• Title/Summary/Keyword: health care system

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A Comparative Study on the Care Services According to Care Levels in the Korean and German Home Care System (한국과 독일 방문요양의 등급별 급여 비교 연구)

  • Park, Jong Duk
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.23 no.2
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    • pp.243-252
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    • 2016
  • Purpose: This study aims to classify multiple forms of home care services from a service user's perspective. By comparing the German system to the Korean one, this study seeks to find better ways of enhancing client-centered care. Methods: The data of 121 home care users were collected from six home care centers that had under the management of nursing managers for more than five years. The researcher used a German instrument to estimate the level of care. Results: High correlation was found between German and Korean assessment criteria (r=0.81, p<.001). However, compared to their German counterparts, Korean home care providers allocated more time towards provision of domestic help per daily visit. German home care providers allocated more time towards services relating to provision of support for physical activities, including personal hygiene. It was confirmed that the level of care in Korea does not correlate with either the categories of home care services and duration. Conclusion: Therefore, care services should be offered according to long-term care needs. This study suggests a need for systematic care aimed at strengthening the client's autonomy which should be properly planned, implemented, and managed.

Effects of Private Health Insurance in National Health Care System (국민보건의료에 대한 민간의료보험의 영향고찰 : 의료서비스 이용만족을 중심으로)

  • Lee, Yong-Jae
    • The Journal of the Korea Contents Association
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    • v.14 no.1
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    • pp.200-208
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    • 2014
  • This study analyze long debate issues by the analysis of existing studies and the effect of private health insurance in the satisfaction of health service utilization. Then make developmental role of private health insurance. The analysis results of literatures, high-income earners are more subscriptions and the poor people in health status are excluded. Thus, enable private health insurance has the potential to lead the polarization of people. The medical use of private health insurance subscriber is more than non-subscriber and is likely to result in additional expenditure spending of public insurance. The contribution of private health insurance on improvement of the health option is clear. However, is not clear the contribution on health care quality improvement and health service customer satisfaction. The contribution on the national health care system efficiency of private health insurance is not clear. Private health insurance in the satisfaction of health service utilization is on effect. In short, supplementary private health insurance is desirable in our country.

A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
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    • v.29 no.2
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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A Study of the Analysis of Treatment Expenses of Selected Common Diseases Covered by Medical Care Inserance System (흔한 질병(疾病)의 진료비분석(診療費分析))

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.14 no.1
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    • pp.16-29
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    • 1989
  • The general objective of this study is to grasp the treatment expenses of common diseases by character of medical care institutions. The specific objective is to find out the treatment expenses for selected common diseases by type of medical care institutions and also by level of symptom. A record review method was employed to obtain required information for the analysis of expenses. A total of 40,000 cases treated by 85 medical care institutions were selected by the study team during the period 22 June to 14 July 1988. The 85 medical care institutions were sampled by stratified proportionate random sampling method. The major findings obtained from the information collected by the study team are as follows ; 1) Treatment expenses were composed of physical examination, medication, injection anesthesia, rehabilitation surgical intervention, lab test, X-ray and diagnosis. The highest expenses was for medication, accounted for 36.7% of the total: 13.9%, injection; Lab, tests respectively: 10.5%, physical examination : 8.6% surgical intervention; 7.9% admission : 6.3%, X-ray and diagnosis: 1.5%, rehabilitation. 2) Treatment expenses per case of common diseases were quite different from not only type of medical care institutions, such as university hospital, general hospital, hospital and clinic, but also from level of symptom. 3) Treatment expenses per case for the aged were higher than that of the young. The treatment cases for over 60 years of age accounted for 19.4% of the total, however the proportion of treatment expenses accounted for 23.8% of the total. 4) Duration of treatment and visits for same diseases varied from type of medical cara institutions. Based on these study findings, the following further research should be conducted: (1) Establishment of health care delivery system. (2) Feasibility of the development of health care programme for the aged. (3) Strengthening for primary health care approach.

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An Operations Study on the Home Care Nursing Delivery System (지역사회 중심 가정간호사업 운영연구(가정간호사업 운영을 위한 정보전달체계 개발Ⅱ))

  • Park, Jung-Ho;Kim, Mae-Ja;Hong, Kyung-Ja;Han, Kyung-Ja;Park, Sung-Ae;Yun, Soon-Nyoung;Lee, In-Sook;Cho, Hyun;Bang, Kyung-Sook
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.5
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    • pp.20-31
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    • 1998
  • The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to examine the validity of it. For these, home care nursing study team of College of Nursing, Seoul National University has studied home care nursing system since September, 1996, and has operated home care center since August, 1997. This study has been supported by the Korean Sience Foundation. We organized Committee of rules, and Clinical specialist consultant group for more efficient running of the home care center. In nursing station, research assistant controlled general work, and 5 home care nurses were hired for home visiting. We developed the Standards for operations, that included criteria for clients, central supply system of nursing materials, central management of nursing care cost, advertisement, patient referral system, and so forth. In our center, 108 patients enrolled, and neurologic disorders including cerebrovascular accident, and cancer were the most prevailing diseases. We tried to overcome the limitations of hopital -based home care, and to provide more accessible, efficient, safe, and stable home care nursing. Therefore, we were referred clients from patients and families, public health care center, industries, as well as from hospitals. Meanwhile, we developed home care recording system and assessment-intervention algorithm for various diseases for quality control and standardization. Also, we did continuing education, and tried to detect problems and to find solutions by regular meeting between the committee of rules and home care nurses. As the results of this study, several limitations of operation were found. First, it was difficult to manage and communicate with the doctor in the emergency situation, Second, we spent too much time for trasnsportation, because only five nurses covered all areas of Seoul and nearby cities. Third, preparation for special care of home care nurses were lacked. Forth, criteria for termination of care and frequency of home visit were ambiguous. Fifth, some difficulties were found in retrospective payment system. And finally, interconnection with home care machinery company were needed. Strategies for solving these problems were suggested.

