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Comparative Analysis on the Characteristics of High Cost Medical Users between the Health Insurance and Medical Assistance Program (고액진료비 환자의 특성 비교분석 - 의료보험과 의료보호환자를 중심으로 -)

  • Kang, Sunny;Moon, Ok-Ryun
    • Quality Improvement in Health Care
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    • v.2 no.2
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    • pp.112-129
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    • 1996
  • Background : A small number of high cost patients usually spend a larger proportion of scarce health resources. Aged, long-term care and readmitted patients usually belong to these high cost patient group. Among others, long length of stay and readmission can be reduced by checking its cause, and these are the areas needed most of quality improvement activity. Characteristics of high cost medical users between health insurance program and medical assistance program were reviewed. Methods : The inpatient claims of health insurance and medical assistance program were analyzed. Patients were divided by 6 groups; long-term, mid-term, short-term, readmitted, cancer and aged. We defined high cost patients as those who had spent one and half million won and over per 6 months. Characteristics of high cost patients for each group were reviewed. Results : medical assistance patients used much more resources than the insured members in the average hospital cost per case but less in daily hospital cost. The former had a longer length of stay and had much heavier diseases. Major diseases of both group were cancer, diseases of circulatory system and chronic degenerative diseases. Gallstone and schizophrenia were more in the insured program. However, pulmonary tuberculosis, asthma were more common among the medical assistance patients. Early readmission before 2 weeks were 28-30% of the total readmission. Readmission rate in the malignat neoplasm and renal failure were 80% and more. Q.A program should be installed to prevent unnecessary readmissions. Conclusion : Almost 30% of early readmissions and admissions due to complications and long length of stay should be reviewed carefully to keep cost down and to enhance the quality of hospital care.

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A Case Study of the Official Development Assistance Medical Device Management: Consultation for a Medical Engineering Education Program in Tanzania (공적개발원조(ODA) 의료기기 관리 사례연구: 탄자니아 의용공학 교육 프로그램 컨설팅)

  • Yoon, Moon-Soo;Chae, Myung-Sin;Lee, Myung-Ken;Hong, Seung-Yeun
    • The Korean Journal of Health Service Management
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    • v.11 no.3
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    • pp.129-144
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    • 2017
  • Objectives : To review a Tanzanian medical engineering education program and determine improvement measures for the Official Development Assistance (ODA) healthcare projects. Methods : A consultation of the Tanzanian medical engineering education program funded by the National Research Foundation of Korea (NRFK) was reviewed. An on site survey, an environmental analysis, and in-depth interviews were performed. Results : Survey results highlighted a lack of medical device education and the low operating rate of medical equipment. The need to establish educational program was thus confirmed. The expansion of healthcare facilities appeared to be limited within the current medical management system. A master coursework plan for Tanzania medical engineering was developed. Conclusions : The needs of medical engineering education were recognized. A plan and curriculum were developed. The medical engineering education program should be planned and budgeted prior to the ODA healthcare program.

Long-term Policy Development for the Aged on Medical and Health Care Security (노인의료보장 및 건강관리를 위한 장$cdot$단기 대책)

  • Rhee Seonja;Lee Yoon Sook
    • Journal of Korean Public Health Nursing
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    • v.5 no.1
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    • pp.70-95
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    • 1991
  • The ageing problem of the population has been emerging in Korea since 1970's so that it is expecting the elderly 65 years and over among the total population from $4.5\%$ in 1988 to be $6.3\%$ in year 2000. This study was conducted to provide secure policy development in coming years for the aged on medical and health care aspects based on the examining current status of the aged problems and health care policies and systems. The study divided into four parts; The first part examined the medical insurance program and public assistance program of the health services in relation to the aged. The second part emphasized on reduction of medical care cost for the aged. The third part studied the regular health check-up program and health education for the aged. The fourth part examined the chronic disease management programs for the aged and strategies of the health care service quality improvement and specialized programs. The following recommendations made as the results of the study. 1. At present, the medical insurance program and public assistance program for the medically indigent is not appropriate to the elderly because it is a part of general medical insurance program so that Health Security Law for the Aged is proposed. 2. Medical cost will be increased due to the high occupancy rate of hospital beds and long stay of the elderly so that it is recommended to develop an early discharge program, home health care program, Health hospice and an althernative programs. 3. At present, a regular health check-ups for the elderly is not included in medical insurance program so that it is recommended to be included in the insurance program and at the same time health education program thoroughly developed for the aged. 4. To make proper medical and nursing services on chronic diseases for the elderly, it is recommended manpower development, specialized clinics or hospitals, nursing homes and an equivalent long term care facilitices should be established on the community based and a research institutions also to be related to supper the care programs.

