• 보건행정학회지
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• 제11권4호
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• pp.1-20
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• 2001

Korean government had introduced copayment system as cost sharing to office-based medical care in order to reduce the demand for care in 1986. This review focuses on trends and characteristics of copayment on office-based medical care from 1991 to the end of Jan. 2001. Objectives of this study is ${\circled}1$ to analyse historical trends of copayment on office-based medical care during the last decade, ${\circled}2$ to analyse the effect of copayment introduced to office-based medical care on NHI finance, ${\circled}3$ to analyse the changing trends of the size of copayment in utilizing office-based medical care for the past 10 years, ${\circled}4$ to evaluate the meaning of copayment alteration implemented after the introduction of new prescription system and finally ${\circled}5$ to draw a some policy implications from the results of this review. We found that the main purpose of copayment introduction had been reduction in the expenditure of NHI finance. But, the reduction effect of insurer's expenditure has turned out to be negative and NHI finance has been in crisis after the introduction of new prescription system. Also, the copayment level of the insured has increased actually on a large scale. It seems that the introduction of new prescription system has changed the meanings and its policy implications of copayment system.

• 보건행정학회지
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• 제22권4호
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• pp.522-537
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• 2012

The purpose of this study was to analyze the level of the cognitive function and activities of daily living of the beneficiary older adults at home based on Korean Long-term Care Insurance System. A cross-sectional descriptive survey was conducted from November 2010 to May 2011, the final respondents were 1,026 beneficiary older adults taking home visit care covered in Korean long-term care insurance system. The questionnaire included general characteristics of subjects, cognitive function, ADL(Activity of daily living). The data was analyzed using the SPSS 20.0 version. There was significant difference in cognitive function and ADL between 1st Grade, 2nd Grade and 3rd Grade of long-term care classification. The correlated factors of cognitive function were ADL, long-term care grade, disability of arm and leg, limitation of joint, bed sore and tube feeding. The correlated factors of ADL were cognitive function, long-term care grade, disability of arm and leg, bed sore and tube feeding. This study suggests that cognitive functions have to be mainly considered in long-term care grade. It is necessary to make an effort to develop long-term care grade in Korean long-term care insurance system an cognitive function improvement program for the beneficiary older adults. Above all things government will be seriously contemplating of revise contents for long-term care grade to provide quality of care for the older adults.

• 대한예방한의학회지
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• 제10권2호
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• pp.147-158
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• 2006

The purpose of this paper is to review the empirical study results of conversion factors(unit prices) for relative values of health care services in the national health insurance system and establish optimal classification of health care institutions for feasible contract of conversion factors between National Health Insurance Corporation(NHIC) and provider groups, based on legal backgrounds and types of health care service delivery system. some empirical research evidences shows the validity of applying multiple conversion factors to annual contract for reimbursement in the national health insurance. Policy recommendations suggest that clinic, hospital, general hospital, tertiary hospital, dental clinic, oriental medical clinic, pharmacy, and public health centers would be a basic category of provider groups for a meaningful price contract between the NHIC and providers.

• International journal of advanced smart convergence
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• 제10권2호
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• pp.168-174
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• 2021

Korea is ranked as the world's No. 1 country in its aging rate. While the interest and demand for health is rapidly increasing, the health status of the elderly is in the lowest among OECD members. Increased chronic diseases, the burden of medical costs and digital/untact changes of societies after COVID-19 have caused the direction of healthcare to be changed from treatment oriented to health care and prevention oriented, along with increased income levels and a desire for a healthy life. Amid this paradigm of change, the gap in health standards and health inequality for the elderly according to local structure and social conditions affects not only socio-economic but also the quality of life for individual senior citizen. Utilizing prior data of Aging Research Panel Survey, this study aims to compare and analyze health conditions and regional gaps which are significant influences on the satisfaction of the life of the elderly, and to suggest direction of studies for health care to provide solutions for health inequalities. The findings are intended to be a basic data for researching models of the New Normal Smart Healthcare System that bridge the health gap between the elderly and enhance life satisfaction with health care models suitable for regional characteristics in aging society.