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De Lege Frenda for Improvement of Marine Telemedicine Service System (해양원격의료 지원제도 개선을 위한 관련 법령정비 방안)

  • JEON, Yeong-Woo;HONG, Sung-Hwa;KIM, Jae-Ho
    • Journal of Fisheries and Marine Sciences Education
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    • v.28 no.4
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    • pp.994-1005
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    • 2016
  • Expansion and spreading of marine telemedicine is rather restricted due to the conflict of laws relating to medical service and lack of provisions in the Seafarers' Act, Medical Service Act, etc. Thus, this study is intended to reveal the current status and problems of marine emergency medical advice system for the furtherance of health care of seafarers and emergency medical assistance conditions and deduce relevant proposals for legislative improvements thereof in order to resolve underlying problems and issues. The results of this study can be summated as follows. First, in respect of directions to provide marine emergency service based on marine telemedicine system, emergency radio medical advice system needs to be strengthened to meet domestic and international instrument, marine telemedicine system needs to be provided through integrating u-Health technology and special marine medical center needs to be established. Second, regarding directions to provide health promotion service based on the marine telemedicine system, a new process of health care service for seafarers needs to be devised and provided involving seafarers' life cycle covering from prior to boarding to after leaving a ship. The conclusions of this study can be given as follows. First, the following new provisions need to be introduced in the Seafarers' Act. (1) The Minister of Oceans and Fisheries and a shipowner shall conduct matters pertaining to preventive health promotion and care for seafarers; (2) a provisions regarding establishment of seafarers' health promotion center by the Minister; (3) a special exemption permitting marine telemedicine service and qualification requirements for marine telemedicine assistant; (4) shipowner's obligation of carrying seafarers' health measuring equipment on board. Second, the relevant provisions regarding medical care persons needs to be revised in such a way that master or chief officer shall be appointed to be in charge of medical care on board. Last but not least, it is also essential to amend and update the minimum standards on drug and medicines to be carried on board and medicine chest and equipment on board.

Implementation of Wireless ECG Measurement System Attaching in Chair for Ubiquitous Health Care Environment (유비쿼터스 헬스 케어 적용을 위한 의자 부착형 무선 심전도 측정 시스템 구현)

  • Ye, Soo-Young;Baik, Seong-Wan;Kim, Jee-Chul;Jeon, Gye-Rok
    • Journal of the Korean Institute of Electrical and Electronic Material Engineers
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    • v.21 no.8
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    • pp.776-781
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    • 2008
  • In this study, ubiquitous health care system attaching in chair to monitor ECG for health care was developed at the unconsciousness state. The system conveniently and simple measured ECG at non-consciousness. We measured the contact impedance to skin-electrode of metal mesh electrodes of the system. Contact impedance enable the electrode to use for ECG measurement. The results are that the impedance of the metal mesh electrodes according to sizes is low when the size is 4$cm^2$. As the result, when the size of the metal mesh electrode is 4$cm^2$, the electrode is fit for ECG measurement. We can acquired by positing the arm on the metal mesh electrode. The ECG signal was detected using a high-input-impedance bio-amplifier, and then passed filter circuitry. The measured signal transmitted to a PC through the bluetooth wireless communication and monitored. Data of the non-constrained ECG system attaching in chair is noise-data when comparing metal mesh electrode with the Ag/Agcl electrode but the data is significant to monitor ECG for check the body state.

Proposed Architecture for U-Healthcare Systems

  • Lee, Jong-Yong;Jung, Kye-Dong
    • International Journal of Advanced Culture Technology
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    • v.4 no.2
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    • pp.43-46
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    • 2016
  • Modernization of the medical healthcare system, through the use of technology, has become an important field of study today. The healthcare system is intended to efficiently deliver care and services to consumers. It is such that the healthcare system is defined as an industry which provides health services (health activities) so as to meet the health needs and demands of individuals, the family and the community. In this study, transforming healthcare so as to better meet the needs of patients will require changes in the strength of delivering care for patients who already have good access to services, while also improving the care for patients who find it harder to get the care they need.

Knowledge Based Recommender System for Disease Diagnostic and Treatment Using Adaptive Fuzzy-Blocks

  • Navin K.;Mukesh Krishnan M. B.
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.18 no.2
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    • pp.284-310
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    • 2024
  • Identifying clinical pathways for disease diagnosis and treatment process recommendations are seriously decision-intensive tasks for health care practitioners. It requires them to rely on their expertise and experience to analyze various categories of health parameters from a health record to arrive at a decision in order to provide an accurate diagnosis and treatment recommendations to the end user (patient). Technological adaptation in the area of medical diagnosis using AI is dispensable; using expert systems to assist health care practitioners in decision-making is becoming increasingly popular. Our work architects a novel knowledge-based recommender system model, an expert system that can bring adaptability and transparency in usage, provide in-depth analysis of a patient's medical record, and prescribe diagnostic results and treatment process recommendations to them. The proposed system uses a set of parallel discrete fuzzy rule-based classifier systems, with each of them providing recommended sub-outcomes of discrete medical conditions. A novel knowledge-based combiner unit extracts significant relationships between the sub-outcomes of discrete fuzzy rule-based classifier systems to provide holistic outcomes and solutions for clinical decision support. The work establishes a model to address disease diagnosis and treatment recommendations for primary lung disease issues. In this paper, we provide some samples to demonstrate the usage of the system, and the results from the system show excellent correlation with expert assessments.