• Title/Summary/Keyword: Admission policy

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Mortality of Stroke Patients Based on Charlson Comorbidity Index (뇌졸중 환자의 Charlson Comorbidity Index에 따른 사망률 분석)

  • Kim, Ka-Hee;Lim, Ji-Hye
    • The Journal of the Korea Contents Association
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    • v.16 no.3
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    • pp.22-32
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    • 2016
  • As the number of aged population rapidly goes up, the cases of stroke and the related medical expenses continuously increase. The purpose of this study is to investigate the mortality of stroke patients based on CCI(Charlson Comorbidity Index) by utilizing the Korea National Hospital Discharge Injury Survey, analyzing the factors associated with the mortality of stroke patients. We analyzed 21,494 cases which are classified as the death of strokes aged over 20 years by using the Korea National Hospital Discharge Injury Survey between the year 2005 and 2010. In order to find out the mortality based on CCI and status of comorbidity, we used the technical statistics. We performed a logistic regression analysis to examine the reasons for the mortality of the strokes. We found that the independent variables for the influence of the mortality of strokes include age, type of insurance, residence urban size, size of hospital beds, the location of hospital, admission route, physical therapy, brain surgery, type of stroke, and CCI. This indicates that the effective monitoring on the age, types of stroke, comorbidity is needed. In addition to this, more medical support toward medicaid patients are needed, too. We believe that these results will be used positively for the evaluation of the stroke patients, providing the basic materials for the further research on the establishment of the health-related policy.

Management Strategies and the Growth Stages Analysis of Local Festival : Cases of Hampyeong Butterfly Festival and Hwacheon Sancheoneo Ice Festival (지역축제의 성장단계별분석과 관리전략 : 함평나비축제와 화천산천어축제를 중심으로)

  • Kim, Hyeonwook
    • The Journal of the Korea Contents Association
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    • v.15 no.5
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    • pp.537-549
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    • 2015
  • The purpose of this study is to analyze the characteristics of two local festivals, already recognized as a successful regional cultural festival, over a period of time to apply the product life cycle theory. As a result of the analysis of the two festivals, in introduction stage, the festival organizers have focused mainly on settling down the festival's core programs and raising awareness on the subject of the festival for the stimulation for basic demands. Second, for maintaining increasing demands, the qualitative improvement of the core program, the development of new programs and the expansion of the programs for the visitors' convenience and safety were focused on. In addition, strategies for promoting awareness of the festival had modified the strategy to promote on the contents and programs of the festival, as well as public relations strategy, not only domestic but also the foreign countries, was established and fulfilled. Lastly, in maturity stage, to overcome declining the number of visitors and economic effect both festivals have showed providing sophisticated programs for the visitors' convenience and safety, improving service quality through the development of the existing programs, providing economic benefits such as admission cuts or giving gift certificates and expanding number of foreign visitors with strengthening the promotion that was implemented in growth stage and enhancing the better image of the festival through the social contribution. Therefore, strategies for the each stage mentioned above present the significant policy implications for festival organizers who were planning to establish a new festival or implementing a festival with experiencing the tepid growth.

A study on the realization of community care for the developmentally disabled: Focusing on Japanese community practice (발달장애인 커뮤니티 케어 실현방안 연구: 일본의 지역사회 실천을 중심으로)

  • Shin, Kyung-An;Lee, Eun-A;Kim, Do-Hoon
    • Journal of Industrial Convergence
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    • v.18 no.5
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    • pp.88-96
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    • 2020
  • The rate of admission to facilities for people with developmental disabilities in Korea is very high for other types of disabilities. Therefore, 'community care', which supports life in the community for people with developmental disabilities, is very important compared to other types of disabilities. However, in Korea, families with disabilities are the problem of care and are appealing for the burden of support. This study analyzed practical cases through welfare institutional visits and interviews on support for community independence in Japan. As a result of the study, the transition of people with developmental disabilities to communities in Japan was centered on group home. The private sector is providing support for people with severe disabilities in group home to live in communities, and Sapporo City Hall is conducting private connections to solve the problem of caring for the developmentally disabled elderly parents. Accordingly, as Korean policy recommendations, it is proposed to expand group home, switch functions of living facilities for the disabled, cope with the problem of caring for the disabled by elderly parents, and provide preventive services through surveys on the actual condition of adults living alone. As practical suggestions, it is necessary to develop and distribute educational textbooks such as pictures to improve daily life skills for self-reliance, expand sufficient manpower and facilities in vocational training for self-reliance, and operate shelters for adults with developmental disabilities and their guardians.

