• Title/Summary/Keyword: national health insurance data

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National hospital discharge survey for the hospitals with fewer than 100 beds: A pilot project and evaluation (100병상미만 의료기관대상 퇴원환자조사 시범운영 및 평가)

  • Choi, Haeng-Jeong;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.9
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    • pp.3336-3340
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    • 2010
  • This study has been carried out against hospitals with less than 100 beds, which were excluded from the previous study on the discharged patients from January 1 to December 31, 2007. To analyze the discharged patients, the general characteristics of discharged patients, means of payment for medical costs, type of disease and surgery and current status of the use of medical services have been investigated based on the medical records. During the year of 2007, the number of discharged patients from the hospitals with less than 100 beds reached 4,697,095 (9.7% of total population). In other words, 9,693 people were discharged from a hospital per 100,000 populations with 9.8 days in terms of annual mean length of hospitalization. The number of patients who returned home after hospitalization reached 4,538,861 (male: 1,784,041, female: 2,754,821) while 119,378 patients were evacuated to other hospitals. Among them, 8,970 patients were returned back to the original hospital. Based on the results of this study, they could be used in could be used in planning a project which is aimed to reduce public health costs by investigating high-risk groups with particular injuries and preventing damage. In addition, the injury monitoring data which are continuously collected could be useful in monitoring and evaluating the efficiency of an injury prevention program.

Evaluation of Nutrient Intakes in the Hemodialysis Patients According to the Socioeconomic Status - In Daejeon and Chungnam Areas - (혈액투석환자의 사회경제적 수준에 따른 영양소 섭취상태의 평가 - 충남지역을 중심으로 -)

  • Chung, Young-Jin;Park, Yoo-Sin;Kim, Han-Sook;Chang, Yu-Kyung;Kim, Chan
    • Journal of Nutrition and Health
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    • v.35 no.5
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    • pp.544-557
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    • 2002
  • This study was performed to evaluate the quality of nutrient intakes of the hemodialysis patients (26 men and 23 women) according to the socioeconomic status by 3-day dietary recall in Daejeon city and Chungnam area, Korea. Mean age of the subjects was 50.7 yrs and BMI was 22.0 $\pm$ 0.4 kg/$m^2$. Education level was divided into two groups ($\leq$ 9 years: LE group, 9 years: HE group), and monthly family income level was divided into three groups (< 500,000 won: LI group, 500,000-1,499,999 won: MI group, $\geq$ 1,500,000 won : HI group). The data were analyzed by Student t-test and Oneway ANOVA using SPSS 9.0 version at p < 0.05 level. Intakes of energy, carbohydrates, cholesterol, potassium, thiamin and riboflavin were significantly higher in HE group than in LE group (p < 0.05). Intakes of all the nutrients except protein and phosphorus were less than Korean RDA, and INQs (Index of Nutritional Quality) of most nutrients were lower than 1.0 but cholesterol, phosphorus. thiamin and niacin being over 1.0 in HE group. MAR (Mean adequacy ratio) of all the nutrients (e.g., energy, protein, calcium, phosphorus, iron, vitamin A, vitamin C, thiamin, riboflavin and niacin) was significantly higher in HE group (0.61 $\pm$ 0.04) than in LE group (0.48 $\pm$ 0.03) at p = 0.036. Intakes of energy, protein (total, animal and plant), fat, cholesterol, potassium, calcium, phosphorus, iron, vitamin A, thiamin and riboflavin were also significantly higher in HI group than in LI and MI group (p < 0.05). Daily intakes of most nutrients were less than Korean RDA except protein ed phosphorus in HI poop, and INQs of thiamin, niacin and phosphorus were higher than 1.0, while those of calcium, iron, vitamin A and riboflavin were lower than 1.0. MAR of energy and 9 nutrients was significantly higher in HI group (0.70 $\pm$ 0.04) than in LI group (0. 56 0.04) and MI poop (0.47 $\pm$ 0.03) at p = 0.000. In conclusion, quality of nutrient intakes, especially energy and protein, was significantly influenced by socioeconomic status such as education and monthly income (p < 0.05). This result suggests that it would be very helpful to develop nutritional education programs considering hemodialysis patients' education levels, and to improve public supports (e.g., medical insurance system, low-rate lease system of dialysis equipments, etc.) focusing on the patients' family income levels f3r their better nutrition and health.

