• Title/Summary/Keyword: Status of National health insurance

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Clinical Nutrition Service at Medical Centers in Seoul (서울지역 의료기관의 임상영양서비스 현황조사)

  • Kim, Hye-Jin;Kim, Eun-Mi;Lee, Geum-Ju;Lee, Jung-Joo;Lim, Jung-Hyun;Lee, Jung-Min;Jeon, Hyun-Jung;Lee, Hae-Young
    • Journal of the Korean Dietetic Association
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    • v.17 no.2
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    • pp.176-189
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    • 2011
  • The purpose of this study was to investigate the status of clinical nutrition services at various medical centers in Seoul, Korea. A questionnaire was distributed to the departments of nutrition at 44 hospitals in Seoul on July 2009. Nutritional screening carried out at a rate of 59.1% at the medical centers, and a significant difference was found according to the type of center, from 100% in tertiary hospitals to 18.8% in normal hospitals. On annual average, the numbers of inpatients, inpatients for malnutritional screening, inpatients with malnutrition, and inpatients for malnutrition management were 15,169.5, 10,870.9, 2,224.8, and 1,546.2, respectively. On average the group nutrition education was done 36.1 times/year for diabetes, 8.2 times/year for cancer, and 1.9 times/year for renal disease, and the numbers of participants 423.1, 95.1, and 31.5, respectively. On average the individual nutrition education of inpatients with diabetes was done 135.4 times/year for ordered-type, and 119.3 times/year for unordered-type, 106.2 times/year for paid-type, and 148.5 times/year for unpaid-type. The mean fee for education and counseling was the highest for peritoneal dialysis (73,090.9 won) but the lowest for heart disease (23,609.1 won). On average the individual nutrition education of outpatients with diabetes was done 234.6 times/year for ordered-type, and 2.5 times/year for unordered-type, 204.4 times/year for paid-type, and 32.7 times/year for unpaid-type. The mean fee for education and counseling was also the highest for peritoneal dialysis (63,500.0 won) but the lowest for heart disease (21,336.4 won). To implement more effective clinical nutrition service, a national medical insurance imbursement policy should be urgently instituted such that diseases left as unpaid are covered by health insurance, including all nutrition-related disease.

Need Assessment of Home-based Cancer Patients (재가암환자 요구도 조사)

  • Kim, Tae-Sook;Yang, Byung-Guk;Jeong, Eun-Kyeong;Park, No-Rai;Lee, Young-Sook;Lee, Young-Sung;Lee, Sok-Goo;Kim, Young-Taek;Yun, Young-Ho;Huh, Gil-Ja
    • Journal of Hospice and Palliative Care
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    • v.2 no.1
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    • pp.36-45
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    • 1999
  • Purpose : Cancer, one of the major causes of death in Korea, tends to become chronic due to the rapid development of diagnostic and therapeutic methods. As a result, the number of home-based cancer patients is in the increasing trend. However, on account of the insufficiency of continuous and comprehensive cancer patient management system, a number of cancer patients are left in a defenseless state. This study was designed for need assessment of home-based cancer patient to establish the community-based health care system for the comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce rare burdens of their families. Methods : Through making a survey for needs assessment toward the health care service, the 455 respondents among home-based cancer patients answered the given enquetes to analyze the management status and problems of home-based cancer patients Results : 1) Unsatisfaction rates of pain control is 25.5 percent for mild cases, 46.5 percent for severe cases. 2) According to the needs assessment of home-based cancer patients, most of the respondents want to receive economical support, alleviation for the pain and symptoms, and the information of health care and consultation. So these needs account for the main contents of the home-based cancer patient management plan. 3) In the aspect of the satisfaction rate for basic care need, most items account for $20{\sim}30%$ of satisfaction. And the proportion of need for special case is under 5%, satisfaction rate for special care need is about 50% of satisfaction. So the home-based cancer patients are not being cared sufficiently. Conclusion : According to the result of need assessment, many home-based cancer patients received inadequate pain and symptom management. And Satisfaction rate for basic and special care need is low. So development of comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce care burdens of their families is very necessary.