A Comparison Analysis on the Facility Standards and Campus Sizes of the National Universities in Korea and Japan (한·일 국립대학 시설 기준 및 캠퍼스 면적 비교·분석)

  • Choi, Hyeong Ju
    • The Journal of Sustainable Design and Educational Environment Research
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    • v.18 no.3
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    • pp.1-15
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    • 2019
  • This study analyzes universities in Japan, which haves many similarities with those in Korea in certain aspects of the educational system and a common problem of reduced university admission resources, Korea's national university facility standards, policy related to nation-level university facility, and practical campus case. Through this, the study aims to examine the difference in the national approach and basic philosophy about university facilities in Korea and Japan, and also identify the major planning factors and improvement directions when establishing plans for university campuses in the future. The results of this study are as follows. First, Korea tends to promote policies related to university facilities by individual projects centered on a major pending problem or issue, while Japan has been shown to promote national university facility policies under a comprehensive mid-to-long-term plan by establishing a maintenance plan aimed at national university facilities every five years. Second, In the case of the university facility areas, the average university facility area of the examined universities in Japan is about 5.6% larger than the average university facility area in Korea. Additionally, the university facility area per student in Japan is about 13% wider than that of Korea. The total floor area of university facilities in Japan is also about 20.7% larger than that of Korea, and the university facility area per student in Japan is about 56.7% wider than that of Korea as well. Among support facilities, the total floor area of dormitories in Korea was 2.5 times wider than that of Japan, however, the acceptance rate of dormitory in Korea was 5.6% higher than Japan. Third, the university facility criteria items and systems of two countries are similar. but there are slight differences in the content such as the method of calculating student capacity, division classification, and the method of calculating the number of teachers.

An Integrated Review on Main Caregiver's Burden of Elderly in Korean Nursing Home (한국 요양시설 노인의 주 돌봄자 부담감에 대한 통합적 고찰)

  • Kim, Eun Jeong;Sung, Kyung Mi
    • Journal of Digital Convergence
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    • v.17 no.6
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    • pp.267-277
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    • 2019
  • The purpose of this study is to investigate the burden of caring for the care-givers of the elderly in Korea by using an integrated literature review method. A total of 23 studies were analyzed using a search database. When care-givers had higher sense of filial and guilt or more than two diseases, they showed high level of feeling of burden. Also, they had high level of feeling of physical burden by their oldness, service period (especially at the period of 1-3 years). In the feeling of economic burden, they had high level of feeling of burden by their oldness, or elderly's disease periods. The feeling of burden by psychological condition was found in elderly in aged and the beginning of admission of nursing home. The feeling of burden by environment situation was found when the functional status of the elderly was bad. Therefore, we need to concern care-givers's feeling of burden with elderly people in the nursing home. In the future, I believe that the findings of this study will be helpful for development of the intervention program for alleviate burden for the care-giver.

Analysis of Operation Efficiency in Private University Using the DEA (DEA를 활용한 국내 사립대학 운영 효율성 분석)

  • Bae, Young-Min;Han, Seung-Jo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.2
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    • pp.67-75
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    • 2021
  • The structure of universities needs to be adjusted and reformed to cope with the decrease in admission resources and the quality of education due to the low birth rate and aging population. Such a policy is receiving much attention. To analyze the relative efficiency of private universities in Korea from the perspective of resource and performance, this study evaluated the efficiency of private university operation by applying a DEA(Data Envelopment Analysis) technique. The DEA measurements were compared with the diagnosis results of the department of education (Government) in 2018. The input and output variables used in the research analysis were utilized by the university's notification materials (public disclosure information). An analysis of the operational efficiency showed that 48% (12 universities) of the 25 DMUs (Decision Making Unit) were efficient for DEA-BCC models and that some of the capacity-building universities were operating efficiently. In addition, the DEA analysis found ways to improve inefficient groups through DEA-Additive results. This paper can be meaningful because it confirmed the relative efficiency of private universities and suggested improvement directions through the DEA method, which is characterized by the simultaneous consideration of various input and output factors. This will help apply the limited resources related to the input and output elements of each university.

Effects of Private Insurance on Medical Expenditure (민간의료보험 가입이 의료이용에 미치는 영향)

  • Yun, Hee Suk
    • KDI Journal of Economic Policy
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    • v.30 no.2
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    • pp.99-128
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    • 2008
  • Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

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A Study on the Economic Valuation of the Suncheon Bay Wetland according to the Logit Model (로짓모형에 따른 순천만습지의 경제적 가치평가)

  • Lee, Jeong;Kim, Sa-rang;Kweon, Dae-gon;Jung, Bom-bi;Song, Sung-hwan;Kim, Sun-hwa
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.6
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    • pp.10-27
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    • 2017
  • Recently, the importance of recognizing the natural environment and the need for its conservation are increasing due to rapid urbanization. Suncheon Bay, designated as Scenic Site No. 41 and one of the World's Five Greatest Coastal Wetlands, is the only tideland among the tidal flats in Korea, which has salt marsh reserves. It has high conservation value from the ecological aspect. In addition to the Suncheon Bay National Garden, it provides various benefits not only to visitors but to local residents as well in terms of economics, environmental issues, and history and cultural aspects. Two million tourists visit the site annually, which has constantly highlighted the limits of ecological capacity. The valuation of the Suncheon Bay wetland is more important for the sustainability of the Suncheon Bay wetland than for its value as a tourism resource for the activation of the local economy. This study used the Logit model, which is commonly used among probabilistic choice models, to evaluate the economic value of Suncheon Bay wetland with the contingent valuation method(CVM). Applying the conservation value of the Suncheon Bay wetland to the benefit of KRW 8,200 for 1 person and 1 day, the benefit from exploration is KRW 2,050, the management and conservation value is KRW 3,034, and the heritage value is KRW 3,116. The results of this study are that benefit from the annual exploration of Suncheon Bay wetland was KRW 44.3 in billion, the management and conservation value was KRW 6.55 in billion, and the heritage value was KRW 6.73 in billion. When converted to the number of paying visitors per year, the conservation value is about KRW 177.1 billion. This study was conducted to evaluate the use and conservation aspects of the economic value of Suncheon Bay wetland. Based on the latent value of the Suncheon Bay wetland, it provides basic data about the efficient management and policy establishment of Suncheon Bay wetland. The study is significant in that the ecological sustainability of the Suncheon bay wetland and the value of non-marketable were evaluated based on the recognition of 'benefit through exploration', 'management and conservation value' and 'value of heritage'. It can be used as policy decision data on the integrated collection of the admission fee of the Suncheon Bay wetland and Suncheon Bay National Garden.

