• 한국병원경영학회지
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• 제29권2호
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• pp.37-47
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• 2024

Purpose: This study aimed to determine the effect of adjusted out-of-pocket maximum rules in the 'differential co-payment ceiling', which means having a higher burden of co-payment, that expanded to the entire ceiling level in long-stay admission patients in long-term care hospitals(LTCH). Methodology: We used health insurance claim data between January 1, 2022, and December 31, 2022 received from the National Health Insurance Service. The study populations were inpatients in long-term care hospitals more than 1 days during the study period. We performed the difference in characteristics of the LTCH patient of the differential and general ceiling by the chi-square test. We estimated the change of the population, cost, and co-payments per person under the assumption of restructuring. Finding: Based on adjusted out-of-pocket maximum rules in 2023, it was expected that the number of benefits decreases at the high-income level while increasing at the low-income level. The burden of health expenditure after reimbursement of co-payment ceiling, is expected to increase by 65.1% in the highest medical necessity, whereas the low medical necessity would decreases compared to 2022. Practical Implications: The results demonstrate that the current out-of-pocket maximum rules do not reflect the needs of medical necessity. This study suggested the need to reflect the medical necessity in LTCH on the out-of-pocket maximum rules in the future.

• 재활간호학회지
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• 제6권1호
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• pp.51-60
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• 2003

This study was a descriptive research in search of a nursing intervention scheme to improve stroke patients' quality of life by understanding the relationship of stroke patients' ADL, depression, self-efficacy and quality of life with various variables and identifying factors that affect their quality of life. Each subject was interviewed one to one based on a structured questionnaire. With regard to research tools, Modified Barthel Index (MBI: Fortinsky et al., 1981), which was translated by Choi, Hye-sook (1996), was used in measuring ADL, Randloff's (1977) tool, which was translated by Choi, Soon-hee, was used in measuring depression, and the tool developed by Sherer et al. (1982), which is to measures self-efficacy under general conditions not limited to specific conditions, and modified by O, Bok-ja (1994) was used in measuring self-efficacy. The quality of life was measured using the scale of satisfaction of life developed by Diener et al. (1985). The results of this study were as follows: 1. The means of ADL of the subjects was $79.5{\pm}31.9$, depression $26.8{\pm}10.4$, self-efficacy $47.1{\pm}25.7$, and the quality of life $12.3{\pm}4.9$. 2. The subjects' quality of life showed a statistically significant difference according to gender (t=7.9, p= .006), satisfaction with income (F=5.8, p= .004), the burden of medical fee (F=3.7, p= .028) and the period of disease (F=2.8, p= .042). 3. With regard to relationship among ADL, depression, self-efficacy and the quality of life, ADL was in a relatively low positive correlation (r= .293, p= .003) with and the quality of life, depression in a high negative correlation (r=- .634, p= .000) with the quality of life, and self-efficacy in a positive correlation with the quality of life (r= .388, p= .000). 4. Factors that made a significant influence on the quality of life were depression (B=- .309, p= .001) and satisfaction with income (B=-2.611, p= .001). Based on these results, this study made following suggestions: 1. It is necessary to run rehabilitation programs to improve stroke patients' ADL, depression and self-efficacy. 2. It is necessary to perform research of monitoring stroke patients' quality of life in various areas using measuring tools.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1717-1723
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• 2016

Background: This study assessed parental experiences with chemotherapy-induced alopecia among children with cancer treated at an Indonesian academic hospital. Materials and Methods: Fifty parents of childhood cancer patients were interviewed using semi-structured questionnaires. Results: The moment that hair fell out was the moment that parents (84%) had to admit their child had cancer. Alopecia was a traumatizing painful experience (46%). Active strategies to hide alopecia, mainly hats, were used by 66% of children, while 34% never covered their bald head. If money had not been an issue, 40% would use another strategy. Alopecia made children limit outdoor daily activities (78%) and engagement with others (60%). Significantly more children from high-educated (95%) than low-educated (60%) parents received sympathy from other people (P=0.012). Significantly more Christian (29%) than Muslim (0%) families confirmed that alopecia lowered the quality of life (P=0.046). Most parents (82%) had no prior plans about alopecia management, yet for significantly more girls (26%) than boys (0%) such plans existed (P=0.044). Parents received most information about alopecia from other parents (66%). Parents (92%) needed more alopecia education from doctors. Of all school-attending children, 53% were bullied and 47% did not want to attend school due to alopecia. Significantly more high-educated than low-educated families received pity from teachers and pupils (94% vs. 0%, P=0.004), and acceptance by pupils (81% vs. 0%, P=0.021). Conclusions: Alopecia is a severe, far-stretching side-effect of chemotherapy with physical, psychological and social consequences for children and parents. Parents should be better informed about occurrence and impact of alopecia. Extra attention is required to facilitate children's return to school. Healthcare providers should facilitate optimal supportive care through open dialogue and provision of educational m aterials for parents, children and their community.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.571-578
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• 2013