• 한국의료질향상학회지
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• 제27권1호
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• pp.26-42
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• 2021

Purpose: This study aimed to explore frontline nurses' experience of patient-centered care and understand the factors affecting its implementation in hospitals. Methods: Four focus group interviews were conducted with 30 nurses in two university hospitals. The following theoretical framework of patient-centered care was used: 1) Respect for patients' values, preferences, and expressed needs, 2) Care coordination and integration, 3) Information, communication, and education, 4) Physical comfort, 5) Emotional support and alleviation of fear and anxiety, 6) Involvement of family and friends, 7) Care transition and continuity, and 8) System issues. We performed a directed content analysis. Results: The most frequent patient-centered nursing practices of the hospital nurses were "promoting physical comfort" in inpatient settings and "providing information and communicating" in outpatient settings. The factors influencing patient-centered nursing included the health professionals' mindfulness, work overload and staff shortage, and unreasonable social demands and regulations. Conclusion: A more comprehensive patient-centered nursing practice should be implemented by improving "care transition and continuity," "family/caregiver involvement," and "system building." Health professionals' mindfulness is significant, and organizational supports addressing work overload and staff shortage are needed alongside change in social awareness.

• 한국농촌간호학회지
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• 제3권2호
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• pp.96-103
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• 2008

Purpose: The Study of vaccination for infants and children business in Primary Health Care Posts from 1980 to 2009. Method: look for national essential vaccination look for the change of vaccination by the times in Primary Health Care Posts and the rate of vaccination for infants and children by a administrative report statistics survey of a vaccine delivery system of Public health care institutions investigation about assistance details of vaccination cost in order to raise the rate of vaccination for infants and children. Results: In 1980s, there are many infants and children management object, but now there are rapidly decreasing infants and children management subject of a Primary Health Care Post because of rural exodus phenomenon of 1990's and a low birthrate of 2000's. Currently, the infants and children that registed, and managed to a Primary Health Care Post is most multi-cultural families. A multi-cultural family assistance program is provided these infants and children to the objects. Conclusions: Infant vaccination execution in Primary Health Care Posts showed to high vaccination rate because the prevention of vaccination delay or omission of the interior child who raised geographical accessibility to object sons nowadays it difficult to management of transportation of vaccine and storage management for a little shroud objects limited and management of inoculation business in quality. A main problem is as follows. There are a little vaccine transportation, trouble of proper temperature maintenance of a storage process, and having a lot of vaccine abolition as a little objects, educational training shortage of health care practitioner regarding to execute an inoculation. Therefore, vaccination business needs measures for management in quality in Primary Health Care Posts.

• 한국콘텐츠학회논문지
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• 제12권12호
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• pp.282-290
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• 2012

현재 우리나라의 재가간호서비스는 보건소의 맞춤형 방문건강관리사업과 의료기관 가정간호사업, 그리고 노인장기요양보험의 방문간호서비스의 독립성과 전문성을 인정하면서, 각 영역간의 연계를 통해 사업의 중복성을 최소화하는 연계방안이 필요한 상황이다. 이에 본 연구는 재가간호서비스의 연계방안을 도출하기 위해 전문가들의 의견을 바탕으로 합의를 이끌어내는 델파이 기법을 활용하였다. 그 결과 제도적 차원의 연계와 의료적 차원의 연계라는 두 영역 안의 총 24개 항목이 연계방안으로 도출되었다. 재가간호서비스의 연계방안으로 도출된 24개의 항목은 재가간호사업 체계의 개선과 제공되는 서비스 질의 향상, 대상자의 만족도 증대 효과를 가져 올 수 있을 것으로 기대되며, 서비스의 중복을 최소화할 수 있는 방안을 모색함으로서 국가적 차원에서 복지 및 국민 건강관리의 효율성을 증대할 것으로 보인다. 이를 통해 궁극적으로 국민의료비의 절감과 더불어 재가간호서비스 증진에 기여할 것으로 여겨진다.

