• 제목/요약/키워드: health insurance standards

검색결과 78건 처리시간 0.031초

노인장기요양보험 재가간호서비스에 대한 방문간호사의 인식 (A Study of Nurses' Perception of the Visiting Nursing Services of Long-term Care Insurance)

  • 권민영;임지영;이영휘;김화순
    • 한국보건간호학회지
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    • 제24권1호
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    • pp.5-18
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    • 2010
  • Purpose: The purpose of this study is to understand nurses' perception of visiting nursing services of long-term care insurance. Method: The descriptive survey study involved 188 nurses selected by the convenient sampling of visiting nurses who participated in professional education sessions. Results: Of the 188 participants, 149 (79.3%) were aware of long-term care insurance. Awareness of aspects of long-term care services was 78.7% for facility service, 77.7% for ordinary visiting care service, 85.1% for visiting nursing service and 77.7% for visiting bathing service. Concerning visiting nursing service provision, the majority of the study subjects considered nurse-aid not to be the appropriate route for delivery of services including nasogastric tube exchange, tracheostomy tube management and stitch removal. Conclusion: Continuous evaluation and research on the standards and requirements of the nursing workforce is needed to secure and maintain the high quality of visiting nursing services. Exhaustive studies concerning task division and workforce separation according to nursing services type and level of difficulty should be done to develop the appropriate job description for visiting nursing service staff.

Development of Models for Regional Cardiac Surgery Centers

  • Park, Choon Seon;Park, Nam Hee;Sim, Sung Bo;Yun, Sang Cheol;Ahn, Hye Mi;Kim, Myunghwa;Choi, Ji Suk;Kim, Myo Jeong;Kim, Hyunsu;Chee, Hyun Keun;Oh, Sanggi;Kang, Shinkwang;Lee, Sok-Goo;Shin, Jun Ho;Kim, Keonyeop;Lee, Kun Sei
    • Journal of Chest Surgery
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    • 제49권sup1호
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    • pp.28-36
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    • 2016
  • Background: This study aimed to develop the models for regional cardiac surgery centers, which take regional characteristics into consideration, as a policy measure that could alleviate the concentration of cardiac surgery in the metropolitan area and enhance the accessibility for patients who reside in the regions. Methods: To develop the models and set standards for the necessary personnel and facilities for the initial management plan, we held workshops, debates, and conference meetings with various experts. Results: After partitioning the plan into two parts (the operational autonomy and the functional comprehensiveness), three models were developed: the 'independent regional cardiac surgery center' model, the 'satellite cardiac surgery center within hospitals' model, and the 'extended cardiac surgery department within hospitals' model. Proposals on personnel and facility management for each of the models were also presented. A regional cardiac surgery center model that could be applied to each treatment area was proposed, which was developed based on the anticipated demand for cardiac surgery. The independent model or the satellite model was proposed for Chungcheong, Jeolla, North Gyeongsang, and South Gyeongsang area, where more than 500 cardiac surgeries are performed annually. The extended model was proposed as most effective for the Gangwon and Jeju area, where more than 200 cardiac surgeries are performed annually. Conclusion: The operation of regional cardiac surgery centers with high caliber professionals and quality resources such as optimal equipment and facility size, should enhance regional healthcare accessibility and the quality of cardiac surgery in South Korea.

국내 학부 보건관리학과의 교육과정 분석연구: 취득면허·자격과의 관계를 중심으로 (Curriculum Analysis on Health Management Schools in Republic of Korea: Focusing on Relationship with Licence and Certification)

  • 이유리
    • 보건행정학회지
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    • 제28권1호
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    • pp.23-34
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    • 2018
  • Background: This study aims to conduct curriculum analysis on health management schools focusing on relationship with licence and certification in Republic of Korea. Methods: Possible employment field, licence and certification as well as curriculum were collected from the home page of 30 health management schools. The subjects and credits of curriculum were analyzed using descriptive statistics. Main subjects by areas were drew using categorization and ranking within qualitative methods. Comparative analysis was conducted for checking relationship between main subject and possible employment field, licence and certification. Results: First, major employment fields after graduation were public health officer, general hospital and clinic, and National Health Insurance Service. Possible licence and certificate were hospital administrator, medical recorder, health education specialist, and medical insurance specialist. Second, total graduate credits were 133.9 including 79.0 for major education, 30.5 for of general education, and 30.5 for elective courses. Third, main subjects were reviewed by areas including basic medicine, health management, hospital business & management, medical records & information, insurance billing & assessment, healthcare marketing & tourism, and health education. There were highest number of subjects on health education area among 8 categories. By subjects, many health management schools open health law, medical terminology, introduction to public health, and biostatistics. Relationship between main subjects and possible employment field, licence and certification in health management schools was strong. Conclusion: It is necessary to review curriculum and for improving educational quality in health management schools. Also, development of curriculum standards for courses in health administration and introduction of accreditation system can be considered.

