• Health Policy and Management
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• v.28 no.4
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• pp.402-410
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• 2018

Background: Monitoring appropriate medication categories can provide early warning of certain disease outbreaks. This study aimed to present a methodology for selecting and monitoring medications relevant to the surveillance of acute respiratory tract infections, such as influenza. Methods: To estimate correlations between acute febrile respiratory tract infection and some medication categories, the cross-correlation coefficient (CCC) was used and established. Two databases were used: real-time prescription trend of antivirals, anti-inflammatory drugs, antibiotics using Drug Utilization Review Program between 2012 and 2015 and physicians' number of encounters with acute febrile respiratory tract infections such as influenza outbreaks using the national level health insurance claims data. The seasonality was also evaluated using the CCC. Results: After selecting six candidate diseases that require extensive monitoring, influenza with highly specific medical treatment according to the health insurance claims data and its medications were chosen as final candidates based on a data-driven approach. Antiviral medications and influenza were significantly correlated. Conclusion: An annual correlation was observed between influenza and antiviral medications, anti-inflammatory drugs. Suitable models should be established for syndromic surveillance of influenza.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.3
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• pp.129-141
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• 2016

Objectives As awareness of the public about Korean medicine health care and the social demand about improvement for quality of health care service is constantly rising, the quality evaluation of Korean medicine health care service is needed to improve the quality. Through trial of Delphi method, we tried to set the priority in short, medium, long term among the disease which is the subject of quality assessment. Methods Carrying out the delphi survey to 50 experts of korean medicine who were recommended by the 41 member societies of Korean medicine and related organizations, we selected final candidates for quality assessment. It is composed with total 2 rounds, and we investigated the priority in three aspects; the importance of the matter, possibility quality assessment, potential about if there's any chance of improvement. Results By delphi method, we set the priority of quality assessment. Base on the result of the second round, we classified importance of the questions into above average, average, below average, and categorized items as short, medium, long term according on the final priority. We classified of musculoskeletal diseases and diseases of connective tissues and musculoskeletal injury as short term and cerebrovascular disease and disease of nerve system and malignant neoplasm as medium term, disease of digestive organs and diseases, symptoms and abnormal findings in clinical field or inspections which are not categorized as long term. Conclusions We set the subjects of quality assessment by delphi survey by experts, and classified into short, medium, long term. Further research is necessary for execution the Quality Assessment to each of the candidate. Also, we can send feedback to medical institution base on the result of Quality Assessment. then it would be able to induce the improvement in quality of medical institution by itself.

• The Korean Journal of Emergency Medical Services
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• v.28 no.1
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• pp.97-112
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• 2024

Purpose: This study compared the relative importance of educational content, teaching methods, and evaluation methods in the patient assessment curricula of 119 emergency medical technicians (EMTs). Methods: First, we identified the educational content, training hours, and teaching and evaluation methods of the existing patient assessment curriculum based on the National Competency Standard learning module. Second, we surveyed 30 EMTs affiliated with 119 services using the Analytic Hierarchy Process (AHP) method. Subsequently, we compared the differences between the current curriculum and the AHP analysis results. Results: Currently in operation, the "Advanced EMT Course" comprises three learning modules: assessment of patient status, scene size-up and triage, and assessment using monitoring devices. Among these, content related to the assessment of patient status received the most allocated time and was deemed the most important according to the AHP survey results. Conversely, while less time was allocated to scene size and triage compared with assessment using monitoring devices, the former was assessed as more important than the latter in the AHP results. Furthermore, scenario-based team training and procedure-focused individual practice were evaluated as relatively important teaching methods, while practical examination using a checklist was deemed the most appropriate evaluation method for all learning content. Conclusion: To improve the patient assessment curriculum, we propose adjusting teaching hours and introducing new teaching and evaluation methods based on the results of relative importance. The proposed improvement plan will contribute to enhancing the competency of 119 EMTs.

• Health Policy and Management
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• v.30 no.3
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• pp.311-325
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• 2020

Background: Health statistics of pharmaceutical use and expenditure are essential to make and implement evidence-based pharmaceutical policy. This study aims to demonstrate the methods and results of pharmaceutical consumption and sales in 2018 according to the sources and methods given by the Organization for Economic Cooperation and Development (OECD). Methods: The medication list contains 39,346 medicines both reimbursed and non-reimbursed by the National Health Insurance in 2018. We used the therapeutic categories based on Anatomic Therapeutic Chemical Classification of World Health Organization. This study analyzed National Health Insurance claims data and supply data generated from wholesalers to health care facilities. The indicators are defined daily dose (DDD), per 1,000 inhabitants per day and US$ per capita. Results: In South Korea, the number of medications to which DDD were assigned was 18,055 and it was 45.9% of the total number of medications on the list. The consumption in anti-infective for systemic use (J) and musculo-skeletal system (M) was higher than the mean consumption among the OECD countries. The pharmaceutical sales per person in Korea was also higher than the mean sales per person across the OECD countries. Conclusion: We sought to explain the methods to produce pharmaceutical consumption and sales statistics which we had submitted annually to OECD. Considering the characteristics of pharmaceutical statistics, a direct comparison should be approached with caution. Since the growth in pharmaceutical spending has greatly increased over the past decade, we need to monitor pharmaceutical consumption and expenditure consistently.

• Health Policy and Management
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• v.19 no.3
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• pp.1-26
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• 2009

Objectives : To identify target areas and set priorities among those areas identified for national quality evaluation. Methods : Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories : short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.