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An Analysis of Infrastructure and Provision of Forest Welfare Service in Nursing Homes for the Elderly (노인요양시설의 산림복지서비스 인프라 및 제공 실태)

  • Lee, Insook;Kim, Sungjae;Bang, Kyung-Sook;Yi, Yunjeong;Kim, Miju;Moon, Hyojeong;Yeon, Poung Sik;Ha, Ei-Yan;Chin, Young Ran
    • The Journal of the Korean Institute of Forest Recreation
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    • v.22 no.4
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    • pp.59-69
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    • 2018
  • This is a cross-sectional study that suggests ways to activate forest welfare services (FWS) by investigating the infrastructure, service status, and perception on FWS in Korea. In August 2016, a structured email survey was conducted in nation widely. The respondents were mostly directors and general secretary (75.0%). The considerable number (16.3%) of nursing homes (NH) use some floors of the complex buildings that would be difficult to have FWS infrastructure and about 30% of those without forests near the facilities. The directors of NH recognize that FWS has positive effects on the elderly. However, FWS is not an requisite of the longterm care insurance benefit, and so costly and effort-intensive that FWS has not been activated so far. In order to activate FWS in NHs, it is necessary to develop and disseminate the guidelines on FWS that anyone can easily followed. In addition, when the National Health Insurance Corporation evaluates NHs, they should evaluate not only whether there is a wandering or walking space, but also whether it has forest healing factors such as forests. It is also necessary to create a barrier-free environment both inside and outside of NHs, increasing accessibility to the toilet in gardens, paving a passage for wheelchairs and lifts in forests near NHs. Through these efforts, it is expected that FWS will be activated to provide physical, mental rest and comfort, appropriate cognitive stimulation to the NH residents at the end of life.

A Study of the Relationship Between Perceived Social Support and Quality of Life of Cancer Patients receiving Gene therapy (유전자 치료를 받는 암 환자가 지각하는 사회적 지지와 삶의 질과의 관계 연구)

  • Chang, Mi-Kyung;Kim, Kyung-Hee;Chung, Yeon-Kang
    • Research in Community and Public Health Nursing
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    • v.8 no.1
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    • pp.74-88
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    • 1997
  • The purpose of this study was to identify the relationship between perceived social support and the quality of life of cancer patients receiving gene therapy. The subjects for this study were 50 cancer patients receiving gene therapy at two general hospital in Seoul. The data were collected during the period from October 14, 1996 to November 11, 1996. The perceived social support was measured by the family support scale made by Hyun Sook Kang, by the medical support of life scale developed by Ok Soo Kim. The quality of life scale developed by Bang-Whal-Ran was used, among the questionnaire, physical factors was developed by U.S.A National Conference on Cancer Nursing. The data was analysed by the SAS statistical program. Percentile, means and standard deviations, t -test, ANOVA, Scheffe test, Pearson correlation were utilized for analysis. The results of this study were as follows. 1. The mean score of the perceived social support of the subjects was 83.66, the item score was 3.8. 1) The mean score of the perceived family support of the subjects was 44.96, the item mean score was 4.5. 2) The mean score of the perceived professional medical support of the subjects was 38.70, the item mean score was 3.2. 2. The mean score of quality of life of the subjects was 120.38, the item mean score was 3.17. For each factor in quality of life scale, the mean score was follows: for attitude toward life, 3.95, for familial relationship and financial status, 3.53, for social activity 3.24, for emotional status, 3.08, for healthy perceptive, 2.90, for physical symptom, 2.80. 3. The result of the analysis of the relationship between perceived social support and quality of life showed a positive correlation(r=.4853, p=.0004). Therefore, the higher the perceived social support of the patients, the higher the quality of life. 1) The result of the analysis of the relationship between perceived family support and quality of life showed significant correlation(r=. 3566, p=.0110). Therefore the higher the perceived family support of the patients, the higher the quality of life. 2) The result of the analysis of the relationship between perceived professional medical support and quality of life showed significant correlation (r=.4477, p=.0011). Therefore, the higher the perceived professional medical support of the patients the higher the quality of life. 4. There was a significant difference in perceived social support according to sex(F=2.1437, p= .0371), others coping non-family (F=2.4863, p=.0164) and duration of treatment (F=4.16, p=.0218). 5. There was a significant differance in quality of life according to sex(F=2.6932, p=.0097), degree of education(F=2.3610, p=.0223), others coping non-family(F=2.0502, p=.0458). In conclusion, this study revealed that social support is an important factor that associated with the quality of life in cancer patients receiving gene therapy.

