Background. Adequate staffing is necessary to meet patient care needs and provide safe, quality nursing care. In November 1999, the Korean government implemented a new staffing policy that differentiates nursing fees for inpatients based on nurse-to-bed ratios. The purpose was to prevent hospitals from delegating nursing care to family members of patients or paid caregivers, and ultimately deteriorating the quality of nursing care services. Purpose. To examine nurse staffing levels and related factors including hospital, nursing and medical staff, and financial characteristics. Methods. A cross-sectional design was employed using two administrative databases, Medical Care Institution Database and Medical Claims Data for May 1-31, 2002. Nurse staffing was graded from 1 to 6, based on grading criteria of nurse-to-bed ratios provided by the policy. The study sample consisted of 42 tertiary and 186 general acute care hospitals. Results. None of tertiary or general hospitals gained the highest nurse staffing of Grade 1 (i.e., less than 2 beds per nurse in tertiary hospitals; less than 2.5 beds per nurse in general hospitals). Two thirds of the general hospitals had the lowest staffing of Grade 6 (i.e., 4 or more beds per nurse in tertiary hospitals; 4.5 or more beds per nurse in general hospitals). Tertiary hospitals were better staffed than general hospitals, and private hospitals had higher staffing levels compared to public hospitals. Large-sized general hospitals located in metropolitan areas had higher staffing than other general hospitals. Occupancy rate was positively related to nurse staffing. A negative relationship between nursing assistant and nurse staffing was found in general hospitals. A greater number of physician specialists were associated with better nurse staffing. Conclusions. The staffing policy needs to be evaluated and modified to make it more effective in leading hospitals to increase nurse staffing.
It has been asserted that per diem payment system should be introduced, in place of the current fee-for-service system, for payment of the inpatient services of the geriatric hospitals, Based on the assentation, this study aims at calculating costs and profits per inpatient-day of the geriatric hospitals, and thereby at contributing to the managerial improvement from the both sides of the Government and the hospitals. Relevant data of the three months, May to August, 2002 were collected from the five geriatric hospitals, and per inpatient-day costs and profits were calculated for the three disease groups. Major results and conclusions are as follow : Firstly, total costs per insured inpatient-day of the geriatric hospitals are 65, 389 won for dementia (including optimal profit of 3,858 won), 69,730 won for stroke (including optimal profit of 4,117 won), and 70,085 won for other diseases (including optimal profit of 4,134 won). Secondly, the amount of the non-insured costs per inpatient-day occupies 34.5% of the total costs for dementia, 30.3% for stroke, and 30.1% for other diseases. Thirdly, the total amount of the per inpatient-day costs calculated including the optimal profits is, on the average, higher by 12% than the present price level calculated for the current fee-far-service system. This implies that the present price level should rise by 12% when the current fee-far-service payment system be maintained, and Finally, introduction of a sliding-scale payment system should be considered for the inpatient medical management fees for the length of stay over six months or more that are being cut in the claim examination process by the insurance corporation.
Kim, Jin-Mi;Youn, Sung-Sik;An, So-Hyun;Choi, Jeong-Sik;Cho, Chung-Sik;Son, Chang-Gue;Kim, Chul-Jung
The Journal of Korean Medicine
/
v.30
no.5
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pp.127-136
/
2009
Objective: This study aimed to analyze the current status of treatments and patients with diabetic peripheral neuropathy, and then map out of a strategy for development of generalized-treatments for diabetic peripheral neuropathy in Traditional Korean Medicine. Methods: We selected research materials from various databases such as PubMed, Google, KStudy, KoreanTK, OIM, KOMS and books. Also, to understand current tendencies of medical examination and treatment related with diabetic peripheral neuropathy, we requested Health Insurance Review and Assessment Service clinical data from 2003 to 2007. Results: It is reported that the incidence of diabetic peripheral neuropathy is increasing in an aging society. The medical fees of National Health Insurance related with diabetic peripheral neuropathy show a year-on-year increase. There are no particularly effective therapies for diabetic peripheral neuropathy in Western medicine, and in some papers, it was reported that treatment of diabetic peripheral neuropathy using Traditional Korean Medicine was effective. However, patients usually visit on Western medical center rather than seek Traditional Korean Medicine. To take charge of clinical fields related with diabetic peripheral neuropathy by Traditional Korean Medicine, we need more studies and experiments of diabetic peripheral neuropathy using Traditional Korean Medicine and should make a standardized protocol. Conclusion: Various studies related with diabetic peripheral neuropathy using Traditional Korean Medicine will have to be undertaken hereafter. We expect that Traditional Korean Medicine will play a vital role in treating of diabetic peripheral neuropathy.
