• Health Policy and Management
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• v.32 no.2
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• pp.164-172
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• 2022

Background: The purpose of this study was to the impact of the coronavirus disease 2019 (COVID-19) outbreak on emergency departments (EDs) in patients under the age of 18 years with respiratory disease. Also, we analyzed similarities and differences in patients including revisit before and after the COVID-19 outbreak. Methods: This study population was respiratory patients under the age of 18 years who visited all 403 EDs in Korea between January 1st, 2019 and December 31st, 2020, using the National Emergency Department Information System Database. The primary outcome was the number of respiratory patients according to age, sex, the type of EDs, season, Korean Triage and Acuity Scale (KTAS) levels, the result of ED, and length of stay. The secondary outcome was the number of revisit respiratory patients within 72 hours. We calculated the risk-adjusted revisit rates according to the KTAS level using a multiple logistic regression model. Results: The number of ED visits decreased from 274,526 in 2019 to 79,007 in 2020; this number was 71.2% lower than that before COVID-19. In spring 2020, this number was 90.1% lower than during the same period in 2019. For the revisit rate in the study population, the adjusted odds ratio (95% confidence interval) was 1.22 (1.05-1.41) in 2019 and 1.39 (1.07-1.81) in 2020. Conclusion: Implementing appropriate emergency care policies in severe respiratory patients would have contributed to improving the safety of reducing in revisit rate.

• Health Policy and Management
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• v.32 no.3
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• pp.282-292
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• 2022

Background: Aging societies face social problems of increased medical expenses for older adults due to increased geriatric diseases. This study aims to analyze the relationship between the state change of multiple chronic conditions (MCC) and out-of-pocket medical expenses in the elderly aged 60 or older. Methods: The 2014-2018 Korean Longitudinal Study of Aging data were used for 2,202 elderly people. Four status change groups were established according to the change in the number of chronic diseases. The association between the change of MCC and the out-of-pocket medical cost was analyzed using the generalized estimating equation model analysis. Results: The average out-of-pocket total medical costs were 1,384,900 won for participants with MCC and 542,700 won for those without MCC, which was a statistically significant difference (p<0.0001). Compared to the reference group (simple chronic disease, SCD→SCD), the change in multiple chronic conditions significantly increased the total out-of-pocket medical expenses in MCC→MCC and SCD→MCC groups (MCC→MCC: 𝛽=0.8260, p<0.0001; SCD→MCC: 𝛽=0.6607, p<0.0001). Conclusion: In this study, it was confirmed that the prevalence of MCC increased with age, and the out-of-pocket medical cost increased in the case of MCC. Continuity of treatment can be achieved for patients with MCC, and the system and management of treatment for MCC are required to receive appropriate treatment.

• 한국노년학
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• v.41 no.3
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• pp.353-371
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• 2021

The purpose of this study is to provide clues to social welfare policy making by revealing discourse on social intervention and response based on big data on elderly living alone in the COVID-19 situation. Keyword analysis, network analysis, and topic analysis were utilized to explore the ways in which news media have portrayed challenges facing older individuals and the ways in which the central and local government as well as private organization have responded to them. Results are as follows. First, networks(degree, closeness, betweenness) were formed around region, delivery, society, support, and vulnerability, suggesting an increased demand for economic assistance and social support as well as stronger service delivery systems. Second, key topics derived included "establishing public delivery systems", "establishing local networks", "Managing care gap", "Establishing a private economic support system", and "Establishing service organization system". Based on the research results, discourse on the organic role of government, communities and the private sector has been presented, suggesting policy and practical implications by proposing a discussion on how to intervene for elderly living alone in disaster situations such as COVID-19.

• Journal of Advanced Technology Convergence
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• v.1 no.2
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• pp.49-55
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• 2022

Women's welfare needs to claim a women-centered and independent welfare implementation line rather than simply staying within the framework of overall social welfare. A significant number of existing women's welfare programs have shown a tendency to protect women under the patriarchal premise. However, women's welfare in the future should go in the direction of helping women to improve the quality of life as an individual out of the limited frame of family. Providing compensation for protecting dependent families is also an important aspect of women's welfare. In other words, it is necessary to study how the government provides economic direct and indirect compensation to women who have lost the opportunity to participate in labor because they have to take care of children, the disabled, or the elderly. In addition, it is expected that welfare can be improved by inducing men's participation in reproductive activities through social education and relieving women's obligations to their families.

• Health Policy and Management
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• v.2 no.2
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• pp.131-151
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• 1992

The contents of prescription service were comparatively analysed between health centers(HC) and private clinics(PC). Medical chart review was done for 330 otu-patients diagnosed with upper respiratory tract infection(UR) of 120 adults and 90 children, and gastritis or duodenitis of 120 adults. Emphasis on comparison was the prime cost of medication which used in prescription service. The results were as follows; 1. The prime costs fro the medication per visit of HC group were significantly higher than PC group in all three diseases, and the out of pocket payments of patients per visit were significantly lower in the HC group than PC group. 2. The reason for high prime costs of medication per visit of HC in adult case of URI were due to the idverse use of medication and long prescription period per visit. And high medication costs in children cases of URI in HC group were due to the longer prescription day. In cases of gastritis, the prime cost of medication was also higher because of longer prescription period and the higher prime cost of medication. The proportions of medications for injection in the HC and PC groups showed similar features. 3. In depth analysis of the prescription services showed the differences of the contents of medication. In adults cases of URI, the averaged cost of oral medication was significantly lower in HC group, but that of medication for injection was higher in HC group. In children cases of URI, the averaged cost of oral medication and medication for injection was lower in HC group than in PC group. But in the cases of gastritis it was was higher in HC group than in PC group. The prescription periods were longer in HC group than in PC group in all three diseases. As a conclusion prime medication cost and quality of prescription services of HC group were higher than PC group. In terms of health care the cost containment and quality assurance in physician visit for common disease, public sector utilization is good option for those perspectives. But it should not be generalized unless future study about structure and outcome research for quality assurance.

