• Title/Summary/Keyword: 의료비부담

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Optimal Nursing Workforce and Financial Cost to Provide Comprehensive Nursing Service in the National Health Insurance System (국민건강보험 간호·간병통합서비스의 전면 도입을 위한 간호인력 및 재정비용 추계)

  • Kim, Jinhyun;Kim, Sung-jae;Lee, Eunhee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.6
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    • pp.119-128
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    • 2017
  • This study estimated the optimal nursing workforce and financial costs of providing comprehensive nursing services at hospitals under the national health insurance system. Data on registered nurses, nursing aids, medical institutions, and number of patients were obtained from the Health Insurance Review and Assessment Service. The optimal size of the nursing workforce was calculated using the workload model. A bottom-up approach was used to estimate the annual total financial cost of comprehensive nursing services. The number of registered nurses and nursing aids would need to be increased by 81.75% and 83.23%, respectively, in order to fully apply comprehensive nursing care on a national scale. The additional financial costs for comprehensive nursing services at all hospitals was estimated to be as much as 110.39% of the current cost. For the comprehensive nursing service, nurses with a career and newcomers need to be retained at their hospitals, and the validity of the nurse-patient ratio should be continuously checked. The financial shock to the national health insurance system could be minimized by gradually extending the system to all hospitals.

Institutionalization of a Patient-Sitter Program in Acute Care Hospitals (보호자 없는 병원 제도화 방안)

  • You, Sun-Ju;Choi, Yun-Kyoung
    • The Journal of the Korea Contents Association
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    • v.13 no.6
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    • pp.370-379
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    • 2013
  • In an effort to resolve the burden of patients hiring patient sitters, this study sought to review the Ministry-of-Health-and-Welfare-initiated pilot program of running hospitals without patient-sitter to identify its background, operation method, performance results, and limitations. Based on the review, the study derived the necessity of introducing a hospital system without patient-sitter as well as its operation and systemization methods. The ministry-initiated pilot programs were conducted twice: in 2007, and in 2010. A review of the 2007 pilot program revealed that the patients and families' satisfaction score with nursing services was 9.1 points (on a 10-point scale), their intention to reuse the service was 97.8%, and their intention to recommend the service was 98.0%, all high scores. Appropriate nursing manpower, derived from the 2007 pilot project, indicated 2.3 patients per nurse and 4.0 patients per nurse aid. The 2010 pilot project results indicated that the patients and families' satisfaction was high at 8.0-9.1 points (on a 10-point scale), and that the intention to reuse and recommend the service was also high. Compared with the 2007 pilot project, however, the types of medical institutions and the nurse to patient ratios were diverse, offering limitations. In conclusion, to systemize hospitals without patient-sitter, it is necessary to develop policies designed to establish criteria for the appropriate nurse to patient ratio and skill-mix, to standardize the work, to prepare finances for securing nursing staff, to evaluate the nursing demands, and to monitor the quality management.

Co-residence and Its Effect on Labor Supply of Married Women (세대간 동거와 기혼여성의 노동공급)

  • Sung, Jaimie;Chah, Eun Young
    • Journal of Labour Economics
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    • v.24 no.1
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    • pp.97-124
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    • 2001
  • Co-residence is a type of intergenerational private transfers of resources: money, time and space. Adult daughters and their elderly parents decide to co-reside, depending on their utility levels before and after co-residence that mainly depend on the health status of the elderly. Therefore, co-residence implies positive net benefits to both parties in the sense that, when they co-reside, elderly parents share childcare and adult daughter provide elderly care. In other words, formal (paid) care can be substituted with informal (unpaid) one. Both marriage and giving births are considered as the major obstacles to labor market attachment of women who bear burdens of home production and childcare. Co-residence can be a solution for married women to avoid career interruption by sharing burdens with their elderly parents. However, most previous studies using the U.S. data on intergenerational private transfers focused on elderly care and have concluded that they reduce government expenditures associated with public subsidies to the elderly. This study focuses on adult daughters and it examines effects of co-residence on labor supply of married women in Korea, who face limited formal childcare programs in terms of both quantity and quality. It applies the Tobit model of married women's labor supply to the data from the Second Wave of the Korean Labor and Income Panel Survey( 1999), in order to investigate effects of co-residence and the work and health status of the co-residing elderly as well as their own health status. Four specifications of the empirical model are tested that each includes co-residence with elderly parents, their gender, or their work and health status. Estimation results show that co-residence, co-residence with female elderly, and co-residence with not-working female elderly have significant positive effects on labor supply of married women while poor health status of co-residing female elderly does not bring about any negative effects. However, co-residence with male elderly, regardless of their work and health status, has no significant effect The results indicate that co-residence is closely related to sharing of home production among female elderly and adult daughters who are married and, through intergenerational private transfers of resources in terms of time, it helps women avoid career interruption.