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What Factors Affect Mortality over the Age of 40? (40세 이후의 사망에 영향을 주는 요인에 관한 코호트내 환자-대조군 연구)

  • Park, Jong-Ku;Koh, Sang-Baek;Kim, Chun-Bae;Park, Kee-Ho;Wang, Seung-Jun;Chang, Sei-Jin;Sin, Soon-Ae;Kang, Myung-Guen
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.3
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    • pp.383-394
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    • 1999
  • Objectives: This study was conducted to identify the factors influencing the mortality of Koreans over the age of 40 by a nested case-control study. Methods: The cohort consisted of the beneficiaries of Korea Medical Insurance Corporation for Government Employees & Private School Teachers and Staff(KMIC) who received health examinations of KMIC in 1992 and 1993 retrospectively. At that time, they were more than 40 years old. The cases were 19,258 cohort members who had died until December 31, 1997. The controls were 19,258 cohort members who were alive until December 31, 1997. Controls were matched with age and sex distribution of the cases. The data used in this study were the funeral expenses requesting files, and the files of health examinations and health questionnaires gathered in 1992 and 1993. To assess the putative risk factors of death, student t-test, chi-square test, multiple logistic regression analysis were used. Results : In multiple logistic regression analysis, independent risk factors of death were as follows; systolic blood pressure, diastolic blood pressure, blood glucose, AST, urine glucose, urine protein, alcohol drinking(frequency), cigarette smoking and perceived health status, intake of restoratives and blood transfusion showed positive associations with death; coffee consumption showed negative associations with death; and body mass index and serum total cholesterol showed J-shaped association with death. Conclusions: Regarding the direction of association, the result of analysis on the data restricted to '96-'97 was same as that of '93-'97. But in some variables such as obesity, serum cholesterol, the odds ratios of death in the data of '96-'97 were higer than those of '93-'94, which suggested that the data of '93-'94 was bearing effect-cause relationship. We concluded that it suggested further researches using long-term follow-up data to be needed in this area.

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A potential user' Need of Utilization and Development Direction of Day Care Center (노인주간보호시설에 대한 잠재이용자의 이용욕구 및 발전방향)

  • Jeong, Ji-Na
    • Journal of Digital Convergence
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    • v.18 no.4
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    • pp.479-487
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    • 2020
  • The purpose of this study is to identify a potential user's need for use and operational of the elderly day care center and to identify the problems and suggest development directions. The data collection was conducted on 320 ordinary people living in J-do through a questionnaire, and sought to understand the operational status of in-depth interview institutions for the heads and employees of six center. As a result of the analysis, a potential user's ware not aware of the functions and specific roles of day care center, the cost of facilities was covered by the government, and that facilities and the environment were important factors when using the center. In-depth interviews show that the current policy or system is far from reality and does not fit the status or role of the workers and the operational status of the agency, requiring the re-establishment of the on-site system. Based on the research results, the development direction of day care facilities requires active promotion and strengthening of family support for improving and enhancing awareness of day care facilities to citizens at the national level. Second, the quality of nursing services should be enhanced through improvements in facilities and the environment that reflect users' needs. Third, The government should improve the quality of nursing services by improving the poor employment conditions and treatment of workers to fit the reality.

A Study on Self-sufficiency for Hospital Injury Inpatients in Korea (우리나라 의료기관 입원손상환자의 자체충족도에 관한 연구)

  • Lee, Hee-Won;Park, Jong-Ho;Kang, Sung-Hong;Kim, Won-Joong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.12
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    • pp.5779-5788
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    • 2011
  • This study was conducted to comprehend the current status of regional self-sufficiency of Hospital injury inpatients and, based on this, to prepare some measures for improving the self-sufficiency. For this purpose, 2005 & 2008 Patient Survey data, regional medical utilization data of National Health Insurance Corporation, yearbook of Central Emergency Medical Center and evaluation results of emergency medical institutions were obtained. Frequency analysis, cross-tabulation, decision tree and logistic regression techniques were used in the analysis of data. Self-sufficiency in 'metropolitan city/Do' area was lowest for Chungcheongnam-do for the year 2005 and 2008, followed by Gyeongsangbuk-do, Gyeonggi-do and Jeollanam-do. As for the self-sufficiency in 'Si/Gun/Gu' area with regard to local medical supply, for both 2005 and 2008, It was higher when general hospital, district emergency medical center, regional emergency medical center and regional emergency medical institution existed in the residential area. It was also found that, the higher the quality level of local emergency medical institution, the higher the self-sufficiency. It was confirmed that, when promoting the national policy for injury patients, priority should be placed on 'Do' area where the level of emergency medical supply was low, and that enhancing the quality level of emergency medical institutions was helpful for the improvement of self-sufficiency.

