• Title/Summary/Keyword: care policy

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The Institutionalization Process of the Visiting Rehabilitation System in Japan and the Challenges Faced in the Process

  • Lee, Minyoung
    • The Journal of Korean Physical Therapy
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    • v.34 no.2
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    • pp.80-89
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    • 2022
  • Purpose: In Japan, the long-term care insurance and health insurance acts have stipulated the visiting rehabilitation system to provide support at the national level. The prior case of Japan would provide guidelines for seeking a suitable policy direction in South Korea. This study aims to examine the historical transition process of the visiting rehabilitation system in Japan, and the issues that emerged in the process of the institutionalization of this system. Methods: To examine the historical transition process of the system, the regulations announced by the government and their reports were reviewed. The relevant issues were qualitatively analyzed based on the opinions of scholars, therapists, and interested organizations that were reported in published papers on the topic. Result: The visiting rehabilitation system has been implemented in the following chronological order: The Health and Medical Service Act for the aged (1982-2006), the Health Insurance Act (1988-), and the Long-term Care Insurance Act (2000-). Currently, visiting rehabilitation is provided through hospitals, clinics, visiting nursing stations, etc. The following issues came to the fore in the process of the institutionalization of the system: (1) the complexity of the system, (2) the necessity of changing perceptions into a life model approach, (3) insufficient service provision by therapists, (4) the lack of human resources and an education system, (5) the lack of awareness of care managers and doctors about visiting rehabilitation, and (6) the necessity of quality enhancement through a team approach. Conclusion: It is deemed worthwhile to refer to the visiting rehabilitation system in Japan and the issues that emerged in the process of institutionalizing the system while seeking a policy direction for a similar system in South Korea.

Individual Variations in the Code of the International Classification of Disease for Similar Outpatient Conditions among General Practitioners (동일 질환에 대한 상병분류기호의 의료기관별 변이에 관한 연구)

  • 문옥륜;김창엽;김명기
    • Health Policy and Management
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    • v.2 no.1
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    • pp.66-79
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    • 1992
  • The code of the International Classification of Disease(ICD) is seriously questioned on its effectiveness in identifing an independent disease entity from similar conditions at general practitioner's offices. This study has attempted to show individual coding variations in ICD for similar ambulatory care conditions. It has been assumed that a following outpatient visit is regarded as the sane kind of visit owing to the same disease if a visit to the different source of care would be mad within an interval of less than two days. The 'D' health insurance association was selected for this analysis. The 'D' association had 153,298 members and made claims of 642,605 outpatient care in 1990. Out of the total outpatient claims, 8.6%(55,102 claims) were counted as the same disease which could meet the above assumption. Percent of conditions classified as the 10 leading causes of frequent visits which were matched accurately to the subsequent ICD diagnostic code found to be 15.8% on the average. The URI was noted for the highest concurrence rate of 20.4%. This proportion was even decreased to 11.6% on the case of chronic disease. Despite the fact that the assumption underlying the definition of the above same disease is rather rough and inappropriate, this study reveals that the code of ICD currently in use has weaknesses in seperating a certain independent disease from similar conditions at the outpatient setting. Thus, efforts need to be elaborated to meet the need of a new system of classification for conditions and diseases encountering at ambulatory care.

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A Ppoisson Regression Aanlysis of Physician Visits (외래이용빈도 분석의 모형과 기법)

  • 이영조;한달선;배상수
    • Health Policy and Management
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    • v.3 no.2
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    • pp.159-176
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    • 1993
  • The utilization of outpatient care services involves two steps of sequential decisions. The first step decision is about whether to initiate the utilization and the second one is about how many more visits to make after the initiation. Presumably, the initiation decision is largely made by the patient and his or her family, while the number of additional visits is decided under a strong influence of the physician. Implication is that the analysis of the outpatient care utilization requires to specify each of the two decisions underlying the utilization as a distinct stochastic process. This paper is concerned with the number of physician visits, which is, by definition, a discrete variable that can take only non-negative integer values. Since the initial visit is considered in the analysis of whether or not having made any physician visit, the focus on the number of visits made in addition to the initial one must be enough. The number of additional visits, being a kind of count data, could be assumed to exhibit a Poisson distribution. However, it is likely that the distribution is over dispersed since the number of physician visits tends to cluster around a few values but still vary widely. A recently reported study of outpatient care utilization employed an analysis based upon the assumption of a negative binomial distribution which is a type of overdispersed Poisson distribution. But there is an indication that the use of Poisson distribution making adjustments for over-dispersion results in less loss of efficiency in parameter estimation compared to the use of a certain type of distribution like a negative binomial distribution. An analysis of the data for outpatient care utilization was performed focusing on an assessment of appropriateness of available techniques. The data used in the analysis were collected by a community survey in Hwachon Gun, Kangwon Do in 1990. It was observed that a Poisson regression with adjustments for over-dispersion is superior to either an ordinary regression or a Poisson regression without adjustments oor over-dispersion. In conclusion, it seems the most approprite to assume that the number of physician visits made in addition to the initial visist exhibits an overdispersed Poisson distribution when outpatient care utilization is studied based upon a model which embodies the two-part character of the decision process uderlying the utilization.