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Application of Skin Color Analysis about Digital Color System for Oriental Medicine Observing a Person's Shape and Color Implementation (한방 찰색 구현을 위한 디지털 색체계의 피부색 분석에의 적용)

  • Lee, Se-Hwan;Cho, Dong-Uk;Kim, Bong-Hyun
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.33 no.2C
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    • pp.184-191
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    • 2008
  • Oriental base diagnosis method is not going to hospital different from Oriental medicine and because of the possible disease diagnosis through the network and many communication equipment. Especially diagnosis development using ocular inspection method aspect of Oriental medicine among an aging society advance into cut the medical cost for contribution. Ocular inspection method the most important look at disease color that is Observing a Person's Shape and Color which is implementation the development of methodology and important the build of application ability system. So in this paper study observing a person's shape and color implementation of ocular inspection. Specially body's the five viscera presentate the five colors disease color in face that is important the color coordinate system thesis so that proceed the experiment for the color coordinate system analysis. Finally five color extract need the observing a person's shape and color through experiment select the digital color system and so real skin color analysis and comparison about the experiment which suggest the something to color coordinate system the best case of digital color system for observing a person's shape and color implementation.

A Study on the Space Configuration according to the Operation of Residential Welfare Facilities for the Aged (노인주거복지시설의 운영에 따른 공간구성에 관한 연구)

  • Choi, Yun-Jin
    • Journal of Industrial Convergence
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    • v.17 no.1
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    • pp.7-16
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    • 2019
  • Korea, which became an aging society in 2000, has made transition to an aged society more quickly than expected since late 2017 after 17 years. Despite this trend, the awareness towards elderly housing facilities has not yet been raised across in society. The primary reason is that use of elderly housing facilities has not been promoted due to lack of understanding about the construction and management of the facilities. The housing of the elderly should be considered in terms of not only residential space but also the issues of medical care and continuous care. Therefore, the trend of elderly housing is pursuing the Continuing Care Retirement Community. Thus, this study analyzed the policies of existing elderly housing facilities and existing elderly housing through comparison with policies and housing of foreign countries. Based on the results, the the government intends to present characteristics and direction of suitable housing design of senior citizens' housing facilities through maintenance of UNIT, securing convergence through changes in the use of facilities, and realising the cost of operation, and studying social welfare measures to cope with the increasing number of elderly residents.

Compensation for Personal Injury and the Insurer's Claim for Indemnity - Focused on the NHIC's Claim for Indemnity - (인신사고로 인한 손해배상과 보험자의 구상권 - 국민건강보험공단의 구상권을 중심으로 -)

