• 한국병원경영학회지
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• 제22권1호
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• pp.1-9
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• 2017

Purpose : Many studies showed that having a usual source of care improved the efficient access of healthcare service. However in Korea there have been few studies on the usual source of care. So this study aims to find whether having a usual source of care affect the medical utilization and expense. Methodology/Approach : We used the Korean Health Panel data in 2012, 2013 to examine the change of utilization and expenses in ambulatory care affected by having a usual source of care. We selected 1,215 hypertension patients without usual source of care in 2012 and performed linear regression analysis to identify the difference between treatment group(with usual source of care in 2013) and control group(without usual source of care in 2013). Then we performed analysis again separated by the age group. Findings : Among study population, 711(58.5%) reported that they have a usual source of care in 2013. Treatment group reported 1.85 less increase in outpatient visits and 69,234 won less increase in expense than control group with weak significance(visit ${\beta}$ -1.85 p-value 0.0807, expense ${\beta}$ -69,234 p-value 0.0541). People under the age of 65 showed significant change in outpatient visits for tertiary hospital (visit ${\beta}$ -0.78 p-value 0.0154, expense ${\beta}$ -91,462 p-value 0.0168). The analysis which focused outpatient for mild disease showed similar trend. Practical Implications : This study supports the positive effect of having usual source of care which decrease inefficient outpatient utilization. Promoting physician-patient relationships is important for efficiency of healthcare service.

• 한국콘텐츠학회지
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• 제13권3호
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• pp.28-33
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• 2015

• 보건의료산업학회지
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• 제10권3호
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• pp.199-211
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• 2016

Objectives : This study compared the influencing factors on life satisfaction after retirement between public pension and specific corporate pension recipients. Methods : This study used the fifth year data of 2013 from the raw data of the Korean Retirement and Income Study collected by the National Pension Research Institute. The data analysis in this study was done with the chi-square test, t-test, and linear regression using SPSS ver. 22.0 to verify the relevance between the general characteristics of pension recipients. Results : This study shows that there was a difference in expenditures and health care costs between public pension and special corporate pension recipients. The influencing factors on life satisfaction for public pension recipients were the level of spending, whether there were limitations in daily life and social activity, whether recipients had financial assets and health care costs while for specific corporate pension recipients, they were education level, level of spending and chronic diseases. Conclusions : A health policy that maximizes life satisfaction and takes into account the type of pencion needs to be considered and implemented.

• 보건행정학회지
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• 제20권3호
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• pp.104-122
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• 2010

Long-term care insurance has been introduced in Korea a year ago, and we are in a stage requiring to set principles regarding the generosity of coverage and how to gradually extend the coverage. This study empirically analyzes how the long-term care insurance in Korea is operated. Special attention is given to who is the main beneficiary of the long-term care insurance introduction, and what is the factors influencing the elderly's decision to apply for or use long-term care services. Use of a detailed information of individuals' public health insurance and long-term care insurance from administration data made it possible to control for health status, socioeconomic status including family type, housing tenure, income level. Logit models were employed to analyze the effects of various socioeconomic factors on the likelihood of applying and using long-term care services. Also, this study employed a survey questioning whether to ever willing to take other option as a alternative to residential care or home-care and the level of cash benefit for which they are willing to replace the formal care with informal care. The result indicated that although the poorest elderly population groups are in the greatest need for the long-term care service, they are in difficulty using the service due to economic burden. This implies the copayment amount needs to be adjusted in order for the poor elderly group to be able to get the benefit of the long-term care service.

• 보건행정학회지
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• 제32권3호
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• pp.258-271
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• 2022

The rapidly aging trend of Korea is a major factor that threatens the sustainability of the long-term care insurance system. Therefore, looking at how Japan and Germany mitigated the financial burden when they managed similar long-term care insurance systems will provide important implications for improving the Korean system in the future. The study was conducted using the literature review method, and the "country" was set as a unit for the case analysis. The three countries selected are Korea, Japan, and Germany. Recently in Korea, the insurance premium rates of all subjects have been rapidly rising, which can exacerbate the issue of intergenerational equity. On the other hand, Japan has responded to the aggravating finances for long-term care insurance due to aging by raising coinsurance for selected groups like the wealthy elderly. Germany is selectively raising the insurance premium rates by additionally increasing the premium rate for childless recipients. A more preventive and quality-oriented care service plan can be promoted by referring to the recent changes in Japan and Germany. In addition, a more effective and selective increase in payment burden in Japan and Germany could be considered in response to a recent equity issue in Korea.

• 디지털융복합연구
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• 제13권8호
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• pp.345-356
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• 2015

오늘날 의료가 단지 치료라는 개념을 넘어 서비스라는 인식이 확대되면서 의료서비스 소비 주체인 이용자들이 인식하는 의료서비스 질의 중요성은 날로 강조되고 있으며, 일차의료라고 해서 예외는 아니다. 이 연구는 65세이상 노인들이 보건소에서 제공하는 의료서비스의 질을 어떻게 인식하고 있는지 파악하고, 어떠한 요인들이 의료서비스 이용량과 관련성이 있는지를 탐색하고자 하였다. 이 연구는 서울시 보건소를 이용하는 노인들을 대상으로 연구원이 면접조사를 통하여 자료를 수집하였고, 총 307명의 설문자료를 분석하였다. 의료서비스 질은 융합적 요소를 고려하여 접근하였으며, 분석 결과, 이들의 구성항목 중에서 이용시설 및 환경, 환자중심진료, 의사의 전문적 지식 및 기술수준, 그리고 직원 및 간호사의 정서적 지지에 대하여 노인들이 긍정적으로 인식할수록 보건소의 의료이용이 증가하였다. 따라서 보건소가 쾌적하고 편리한 시설환경을 갖추고, 직원 및 간호사들은 이용자들과 원활한 의사소통을 위해 노력하며, 동시에 의사가 환자중심의 전문적인 의료서비스를 제공한다면 보건소의 의료서비스 질과 가치 향상에 도움이 될 것이다.