Effects of Telephone Hotline Counseling Program on Stroke Care (뇌졸중 환자에 적용한 핫라인 전화상담 프로그램의 효과)

  • Baik Kyun Kim;Dong-Wan Kang;Do Yeon Kim;Jung Hyun Park;Ji-Seok Woo;Young-Hee Kim;Hyun-Sook Kim;Min-Joo Moon;Jeong-Yoon Lee;Hyung Seok Guk;Nakhoon Kim;Sang-Won Choi;Hakyeu Ahn;Bosco Seong Kyu Yang;Jun Yup Kim;Jihoon Kang;Moon-Ku Han;Hee-Joon Bae;Beom Joon Kim
    • Health Policy and Management
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    • v.33 no.2
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    • pp.185-193
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    • 2023
  • Background: This study focuses on the establishment and operation of a stroke patient hotline program to help patients and their caregivers determine when acute neurological changes require emergency attention. Method: The stroke hotline was established at the Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, in June 2016. Patients diagnosed with stroke during admission or in outpatient clinics were registered and provided with stroke education. Consulting nurses managed hotline calls and made decisions about outpatient schedules or emergency room referrals, consulting physicians when necessary. The study analyzed consultation records from June 2016 to December 2020, assessing consultation volumes and types. Outcomes and hotline satisfaction were also evaluated. Results: Over this period, 6,851 patients were registered, with 1,173 patients (18%) undergoing 3,356 hotline consultations. The average monthly consultation volume increased from 29.2 cases in 2016 to 92.3 cases in 2020. Common consultation types included stroke symptoms (22.3%), blood pressure/glucose inquiries (12.8%), and surgery/procedure questions (12.6%). Unexpected outpatient visits decreased from 103 cases before the hotline to 81 cases after. Among the 2,244 consultations between January 2019 and December 2020, 9.6% were recommended hospital visits, with two cases requiring intra-arterial thrombectomy. Patient satisfaction ratings of 9-10 points increased from 64% in 2019 to 69% in 2020. Conclusion: The stroke hotline program effectively reduced unexpected outpatient visits and achieved high patient satisfaction. Expanding the program could enhance the management of stroke-related neurological symptoms and minimize unnecessary healthcare resource utilization.

Effects of Visiting Prehabilitation Program against Functional Decline in the Frail Elderly: A Prospective Randomized Community Trial (허약노인을 위한 방문재활 프로그램의 장애발생예방 효과에 대한 연구)

  • Kim, Chang-O;Lee, Heeyeon;Ho, Seung Hee;Park, Hyunsuk;Park, Chulwoo
    • 한국노년학
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    • v.30 no.4
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    • pp.1293-1309
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    • 2010
  • This study is aimed to evaluate the effects of community-based prehabilitation program developed to prevent functional decline in the frail elderly and to provide a basis to practically operate this program in the public health care service. From March to August 2009, 110 frail elderly people were recruited among the registered participants of the home visit program in Korea to perform a prospective randomized community trial. We randomly assigned these people into two groups. One group (n=50) participated in the visiting prehabilitation program for 3 months focusing on improving their muscle strength of upper and lower limbs, walking ability, and balancing. The other group (n=60) underwent our visiting fall prevention program for control. To assess the effectiveness of prehabilitation program, physical functioning (PF) and short physical performance battery (SPPB) were measured for the primary outcomes and also some other indicators: exercise performance, nutritional status, emotional functioning, experience of admission, and events of fall. As a result, significant improvements of geriatric functional status were noticed among the participants. After 3 months, PF increased by 1.3 ± 3.8 points in prehabilitation group and decreased by 1.1 ± 5.4 points in controls (p=.020). SPPB improved by 2.4 ± 2.0 points in prehabilitation group and increased only 0.3 ± 1.5 points in controls (p<.001). Significant effects were also shown in their exercise performance tests and emotional status, the number of multiple falls, and the experience of functional decline after the fall (p .002-.038). Visiting prehabilitation program is safe and effective program for frail older adults. Thus, it is strongly recommended to universally adopt this program to prevent functional decline in the frail elderly.