• Health Policy and Management
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• v.33 no.3
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• pp.295-310
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• 2023

Background: The long-term care (LTC) group has higher rates of chronic disease and disability registration compared to the general older people population. There is a need to provide integrated medical services and care for LTC group. Consequently, this study aimed to identify medical usage patterns based on the ratings of LTC and the characteristics of benefits usage in the LTC group. Methods: This study employed the National Health Insurance Service Database to analyze the effects of demographic and LTC-related characteristics on medical usage from 2015 to 2019 using a repeated measures analysis. A longitudinal logit model was applied to binary data, while a linear mixed model was utilized for continuous data. Results: In the case of LTC ratings, a positive correlation was observed with overall medical usage. In terms of LTC benefit usage characteristics, a higher overall level of medical usage was found in the group using home care benefits. Detailed analysis by medical institution classification revealed a maintained correlation between care ratings and the volume of medical usage. However, medical usage by classification varied based on the characteristics of LTC benefit usage. Conclusion: This study identified a complex interaction between LTC characteristics and medical usage. Predicting the requisite medical services based on the LTC rating presented a challenge. Consequently, it becomes essential for the LTC group to continuously monitor medical and care needs, even after admission into the LTC system. To facilitate this, it is crucial to devise an LTC rating system that accurately reflects medical needs and to broaden the implementation of integrated medical-care policies.

• Journal of Home Health Care Nursing
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• v.20 no.1
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• pp.44-52
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• 2013

Purpose: To identify factors that affect the job stress of visiting nurses at health centers in Seoul, Korea, who perform home care services. Methods: Data were collected in the period from November 20 to December 10, 2008, from 206 visiting nurses working at 25 health centers in Seoul metropolitan city. Self-report questionnaires of the Organization-Based Self-Esteem (OBSE) and the Korean Occupational Stress Scale (KOSS) were used. Data were analyzed by the SPSS win 15.0. Results: Several findings were obtained from the study. First, the mean of job stress was 52.4 points, which was higher than that of Korean women. Second, it was shown that by the sub-domain of job stress, the mean value belonged to the top 50% in the four sub-domains of physical environment, job demand, interpersonal conflict, and organizational system. Additionally, it belonged to the top 25% in the sub-domain of job insecurity, wherein the job stress was the highest. Third, the self-esteem of the nurses had the most significant effect on their job stress. Conclusion: Stress related to job insecurity was the highest among the visiting nurses at health centers in Seoul who perform the custom home care service thus, institutional support is urgently needed to alleviate such stress and secure their employment.

• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.690-705
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• 2000

This ethnography was based on Kleinman's explanatory model of a health care system. It is conducted to make thick discription of illness conception of the elderly in a sociocultural context. The basic assumptions were as follows. 1) A health care system is a cultural system, and as with any other cultural system, it is a system of symbolic meanings anchored in a particular arrangement of social institutions and patterns of interpersonal relationships; 2) In all societies health care activities are more or less interrelated. Therefore, they need to be in a holistic manner as socially organized responses to disease that constitute a special cultural system; health care system; 3) Health and illness experiences are the natural process of disease. Individuals who recognized a for state of health, their family, neighbors, and communities define the state, search for causes of the health problems, and response to it. According by, they proceed to search for healing stratagies. So, understanding of the illness experience is the starting point for health care. The study participants were 12 elders aged 60 or more. The fieldwork was conducted in an agricultural clan village of Namwon city. The data collection and analysis were cyclic, from descriptive observation, domain analysis, focused observation, taxanomic analysis, selected observation, componential analysis, and finally cultural themes were all analysed. Proxemic and text analysis techniques were used according to the characteristics of the data. The data of sociocultural context and descriptive data were collected from 1990 to 1992. Informations on illness concepts were collected during 1994 using focused observation. Data confirming and contrast observations were conducted from 1997 and 1999. Illness concepts of the elderly were taxonomized supernatural cause, non-supernatural cause, immediate cause, and ultimate cause. The supernatural ones were ancestors, god of home, god of village, and ghost such as 'sal(evil force of dead man)' and 'gagqui(ghost of begger)'. The non-supernatural ones were Ki, natural phenomenones, natural objects, foods, human and human behaviors. Immediate ones were insufficiency and overflows, discretion and consolidation, disorder and out of order, cloudness and contamination, and fluctuation and stagnation of supernatural cause and non-supernatural ones. Ultimate causes were intrusion and loss of supernatural and nonsupernatural ones. The cultural themes of illness concepts of the elderly are: 1) illness concepts are not based on causality principle, but on reciprocal principle; 2) illness concepts are affected by social level and charicteristics of the patients; 3) the causes of disease are recognized as imposed both positive and negative effects on health based on interpretation of the indiviuals; 4) illness concepts reflects on principles of everyday life of the society members such as hierachial structure and group cohesiveness; 5) illness concepts are ruled on principle of reciprocity and spread; 6) illness concepts are interrelated with physical environment of the participants. It can be concluded that the illness concepts of the elderly in a traditional clan village are a component of health care system as a cultural system based on these results. The these results can be a useful basis for gerontological nursing practice and education.

• Journal of Preventive Medicine and Public Health
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• v.45 no.3
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• pp.148-155
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• 2012

Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poorquality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.