• 한국컴퓨터정보학회논문지
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• 제10권3호
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• pp.119-132
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• 2005

헬스 케어 정보 시스템의 데이터는 병원 업무에 필요한 많은 정보들을 포함하고 있다. 이러한 정보들은 전자 분산 환경을 통하여 네트워크 상에서 분산되어 있으며 많은 의료 관계자들은 쉽게 환자들의 정보에 접근할 수가 있다. 또한 모바일 환경의 발달로 모바일 폰을 사용하는 사용자가 급격히 증가하였고 이에 따라서 환자와 의사가 자유롭게 이동하면서 의료서비스를 주고받는 모바일 헬스 케어가 나타나게 되었다. 또한 이는 원래 목적을 위해 사용되지 않을 뿐 아니라 환자 개인의 프라이버시를 침해 할 위험을 가져 올 수 있다. 본 논문에서는 모바일 헬스 케어 정보 시스템에서의 데이터 누출 및 수정 등에 의하여 환자의 생명과 직접적인 관련이 있는 정보들을 안전하게 보호하기 위하여 사용자의 접근을 제어하는 방법을 제시하고 이를 모델링함으로써 환자 개인의 정보 및 시스템 안전을 가져올 수 있는 효과적인 접근제어 방법을 제시한다.

• 한국의료질향상학회지
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• 제12권2호
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• pp.113-123
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• 2006

Objective : This research is focused on understanding the current status of the Health Smart Card already in use in other advanced countries. This research will analyze the current status of the medical institutions Health Smart Card system adoption process and its effects, and provide a basis for future policy decisions for the effective adoption and diffusion of a Health Smart Card system, in the medical field, through the completed research and analysis. Method : This research surveys the domestic, and foreign, status of Health Smart Card usage. The research also presents up-to-date methodology for the evaluation of the effects of medical and health care technology. The research also conducts a survey of the domestic medical institutions that have implemented a Health Smart Card system, and then analyzes the results of the survey. Additionally, the research carried out a survey and analysis of medical institutions with no Health Smart Card system implemented, and considered the factors affecting the diffusion of Health Smart Card systems in considering an effective policy for the introduction and diffusion of such a system. Research Results : Through the study of the methodology of medical and health care information technology in advanced countries, the methodology for assessing Health Smart Card technology has been established, and focuses on 6 aspects. The study on the status of foreign implementation has shown a model for the Health Smart Card system. A survey was conducted on the current status of medical institutions with an implemented Health Smart Card system, and the survey results have been analyzed. Also, factors influencing the adoption of Health Smart Card systems have been analyzed through the survey on those medical institutions that have not implemented a Health Smart Card system. Conclusion : The government must provide institutional measures for sharing medical records by constructing an IT infrastructure at the national level to enable the adoption and diffusion of a Health Smart Card system. Such a network will make connections between medical institutions possible, thus making the diffusion of the Health Smart Card system nationwide. For the successful adoption and diffusion of a Health Smart Card system, a model system development, under a medical record sharing system, should be conducted. Additionally, a regional unit based model should be developed for the model project, as is done in advanced countries, along with the application of such results.

• 보건의료산업학회지
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• 제8권4호
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• pp.209-220
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• 2014

This study found a relationship between the characteristics of the elderly with disabilities and extra health care monthly costs caused by disability and suggests methods for effectively managing health care spending of the elderly with disabilities. This study used data from the 2011 Survey on the Disabled conducted by the Ministry of Health and Welfare and the Korea Institute for Health and Social Affairs. The results of the analysis indicate that the relations between the socio-demographic characteristics of the elderly with disabilities and extra health care monthly costs caused by disability of the elderly are influenced by factors such as gender, age, members of the household, average monthly income and type of health insurance. Elderly people with disabilities spend too much for their medical care. To solve this problem, the government needs to find a variety of policy approaches to improve administrative procedure, establish a medical delivery system and enhance health care services.