  • Noh, Tae Heon
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.87-130
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    • 2015
  • In a case in which National Health Insurance Corporation (NHIC) pays medical care expenses to a victim of a traffic accident resulting in injury or death and asks the assailant for compensation of its share in the medical care expenses, as the precedent treats the subrogation of a claim set by National Health Insurance Act the same as that set by Industrial Accident Compensation Insurance Act, it draws the range of its compensation from the range of deduction, according to the principle of deduction after offsetting and acknowledges the compensation of all medical care expenses borne by the NHIC, within the amount of compensation claimed by the victim. However, both the National Health Insurance Act and the Industrial Accident Compensation Insurance Act are laws that regulate social insurance, but medical care expenses in the National Health Insurance Act have a character of 'an underinsurance that fixes the ratio of indemnification,' while insurance benefit on the Industrial Accident Compensation Insurance Act has a character of full insurance, or focuses on helping the insured that suffered an industrial accident lead a life, approximate to that in the past, regardless of the amount of damages according to its character of social insurance. Therefore, there is no reason to treat the subrogation of a claim on the National Health Insurance Act the same as that on the Industrial Accident Compensation Insurance Act. Since the insured loses the right of claim acquired by the insurer by subrogation in return for receiving a receipt, there is no benefit from receiving insurance in the range. Thus, in a suit in which the insured seeks compensation for damages from the assailant, there is no room for the application of the legal principle of offset of profits and losses, and the range of subrogation of a claim or the amount of deduction from compensation should be decided by the contract between the persons directly involved or a related law. Therefore, it is not reasonable that the precedent draws the range of the NHIC's compensation from the principle of deduction after offsetting. To interpret Clause 1, Article 58 of the National Health Insurance Act that sets the range of the NHIC's compensation uniformly and systematically in combination with Clause 2 of the same article that sets the range of exemption, if the compensation is made first, it is reasonable to fix the range of the NHIC's compensation by multiplying the medical care expenses paid by the ratio of the assailant's liability. This is contrasted with the range of the Korea Labor Welfare Corporation's compensation which covers the total amount of the claim of the insured within the insurance benefit paid in the interpretation of Clauses 1 and 2, Article 87 of the Industrial Accident Compensation Insurance Act. In the meantime, there are doubts about why the profit should be deducted from the amount of compensation claimed, though it is enough for the principle of deduction after offsetting that the precedent took as the premise in judging the range of the NHIC's compensation to deduct the profit made by the victim from the amount of damages, so as to achieve the goal of not attributing profit more than the amount of damage to a victim; whether it is reasonable to attribute all the profit made by the victim to the assailant, while the damages suffered by the victim are distributed fairly; and whether there is concrete validity in actual cases. Therefore, the legal principle of the precedent concerning the range of the NHIC's compensation and the legal principle of the precedent following the principle of deduction after offsetting should be reconsidered.

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A Study on the Job Performance of Dental Coordinators and Their Perception (치과코디네이터의 업무수행 및 인식도에 관한 조사연구)