Background: Patients with breast cancer can experience a feeling of hopelessness very deeply in the adjustment process, and the social support provided during this period can be effective in increasing the level of hope. The present study aimed to identify breast cancer patients' social support and hopelessness level. Materials and Methods: The target population of this analytical study was all breast cancer patients (total of 85) who had treatment in the oncology department of a university hospital located in Adana/Turkey and who met the inclusion criteria. Data were collected through "Personal Information Form", "Beck Hopelessness Scale (BHS)" and "Multidimensional Scale of Perceived Social Support" (MSPSS). Analysis was performed using Shapiro Wilk, One Way ANOVA Welch, Student t-test, Mann Whitney U, and Kruskall Wallis tests. Homogeneity of variance was tested with the Levene, Bonferroni and Games Howell tests. Mean scores and standard deviation values are given as descriptive statistics. Results: Average age of the participants with breast cancer is $48.6{\pm}10.6$. Of all the participants, 84.7% are married, 49.4% graduated from primary school, 81.2% are housewives, and 82.4% had children. The participants' multidimensional perceived social support total scores were found to be high ($57.41{\pm}13.97$) and hopelessness scale scores low ($5.49{\pm}3.80$). There was a reverse, linear relationship between hopelessness scale scores and social support total scores (r=-0.259, p=0.017). A statistically significant relationship was found between hopelessness scores and education level and having children, occupation, income status, and education level of spouses (p<0.05). Conclusions: The present study indicates that hopelessness of the patients with breast cancer decreased with the increase in their social support. Therefore, activating patient social support systems is of importance in increasing their level of hope.

• 보건행정학회지
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• 제19권4호
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• pp.66-77
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• 2009

This study aims to examine the effect of socioeconomic status (hereafter, SES) on healthcare utilization of the patients with rare and incurable diseases. Information of 2,973 patients who were self-employed insured and utilized healthcare service in 2007 was drawn from the National Health Insurance (hereafter, NHI) claim data. SES was set as four groups based on the monthly contribution. Outcome variable was the expense for outpatient and in-hospital services, which was log-transformed and square-rooted in oder to obtain normal distribution. Covariates included age, gender, residence and diagnosis. To examine the effects after controlling for covariates, we employed generalized estimating equation model, since patients with the same diagnosis are likely to have similar characteristics of demographics and healthcare utilization. Univariate statistics showed that lower SES was associated with less utilization of healthcare services. After controlling for covariates, a significantly smaller amount of money was expended for the lowest SES group compared to the highest one. Rural residence was associated with less utilization, except that residents in Seoul significantly more utilized outpatient services in tertiary hospitals. Considering that there is a subsidy program for the low income patients, such differences in healthcare utilization according to SES seems to result from the burden of out-of-pocket payments for uncovered services of the NHI.

• 대한간호학회지
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• 제29권1호
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• pp.84-96
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• 1999

This study was conducted to identity the degree of burden and social support perceived by mothers of nephrotic syndrome patients. Also, relations between burden and social support were investigated to provide basis data for their family health and nursing intervention. The study subjects were mothers of nephrotic syndrome patients whose children were hospitalized in 2 Pediatric wards of University Hospital in Seoul and 1 in Pusan from Jun. 1, 1998 to Jun. 30, 1998. Burden measurement Instrument for this study was designed by the researcher and its basis in one developed by Montgomery et al.(1985) and the reliability was .78. Also. P.R.Q. Part I, II by Brandt and Weinert(1981) was used as social support measurement instrument and the reliability .71. The data analysis was done by SPSS, t-test, ANOVA Pearson correlation. The result were as follows. 1. Burden felt by mothers shows an average value of 60.82 (Maximum 86, Standard deviation 1.244). 2. Of the mother characteristics, the score of burden was high in case of no religion and low income. Of the patient characteristics, the score burden ranked as high MCNS, doing oral therapy, injection therapy at the same time and negative perceived patients condition. 3. The mean score of support was 77.54(Maximum 96, Standard deviation 1.096). 4. The main supporters were husband (the highest), brother, sister, health speciality and the subject expressed the highest satisfaction toward supporters in chronic disease. 5. Of the patient characteristics, the higher age group and the elder group showed high support. Also, positive perceived patient's condition, high support. 6. The relationship between burden and social support is not significant. In conclusion to the above study, the researcher suggests. 1. The Qualitative research to investigate influential factors on burden of family of nephrotic syndrome patients is needed.

• Journal of Korean Biological Nursing Science
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• 제23권1호
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• pp.31-42
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• 2021

Purpose: This study was performed to assess the level of blood glucose and to identify poor glycemic control groups among patients with type 2 diabetes mellitus (DM). Methods: Data of 1,022 Korean type 2 DM patients aged 30-64 years were extracted from the Korea National Health and Nutrition Examination Survey VII. Complex samples analysis and a decision-tree analysis were performed using the SPSS WIN 26.0 program. Results: The mean level of hemoglobin A1c (HbA1c) was 7.22±0.25%, and 69.0% of the participants showed abnormal glycemic control (HbA1c≥6.5%). The characteristics of participants associated with poor glycemic control groups were presented with six different pathways by the decision-tree analysis. Poor glycemic control groups were classified according to the patients' characteristics such as period after DM diagnosis, awareness of DM, sleep duration, gender, alcohol drinking, occupation, income status, low density lipoprotein-cholesterol, abdominal obesity, and number of walking days per week. Period of DM diagnosis with a cut-off point of 6 years was the most significant predictor of the poor glycemic control group. Conclusion: The findings showed the predictable characteristics of the poor glycemic control groups, and they can be used to screen the poor glycemic control groups among adults with type 2 DM.