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Comparing Difference of Volume of Psychiatric Treatments between the Patient with Health Insurance and Those with Medical Assistance - For Inpatients of Korean Psychiatric Hospitals - (건강보험과 의료급여 환자간의 정신요법 진료량 차이 비교 - 정신병원 입원환자를 대상으로 -)

  • Lee, Dae-Hee;Park, Eun-Cheol;Nam, Chung-Mo;Lee, Sang-Gyu;Lee, Dong-Han;Yu, Seung-Hum
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.1
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    • pp.33-38
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    • 2003
  • Objectives : To assess the difference in the volume of psychiatric treatments provided to health insurance inpatients, compared with those on medical assistance(the medical aid program) Korean psychiatric hospitals, and to determine factors which affect the volume of the services. Methods : 21 psychiatrists, from 3 Korean psychiatric hospitals recorded the frequencies psychiatric treatments provided to inpatients in one week (February 18-24, 2002). The records of 329 patients were analyzed through t-tests, and random effectmixed model analyses to define the difference between the two groups, and to find other factors affecting the volume of service. Results : A significant difference in the volume of psychiatric treatments provided was observed between the health insurance and medical assistance groups. The variation in the volume of service between hospitals was prominent, and other factors (gender, agegroup, length of stay and mental disorder)were also found to be significant. The patients on medical assistance received only 70% of the psychiatric treatments of those on health insurance. Conclusions : More effort is required to improve the methods of payment to increase the level of fee scheduling for medical assistance. Further studies on the mechanisms causing these differences in the volume of service are required.

Beating Obesity: Factors Associated with Interest in Workplace Weight Management Assistance in the Mining Industry

  • Street, Tamara D.;Thomas, Drew L.
    • Safety and Health at Work
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    • v.8 no.1
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    • pp.89-93
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    • 2017
  • Background: Rates of overweight and obese Australians are high and continue to rise, putting a large proportion of the population at risk of chronic illness. Examining characteristics associated with preference for a work-based weight-loss program will enable employers to better target programs to increase enrolment and benefit employees' health and fitness for work. Methods: A cross-sectional survey was undertaken at two Australian mining sites. The survey collected information on employee demographics, health characteristics, work characteristics, stages of behavior change, and preference for workplace assistance with reaching a healthy weight. Results: A total of 897 employees participated; 73.7% were male, and 68% had a body mass index in the overweight or obese range. Employees at risk of developing obesity-related chronic illnesses (based on high body mass index) were more likely to report preference for weight management assistance than lower risk employees. This indicates that, even in the absence of workplace promotion for weight management, some at risk employees want workplace assistance. Employees who were not aware of a need to change their current nutrition or physical activity behaviors were less likely to seek assistance. This indicates that practitioners need to communicate the negative effects of excess weight and promote the benefits of a healthy lifestyle to increase the likelihood of weight management. Conclusion: Weight management programs should provide information, motivation. and trouble-shooting assistance to meet the needs of at-risk mining employees, including those who are attempting to change and maintain behaviors to achieve a healthy weight and be suitably fit for work.