• Health Policy and Management
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• v.25 no.2
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• pp.107-117
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• 2015

Background: The purpose of this study is to analyze the cost for the denture treatment in accordance with the government's plan to expand the National Health Insurance coverage for dental prothesis from July 1, 2012. Methods: We developed the draft of classification of the treatment activities based on the existing researches and expert's review and finalized the standard procedures through confirming by Korean Dental Association. We also made the list of input at each stage of treatments. We conducted survey of 100 dental clinics via post from April 4 to May 20 in 2011 and 37 clinics took part in the survey. The unit of cost calculation is the process from the first visit for denture treatment to setting of denture and adjustment. The manufacturing process performed by dental technician was not included in the cost analysis. Results: The process for the complete denture treatment was classified with 10 stages. The partial denture treatment was classified with 8 stages. The treatment time per each denture is about 5.6 hours for complete dentures and about 6.6 hours for partial dentures. The treatment cost were from 591,108 won to 643,913 won for complete denture and from 670,219 won to 738,840 won for partial denture in 2011, depending on the location, type of the clinics and the types of physician's income. Conclusion: This study shows the example of cost analysis for the treatment to set the fee schedule. Measures to get representative and accurate information need to be made.

• Korea Journal of Hospital Management
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• v.26 no.1
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• pp.55-70
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• 2021

Purpose: The purpose of this study was to examine the influencing factors of the patient leaning phenomenon in tertiary hospitals. Based on the results of this study, we intended to find implications for improving the problems of the delivery system imbalance in tertiary hospitals caused by patient leaning phenomenon. Methodology/Approach: Qualitative studies were conducted, using focus group interviews and in-depth interviews. The focus group interviews were conducted for 12 users of tertiary hospitals by 2 groups. And in-depth interviews were conducted for 6 tertiary hospital managers. This was considered to be the most effective approach to gather diverse and in-depth information about the influencing factor of patient leaning phenomenon in tertiary hospitals. Findings: In focus group interviews, the reason for choosing tertiary hospitals was the reliability of the hospital(physician, reputation, etc.). And the effect of the policy to strengthen coverage of National Health Insurance and private medical insurance was relatively small. In other words, we found that the individual's desire to receive medical services suitable for one's health status and disease condition was the biggest factor, rather than the cost and policy factors. Practical Implications: We suggested that the appropriate medical care provision should be strengthened according to the role and function of medical institutions. In addition, the education system needs to be reorganized to activate the referral program, expand community medical capabilities, and foster quality primary medical care.

• The Journal of the Korea institute of electronic communication sciences
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• v.14 no.2
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• pp.331-338
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• 2019

Video services over Internet is getting important. Since the service quality of the video service provided by streaming over Internet may be degraded, the quality assessment and management are very important. Currently the objective method based on the measured values of parameters is being widely used for video services. The subjective assessment, however, is more ideal in that the quality that is experienced by human. This paper, therefore, proposes a subjective quality management scheme for video service in a mobile environment that overcomes the limitations of the subjective method. The proposed scheme is expected to contribute to implement a more efficient quality management system for video services in a mobile environment.

• Korean Journal of Veterinary Service
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• v.34 no.4
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• pp.441-448
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• 2011

According to the Korean government policy of expanding HACCP system application to food chain from farm to meat market, the importance of HACCP assessment to keep balance among the certified HACCP plants is urged. The objective of this study is to recommend more effective HACCP assessment methods. We reviewed major foreign countries HACCP implementation policy focused on the audit system, and compared with the Korean HACCP assessment system. We found that the checklist guidelines of prerequisite program were not enough for precise evaluation and many of the items were not directly related to the risk occurrences. And current rating grade for each items and judgments were inadequate to induce non-compliances and corrections for better HACCP implementation. We suggest revision points as follows; (1) checklists should be revised and reorganized according to the possibility of risk occurrences, (2) all the items should be supported by detailed guidelines for more objective inspection, (3) non-compliances identified must be reconfirmed after correction, (4) the items for HACCP plan should be divided into an accreditation inspection and a regular inspection, (5) rating grade 'high', 'medium', 'low', 'failure' was better for indicating non-compliances.

• Health Policy and Management
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• v.21 no.2
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• pp.195-212
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• 2011

Objectives: This study investigates the relationship between nurse staffing levels and differences in patient outcomes in terms of average length of stay, in-hospital mortality rate and 30-day death rate in order to evaluate the effectiveness of a policy that differentiates fees for inpatients on the basis of nurse-to-bed ratios. Methods: We obtained information on inpatients from health insurance claims data published by the Health Insurance Review and Assessment Service(HIRA) in 2008, organizational factors(type of hospital, ownership) from the records of the hospital report system in 2008, and nurse staffing levels, which were graded on a scale of 1 to 7, from data compiled between December 15, 2007, and September 20, 2008. The data were segregated according to type of hospital and quarter and finally 3,517 records of 1,182 hospitals were analyzed using multi-level analysis. Results: The average length of stay in grade 1~6 hospitals was lower than that in grade 7 ones, but the difference was much below one day. No significant difference was found among different grades in tertiary hospitals. Further, variations in staffing levels did not result in any significant difference in the in-hospital mortality rate and 30-day death rate. Conclusions: High nurse staffing levels did not result in better patient outcomes compared with low staffing levels. We therefore recommend modifying the above nurse staffing policy so as to make it more effective in improving patient outcomes.