• Journal of Digital Convergence
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• v.21 no.2
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• pp.17-25
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• 2023

The purpose of this study was to analyze the characteristics of elderly motorcycle accidents according to data from elderly inpatients to prepare prevention measures for the elderly against injury in motorcycle accidents. Chi-squared test, independent sample t-test, and canonical correlation analysis were performed on the Korea Disease Control and Prevention Agency's National Hospital Discharge In-depth Injury Survey data from 2015 to 2019, from which the records of 1,384 elderly inpatients hospitalized because of motorcycle accidents were obtained. intracranial injury(S06) was the most common care and treatment characteristic for both age groups. The most frequent injury site was the head and neck, and the most frequent injury type was a fracture. The above findings show that prevention education and policy formulation at the national level are necessary to identify and manage the factors of elderly motorcycle accidents. This study provides basic data for developing measures and policies to prevent and reduce injuries, making it significant for public health causes.

• Health Policy and Management
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• v.33 no.1
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• pp.55-64
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• 2023

Background: Despite the various activities of the regional public hospitals, discussions are being made as to whether or not to continue due to the issue of financial deficit. Therefore, the main factors affecting the fiscal deficit were analyzed with 10-year data. Methods: This study is a panel analysis that analyzed the characteristics of 34 regional public hospitals and influencing factors on medical benefits for 10 years from 2010 to 2019. First, we analyze the determinants of medically vulnerable areas set by the government, analyze the trend of medical profit per 100 beds and medical profit rate from 2010 to 2019, and identify the factors that affect them. Results: Differences in medical profit per 100 beds and medical profit-to-medical profit rate were caused by market share representing regional characteristics, and both indicators improved as the number of outpatients increased. The important influencing variables are the number of doctors and nurses, and both indicators improve when there are specialists, but medical benefits decrease as the number of doctors increases when judged by the number of people per 100 beds. In addition, the number of nurses per 100 beds does not contribute to medical profit and has a negative effect on the medical profit ratio. Conclusion: As only regional characteristics were taken into account for medically vulnerable areas, operational characteristics need to be considered. The greatest impact on the finances of local medical centers is the proper staffing of doctors and nurses, and their efficient arrangement is the most important factor in financial stability.

• Journal of Digital Convergence
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• v.20 no.1
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• pp.15-23
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• 2022

There is little research about medical treatment after prison. The purpose of this study is to examine factors influencing mentally-ill prisoner's decision making for medical treatment on release from prison. With the data collected from prisoners in 2019, binary logistic regression was used to analyze the effect of variables on the mentally-ill prisoner's decision making. In result, bipolar disorder, depression, anxiety disorder, and panic disorder decreased the likelihood of answering that I will have no medical treatment plan after prison, whereas lack of experience in receiving medical care increased the likelihood of answering as such. Bipolar disorder, anxiety disorder, counseling, medical treatment, and education had a positive effect on selecting mental hospital in the answer. Depression enhanced the likelihood of choosing mental health center for treatment. Policy implications and directions for future research are discussed.

• Journal of Digital Policy
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• v.2 no.2
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• pp.21-33
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• 2023

The purpose of this study was to explore the night duty experience on the personal life of fixed night shift nurses working in various health care delivery systems. Data collection was conducted through three focus group interviews from September to October 2022, The subjects of the study were 13 nurses working fixed night shift. For analysis, all interviews were recorded and transcribed and analyzed using qualitative content analysis. In results, 5 themes, 11 categories and 24 subcategories were derived. The five themes were 'it's a voluntary choice', 'efforts to adapt to the shift', 'awareness about fixed night shift', and 'hope to improve the system'. The study aims to help understand fixed night shift work and systems by showing various night-duty experiences on the personal life of the nurses and to provide basic data for preparing measures to improve the system.

• Journal of Digital Policy
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• v.2 no.2
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• pp.7-14
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• 2023

The purpose of this study is to emphasize the need for brand equity management to survive in a rapidly changing medical environment by identifying the impact of digital customer experience on brand equity and analyzing the influence of hospital brand equity on word-of-mouth (WOM) intention. The main findings are as follows. As a result of analyzing the effect of digital customer experience on brand equity, the relationship between aesthetic value and brand equity, functional value and brand equity, customer service value and brand equity all showed significant results. In addition, the relationship between brand equity and WOM intention also showed significant results. These findings have practical implications for revealing the importance of the digital service environment in building hospital brand equity, in strengthening relationships with customers and WOM activities, and suggesting the provision of customer services and benefits using digital technology.