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Recognition on national health insurance coverage and the actual condition of denture among the elderly at senior welfare centers in Seoul (ORIGINAL ARTICLE - 노인틀니 보험화에 대한 인식과 틀니 사용실태 조사 - 서울특별시 일부 노인복지관이용 노인을 대상으로 -)

  • Han, Sun-Young;Kim, Cheoul-Sin
    • The Journal of the Korean dental association
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    • v.50 no.7
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    • pp.407-419
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    • 2012
  • The aim of this study was to investigate the recognition on the national health insurance and the actual condition of denture among the elderly in Seoul city. This survey was performed on 710 of the elderly aged over 60 years and visited the senior welfare centers. The recognition of the elderly on the national health insurance of denture was 61.7%, but there was a low recognition on the details. The elderly had started using dentures from 66.24 years old. The average used period of the past denture was 7.09 years. In conclusions, the provider is required to promote the insurance coverage of denture to increase the coefficient of utilization of the elderly. Also, further studies for the extending coverage of the details are needed.

Health Promotion Behavior of the Korean College Students and Factors on its Influences (대학생들의 건강증진행위에 영향을 미치는 요인)

  • Hwang, Hong-Gu;Shin, Jung-Kyu;Choi, Chan-Ho;Yoo, Wang-Keun
    • Journal of Society of Preventive Korean Medicine
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    • v.11 no.2
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    • pp.141-157
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    • 2007
  • This study aimes to devote development of health policy and program to obtain health promotion by finding the level of health behavior of college students in Korea and analysing its effects. The finds of this research was as follows ; First, the lower classes was lower concerns on health care and health behavior on hygiene controls than the higher classes. Based on this investigation, this paper suggests that the development of the effective sports program is specially necessary to obtain health promotion for the lower classes.

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Injury prevention for children (아동 사고 예방)

  • Son, Ina
    • The Korean Journal of Emergency Medical Services
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    • v.5 no.1
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    • pp.99-107
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    • 2001
  • Injury has now replaced disease as the biggest single cause of death in children after their first birthday. Each month one child dies from preventable, unintentional injury and the medical cost of these injury is increasing remarkably. It is necessary to develop injury prevention system to manage, evaluate and analysis the information about accident. This resource manual developed as a result of literature review of child care safety project which is based on the Kidsafe Tasmanian Division in Australia and the other resources. The purposes of this study is to; 1. Develop model to enable services to focus on injury prevention 2. Develop standardized child care injury report form 3. Develop home safety checklist 4. Development of injury prevention policies The suggestions to develop injury prevention policies : 1. detail analysis of injury occurrence 2. investigation of known intervention and their effectiveness 3. analysis of policy environment 4. development of policy on implementation of intervention 5. develop protocol and materials to develop an injury prevention focus 6. increase knowledge and awareness among staff and parents of where injuries were occurring and develop.

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An Analysis on Willingness to pay for Environmental-Friendly Agri-Product Food Service of Child-care Centers (보육시설 친환경농산물 급식에 대한 지불의사 분석)

  • Oh, Ho-Young;Heo, Seung-Wook
    • Korean Journal of Organic Agriculture
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    • v.13 no.4
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    • pp.375-388
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    • 2005
  • The objectives of this study were to analysis willingness to pay (WTP) for environmental-friendly agri-product (EFAP) food service of child-care centers. To analysis preference about EFAP and WTP, parent' survey were conducted residing in Asan city. The sample size of the survey is 143 respectively. As a result, most of parents really recognized that EFAP is good for their children as well as they want to change food material from general agri-product to EFAP. Moreover, additional willingness to pay fur EFAP food service is 8,360 won on average per month. Therefore, environmental-friendly agri-policy to be more focused on the promotion of the consumer's interests and food security needs.