The study on the entry of dental technicians in the public health center for a manpower supply and demand plane (Centering around a denture insurance policy in 2012) (인력수급 대책을 위한 치과기공사의 보건지소 진출에 관한 연구 - 2012년 틀니보험화 정책을 중심으로 -)

  • Lee, Jong-Do;Kim, Jeong-Sook;Park, Kwang-Sig
    • Journal of Technologic Dentistry
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    • v.32 no.4
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    • pp.417-433
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    • 2010
  • Purpose: This study evaluated the manpower planning of dental technicians. Methods: Methods : Survey was conducted regarding subject's general characteristics, characteristics of dental technician's occupational view and working conditions, and reason to enter into branches of the public health enter. The survey sample consisted of 323 dental technicians (221 male/ 102 female). Survey was conducted for one month from August 1 to September 1 in 2010. Following results were obtained. Results: 1. Regarding general characteristics of the subjects, there was a slight male predilection with 68.4%. Subjects in their 40s occupied the highest proportion of 32.2%. Majority of subjects worked in the big cities (71.5%). Favored working places were dental laboratory (57.6%) and dental hospital or dental clinic (19.5%). Although no position is available in the public sector such as public health center or health care civil servant, 9.3% preferred working in the public health center. Public sector is more favored than 2-year technical colleges or dental supply and equipment companies. In respect to education, 57% of the subjects graduated college. 67.8% were married. Subjects who specialize in the porcelain or all-ceramic were 57.9%. With regard to current position, head of the dental laboratory was most common. 2. Following occupation characteristics were found. Economic reason took the highest proportion when deciding their occupation (39.9%) followed by gaining social experience (36.5%). Majority of the subjects (76.5%) wanted to work as dental technicians until their retirement. 71.5% pursuit to become a manager of the dental laboratory. 76.1% agreed on opening a dental technician position in the public health center. Regarding an authority to lead developing the dental technician position in the public sector, majority of the subject chose ministry of health and welfare (35.6%) and Korean dental technologist association (34.7%). Employment (average, 30%) and turnover rate (average, 36.5%) of dental technology college graduates ranged from 40% to 60%. Most important factors for the employment were practical experience (41.2%) and competency (34.4%). With regard to job satisfaction, so-so as 46.7% and satisfactory was 42.7% 3. In respect to the reason for opening a position in the public health center, 'It is needed to continue denture rogram for elderly patients' obtained the highest score (4.14 point). 'Institutional devices are required to open a position for dental technicians as a public healthcare provider' received high score (4.11 point). 4. Concerning the working conditions, 'professional knowledge is required' received the highest score (4.23) followed by 'too short maternity and parental leave' (4.21). 5. Relationship between general characteristics of the subjects and favor of working in the public health center was investigated. Significant differences were found according to the current and favored working area, favored occupation, education level, marital status, and specialty. Working in the public health center was favored by following subjects: working in mid- or small-sized cities (4.16 point, p<0.05); PhD degree-holder (4.59 point, p<0.01). 6. Among general characteristics of the subjects, significant difference of working conditions was found in the following factors: gender; working areas; favored working areas; favored working positions, and education level. Majority of subjects favored working in big cities and currently work in big cities although satisfaction was comparatively low (3.75 score). 7. Future plan to work in public health center was evaluated according to occupational characteristics. Subject's intention to work in the public healthcare center was significantly affected by opening of dental technician position, leading authority, average turnover rate, and factors affecting employment. Working in the public health care center was favored by the following subjects: Dental technicians who actively supported opening of the dental technician position (4.34 point, p<0.001); subjects who thought the Korean dental technologist association is responsible for the opening of positions in the public sector (4.26 point, p<0.001); and subjects who thought that attitude and character are important for the employment (p<0.001). 8. Concerning difference of working conditions according to the occupational characteristics, significant difference was demonstrated by factors such as a reason to choose to be a dental technician, work plan, pursuing position, responsible authority, average employment rate, and job satisfaction. High standard of working conditions was required in subjects who selected to be a dental technician for the leisure time after work (s.05 point, p<0.01), who planted to work until their marriage (4.25 point, p<0.001), and who pursuit to be a manager (3.98, p<0.05). 9. In respect to influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.068 and age affected the working condition with significant difference according to the pvalue. 10. Regarding influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.335 and work plan, opening of dental technician position in the public sector, and responsible authority had significant influence over the subject's intention to work in the public health center according to the p-value. 11. With regard to the influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.091 and reason to choose to be a dental technician, work plan, and responsible authority significantly affected subject's working conditions. Conclusion: Korean society is becoming a super-aged society according to several statistics. As aged population is rapidly increasing, national health insurance plans to cover denture for senior citizen over 75 years old from 2012. Therefore, dental technicians are urgently needed in the public health centers all over the nation. Many subjects in this study planed to work until their retirement and recognized dental technician's expertise. Ministry of health and welfare and Korean dental technologist association should co-operate each other to prepare foundation and institutional devices for dental technicians to advance into the public health center. This will improve oral health of the population. This study showed urgency of medical facilities and services which meets increasing number of aged population and welfare of the population.