  • Kwon, Soon-Bok;Kim, Young-Nam;Moon, Hee-Jung;Shin, Myung-Suk;Han, Gyeong-Soon;Han, Su-Jin
    • Journal of dental hygiene science
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    • v.5 no.4
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    • pp.211-220
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    • 2005
  • The purpose of this study was to examine the job performance of dental coordinators and their perception of their job to lay the groundwork for utilizing dental personnels more efficiently. The subjects in this study were dental coordinators who worked at selected dental hospitals and clinics in Seoul, Gyeonggi province and Incheon. A survey was conducted to gather data from May 1 to August 8, 2005 and answer sheets from 108 respondents were analyzed. The findings of the study were as follows: 1. As for the length of service, 43.5 percent of the dental coordinators investigated had worked at dental institutes for five years or more, which was followed by less than two years(19.5%) and three years to less than five years(19.4%). Concerning the length of service as dental coordinators, 39.8 percent had served for less than two years, and 19.4 percent had worked for two years to less than three years and for five years or more respectively. Regarding the name of position, 38 percent were called team leaders, and 30.6 percent were called coordinators. As to duties, the largest group of them that stood at 30.6 percent were in charge of receiving, and in regard to department, the largest group, 57.4 percent, belonged to the treatment backup department. 2. Concerning education, the greatest number of them, 45.4 percent, had received education at private institutes, and 73.1 percent found it necessary for dental coordinators to take an authorized qualification test. 43.5 percent, the largest group, looked upon the central government as the best organization to authorize their qualifications and 70.8 percent believed that what they learned enabled them to perform their job successfully. As to the necessity of follow-up education as a means to improve job performance, 96.3 percent consented to it. As for the reason, 63.9 percent considered that necessary to enhance their own ability and 22.2 percent were in want of systematic education. Regarding educational expenses, 29.6 percent were subsidized by the dental institutes where they had worked and 25.9 percent had totally been responsible for that. Regarding a required course, medical service and marketing was most widely pointed out(66.7%), followed by theory and practice(65.7%) and introduction to dentistry(57.4%). As to what sort of education they wanted to receive more, dental service and marketing was selected the most, followed by practical health insurance(35.2%). 3. In regard to what type of job they performed as dental coordinators, 88.9 percent were in charge of appointment in the field of customer service, and 87.9 percent paid attention to having good manners as service providers in the area of self-management. In the field of hospital affairs, 81.3 percent were in charge of receiving. 4. As to their awareness of dental coordinator job, the largest group took pride in the job they performed ($3.99{\pm}0.76$), and the second largest group believed that dental coordinators made a great contribution to hospital management ($3.92{\pm}0.70$). The third largest group gave a great weight to their own job ($3.91{\pm}0.84$) in light of overall dental duties and the fourth largest group found themselves to get along with other employees regardless of position ($3.86{\pm}0.74$). The fifth largest group believed their job was of great use for promoting the oral health of patients ($3.76{\pm}0.75$), and the sixth largest group thought the future of dental coordinators was promising($3.74{\pm}0.86$). 5. In regard to their perception by age group, those who were older had a better opinion on every item of their job in general. Their age made a statistically significant difference to their view of the weight of dental coordinator job(P < 0.001) in light of overall dental duties, of being approved and trusted by managers(P < 0.01), of social awareness of dental coordinator, and of being understood and approved by other employees and dentists. Their pride in current job and their satisfaction with the name of their position were statistically significantly different according to their age as well. Besides, their age made a statistically significant difference to their opinion about whether or not there was an age limit to their occupation and about their contribution to hospital management (P < 0.05). 6. As for their perception by type of job, the dental hygienists were generally most satisfied with their job, followed by nursing aids and others. There was a statistically significant gap among their opinions about whether to make a job-related decision on their own(P < 0.001). the weight of their job in terms of overall dental duties, whether their job improved their ability, whether their job made a great contribution to enhancing the oral health of patients, whether their job was understood and approved by other employees(P < 0.01), social awareness of their job, whether they conflicted with other employees during job performance, and whether dental hospitals or clinics offered a self-development opportunity for them to take their ability to another level(P < 0.05). And their satisfaction with current pay was statistically significantly different as well.

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Effectiveness of stages-matched educational program for cervical cancer screening among adult women in a community (일개 지역사회 여성 주민의 자궁경부암 조기검진 수검에 관한 행동변화단계별 교육 프로그램의 효과)

  • Kim, Young-Bok
    • Korean Journal of Health Education and Promotion
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    • v.24 no.5
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    • pp.23-37
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    • 2007
  • Background: Even though cervical cancer poses a significant global cancer burden, successful implementations for early detection offer an opportunity to prevent deaths and reduce the cancer burden. In Korea, cervical cancer is the most prevalent type of cancer among adult women, but it is one of the few cancers in which a consensus-approved screening test exists for early diagnosis, Pap test, that can be combined with highly efficacious treatment regimens for early-stage disease. Purpose: This study was carried out to identify the cognitive-behavioral factors associated with cervical cancer screening behavior among adult women, aged 40 to 59, and to develop tailored messages and to evaluate the effectiveness of stage-matched educational program. Method: A total of 283 women who aged 40 years or older was recruited in Seoul, from September, 1st to November, 14th, 2003. The intervention group (N=162) and the control group (N=121) were selected from five sub-districts in Seocho-gu, Seoul. Building on the TTM, a quasi-experimental study was conducted to test the effectiveness of stages-matched intervention addressed at the five stages of cervical cancer screening behavior. Women in the intervention group were randomly assigned to one of two conditions, internet or postal services. Results: In our results, 88.9% of participants had received a Pap test at least once in their life-time, and 65.4% had got it in the past two years. With regard to cognitive-behavioral factors, the stages-matched educational program increased attitude and process of change for cervical cancer screening. The percentage changed was the largest in maintenance stage. With regard to delivery methods for tailored messages, the print materials were more effective at increasing screening adherence than the e-mail. Whereas the postal service group showed remarkable the change of behavior stage, the internet service group did not. Also it was not shown any difference of the satisfaction with stages-matched educational program between internet and postal service groups. Conclusion: This study suggested that cervical cancer screening behavior could be changed by tailored messages which had developed with cognitive-behavioral factors. The stages-matched educational program was effective to promote the screening adherence for cervical cancer.