Objectives: Fatigue is a prevalent symptom encompassing both acute and chronic manifestations. Most fatigue symptoms can be cured by taking a rest or removing underlying causes. However, chronic fatigue is frequently problematic due to its duration and effect on quality of life. There are no particularly effective therapies for chronic fatigue of unknown causes, and patients in Korea usually visit an Oriental clinic. This study aimed to analyze the current status of treatments and patients with chronic fatigue, and then map out of a strategy for development of generalized-treatments for chronic fatigue in Oriental Medicine. Methods: Clinical information related to chronic fatigue was selected from various different databases such as PubMed, KoreaMed, KStudy, DBPIA, OIM, and KOMS. Also, to understand current tendency of medical examination and treatment related with chronic fatigue, we requested Health Insurance Review & Assessment Service for clinical datum from 2003 to 2007. Results: The medical fees of National Health Insurance related with fatigue show an explosive year-on-year increase. On the other hand, it has been decreasing annually in the western medical fields. To take charge of clinical fields related with chronic fatigue by Oriental Medicine, we should make a unified diagnostic system. Then, we should also make standard evaluation tools and develop herbal drugs according to this unified diagnostic system. Conclusions: Fatigue-related symptoms will be a main target of Oriental medicine in the future. We expect that various studies related with chronic fatigue will be undertaken hereafter.
The objectives of the study are to investigate pharmacy remuneration levels stratified by the number of prescriptions dispensing and the type of nearby medical facilities using the Korean National Health Insurance (NHI) database, and to classify community pharmacies based on the characteristics. Claims data of all community pharmacies were extracted from the Korean NHI database from January 1 to June 30, 2010. A total of 14,985 pharmacies were included for the analysis. The remuneration amounts per pharmacist were directly associated with the number of prescription dispensing, and varied by the type of nearby medical facilities where more than 90% of prescriptions dispensed at the pharmacy are issued from. We classified pharmacies to six groups according to the number of prescription dispensing and the type of nearby medical facilities; (1) pharmacies with equal to or less than 200 prescriptions per month per pharmacist, (2) pharmacies near a general hospital, (3) pharmacies near a regular hospital, (4) pharmacies near a clinic, (5) pharmacies near multi clinics, and (6) pharmacies that do not belong to the above types. Compared to pharmacies near a clinic or multi clinics, pharmacies near a general hospital showed a lower number of prescription dispensing per pharmacist, but the income from dispensing fees was higher (p<0.05). The new taxonomy of community pharmacies can be a useful basis for further policy development in pharmacy remuneration system.
Myungsun Kim;Myung-Ho Kim;Minjung Lee;Dongyeop Jang;Sa-Yoon Park
The Journal of Korean Medicine
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v.44
no.3
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pp.59-73
/
2023
Objectives: The role of physician-scientists who bridge the gap between basic science and clinical medicine is crucial in advancing medical innovation. This study aims to examine the educational and research environment and career satisfaction of graduate students in Korean Medicine among those who are Korean medicine doctor (KMD). Methods: This study analyzed the results of a survey consisting of respondents' composition, job status, graduate education and job satisfaction, economic conditions, career determinants, and obstacles to the career path of KMD-scientists from 65 participants including both full-time and part-time graduate students. Results: The results revealed significant differences between full-time and part-time graduate students in terms of weekly hours spent and job priorities, motivation for entering graduate school, career preferences, and desired career paths. The study highlights the need for tailored support for full-time and part-time graduate students and the importance of economic assistance in fostering KM scientists. Economic difficulties were identified as a major obstacle for full-time graduate students pursuing research careers. Tuition fees were found to be a significant burden for all graduate students. Furthermore, it emphasizes the importance of enhancing the research capabilities of part-time graduate students and improving the quality of education to foster KMD-scientists. Conclusion: This research provides essential insights for Korean Medicine colleges and graduate schools to develop targeted improvement plans and effectively train KMD-scientist.
Juchul Kim;Sohyun Kim;Hyunjoo Oh;Eunji Ahn;Dongsu Kim
The Journal of Korean Medicine
/
v.45
no.1
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pp.100-113
/
2024
Objectives: Following the global COVID-19 pandemic, with the escalation of remote medical care formalization in Korea, there is a pressing need for objective data in the Korean medicine field to respond to remote treatment medical care policies. This study aims to investigate the perceptions and acceptance of remote treatments among Korean Medicine Doctors (KMDs). Methods: After expert reviews and pilot testing, the 31-question survey covered participant characteristics, experiences, forms, intentions, and perceptions related to Remote Treatments. The survey was electronically distributed to members of the Association of Korean Medicine, and 662 clinical KMDs provided valid responses. Results: Among respondents, 76.1% engaged in remote treatments, utilizing various platforms. Those with experience in Remote Treatments showed a significantly higher willingness to continue participating during the institutionalization process (p<0.001). 49.7% of respondents stated that traditional Korean medicine is competitive in remote treatments, with the main reasons being the ability for regular management after herbal medication(26.1%) and increased patient satisfaction due to sufficient counseling compared to Western medicine(25.2%). Respondents preferred Remote Treatment conditions with a treatment time of less than 10 minutes(47.6%) and equivalent fees to in-person visits(45.6%). Regarding suitable intervention tools during Remote Treatment, respondents favored non-covered herbal prescriptions(39.0%), covered herbal granules(24.6%), and non-covered herbal granules(23.0%). Conclusion: This study investigated the perceptions and acceptance of KMDs regarding remote treatments. These findings provide valuable insights for policymakers aiming to establish effective policies for Remote Treatments suitable for the Korean medicine healthcare environment.
