hee-Jung
    • Research in Community and Public Health Nursing
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    • v.4 no.2
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    • pp.139-145
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    • 1993
  • The purpose of this study was to identify the degree and the relationship of the Knowledge, Attitude and Practice of industrial health care services of workers. This information will provide useful data for an effective industrial health care service. The was collected from 600 data employees in Kwang-ju city & Chonnam province. The data was gathered by questionnaire from Dec 20, 1992 to Jan 20, 1993. The questionnaire was developed by the Academic Affairs of Community Health Nursing Academy. Data was analyzed by using the statistical computer package, SPSS to manipulate the data along with percentages, means, standard deviations, modes, t-test and ANOVA. The results in this study were summarized as follows: 1. General characteristics of workers: Distributions of workers was laborer(76.2%). in the 25-34 age group(50.2%), married(63.3%), males comprised(77.5%), the educational level with the highest percentage was high school graduates (71.1%), with a monthly income of 300-700 thousand won(43.8%), and has been working in the present career over seven years (31.5%). 2. The Knowledge, Attitude and Practice levels of employees about industrial health care services The levels were measured according to a five point scale. The total mean score of knowledge was 2.92 points out of 4. The following are the scores of Knowledge of special medical examination and location of industrial clinic(3.48), periodic medical examination (3.18), occupational disease(3.08), personal protective equipment (2.92), and health education(1.37). The total mean score of Attitude was 2.77 point out of 4. The following are the scores of Attitude in order of working environment (3.35), necessity of periodic medical examination and health education(3.15), the worker's perception influence on the working environment to health was high(3.11). But, the level of satisfaction in the content of periodic medical examination was low(2.19). The total mean score of Practice was 2.70 points out of 4. The scores of Practice in order were, practice of periodic medical examination(3.70), utilization of industrial clinic(2.92), and to participate in health education(1.47). 3. The relationship of general characteristics to Knowledge, Attitude, and Practice of workers: Knowledge had a significant difference by sex (P<.01), marital status(P<.01), education level (P<.05) and monthly income(P<.01). Attitude was significantly different with sex(P<.05) and Practice was significantly related to monthly income (P<.01).

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Impact of oral health behaviors on the presence or absence of periodontal diseases and missing tooth (당뇨환자의 구강건강행태가 치주질환 및 상실치 유무에 미치는 영향)

  • Ju, On-Ju
    • Journal of Korean society of Dental Hygiene
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    • v.11 no.4
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    • pp.511-522
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    • 2011
  • Objectives : The purpose of this study was to provide some information on the development of oral health care programs geared toward diabetics and ways of promoting their oral health. Methods : The subjects in this study were 586 diabetics who were selected from the 2009 third-year raw data of the 4th(2007~2009) National Health & Nutrition Survey. The data were analyzed with the statistical package SPSS 12.0 to grasp the influence of their sociodemographic characteristics and oral health behaviors on the presence or absence of periodontal diseases and missing tooth. Results : 1. Periodontal diseases were twofold more prevalent among the men than the women(p<0.01). By age, those who were in their 60s had 1.11-fold more periodontal diseases than those who were in their 70s and up(p<0.05). 2. The men and women were similar to each other in the number of missing tooth. By age, the number of missing tooth got smaller in proportion to decrease in age. By income, the number of missing tooth was 1.48-fold larger among the patients who earned an income of one million won or less than those who earned an income of two million won or more(p<0.01). Conclusions : The above-mentioned findings suggest that prospective cohort studies should be implemented to present prediction models of periodontal diseases and diabetes instead of merely sticking to cross-sectional studies. And oral health programs should be developed based on the findings of cohort studies to encourage diabetics to care about their oral health, and in which way they should be helped to promote their oral health should carefully be considered.

Public Participation in Healthcare Decision Making : Experience of Citizen Council for Health Insurance (보건의료 정책 의사결정과 시민참여 : 『건강보험 보장성 시민위원회』의 사례)

  • Kwon, Soonman;You, Myoungsoon;Oh, Juhwan;Kim, Soojung;Jeon, Boyoung
    • Health Policy and Management
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    • v.22 no.4
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    • pp.467-496
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    • 2012
  • Public participation in the decision making for scarce health resources is important because health policy requires trust based consensus, which can be achieved by public's understanding and involvement of related policies. In the past, opportunities for interaction between health policy decision makers and lay public were rare in Korea. As political impulses towards public participation in health policy have increased, a few of deliberation methods were attempted. However, there is little research, reporting such cases with a critical examination of relevant theories and previous studies. We first critically review the literature on public participation within theories of democracy, governance, and empowerment. Next, we report a case of a citizen council experiment, which was held to examine public's preferences among different benefit options regarding new drugs and medical technologies. Specifically, in an one-day long citizen council with a total of 28 lay public, twelve questions of whether a drug or a technology should be included in the benefit package of health insurance were asked. Pre- and post-surveys investigated participants' perception of public engagement in health policy. Although it was experimental, the citizen council ensured that lay public could be careful enough to rationally compare the costs and benefits of different options and collectively make decisions. Further, results from pre- and post-survey showed a strong willingness of members to be involved in health care decision making. In the conclusion, we emphasize that better theories and methods need to be developed for more cases of citizen participation in health care policy and management.