치과 무면허 불법 시술에 대한 연구 (A study on illegal dental treatment)

  • 김형수;김빛나
    • 한국치위생학회지
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    • 제13권2호
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    • pp.211-220
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    • 2013
  • Objectives : This study intended to figure out illegal treatment by unlicensed person in dental area and factors, which were considered as user's position on the basis of the local community investigation of health conditions in chungbuk provinces in 2008. Methods : This study used chi-square test and complex sample design of multi-variate logistic regression analysis to question 12,443 peoples who have experience on illegal dental treatment. Results : Multi-variate logistic regression analysis results showed that factors having related to illegal dental treatment are sex, age, education standards, subjective awareness of oral health condition, drinking experience of lifetime, unmet need of dental treatment, chewing difficulty, use of dentures, experience of scaling and the use of interdental care instrument. Conclusions : As a result of this study, in order to root out illegal dental treatment, we need to expand the breadth of health insurance coverage so that it can reduce the burden of dental expenses. Moreover, we need to set out health service of public oral health to inform the importances of maintaining good oral health and the problems of illegal dental treatment by unlicensed person.

보험심사간호사의 직무만족도에 영향을 미치는 요인 (Analysis of Influencing Factors that Influence on the Job Satisfaction of Nurses involved in Medical Insurance Reviews)

  • 박정랑;정상혁;채유미
    • 보건행정학회지
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    • 제17권4호
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    • pp.82-98
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    • 2007
  • This study aimed to analyze the factors that influence the job satisfaction of nurses involved in medical insurance reviews. The study involved a self-administered questionnaire survey which was conducted with to 297 nurses who were in charge of medical insurance reviews between April 10 and April 28, 2000. The average job satisfaction of the subjects was 3.04. The sub-items of job satisfaction were noted to be high for 'professional status'(3.79) and low for wage (2.46). The job satisfaction of subjects showed statistically significant differences with regard to education, career, and volume of service(p<0.05). The average job stress of subjects was 2.57. The sub-items of job stress included problems pertaining to human relationships problem(2.84), conflicts with doctors at work (2.79), and the burden of excessive workloads(2.79), in that order. Multiple regression analysis demonstrated that job satisfaction was significantly low when the job stress was higher. It also showed that the job satisfaction was significantly high as there was more frequency of judgements and higher education. These results suggest that the job stress of nurses involved in medical insurance reviews has a profound impact on their job satisfaction. Therefore, the efforts should be made to reduce their job stress. It may also be beneficial to reinforce the training with the doctors and nurses in order to improve their communication skills. Disseminating more information about insurance standards may also be considered.

다수준 분석을 이용한 요양병원 서비스 질에 영향을 미치는 요인 분석 (Multi-level Analysis of Factors related to Quality of Services in Long-term Care Hospitals)

  • 이선희
    • 대한간호학회지
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    • 제39권3호
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    • pp.409-421
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    • 2009
  • Purpose: In this research multi-level analysis was done to identify factors related to quality of services. Patient characteristics and organizational factors were considered. Methods: The data were collected from the Health Insurance Review and Assessment Service(HIRA) data base. The sample was selected from 17,234 patients who had been admitted between January 2007 and May 2008 to one of 253 long-term care hospitals located in Seoul, six other metropolitan cities or nine provinces The data were analyzed with SAS 9.1 using multi-level analysis. Results: The results indicated that individual level variables related to quality of service were age, cognitive ability, patient classification, and initial quality scores. The organizational level variables related to quality of service were ownership, number of beds, and turnover rate. The explanatory power of variables related to organizational level variances in quality of service was 23.72%. Conclusion: The results of this study indicate that differences in the quality of services were related to organizational factors. It is necessary to consider not only individual factors but also higher-level organizational factors such as nurse' welfare and facility standards if quality of service in long term care hospitals is to be improved.