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THE ROAD TO THE 85 DB(A) NOISE FENCE IN QUEENSLAND: VALUES, POLITICS, AND PUBLIC POLICY

  • Eddington, Ian;Gapp, Rod;James, Julie
    • Proceedings of the Acoustical Society of Korea Conference
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    • 1994.06a
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    • pp.631-637
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    • 1994
  • For at least 14 years after the publication of minimum permissible exposure limits that would largely eradicate industrial deafness, statute legislation in Queensland remained unchanged and ineffective. Industrial deafness continued to occur. New legislation, introduced in 1989 and amended in 1993, and based on a duty of care responsibility incumbent on all, may remedy this situation. The new legislation is examined and comments are made about the values inherent in the new approach. It is concluded that public policy strategists may increase the likelihood of success of they ensure that the duty of care provisions (together with the general provisions of the Act) are backed up by innovative complementary economic, financial and marketing incentives.

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A Review on the Baby Hotel in Japan (일본(日本)의 「베이비·호텔」에 관(關)한 고찰(考察) - 동경도(東京都)의 현황(現況)을 중심(中心)으로 -)

  • Hwang, Young Ja
    • Korean Journal of Child Studies
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    • v.2
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    • pp.83-103
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    • 1981
  • 1. Outline of the Study A boom of baby hotels is taking place in Japan. Baby hotel means day care centers that renders services day and night for babies of working mothers. These baby hotels are thriving because many mothers welcome the system because of their needs. However, accidents occurred in a row recently and therefore baby hotel has suddenly become a social issue. According to the ministry of health welfare, there are 587 baby hotels in Japan accommodating about 10,000 children and they are mostly located around amusement centers. The reasons that these baby hotels thrive in spite of the fact that there are 22,000 day care centers in Japan are : (1) shortage of day care centers compared to the needs (2) most centers do not take in babies below 1 year. This study aims to describe the present status of the baby hotels and the background of the phenomena that made it possible for them to thrive with no permission from the government. This study mostly deals with the phenomena in Tokyo. 2. Day Care Policy in Japan and the Problems of Baby Hotels The present review deals with the problems from the following 6 dementions. (1) the shortage of day care centers (2) inadequate system for the care of babies (3) inadequate daily hours of day care centers (4) Unflexable enrollment system of day care centers (5) imperfect enfollment process & guidelines (6) lack of alternative institutions 3. Result The Ministry of Health & Welfare affered the following ways to cape with the problems of baby hotels : (1) restraint of the baby hotels (2) utilization of existing day care centers for the care of babies. In my opinion, these suggestions seem too superficial in solving the problems. I would rather suggest that the Japanese government review the whole system of child welfare administration. The Child welfare Law of Japan made a clear statement in its article 24 that, "if day care centers are not available, alternative institution for proper care of children must be sought for." My suggestions for the alternative care are : (1) public nursing rooms (2) family day care (3) extention of kindergarten hours (4) foster family care.

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An Analysis of the Work of Visiting Health Care Providers In Public Health Centers (보건소 방문보건인력의 방문보건 업무수행 실태 조사)

  • Kim Cho Ja;Lee Won Hee;Lee Chung Yul;Kweon Bo Eun;Kim Chung Soon;Moon Seong Mi;Kang Kyeong Hwa
    • Journal of Korean Public Health Nursing
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    • v.18 no.1
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    • pp.178-186
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    • 2004
  • The purpose of this study was to analyze the work of visiting health care providers in public health centers. A descriptive analysis of self-records for work data from 875 visiting health care providers working in 242 public health centers in South Korea was done. The results of the study are as follows: 1. The number of households for each visiting health care provider ranged from under 100 households to over 500 households. 2. Low performance was found for several items on the work list for visiting health care providers. 3. There were significant differences in the work performance of visiting health care providers between nurses and nursing assistants. 4. There were significant differences in the work performance of visiting health care providers according to region. In conclusion. work performance of visiting health care providers was low and differed according to type of occupation and region. This study suggest the need for further studies which analyse the quality of visiting health care providers and services, and the visiting health care system.

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