A Clinicostastical Analysis of Genitourinary Diseases from the Nationwide Hospital Discharge Survey (전국 퇴원환자 자료분석을 통한 소아 청소년의 비뇨생식기질환의 분포)

  • Kim, Sa-Ra;Park, Hyun-Ju;Moon, Jin-Soo;Lee, Chong-Guk
    • Childhood Kidney Diseases
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    • v.13 no.1
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    • pp.63-74
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    • 2009
  • Purpose : The current nationally representative data on inpatient care are important to make the of the national public health policy because distributions and the prevalence of diseases among children and adolescents represent the socioeconomic status of the society. The prevalence of chronic disease is increasing now in Korea as the socioeconomic condition is improving. We analyzed a part of genitourinary tract disease of the cross-sectional hospital discharge survey data in Korea collected recently to delineate the trend of genitourinary tract diseases. Methods : Korean nationwide hospital discharge survey for pediatric inpatients in the period from 2004 to 2006 was analyzed. Diagnoses in the data were coded using ICD-10 classification. Totally 826,896 cases were collected from the 85 training hospitals. Selected data of genitourinary tract diseases (belonging to N00-N99 by ICD-10) among 826,896 cases of final inpatients data were analyzed for this study. Results : Among total patients of 826,896, diseases of the genitourinary system accounted for 4.1%. and four diagnostic categories accounted for 92.8%. These were other diseases of the urinary system (N30-39), 45.8%, disease of male genital organs (N40-51),19.1%, glomerular diseases (N00-08), 17.3%, renal tubulo-interstitial diseases (N10-16), 10.6%, respectively. Conclusion : Genitourinary tract disease in pediatric inpatient shows decreasing tendency but the prevalence of chronic diseases is increasing in Korea as the socioeconomic condition is improving. For further comprehensive analysis, regular and organized nationwide survey should be performed. Development of a new data collecting system will improve the performance of such nationwide survey.

Development of the evaluation tool for the food safety and nutrition management education projects targeting the middle class elderly: Application of the balanced score card and the structure-process-outcome concept (중산층 노인대상 식품안전·영양관리 교육 사업 평가를 위한 도구 개발: 균형성과표와 구조·과정·성과 개념 적용)

  • Chang, Hyeja;Yoo, Hyoi;Chung, Harim;Lee, Hyesang;Lee, Minjune;Lee, Kyungeun;Yoo, Changhee;Choi, Junghwa;Lee, Nayoung;Kwak, Tongkyung
    • Journal of Nutrition and Health
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    • v.48 no.6
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    • pp.542-557
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    • 2015
  • Purpose: The aim of this study is to develop an evaluation tool for operation of food safety and nutrition education projects for middle class elderly using the concept of the balanced score card. Methods: After the draft of the evaluation tool for the elderly training projects was completed, it was revised into the questionnaire and the validity of the indicators was tested by the Delphi group. The validity of the indicators was rated using a 5-point scale. The Delphi group consisted of 26 experts in the education sector, 16 government officials, and 24 professionals of the related area in communities. The first round test was conducted from July 9 to July 17, 2012, and 45 persons responded. The second round test was conducted from July 18 to July 25 and 32 persons responded. Results: The indicators, which were answered by more than 75 percent of the experts as 'agree' (4 points), 'strongly agree' (5 point) were included as the final indicators for the evaluation tool: 28 items out of 36 in outcome perspectives, 9 items out of 12 in process perspectives, and 17 out of 20 items in structure perspectives. The score was allocated as 50 points for outcome indicators, 20 points for process indicators, and 30 points for structure indicators. Conclusion: Completion of the evaluation tool is a prerequisite to determine whether the program is effectively implemented. The monitoring tool developed in the study could be applied for identification of the most optimal delivery path for the food safety and nutrition education program, for the spread of the food safety and nutrition education program for middle class elderly.