A Study about Promoting Health Lifestyles and Relating Variables on the Life-cycle of women (여성들의 생애주기별 건강증진행위와 관련요인에 관한 연구 - 일개 통합시를 중심으로 -)

  • 이은희;소애영;최상순
    • Journal of Korean Academy of Nursing
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    • v.29 no.3
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    • pp.700-710
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    • 1999
  • Promoting women's health lifestyles are important due to their connection to family health. The purpose of this study was to analyse women's health lifestyles(HPL) and their effects on women's life-cycle, so in order to develop a program in a women's health care center. The subjects included were 1080 women over 18 years old living in Wonju city, and were selected by stratified and purposive sampling. The data were collected through a questionnaire and interview. The Cronbach $\alpha$, %, mean, ANOVA, Pearson's correlation, and regression in SPSS PC Win. package was used to analyze the data. The sample was sepernted into three groups premarital group 20.2%(premarital women between 18 and 40 years old), delivery and children rearing group 49.9%(marital women between 18 and 40 years old), over middle agedelderly group 29.9%(women over 41 years old). Significant difference were found in the HPL according to group. Also, relating variables, such as self-efficacy, family functions, health locus of control and gender role perception that were considered relating variables to HPL significantly differed among the three groups. HPL significantly correlated with self-efficacy, family functions, HLOC and gender role perception in all participants and at all groups. The regression analysis of HPL was interpreted 40.6% with relating variables, self-efficacy, health attention, family functions, and internal locus of control, health perception, power other locus of control and chance locus of control in all participant. Self-efficacy, family functions, health attention were considered important variables in premarital group, self-efficacy, family functions, internal locus of control, health attention, health perception and power of control were important in delivery-rearing group. Self-efficacy, health attention, internal locus of control, family functions and health perception were important in middle aged-elderly group. As a result, we found the differences HPL scores and relating variables according to life-cycle groups. Therefore, we should prepare health promoting education programs for women according to women's life cycles. Also we suggest that women's health care centers based on communities was needed for proper management of women's health.

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Implications of Price Setting Strategies for New Health Technologies from Five Countries (신의료기술에 대한 진료비 지불: 외국사례와 시사점)

  • Chung, Seol-hee;Kwon, Ohtak;Choi, Yeonmi;Moon, Kyeongjun;Chae, Jungmi;Lee, Ruri
    • Health Policy and Management
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    • v.30 no.2
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    • pp.164-177
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    • 2020
  • This study aims to compare the experience of selected countries in operating separate payment system for new healthcare technology and to find implications for price setting in Korea. We analyzed the related reports, papers, laws, regulations, and related agencies' online materials from five selected countries including the United States, Japan, Taiwan, Germany, and France. Each country has its own additional payment system for new technologies: transitional pass-through payment and new technology ambulatory payment classification for outpatient care and new technology add-on payment for inpatient care (USA), an extra payment for materials with new functions or new treatment (C1, C2; Japan), an additional payment system for new special treatment materials (Taiwan), a short-term extra funding for new diagnosis and treatment (NUB; Germany), and list of additional payments for new medical devices (France). The technology should be proven safe and effective in order to get approval for an additional payment. The price is determined by considering the actual cost of providing the technology and the cost of existing similar technologies listed in the benefits package. The revision cycle of the additional payment is 1 to 4 years. The cost or usage is monitored during that period and then integrated into the existing fee schedule or removed from the list. We conclude that it is important to set the explicit criteria to select services eligible for additional payment, to collect and analyze data to assess eligibility and to set the payment, to monitor the usage or cost, and to make follow-up measures in price setting for new health technologies in Korea.

An Importance Analysis on the NCS-Based Skin Care Qualification L3 Level of Education in Life Care (라이프케어의 피부미용 NCS기반 자격 L3수준의 교육 중요도 연구)

  • Park, Chae-Young;Park, Jeong-Yeon
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.5
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    • pp.263-271
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    • 2019
  • The recent phenomenon of job "Miss Match", which is inconsistent with knowledge in the demand of educational training institutes and industries, has spread to an increase in private education costs for reeducation and employment of new hires, resulting in weak individual job competency and poor employment capability, as well as economic and material waste at the national level. To compensate for these problems, the National Competency Standards(NCS), which are available immediately in practice and look for a standard point of national job competency with the aim of fostering human resources sought by industries, were developed, and even the NCS-based qualification system was launched in line with the stream of times. This study is intended to look into the importance and priority of competency units and competency unit elements at the NCS-based qualification L3 level in the skin care field for an overall check of the NCS-based qualification level at a time when educational institutes are organizing and operating the school curriculums according to the NCS and NCS-based qualification level. And it is attempted to provide basic data for the development of curriculum in fostering professional human resources required by industries. To analyze the needs for competency units and competency unit elements at the L3 level, a survey using AHP method was carried out to a group of field experts and a group of education experts. In addition, the SPSS(Statistical Package for Social Science) ver. 21.0 and Expert Choice 2000, an AHP-only solution was used to do statistical processing through the processes of data coding and data cleaning. The findings showed that there was a partial difference of opinion between a group of field experts and a group of education experts. This indicates that the inconsistencies between educational training institutes and industrial sites should be resolved at this time of change with the aim of fostering field customized human resources with professional skills. Consequently, the solution is to combine jobs at industrial sites and standardized educations of educational institutes with human resources required at industrial sites.