The difference in knowledge, awareness, and educational demand about disaster medical response-related institutions in Jeollanam-do (전남지역 재난의료대응 유관기관 재난의료대응 지식, 인식 및 교육 요구도 차이 분석)

  • Park, Myeong-Hui;Jung, Eun-Kyung
    • The Korean Journal of Emergency Medical Services
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    • v.26 no.1
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    • pp.21-36
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    • 2022
  • Purpose: This descriptive research study aimed to investigate the knowledge and perception of the natural disaster medical system by relevant disaster medical response teams in Jeonnam region, and provide baseline data for a disaster education program based on analysis of priorities of educational demand. Methods: Online questionnaires were distributed to 200 research participants including paramedics from five fire stations in J province, 22 public health centers, two disaster base hospitals, ERU (Emergency Response Units), and DMAT (Disaster Medical Assistance Team). The questionnaires elicited basic information about respondents, their knowledge and perception on disaster preparation and response, cooperation system, and educational and training needs. Results: The top priority items selected were: other disasters for paramedics, first aid for the rapid response team, and command system for DMAT. Conclusion: Customized education and training programs must be developed to suit each organizational need. Detailed operational guidelines must be established and with them a unified educational curriculum should be put into practice.

Assistant device development and effects for promotion of bag-valve-mask ventilation (백-밸브-마스크 환기증진을 위한 보조기구 개발 및 효과)

  • Kwon, Chan-Yang;Lee, In-Soo
    • The Korean Journal of Emergency Medical Services
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    • v.22 no.1
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    • pp.49-59
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    • 2018
  • Purpose: The purpose of this study was to develop an assistant device for the promotion of bag-valve-mask ventilation based on a non-equivalent control group pre-test and post-test design. Methods: The experimental tool was a mask assistance device developed by the researchers. Data were analyzed using SPSS 21.0 with the cardiopulmonary resuscitation (CPR) evaluation program from August 18 to 30, 2016. The research tools included general, hand-related, and ventilation-related characteristics. Results: Before and after using the mask assistance device, the tidal volume increased by 64 mL (p<.001) from 461.76 mL to 525.86 mL. The tidal volume for control was 477.86 mL, and there was a statistical difference (p<.05). The ventilation frequency in device users was 10 times per minute for a total of 20 ventilations with before 10.65 after 10 times, and that of the control group was before 10.36 times after 10 times; there was no difference in both groups(p>.05). The accuracy of the assistance device was $81.72{\pm}30.86%$, which was a very high value. However, the accuracy of ventilation in the control group with no assistance device was $18.97{\pm}32.44%$, which was a very low accuracy rate. Conclusion: This study's results suggested utilizing the newly-developed mask assistance device in CPR, and showed increases in tidal volume and accuracy of ventilation using the bag-valve-mask ventilation equipment. The general and hand-related characteristics did not have any effect, so the use of the device proved to increase the efficacy in all users.

The effect of fairy-tale based cardiopulmonary resuscitation education on cardiac arrest recognition and EMS activation abilities in kindergarten children (동화책을 활용한 심폐소생술 교육이 유치원생의 심정지 인지 및 구조요청 능력에 미치는 효과)

  • Min Namgoong;Hyun-Mo Yang
    • The Korean Journal of Emergency Medical Services
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    • v.28 no.1
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    • pp.113-126
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    • 2024
  • Purpose: Education for children in South Korea is similar to that for adults, necessitating additional enhancements. Therefore, this study aimed to examine the effectiveness of fairy-tale books in cardiopulmonary resuscitation (CPR) education among kindergarten children. Methods: The study involved 64 kindergarten children enrolled in an affiliated kindergarten program were included. The participants were divided into an experimental group of 32 who received CPR education using picture books, and a control group of 32 who received education through traditional methods. Participant characteristics such as sex, age, height, weight, cardiac arrest awareness, and ability to request assistance were measured, and the collected data were statistically analyzed. Results: Following education, the experimental group showed significantly higher scores than the control group across all measures, including cardiac arrest recognition (2.25 vs. 0.34, p<.001) and consciousness assessment (1.81 vs. 0.09, p<.001). Additionally, in requesting assistance, the experimental group exhibited statistical superiority in phone usage (1.75 vs. 0.28, p<.001), situational explanation post-call (2.25 vs. 0.34, p<.001), and self-location explanation (0.84 vs. 0.00, p=.001). Conclusion: The use of fairy-tale books in CPR education enhanced cardiac arrest recognition and the ability to request assistance (EMS Activation) more effectively than the traditional educational methods among kindergarten children.

