• Radiation Oncology Journal
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• v.37 no.4
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• pp.249-253
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• 2019

Purpose: We aimed to analyze the trend in intensity-modulated radiation therapy (IMRT) use in Korea from 2011 to 2018. Materials and Methods: We collected data from the Health and Insurance Review and Assessment Service (HIRA) big data based on the National Health Insurance Service claims and reimbursements records using primary treatment planning codes (HD 041) for IMRT from 2011 to 2018. We analyzed the changing patterns in clinical application to specific tumor sites and regional differences in IMRT utilization. Results: The use of IMRT has exhibited an 18-fold steep rise from 1,921 patients in 2011 to 34,759 in 2018. With regard to IMRT in 2018, 70% of patients (24,248/34,759) were treated in metropolitan areas (Seoul, Incheon, and Gyeonggi Province). IMRT was most commonly used to treat breast, lung, and prostate cancers in 2018. Among these, the use of IMRT for breast cancer shows the most remarkable increase from 2016 when the National Health Insurance began to cover IMRT for all solid tumors. Conclusion: The use of IMRT is steadily increasing to treat cancer and is concentrated in metropolitan areas.

• The Korean Journal of Applied Statistics
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• v.30 no.3
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• pp.391-401
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• 2017

This study develops an indicator to manage regional variations of approval rates for long-term care (LTC) service. We used LTC insurance data for grade assessment that include 433,155 applicants from 227 LTC centers across Korea in 2015. The approval rate for each center was defined as the proportion of the numbers of approved applicants out of all applicants. We assumed that the approval rates depended on the characteristics of applicants. We estimated the 'standard' approval rates from a multiple linear regression analysis using the characteristics of applicants as independent variables. The difference between the observed and the standard rates was then defined as an indicator for deviation. A center having a large difference could be considered as a center with a potential error in grade assessment. We also examined if the characteristics of investigators affected the approval rates. We found that the socio-demographic characteristics of applicants and reapplication rate for LTC grade were independent factors affecting the approval rates. Centers having the management indicator values falling outside the middle 95% of the distribution were identified as centers with an error in grading. We expect that this study will contribute to enhancing reliability and equity in LTC grading.

• Journal of Korean Academy of Oral Health
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• v.42 no.4
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• pp.145-151
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• 2018

Objectives: The purpose of this study was to interpret regional disparities in the number of teeth sealed with pit and fissure sealants, identify the factors that affect these disparities and find solutions for the same. Methods: Data were collected from the National Health Insurance Service and Korean statistical information service using metropolis-city-rural area dental health infrastructure variables, regional health behavior variables, and local finance-related variables. Results: In 2015, the number of teeth sealed with pit and fissure sealants per 100 people was higher in the metropolis or city than in the rural area. There was a positive correlation between the number of teeth sealed with pit and fissure sealants and the number of dentists, dental hygienists, dental institutions, standardization rate of subjective awareness of well-being, standardization rate of brushing after lunch, and the proportion of welfare budget in the general budget. There was a negative correlation with the annual standardization rate of health institution use, the standardization rate of unused medical services, and the local government's financial independence. According to the final model of the multiple regression analysis, while the impact of infrastructure on dentistry was not statistically significant, the statistical significance of standardization rate of brushing after lunch, the local government's financial independence, and the proportion of welfare budget in the general budget were maintained. Conclusions: To reduce regional disparities in the volume of use of pit and fissure sealants, it was concluded that it may be effective to select regions with a consideration of the level of regional economic power, implement separate and appropriate policies and projects, and improve the awareness in residents.

• Health Policy and Management
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• v.16 no.4
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• pp.128-146
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• 2006

The objective of this paper is to examine the proportion and characteristics of non-emergent patients at emergency departments. The observational survey was conducted using a structured form used by emergency medicine specialists or senior residents on June 7-20, 2005. 1,526 patients at ten emergency centers took part in this study. The structural form contained type of insurance, route and means of emergency department (ED) visit, triage based on the Manchester Triage Scale(MTS)-modified criteria, emergency level based on the government defined rule, type of emergency centers (Regional Emergency Medical Center; REMC, Local Emergency Medical Center; LEMC, Local Emergency Agency; LEA), as well as patient's general information. Data were analyzed using SAS statistical program(V.8.2). Descriptive analysis was performed to describe the magnitude of non-emergent patients. ${\chi}^2-analysis$ and logistic regression analysis was performed to identify the nonurgent patients' characteristics. In the MTS-modified criteria, we found a 15.3% rate of non-emergent patients. This rate differed from that of non-emergent patients obtained using government's rule. In particular, there were inaccuracies in the definition of government rule on non-emergent patients, so it is necessary to apply the new government rule regarding classification of non-emergent patients. There were significant differences in the rate of non-emergent patients according to type of ED, means of ED visit, time to visit, and insurance. Non-emergent patients are more likely to visit a D-type ED(LEA having less than 20,000 patients annually), not to use ambulance, to have 'Automobile Insurance, Industrial Accident Compensation Insurance, or pay out-of-pocket'. Non-emergent patients tend to visit ED due to illness rather than injury. Further studies on the development' of triage scale and reexamination of the government's rule on emergency visits are required for future policy in this area.