• 동의신경정신과학회지
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• 제30권2호
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• pp.47-58
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• 2019

Objectives: To conduct and report the results of a public health promotion program in Korean medicine (KM), namely the KM Visiting Care Service for Solitary Elderly, from November 2018 to April 2019. Methods: Six elderly people living in a rural area received the KM visiting care service, twice a week, for four months. This service consisted of acupuncture, auriculotherapy, and supportive counseling to manage their musculoskeletal pain, cognitive impairment, and/or depression. The changes of symptoms were assessed using Numeric Rating Scale (NRS), Korean version of Mini-Mental State Examination for Dementia Screening (MMSE-DS), Korean version of Montreal Cognitive Assessment (MoCA-K), and Geriatric Depression Scale-Short form Korean (GDS-SF-K). Results: Through the 4-months KM visiting care service, the overall subjects' NRS-rated pain decreased slightly. Most showed improvement in MMSE-DS and/or MoCA-K, except one subject who was diagnosed with Alzheimer's disease. Depression assessed by GDS-SF-K showed improvement in a few subjects who were unable to walk independently. Satisfaction assessed through survey was generally high in all subjects. Conclusions: This KM Visiting Care Service for Solitary Elderly may help improve the pain and cognitive function of frail solitary elderly in rural areas. However, the protocol need to be improved to optimize the effect.

• 보건행정학회지
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• 제27권2호
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• pp.167-176
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• 2017

Background: This study aimed to analyze the impact of community health care resources on the place of death of older adults with dementia compared to those with cancer in South Korea, using public administrative big data. Methods: Based on a literature review, we selected person- and community-level variables that can affect older people's decisions about where to die. Data on place-of-death and person-level attributes were obtained from the 2013 death certification micro data from Statistics Korea. Data on the population and economic and health care resources in the community where the older deceased resided were obtained from various open public administrative big data including databases on the local tax and resident population statistics, health care resources and infrastructure statistics, and long-term care (LTC) insurance statistics. Community-level data were linked to the death certificate micro data through the town (si-gun-gu) code of the residence of the deceased. Multi-level logistic regression models were used to simultaneously estimate the impacts of community as well as individual-level factors on the place of death. Results: In both the dementia (76.1%) and cancer (87.1%) decedent groups, most older people died in the hospital. Among the older deceased with dementia, hospital death was less likely to occur when the older person resided in a community with a higher supply of LTC facility beds, but hospital death was more likely to occur in communities with a higher supply of LTC hospital beds. Similarly, among the cancer group, the likelihood of a hospital death was significantly lower in communities with a higher supply of LTC facility beds, but was higher in communities with a higher supply of acute care hospital beds. As for individual-level factors, being female and having no spouse were associated with the likelihood of hospital death among older people with dementia. Conclusion: More than three in four older people with dementia die in the hospital, while home is reported to be the place of death preferred by Koreans. To decrease this gap, an increase in the supply of end-of-life (EOL) care at home and in community-based service settings is necessary. EOL care should also be incorporated as an essential part of LTC. Changes in the perception of EOL care by older people and their families are also critical in their decisions about the place of death, and should be supported by public education and other related non-medical, social approaches.

• 가정∙방문간호학회지
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• 제13권1호
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• pp.33-45
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• 2006

Purpose : The purpose of this study is to present the desirable level of home health care services by identifying the roles and activities by task of home health nursing specialists as well as to raise the level of professionalism in home health care services. Method : This is a methodological study. The roles and activities by task were identified through a review of literature and a state-of-the-practice survey, and were structured into a questionnaire after being reviewed and modified through a consensus of experts. The field survey was conducted on 136 home health nursing specialists at medical institutions, public health centers. public medical institutions, non-governmental organizations, and religious institutions in Seoul, Gyeonggi Province. Incheon, Busan, Daegu, and Gwanggju from June 4 to August 4. 2004. Seven roles. 34 tasks and 130 activities were identified in association with home health nursing specialists. Result : The roles of home health nursing specialists were identified as professional nursing service provider, advisor, educator, administrator, case manager, researcher and leader. Under these roles. 34 tasks and 134 task-specific activities were identified. Conclusion : The the roles and activities of home health nursing specialist identified in this study can be used in various home health care settings. These the roles and activities should provide the evaluation criteria of home health care services for institutions with existing home health care programs. An evaluation tool should be developed in order to ensure the hish quality of home health care services.

• 한국보건간호학회지
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• 제33권3호
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• pp.311-325
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• 2019

Purpose: This study examined the definition of care coordination, and the activities and roles of nurse care coordinators. The study also proposed suggestions for establishing and expanding the role of nurse care coordinators in community health practice. Methods: This study derived its conclusions by conducting a literature review. Results: The definition of care coordination is a comprehensive concept that includes case management and transitional care, and can be summarized as organizer and integrator of care. According to the literature review, 12 activities and 6 roles of nurse care coordinator were identified such as a collaborator, an individualized care planer, an educator/counselor, a direct nursing care providers, a population care coordinator, and a program evaluator. Training for nurse care coordinators is currently addressed in the Primary Medical Chronic Disease Management Program. Visiting nurses working at the Eupyeong-dong visiting health and welfare service are expected to act as nurse care coordinators, and the role of nurse care coordinators will, in the future, gradually increase in various nursing facilities. Conclusion: In addition to developing competencies to act as a nurse care coordinator, there is need for approaches to health policy that develop both independent role and population focused role as care coordinators.