Oral Health Status of Some Patients with Chronic Mental Illness in Korea (일부 만성 정신질환자의 구강건강 상태)

  • Seo, Hye-Yeon;Jeon, Hyun-Sun;Park, Su-Kyung;Park, Ki-Chang;Chung, Won-Gyun;Mun, So-Jung
    • Journal of dental hygiene science
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    • v.13 no.4
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    • pp.493-500
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    • 2013
  • The study aims to determine the status of oral health of mental illness patients and establish the preliminary data. The examinations and questionnaire survey were done 92 psychiatric patients to measure sociodemographic characteristics, decayed, missing and filled teeth (DMFT) index, patient hygiene performance (PHP) index, community periodontal index of treatment need (CPITN). Result of the missing teeth index in the state of oral health was higher in the hospital group (6.42) while the filled teeth index was higher in the center group (4.78). In the DMFT index, mental illness patients were higher than the national sample. The oral health status of medical aid recipients was poorer as the subjects were older and less educated (p<0.05). The PHP index was 3.41, close to the bad oral hygiene state. The hospital group (81.7%) required higher need for periodontal treatment. The periodontal health state was much poorer especially when the subject was in the age of 40's and 60's, received less education, and had no family (p<0.05). $CPITN_3$ was higher in the hospital group (13.3%) than the national sample (5.7%). The mental illness patients were socially vulnerable, therefore oral health care program should be needed and age, education level, health insurance type, presence of family and other factors needs to be considered in this approach.

Risk Factors for Vancomycin-Associated Nephrotoxicity in Elderly Patients (노인 환자에서 Vancomycin 사용과 관련한 신독성의 위험인자 연구)

  • Kim, Ha Nui;Kim, Hae Sook;Lee, Yang Hyun;Lee, Kyeong Ju;Shin, Seung Woo;Park, Seon Cheol;Lee, Yu Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.1
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    • pp.22-29
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    • 2017
  • Objective: Infection is very common in the elderly, so there is a high prevalence of antibiotics use among this population. Especially, due to the emergence of resistant bacteria, the use of vancomycin is growing. The purpose of this study was to evaluate risk factors associated with vancomycin-induced nephrotoxicity in elderly patients. Methods: The subjects of this study were patients over 18 years old who received intravenous vancomycin in a general hospital located in Gangneung-si, Korea between August 1, 2013 and July 31, 2015. Data collection regarding vancomycin use and baseline characteristics was conducted using computerized hospital database. Logistic regression analysis was used to identify risk factors associated with vancomycin-induced nephrotoxicity. Results: A total of 290 patients were finally included, and 191(66%) out of these patients were age 65 or older. The incidence of vancomycin-induced nephrotoxicity was 11.0%, 12.6%, and 7.0% in the all adult patients, the elderly patients, and the non-elderly patients, respectively. There were significant differences in comorbidities between patients with nephrotoxicity and patients without nephrotoxicity in the all adult patients, and there were significant differences in vancomycin duration, comorbidities, and number of nephrotoxic agents between patients with nephrotoxicity and patients without nephrotoxicity in the elderly patients. However, according to the logistic regression analysis, there was no significant risk factor that increases the incidence of vancomycin-induced nephrotoxicity in all three age groups. Conclusion: There were no differences in risk factors that increase the incidence of vancomycin-induced nephrotoxicity between all adult patients, elderly patients, and non-elderly patients. Further studies with larger sample sizes to identify risk factors associated with vancomycin-induced nephrotoxicity in the elderly to improve the outcome of pharmacotherapy are required.