Effect of the Intra-arterial Papaverine Infusion on the Symptomatic Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage (뇌지주막하 출혈 후 뇌혈관 연축에 대한 동맥내 Papaverine 주입의 치료효과)

  • Shin, Jun Jae;Lee, Jae Whan;Shin, Yong Sam;Huh, Seung Kon;Kim, Dong Ik;Lee, Kyu Chang
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.325-333
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    • 2001
  • Objective : To clarify the benefits and therapeutic effects of intra-arterial papaverine infusion on the symptomatic cerebral vasospasm, we analyzed the results of treatment in 32 patients retrospectively. Methods : A total of 510 patients underwent surgical clipping or endovascular intra-aneurysmal treatment for ruptured intracranial aneurysm between May, 1996 and June, 1999. The delayed ischemic deficit(DID) was developed in 90 of 510 patients. Of these 90 patients, 32 developed symptomatic vasospasm inspite of using modest "3H therapy". The brain CT scan was taken before the intra-arterial infusion of papaverine. The 32 patients underwent 42 intra-arterial papaverine infusion. The symptomatic vasospasm was divided into three groups : deterioration of mental status(Group 1), appearance of a focal neurologic deficit(Group 2), or both(Group 3). We measured Glasgow Coma Scale(GCS), arterial diameters, and cerebral circulation time(CCT) at the time of pre- and postangioplasty. Results : The number of patients in group 1, 2 and 3 were 26, 7, 9 respectively. Eighteen cases showed improvement of GCS more than 2 scores, 16 more than 1, and 8 showed no change of GCS. Average cerebral circulation time(CCT) was decreased ranging from 0.0%-67.5%, and arterial diameters were increased in 21 cases ranging from 1 to 4 folds. Conclusion : Intra-arterial papaverine infusion seemed to have therapeutic effects on symptomatic vasospasm by improving the neurological signs and increasing the arterial diameter. We suggest that intra-arterial papaverine infusion would be an useful adjunctive therapeutic modality in symptomatic vasospasm.

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Cardiovascular Surgery in Korea (한국의 심장혈관수술 현황)

  • 김형묵
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.371-382
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    • 1985
  • Over the past 4 decades after World War II a great deal of data and clinical experiences have been accumulated relating to the diagnosis and surgical treatment of congenital and acquired cardiovascular diseases in Korea. Clinical data on cardiovascular surgical cases performed in all 22 hospitals for open heart surgery in Korea was collected from it`s starting up to December 1984. The first recorded open heart surgery for a young adult atrial septal defect was performed by Young Kyoon Lee, M.D. on August 7, 1959, Seoul National University Hospital, Korea. And, some scattered reports on cardiovascular surgical cases in it`s early period have changed recently the number of hospitals for open heart surgery and clinical cases enormously in total amount of 13, 100 cardiovascular operations performed on 12, 990 cases up to December 1984. Of the total 13, 100 cardiovascular operations, congenital cardiovascular anomaly occupied 70%. Of the congenital cases, 6, 580 operations for acyanotic group [operative mortality 4.5%], and 2, 489 operations for cyanotic group [operative mortality 20%]. The incidence of congenital cardiovascular anomaly in order of frequency was ventricular septal defect [29%], patent ductus arteriosus [26%], Tetralogy of Fallot [22%], atrial septal defect [8, 6%], pulmonary valve stenosis [3.0%], and endocardial cushion defect [1.1%]. Of the 3, 412 valvular heart disease cases, which occupied 85% of total 4, 031 acquired cardiovascular disease, individual incidence was in mitral 2, 565 [63.5%], double valve 451 [11.1%], and simple aortic valve 351 [8.7%]. Total number of valve replaced, mechanical and tissue, was 2, 795, and 1, 884 for mitral, 808 for aortic, and 103 for tricuspid in position. Operative mortality for prosthetic valve replacement in total was 9.8%. Remained acquired cardiovascular cases chronic constrictive pericarditis [7.9%], cardiac tumor [1.9%], coronary artery bypass [1.8%], cardiac trauma [1.2%] and less than 1% of thoracic aortic aneurysm. Overall operative mortality for open and non-open cardiovascular surgical operation was 7.7% [congenital acyanotic group 3.2%, congenital cyanotic group 19.4%, and acquired group 7.8%]. In conclusion, present status of cardiovascular surgery in Korea is stabilized with accumulation of clinical cases and experiences, and the future in the field of cardiovascular surgery is promising, especially in the infant cardiac surgery and aortocoronary bypass surgery, with abrupt increase of specialized cardiac centers, trained specialists, and expanding social health insurance.

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