• 대한세포병리학회지
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• 제14권2호
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• pp.43-52
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• 2003

The incidence of cervical cancer has been gradually decreased since 1990, now it ranks the fourth most common carcinoma among Korean women in 2001. If squamous cell carcinomas in situ are included, the cervical cancer is still the most frequent tumor in Korean women. However, cervical cancer mortality in Korea has been decreased over the last 10 years in large part attributable to the introduction of the Papanicolaou test (Pap. test). The guidelines for the early detection of cervical cancer recommend women aged 30 and more to lake biennial screening with Pap. lest. According to the screening data of National Health Insurance Corporation (NHIC), 4,425 women (0.94%) showed an abnormal Pap among 473,395 cases tested in 2001; dysplasia was in 3,953 (0.84%) women, in situ carcinoma in 357 (0.075%) women, and invasive carcinoma in 115 (0.024%) women. The detection rates of abnormal Pap. were 4.21% in Korean Society for Cytopathology(KSC-2001), 1.37% (ASCUS : 0.26%, AGUS : 0.03%, LSIL : 0.45%, HSIL : 0.55%, Carcinoma 0.09%) in health check-up and 5.41% (ASCUS : 1.89%, AGUS . : 0.69%, LSIL : 1.39%, HSIL : 0.84%, Carcinoma : 0.64%) of patients in out-patient clinic without having history of cervical neoplasia at Hanyang University Hospital in 2002 Low rate of cervical cancer screening (34%) in Korea is mainly due to the lack of information for the Row income people regarding national cancer screening program. More adenuate budget by government and more man-power for precise screening, new guideline and system for management of the cervical cancer patients are required.

• Journal of Preventive Medicine and Public Health
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• 제3권1호
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• pp.31-36
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• 1970

An epidemiological survey on cholera was made toward the 291 cases admitted in Pusan National University Hospital. The results were as follows. 1. The most predominant age groups among all cholera patients were from 30 to 39(21.3%). 2. 74.9% of all cases got under the educational background of primary school and 69.4% of all cases occurred at the low income group. 3. Daily average numbers of patient were 6.2 and maximum numbers wore 15, August 19, 1970. 4. Among the food eaten prior to onset, drinking water was the most predominant with 16.2% and next, food and noodle groups were 14.8% and 10.3% respectively. 5. Regarding incubation period, it was found that 'within 48 hours' was 83.5%. 6. Patients occurred mainly in Suh Ku area with 105(36.1%) of all cases. 7. Carrier rates among family members were 1.78%. 8. Carrier rates among residents of epidemic area were 0.12%.

• 한국치위생학회지
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• 제11권5호
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• pp.671-683
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• 2011

Objectives : The purpose of this study was to examine the oral health knowledge and actual oral health care of the selected subjects, their decision making about prosthetic treatment, the state and characteristics of their prosthetic treatment and their satisfaction with prosthetic treatment in an attempt to provide some information on the improvement of the quality of life related to oral health and the promotion of oral health. Methods : The subjects in this study were 250 people who received education in two different lifelong education institutions in the city of Busan. After a survey was conducted from May 23 to June 15, 2011, the answer sheets from 217 respondents were analyzed. Results : 1. As for the general characteristics of the respondents, the men(52.1%) outnumbered the women. Those who were in their 60 and up(47.5%) made up the largest age group, and the married people(65.4%) outnumbered the unmarried ones. By occupation, the company employees(20.3%) made up the biggest group. By education, the greatest group was high-school graduates(36.1%). By monthly mean income, the biggest group gained an income of 2.01 million won or more(36.9%). As to medical security, community-based insurance was most prevailing (36.9%). In terms of health promotion, the largest group worked out to stay fit(52.4%). 2. Regarding oral health knowledge, they had a good knowledge about the cause of dental caries(56.7%), but they weren't well aware of the right time for regular dental checkup(47.9%). In relation to oral health care, regular scaling wasn't prevailing(16.9%). 3. Regarding connections between the general characteristics and satisfaction with prosthesis, the less-educated respondents expressed significantly more dissatisfaction(p=0.015). By monthly mean income, those who had a smaller income were dissatisfied in general(p=0.028). Conclusions : The findings of the study illustrated that it's required to spread awareness of the importance of oral health among people in general, and that differentiated incremental oral health care should be provided for different age groups. In order to raise the satisfaction of patients with prosthesis, how to relieve their pain and anxiety and how to adjust prosthetic treatment cost properly should carefully be considered. In addition, the government should take measures to offer assistance for the low-income classes in preparation for an increase in the elderly population.