A Study on the Development and Implementation of a Data-mining Based Prototype for Hospital Bill Claim Reduction System (데이터마이닝 기법을 활용한 의료보험 진료비청구 삭감분석시스템 개발 및 구현에 관한 연구)

  • Yoo, Sang-Jin;Park, Mun-Ro
    • Information Systems Review
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    • v.7 no.1
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    • pp.275-295
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    • 2005
  • Changes in business environment caused by globalization of the world economy and the beginning of the knowledge society forced hospitals to equip with tools for the enhanced competitiveness. In other words, hospitals must aim three targets such as acquisition of advanced medical skills and equipments, improvement of service level for patients, and achievement of superior managerial performance simultaneously. This study has been done to suggest a way to reduce the possibility of hospital bill claim reduction as an alternative for the achievement of superior managerial performance. If the reduction rate of hospital bill claim is high, it will put negative impact on the hospital's revenue stream and hospital's reliability. Thus, if they want to stay competitive, hospitals need to device ways to cut the reduction rate as much as possible. In this study, a prototype system has been developed and implemented to check the possibility to cut the reduction rate through deep analysis of causes of reduction. The prototype first developed utilizing data mining techniques and the relation rules algorithm. Then the prototype was tested its performance using the D hospital's live data.

Factors Influencing Satisfaction on Home Visiting Health Care Service of the Elderly based on the degree of chronic diseases (만성질환 유병상태에 따른 노인 방문건강관리 서비스 만족도 영향요인 연구)

  • Seo, Daram;Shon, Changwoo
    • 한국노년학
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    • v.41 no.2
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    • pp.271-284
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    • 2021
  • This study was conducted to derive factors that affect the satisfaction of home visiting health care services and to develop effective community care models by using the results of Seoul's outreach service which is the basis for Korean community care. The population of the study was the elderly aged 65 and 70 who participated in the Seoul's outreach community services 3rd stage (July 2017 - June 2018) and 4th stage (July 2018 to June 2019). 2,200 people were extracted by the proportional allocation method and home visit interviews were conducted on them. Subjects were divided into sub-groups based on chronic disease prevalence, and logistic regression was conducted to derive factors that affect the satisfaction of home visiting health care services. The results demonstrated that the elderly without chronic diseases were more satisfied when they received health education and counseling services, the elderly with one chronic disease were more satisfied when they received Community resource-linked services. In the case of elderly people with two or more chronic diseases, the service satisfaction level is increased when health condition assessment and Community resource-linked services are provided. Regardless of whether or not they have chronic diseases, service delivery time was a factor that increased satisfaction in home visiting health care. And the degree of explanation understanding was a factor that increased satisfaction for both single and complex chronic patients. Home Visiting health care services based on the community is a key component of the ongoing community care. In order to increase the sustainability and effectiveness of community care in the future, Community-oriented health care services based on the degree of chronic diseases of the elderly should be provided. In order to provide more effective services, however, it is necessary (1) to establish a linkage system to share health information of the subject held by the National Health Insurance Service to local governments and (2) to provide capacity-building education for visiting nurses to improve the quality of home visiting health care services. It is hoped that this study will be us ed as bas ic data for the successful settlement of community care.

Comparision of Maternal Charcteristics and Birth Weight among Five Different Categories of Medical Facility for Delivery in Taegu (대구시내 각급 의료기관에서 분만하는 산모들의 특성 및 출산결과의 비교 분석)

  • Song, Jung-Hup;Park, Jung-Han;Kim, Gui-Yeon;Kim, Jang-Rak
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.1 s.23
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    • pp.10-20
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    • 1988
  • This study was conducted to compare the maternal charactristics, and birth weight of infants delivered at five different categories of medical facility in Taegu to examine the risk level of pregnant women and children by the medical facility for delivery. The study population included 1,410 pregnant women who delivered a baby at one of nine medical facilities (3 university hospitals, 2 general hospitals, 2 private clinics, 1 midwife clinic, 1 MCH center) in Taegu in April, 1987(April and May, 1987 for K university hospital), Pregnant women were interviewed to ask the age and educational level of woman, payment of medical fee, birth order, delivery method. Birth weight of infant was obtained from medical record. Mean ages of the women delivering at the university hospitals(27.5 years) and at general hospitals(26.7 years) were higher than those at midwife clinic(25.4 years) and at MCH center(26.1 years). Also, mean years of school education were higher in women of university hospitals(12.7 years) and general hospitals (12.2 years) than in women of midwife clinic(9.2 years) and MCH center (9.3 years). The percentages of women covered by the medical insurance were far greater in the university hospitals(78.1%) and general hospitals(82.9%) than in private clinics(44.3%) , midwife clinic(29.1%) and MCH center (5.4%). Infants born at the MCH center were mostly the second birth (47.3%) while 56.0% to 61.7% of infants born at all the other medical facilities were the first birth more women delivering at the university hospitals had history of spontaneous abortion as well as still birth than the women delivering at the other medical facilities. The preform birth rate (11.4%) and low birthweight incidence rates(5.8-13.0%) in university hospitals were significantly higher than those of other medical facilities. Accordingly, c-section rates showed a wide variation among the medical facilities. Study findings revealed that most of women delivering at the university hospitals and general hospitals are in the middle of or upper socio-economic class and obstetrically high risk group regardless of socioeconomic class while the wome delivering at the midwife clinic and MCH center are low risk group of low socioeconomic class. Therefore, the data of a specific medical facility are highly limited in interpretation and can not be generalized.