Development and Maintenance of Cohort Data at Chonnam National University Medical School (전남대학교 의과대학 코호트 구축과 운영 사례)

  • Eun-Kyung Chung;Eui-Ryoung Han
    • Korean Medical Education Review
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    • v.25 no.2
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    • pp.126-131
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    • 2023
  • The aim of this study was to systematically collect data for evaluating short- and long-term outcomes using Kirkpatrick's four-level evaluation model, Chonnam National Medical School has established plans for developing and managing a database of student and graduate cohorts. The Education Evaluation Committee, with assistance from the Medical Education Office, manages the development and maintenance of cohort data. Data collection began in the 2022 academic year with first- through fourth-year medical students and graduates of the year 2022. The collected data include sociodemographic characteristics, admission information, psychological test results, academic performance data, extracurricular activity data, scholarship records, national medical licensing exam results, and post-graduation career paths. The Education Evaluation Committee and the Medical Education Office analyze the annually updated student and graduate cohort data and report the results to the dean and relevant committees. These results are used for admissions processes, curriculum improvement, and the development of educational programs. Applicants interested in using the student and graduate cohort data to evaluate the curriculum or conduct academic research must undergo review by the Educational Evaluation Committee before being granted access to the data. It is expected that the collected data from student and graduate cohorts will provide a sound and scientific basis for evaluating short- and long-term achievements based on student, school, and other characteristics, thereby supporting medical education policies, innovation, and implementation.

The Analysis of Need with Homebound Disabled Persons in a Country Area (일부 농촌지역 재가 장애인의 요구도 분석)

  • Jung, Byeong-Ok;Lee, Cu-Rie;Kim, Keun-Jo;Park, Heung-Ki;Kim, Bonn-Won
    • Journal of Korean Physical Therapy Science
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    • v.13 no.4
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    • pp.43-62
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    • 2006
  • The survey was conducted with participation of the 289 handicapped persons residing at the rural area OOeup-gun in Kyungbook for the period of March 2 - May 31, 2006, to study the nature in general of the handicapped and the boundaries of their need. For the nature in general of the handicapped, the study was done by gender iscrimination, age, marital status, religion, educational level, occupation, monthly income, disability cause, disabled duration, disability type, disability level. For the boundaries of their need, the study was done by demand of financial support, educational demand, demand of voluntary workers, need of rehabilitation and medical treatment, job training, improvement of living conditions, or so. Using the Win.SPSS program, we made a frequency analysis and conclusions on the nature in general of the handicapped and the boundaries of their need on a 2-test. Conclusions are : 1. Nature in general of the handicapped The existence of the handicapped shows high at the age over 51 (71.6%), male-handicapped (65.1%), primary school graduates (62.9%), farming engaging (65.2%), monthly income less than one million Won (80.5%), cause by disease (53.8%), duration more than 10 years (61.6%), disability at level 3 (39.8%), extremity disability (66.4%). 2. Correlation of nature in general with demand of the handicapped a. In demanding the financial support, support for helper’s compensation shows high (p<0.05). In demanding the necessity of voluntary workers, the male-handicapped appears high during the absence of family assistance and the female-handicapped appears differently per week and also appears high during the absence of family assistance (p<0.05). b. In educational demand of the handicapped by their age, the age below 30 demands technical-job training and the age over 31 demands medical education for health care (p<0.01). c. In demanding the financial support by educational level, support for living cost shows high (p<0.05). d. In demanding improvement of living conditions by postnatal cause of disability, improvement of house structure shows high (p<0.05). e. In demanding assistance of voluntary workers by disabled duration, "No Need" shows high in the disabled duration more than 4 years (p<0.05). f. In demanding rehabilitation and medical treatment by disability type, home-visiting treatment, oriental medical treatment and physical therapy show high (p<0.001). g. In educational demand by disability level, medical education for health care shows high (p<0.01).

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