• IMMUNE NETWORK
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• v.3 no.2
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• pp.83-88
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• 2003

The number of umbilical cord blood transplantation is increasing worldwide as it has expanded the ability of the transplantaion community to meet the growing needs of their patients. Clinical data over the last decade show promising results in transplantation using both related as well as unrelated cord bloods. Cord blood banks are essential for the clinical use for transplantation and are now established around the world with the major efforts to standardize banking in collection, processing and distribution of cord blood for providing the highest quality stem cells for the patients. In Korea, Medipost, Histostem and some regional cord blood banks were established some years ago and collected thousands of cord blood for public but it had some limitations and was not expanded as the cord blood transplantation was not covered by medical insurance. Recently with the change in the policy of medical insurance to cover the cord blood transplantation, several venture companies are showing great interests in cord blood banking and trying to establish private cord blood banks in Korea. This review article discusses the current status of cord blood transplantaion and also the clincial use of stem cells from cord blood.

• Journal of agricultural medicine and community health
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• v.2 no.1
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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.

• Health Policy and Management
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• v.19 no.2
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• pp.127-134
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• 2009

It is known that socioeconomic status(SES) of the cancer patient is associated with survival in recent studies, performed in other countries. The purpose of this study was to determine whether the association between status of national health insurance and survival is also present in a community in Jeonnam province, South Korea. The Gwangju-Jeonnam Cancer Registry, a population-based cancer registry, provided information to identify the cancer cases of study community diagnosed from 1998 to 2007. Total of 2,046 cases were identified during the period. There were significant associations between the status of national health insurance and survival for total cancer after adjusted by age, geographic accessibility to health care, and stage at diagnosis. However, this differences were not found in the analysis using only stomach and colorectal cancer cases. Despite of some limitations, this results suggest that the policy for reducing the difference according to the SES is required in national cancer management program.

• The Korean Journal of Health Service Management
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• v.10 no.2
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• pp.71-82
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• 2016

Objectives : This study purposed to analyze the productivity trends of regional health care resource uses in South Korea. Methods : Data was provided from the regional health care statistics by the National Health Insurance Service(NHIS) and collected from 2011 to 2014 at the 226 administrative regions such as Si(city in Korean), Gun(county in Korean), Gu(district in Korean). Productivity trend was analyzed with Malmquist Productivity Index(MPI). Input variables were the number of medical personnels, facilities, and major medical equipments. Output variables were the number of inpatient and outpatients in model A, and the amount of inpatient and outpatient reimbursements in model B. Results : In model A, the productivity of 62 regions were increased but it was decreased in 164 regions. In model B, the productivity of 123 regions were increased but it was decreased in 123 regions. Conclusions : If these trends were continued, there will be problems with the efficiency of national regional healthcare resource utilization. Health policy makers will require to focus in solving this phenomenon.

• Journal of Preventive Medicine and Public Health
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• v.23 no.3 s.31
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• pp.285-295
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• 1990

The utilization of medical care services has been partly regionalized with the implementation of referral requirement by the government since July 1, 1989 when the health insurance coverage was extended to all the people. For the purpose of regionalization, the whole country has been primarily divided into tertiary care regions, and each of them again into secondary care regions. This study investigates the self-sufficiency for in-patient care services of secondary care regions focusing on why it varies among the regions. In doing so, analysis is performed to examine a model which embodies three sets of hypotheses as follows : 1) The regional self-sufficiency for medical care services would be subject to direct influences of regional characteristics, amount of available services and structural properties of regional medical care system ; 2) The regional characteristics would have indirect effects on the self-sufficiency which are mediated by medical care services ; and 3) The amount of available services would indirectly affect the self-sufficiency by influencing the structure of regional medical care system. The results of analysis were generally consistent with the model. The findings have some practical implications. The regional self-sufficiency for medical care services partly depends upon basic properties of each region which cannot be changed in a short period of time. Thus the self-sufficiency for medical care services can be improved mainly by health policy measures. In some of the regions the self-sufficiency for in-patient care services was much higher or lower than can be predicted from the bed-population ratio. Indication is that the allocation of health resources should be made considering a variety of factors bearing upon the supply of and demand for health care ; not on the basis of just a single criterion like the availability. The self-sufficiency of a certain region is related to not only its own characterstics but also the characteristics of neighboring regions. Therefore, attention should be also directed to the inter-regional relationships in health care when the needs for investment of health resources in a region are assessed. However, it should be noted that this study used the data collected before the referral requirement was imposed. A replication of this analysis using recent data would provide an evaluation of the impact on the self-sufficiency of the referral requirement as well as a confirmation of the findings of this study.

• Journal of Preventive Medicine and Public Health
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• v.14 no.1
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• pp.33-38
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• 1981

During 2 months from December 1979 to January 1980, Medical practitioners in Chonnam province were grouped into Si (city), Eup (town) and Myun (rural area) groups according to the locations of their clinic. 40 practitioners were randomly selected in each group and were asked their opinions about rural medical care in general. Total of 88 practitioners replied to the question as 73.9 percent of response rate in average. The most frequently mentioned advantages of rural practice were ease of clinic opening in Si-and Myun-group respondents and good social relationship in Eup-group respondents. The most frequently mentioned disadvantages were medical isolation in Si-group respondents and residents' ignorance in medicine in Eup-and Myun-group respondents. In all groups, most respondents thought that rural medical care should be delivered by and controlled by physician. Suggestions made by Eup-and Myun-group respondents for improving rural medical care by structural change focused on the regional medical insurance system, while Si-group respondents noted district hospital or hospital linkage as the most preferrable system.