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The Homecare Needs of Cancer Patients (암환자의 퇴원 후 가정간호 요구)

  • Kwon, In-Soo;Eun, Young
    • Journal of Korean Academy of Nursing
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    • v.29 no.4
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    • pp.743-754
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    • 1999
  • The purpose of this descriptive study was to identify the homecare needs of patients with cancer and to provide a basis of interventions. One hundred and two patients at one general hospital in Gyeongnam responded to a questionnaire developed on the basis of care needs perceived by nurses caring for hospitalized patients with cancer. The questionnaire was a Likert type 5 point scale with 56 items on five need categories ; 1) informational 2) physical care : 3) emotional care 4) socioeconomic care and 5) special care needs. Internal consistency of this questionnaire was Cronbach's $\alpha$=.9101 for total items. The data was collected from March 1st to May 31th, 1998, by two graduate nurses. In the data analysis, mean & standard deviation were calculated to identify the degree of care need of each item, and the t-test & ANOVA were done to determine the effects of patients' demographic background on their care needs. The findings are summarized as follows ; 1) The mean score of total of need items was 3.048. Of the four need categories the highest score was informational at 3.4, followed by emotional care, 3.063, physical care, 2.623, and socioeconomic care, 2.599. 2) In the informational need category there were four subcategories with 19 items. Medication and pain control had the highest score, 3.755 ; second was diet and exercise, 3.613 ; third was disease and treatment process, 3.337 ; and last was personal hygiene and infection prevention at 2.687. 3) In the physical care need category there was nine items, IV infusion for nutrition and management of treatment complication was above 3.2 points and the remaining items were in the 2.847-2.070 score ranges. 4) In the emotional care need category there were seven items. The highest need was in support for relationships with health personnel, 3.673. The need for support of religions beliefs and support for having a religion were low at about 2 points. 5) In the socioeconomic care need category there were six items. Support for medical insurance expansion and financial support were above 3 points. Legal support and support for caring of children were low in the care needs. 6) In the special care need category the there were 15 items. Informational need about immunization and informational need about effects of disease on growth and development were high, above 4.1 points. Need for decubitus care and prevention, sitz bath and incontinence care were low, below 2 points. 7) There were significant differences in degree of care need according to admission rate, education level, marital status, religion and caregiver's religion. In conclusion, homecare needs perceived by hospitalized patient's with cancer was moderate, but informational need was higher than direct care need, leading to the conclusion that the provision of sufficient information to patients with cancer at discharge is needed. Nursing interventions should be developed considering the patient's background.

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A Study on the Nurses' Contingent Employment and Related Factors (간호사의 비정규직 고용실태 및 관련요인에 관한 연구)