Background : Coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted all aspects of life, from disease prevalence to the utilization of medical services. In Republic of Korea, there exists both a duty and a right for Korean Medicine to treat epidemic diseases. However, no studies have been conducted to examine changes in the utilization of Korean Medicine during the pandemic. This study aims to identify the differences in the utilization of Korean Medicine before and after COVID-19. Method : This study analyzed data from the Health Insurance Statistics of the National Health Insurance Service and the Health Insurance Review & Assessment Service from 2016 to 2022. To compare the utilization of Korean Medicine with Western medicine, the analysis was limited to the clinic level. Results : The top 10 most frequently treated conditions in Korean Medicine from 2016 to 2022 remained consistent, primarily involving musculoskeletal diseases, with the exception of functional dyspepsia. Visits to Korean Medicine clinics have declined, while visits to Western Medicine clinics recovered. Despite the overall decline in visits, certain Korean Medicine services increased in frequency, especially in precipitator-simulated acupuncture, indirect moxibustion (moxa burner), pricking cupping (two areas), warming meridian sinew, and complex Chuna therapy (80% as out-of-pocket expenses). Although the relative value units in Korean Medicine services varied, the fees for all services, except for precipitator-simulated acupuncture, increased. Conclusion : These findings indicate that COVID-19 has affected the utilization of Korean Medicine. Further studies are needed to explore the broader impact of epidemics on medical services and to develop policies to address these changes.
Park, In-Hyae;Kang, Hae-Young;Lee, Jeong-Hee;Ryu, Hyun-Sook
Research in Community and Public Health Nursing
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v.11
no.1
/
pp.21-36
/
2000
The purpose of this study was to assess the needs of breast self examination education (BSEE) programs for developing nursing centers. A first, we reviewed the literature of activity and management-related factors of nursing centers: and, second. we used a questionnaire to discover the degree of knowledge, attitude, and practice on breast cancer, as well as an individual's intention to participate BSEE program. 1. Reviewing the literatures of nursing center activities. Nursing centers which were administered by a professional nurse are an ideal site for faculty and student practices. With the use of nursing models of health. professional nurses in nursing centers diagnose and treat human responses to potential and actual health problems and offer holistic, client-centered health service. In nursing centers professional nursing services include health education, health promotion, and health-related research. A nursing center is comprised of the advisory and exacutive commitee; the advisory commitee serves consultants and links community needs to the nursing center, while the director of the exacutive commitee identifies the potential resources to generate funds, support, and facilitate the activities of staffs in a nursing center. Nursing centers mobilize various financal resources for reimbursement of services from college and insurance companies, collect minimum service fees from the client, and further collect fees for providing programs to community groups, this also includes membership fees, and donations. The services provided by nursing centers focus on services related to primary prevention, health maintenance & health promotion, direct nursing care for acute & chronic diseases, and holistic care for actual and potential health problems. The client satisfaction for the services was high. Students also showed positive reponses for their clinical experiences and independent working conditions. 2. The degree of knowledge, attitudes, and practices for breast cancer. and an individual's intention to participate in the BSEE program. The subjects of this study were 308 females in K-city in the Republic of Korea. Data were collected using a self-administered questionnaire. The mean age of the respondents was 35.0 years old. Those who already participated in the BSEE were 64.9%, and those who had support and encouragement to practice BSE from significant others were 25.1 %. Clients intent to participate in the BSEE were 37.0%. The mean score of knowledge(2.4 out of 5 points) and practices(1.8 out of 5 points) for breast cancer were quite low, but the mean score of attitudes was relatively positive04.5 out of 20 point) for breast cancer. Those who already had BSEE showed significantly high scores in knowledge(t=6.48, p<0.01), attitudes (t=10.54, p<0.01). and practices(t=57.07, p<0.001) for breast cancer than those who had not participated in the BSEE. In all age groups no intention to participate in the BSEE was higher than who the intention to participate. These findings suggest some strategies should be developed to increase the awareness of breast cancer's early detection.
This study was to find a patient's motive for receiving implant treatment by age and gender using a self-reporting questionnaire survey with adults(men & women) in Woolsan. The result was as follows: 1. As a result of questionnaire survey with 155 patients in total(86 men, 69 women), 24 of 86 men(27.9%) valued the natural mastication feature of dental implant most, that is as similar as natural teeth, while 18 of 69 women(26.1%) had the most priority over the longer life of implant than common dental prostheses. By age, those in their 20s and 30s had a preference to implant treatment because it does not need to pulling out teeth for prostheses, while those in their 40s and over had a priority to the natural mastication feature of implant that is similar as much as natural teeth. By dental treatment, all of respondents said that the natural mastication feature is the most important in getting dental implant. It was founded that whether one can taste food as it is or not is less important, regardless of age or gender. 2. The greatest obstacle to implant surgery was expensive medical fees, 88 of 155 respondents(56.8%), with a fear of surgery itself being the least obstacle. 3. 90.2% of the total respondents said that they will want to receive dental implant treatment if their economy allow.
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