의료정보 표준에 관한 연구 : 표준화 분석 및 전망 (The Trends and Prospects of Health Information Standards : Standardization Analysis and Suggestions)

  • 김창수
    • 대한방사선기술학회지:방사선기술과학
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    • 제31권1호
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    • pp.1-10
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    • 2008
  • 최근의 IT, BT와 NT의 발달로 U-헬스케어가 도입되고, 원격진료 및 전자의무기록(EMR), 의료영상저장전송시스템(PACS) 등의 보편화는 의료정보시스템을 때와 장소를 가리지 않는 유비쿼터스 의료 환경으로 진화시키고 있다. 이에 병원은 의료정보시스템의 활성화 및 보편화를 적극적으로 장려하며, 국가 차원의 디지털 의료정보의 통합 및 의료기관간 네트워크화가 구축하여 유 무선 의료 통신망이 개방되고, 환자의 진료 데이터 및 영상 공유가 실시되고 있다. 그리고 의료 산업 분야에서는 의료장비, 의료정보시스템, 의료 애플리케이션 등 관련 기술이 복잡화, 고도화되는 추세를 나타내고 있다. 이전의 의료정보 표준은 HL7, DICOM, IHE, ASTM 등의 많은 관련 기구가 독자적으로 기술 표준을 제정하는 상황으로 대부분의 기술들이 국가 간, 동일 국가의 지역 내, 업체 간 긴밀한 상호 관계없이 독립적으로 개발 및 구현이 되고 있어, 시스템의 통합 및 표준화에 어려움이 많이 있다. 이에 의료데이터의 적합성 및 상호운용성을 위하여 국제 표준화 기구는 긴밀한 협조로 관련 표준을 공동 개발하는 추세이다. 본 논문에서는 최근의 의료정보기술 표준화 동향을 살펴보고, 향후의 의료정보시스템의 전망을 예측하여 실제 국내에서 의료정보 및 애플리케이션 개발에 필요한 의료정보 표준을 제시하고자 한다. 특히 최근 각 선진국들의 의료정보 표준화를 기술 선점의 기회로 국가적 차원에서 지원이 증대함에 따라 의료산업 및 의료정보기술의 표준 연구가 절실하다고 생각된다. 결과적으로 환자 중심의 의료정보 환경에서의 국내 의료기관의 정보화 촉진 및 선진화를 도모하기 위하여 의료정보 표준의 국내 적용의 개발이 선행되어야 하며, 병원 및 의료 산업에서 의료정보 표준 정착과 공유 활용의 기반을 마련하는 의료정보시스템을 구축하여야 할 것으로 생각된다.

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건강보험심사평가원 데이터의 분석을 통한 체성기능부전 환자의 특성 및 M99 진단명의 사용현황 분석 (Through analyzing the health insurance data provided by Health Insurance Review & Assessment Service (HIRA) of Korea, understanding the characteristic of patient who were diagnosed somatic dysfunction and analysis of the current local status of the usage of code M99)

  • 신재권;주환수;이성엽;신예슬;고원일;박기병;김민규;하인혁
    • 척추신경추나의학회지
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    • 제11권1호
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    • pp.53-64
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    • 2016
  • Objectives : The aim of this study is to assess the usage of diagnosis codes for somatic dysfunctions and the general characteristics of patients diagnosed with the code, by analyzing health insurance data provided by the Health Insurance Review & Assessment Service(HIRA) of Korea. This investigation is intended to outline future and willing to contribute to further use of diagnosis code and the approach of Oriental Medicine to somatic dysfunction. Materials and Methods : By analyzing HIRA data, those diagnosed with M99 codes, a code attributed to somatic dysfunction, were selected for analysis. Patients included were assessed for the relevant general characteristics, and the specific diagnostic criteria. The current usage rates and noteworthy characteristics of diagnostic codes of somatic dysfunctions were assessed. A comparative analysis between clinical departments and subcategories, and a comparative analysis to data of 2014 was conducted. Results : Patients given M99 codes constituted a small minority of all patients diagnosed in 2011 as shown by HIRA data. The codes were more frequently to older patients, females, outpatients, and those who filed for Health Insurance compensation. Medical institutions participating in the diagnosis were mostly primary care facilities, usually specializing in orthopedic(Western medicine sector) and internal medicine (Oriental Medicine sector). The most registered code in 2011 and 2014 was M995. The same trend can be observed in Oriental/Western medicine institutions and Public health center, on the other hand, between them, have some different patterns both 2nd and 3rd. Conclusions : This investigation is that of current usage of diagnostic codes of somatic dysfunction. HIRA insurance claim data was analyzed. Based on the current results, more precise diagnostic standards of somatic dysfunction are warranted. This study will provide a foundation for future Oriental Medicine approach to somatic dysfunctions.