  • Choi, Sook-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.3
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    • pp.477-500
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    • 1999
  • Korean labor market has showed remarkable change of the increase in the amount of unemployment and contingent employment since IMF bailout agreement. There is a theoretical position to explain this increase in contingent employment at hospitals with the notion of flexibility. The high flexibility of employment due to the increase of contingent employees is becoming very important part in new business strategy of hospitals. The types of contingent employment of the nurse are part-time employment temporary employment, fixed-term employment, and internship which was introduced in early 1999. Recently, Korean health care industry managers have paid attention to the customer oriented service, rationalization of business administration, service quality control so that they can adjust their business to outer environment. Especially their efforts concentrate on the wage reduction through efficient and scientific control of man power because wage shares about 40% of total cost. This dissertation aims at verifying the phenomena of the contingent employment of the nurse and analyzing the related factors and problems. To rephrase these aims in ordinal: First, verifying the phenomena of contingent employment of the nurse. Second, verifying the problems of that phenomena. Third, analyzing the related factors of the contingent employment of the nurse. To accomplish these research goals, a statistical survey was executed. in which 384 questionnaires-66 for manager nurses, 318 for contingent nurses - were given to nurses working at 66 hospitals-which have at least 100 beds-in Seoul. Among them, 187 questionnaires-38 from manager nurses, 149 from contingent nurses'- 'were returned. Then, the data coded and submitted to T-test, $X^2$ -test, variance analysis(ANOVA), correlation analysis, multiple regression analysis, Logistic Regression with SAS program. The research results of the contingent nurses are followings: 1. The average career term at the present hospital 8.4 months: duty-on days per month are 24.2 days: working time per day is 7.9 hours. These results showed little difference from regular nurses. 2. Their wage level is about 70% of regular nurses except for internship nurses whose wage level is 41% of regular nurses. To break down the wage composition, part-time nurses and internship nurses get few allowance and bonus. And contingent nurses get very low level of additional pay except for fixed-term nurses who are under similar condition of employment to regular nurses. These results show that hospital managers are trying to reduce the labor cost not only through the direct way of wage reduction but through differential treatment of bonus, retirement allowance, and other additional pay. 3. The problem of contingent employment: low level of pay; high level of turn-over rate: weakening of union; low level of working condition: heavy burden of work; inhuman treatment. The contingent nurses consider these problems more seriously than manager nurses do. What manager nurses regard problematic is the absence of feeling-belonged and responsibility of the contingent nurses. 4. The factors strongly related with the rate of the number of contingent nurses for the number of regular nurses; gross turn-over nurses; average in-patients per day; staring wage of graduate from professional college: the type of hospital ownership; the number of beds; the gap between gross newcomer nurses and gross turn-over nurses. The factors related with their gross wage per month; the number of beds; applying of health insurance; applying of industrial casualty insurance; applying of yearly-paid leave; the type of hospital ownership; average out-patients per day; gross turn-over nurses. The meaningful factors which make difference by employment type: monthly-paid leave; physiological leave. The logistic regression analysis using these two factors shows that monthly-paid leave is related with the type of hospital ownership; the number of beds; average out-patient per day, and physiological leave is related with the gross newcomer nurses; gross turn-over nurses; the number of beds.

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A Comparative Study on Total Payment of Mental and Behavioral Disorders Patients Admitted through the Emergency Room: Focusing on Main & Sub Sick (응급실 경유 정신 및 행동장애 입원환자들의 총진료비 비교 : 주상병과 부상병 환자 중심으로)

  • Choi, Hyun-Sik;Lee, Hyun-Sook
    • The Journal of the Korea Contents Association
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    • v.14 no.10
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    • pp.562-569
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    • 2014
  • The purpose of this study was to investigate the determinants of total payment for mental and behavioral disorders patients admitted through the emergency room. Study data was selected from the Korean National Health Insurance sample data in 2009. This data was consisted of 753 inpatients who are 331 inpatients with only main sick(F31-F39) and 422 inpatients with main sick codes(F31-F39) and sub sick(F00-F99) admitted through the emergency room. SPSS v.18 was used for the statistical analysis such as descriptive analysis, t-test, ANOVA, and multiple regression analysis. In multiple regression analysis, significant variables affecting total payment of main sick patients were gender(p<.01), treatment result(p<.001), path of the emergency room(p<.001), and length of stay(p<.001). Also, main sick patients with sub sick were gender(p<.01), age(p<.001), treatment result(p<.001), path of the emergency room(p<.001), and length of stay(p<.001). These findings implied that it is necessary to build short, middle, and longterm program and system for high risk mental and behavioral disorders groups.