• Journal of Korean Clinical Nursing Research
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• v.17 no.2
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• pp.228-238
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• 2011

Purpose: The purpose of this study was to investigate parent expectation and satisfaction with respect to pediatric inpatient care and to identify the variables related to parent satisfaction. Methods: The study was conducted in pediatric wards of a tertiary children's hospital in Korea. The participants were 361 parents of children who were inpatients. Data were collected using a structured questionnaire (The Pediatric Family Satisfaction Questionnaire) at the time of discharge. Results: The highest parent expectation domain was medical service. The parents were most satisfied with nursing service and least satisfied with general hospital service and accommodation. The parents expressed lower satisfaction with hospital facilities, equipment, noise, cleanliness, and communication by health care professionals. Parents with younger children reported higher expectation from the complete hospital service and those who had a longer length of stay reported higher expectation from the nursing service. Conclusion: To improve the quality of hospital services, we need to understand parent expectation and improve and provide clear communication. In addition, the general hospital service and accommodation should not be overlooked for improvement.

• Health Policy and Management
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• v.27 no.2
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• pp.128-138
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• 2017

Background: The purpose of this study is to analyze the effects of differential coinsurance policy on prescription drug coverage of outpatients by types of medical institutions. Methods: In this study, we used a sample cohort database of the National Health Insurance Service and frequency analysis and marginal logistic regression model using generalized estimating equation were used for statistical analysis. Results: The summary on the major research is followed. First, about 16% of patients who used only tertiary or general hospital due to 52 ambulatory care sensitive conditions before policy implementation moved to hospitals and clinics. However, about 57% of them still use tertiary or general hospital. Second, the factors influencing the utilization of hospitals and clinics after the implementation of the policy were gender, age, and income level. As a result, the policy is effective to reduce the medical use of outpatient mental patients in tertiary or general hospital, but the effect is not significant. Conclusion: Therefore, in order to achieve the purpose of the policy for establishing the health care delivery system, it is necessary to adjust the co-payment so as to feel the burden on the co-payment when the outpatient for 52 ambulatory care sensitive conditions is used at the tertiary or general hospital.

• Health Policy and Management
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• v.30 no.2
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• pp.253-262
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• 2020

Background: The public health care system of a country is shaped and driven by its historical background as well as social, economic, and cultural structures. This study sheds light on the unique features, strengths, and weaknesses of the health insurance systems of South Korea (Korea) and Peru. Methods: The capacity mapping tool was used to explore the Korean and Peruvian population and geographical structures; health insurance laws, regulations, and policies; payment systems; eligibility and contribution collection; and long-term care insurance. Results: The study found that the Korean government took the lead in integrating multiple insurers into a single-payer system in an effort to reinforce and stabilize its health insurance system in 2000. Peru has been developed mixed model such based on taxes and contributions, to address a gap between different social classes. Peruvian government developed a two-axis system, one for low-income earners, financed by taxes, and another financed by contributions paid by workers and government officials in the formal sector. Peru has introduced many variations to its fee payment and insurer systems, target population, and coverage scope, and maintains its health insurance system accordingly to this day. Conclusion: The current study provides observation of the Health Insurance System in two different countries and helps to understand possible ways to improve the health insurance system in both countries. Based on this study, Peru will be able to see how its system differs from Korea's and benefit from the related policy implications.

• The Journal of Health Technology Assessment
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• v.6 no.2
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• pp.88-94
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• 2018

This review aims to provide implications for relevant domestic policies and researches from Patient-Centered Medical Home (PCMH), a reinforcement model for primary care and its evaluations in the United States. As chronic diseases became dominant, changes in the health care delivery system in which primary care is central was required. The United States initiated primary care-reinforcing policies based on the PCMH following the increased demand for evidence-based health care policies. The current activities of the United States such as sharing research tools used to evaluate primary care interventions and circulating evaluation findings provide examples to Korea. Systematic evaluations for primary care interventions are required and appropriate methods using various types of data to reflect the real-world settings should be prepared. It is necessary to conduct policy assessment studies of public interests considering regional context. Support for the researches to make and advance from the existing environment must be examined.

• Korean Journal of Health Education and Promotion
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• v.9 no.1
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• pp.79-87
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• 1992

The objective of the present study is to review of the system, type of care and utility of the Geriatric Health Care Facility(GHCF) in Japan. Geriatric Health Care Facilities in Japan were started with subsidies from the Ministry of Health and Welfare in 1987 to encourage return of the elderly from hospitals to their homes rather than other destinations such as nursing homes or hospitals. Concerning to the type of care, there is the difference between GHCF and other geriatric care facilities(i.e., geriatric hospital and nursing home). GHCF provides both medical and nursing care. The following services are available for the GHCF's user's. As institutional care services, rehabilitation training, ADL exercise, nursing care and management of medicine, are available. For the out-patients, supplying meals, taking a bath, and rehabilitation services, are also available. The medical treatment fee at the facilities is about US $ 1,500 per month. Expenses for meals, daily necessities, shall be borne by the recipient, Those expenses are about US $ 360 per month. In anticipation of the coming of the aging society, the Goverment must be formulated consecutively several vital policies of measures, especially GHCF, for the elderly in the future few years.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2007.10a
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• pp.67-71
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• 2007

Recently, a health care need according to the increase of an advanced age population is increasing. The requirement about a health care monitoring is increasing rapidly from general people as well as patient. The requisition about a medical treatment technique and a medical treatment information service is the trend to be expanding. That can be possible minimizing the inconvenience of the patient to take a medical service and continuously monitoring the status of the patient to take a health care service. This paper discusses an implementation of wireless physiological signal monitoring system for health care. The system are composed of the sensor node and monitoring program. The sensor node has the physiological signal measurement part and the wireless communication part. The remote monitoring system has a monitoring program that are communicating the sensor node using bluetooth. The sensor node measured the ECG, pulse wave, blood pressure, Sp02, and heart rate.