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World Federation Medical Education Global Standards의 교육과정 표준에 따른 한의학 교육 연구 (Screening of 56 Herbal formulas covered by the National Health Insurance Service on Dementia-related Factors)

  • 이정혁;김병수
    • 대한한의학회지
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    • 제39권3호
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    • pp.28-40
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    • 2018
  • Objectives: The aim of this study is to introduce the WFME Global Standards and Recognition process and to consider Improvement direction of Korean traditional medical curriculum. Methods: To Investigate the Standards and Recognition process of WFME and the traditional medical curriculum of each country(China, Taiwan, Japan, Korea). Results: The WFME Global Standards and Recognition process aims to train doctors who are educated and active in world standard medical Curriculum. The traditional medical colleges have not received recognition, but those colleges in Korea, China and Taiwan contain a lot of standards contents, and they need to be recognized if they belong to WDMS. Conclusions: Korea University of Oriental Medicine has a lot of subjects of WFME Standards and there is a medical education recognition association, which is advantageous for the standardization process of world medical education. Therefore, it is necessary to aim at world standard medicine while preserving the tradition of Oriental medicine, WFME Global Standards should be used to reorganize the curriculum and train a world-class medical professional.

산재보험 수준의 연구실안전보험 보장성강화 방안 - 장해보험금 연금형태 지급을 중심으로 - (A Study on the Improvement of the Safety Insurance for the Laboratory at the Korean Worker's Compensation Insurance - Focusing on Disability Benefit Pension Type Payment -)

  • 송혜숙;이난희;최재규;천성현;김재중;이병현
    • 한국안전학회지
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    • 제34권1호
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    • pp.115-121
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    • 2019
  • Background: Due to the diversification and advancement of research, researchers have become to deal with a variety of chemical and biological harmful materials in the laboratories of universities and research institutes and the risk has increased as well. Therefore, it is necessary to strengthen the social safety net for laboratory accidents by strengthening the compensation to the level comparable to that of Korean Workers' Compensation & Welfare Service, when the researchers become physically disabled by laboratory accidents. The purpose of this study is to secure researchers' health rights and to create a research environment where researchers can work with confidence by strengthening the compensation to the level comparable to that of Korean Workers' Compensation & Welfare Service. Method: We analyzed the laboratory accidents by year, injury type, severity of accident and disability grade with the 6 year data from 2011 to 2016, provided by Laboratory Safety Insurance. Based on the analysis result, we predicted the financial impact on Laboratory Safety Insurance if we introduce a compensation annuity by disability grade which is similar to Injury-Disease Compensation Annuity of Korean Workers' Compensation & Welfare Service. Result :As of 2011, the insured number of Laboratory Safety Insurance was approximately 700,000. The Average premium per insured was KRW 3,339 and there were 158 claims. Total claim amount was KRW 130 million, whereas the premium was about KRW 2.3 billion. The loss ratio was very low at 5.75%. If we introduce a compensation annuity by disability grade similar to Injury-Disease Compensation Annuity of Korean Workers' Compensation & Welfare Service, the expected benefit amount for 1 case of disability grade 1 would be KRW 1.6 billion, assuming 2% of interest rate. Given current premium, the loss ratio, the ratio of premium income to claim payment, is expected 41.4% in 2017 and 151.6% in 2026. The increased loss ratio due to the introduce of the compensation annuity by disability grade is estimated to be 11.0% in 2017 and 40.4% in 2026. Conclusion: Currently, laboratories can purchase insurance companies' laboratory safety insurance that meets the standards prescribed by Act on the Establishment of Safe Laboratory Environment. However, if a compensation annuity is introduced, it would be difficult for insurance companies to operate the laboratory safety insurance due to financial losses from a large-scale accident. Therefore, it is desirable that one or designated entities operate laboratory safety insurance. We think that it is more desirable for laboratory safety insurance to be operated by a public entity rather than private entities.