• Journal of health informatics and statistics
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• 제43권4호
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• pp.318-328
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• 2018

Objectives: People are living longer, but often with diseases or chronic conditions. As a consequence, interest in resolving insurance blind spots is growing. This study provides substandard risk-relevant statistics to help substandard risks who are likely to fall in insurance blind spots obtain insurance coverage, such as the reimbursement of medical costs, as well as to stimulate insurance product development. Methods: This study uses National Health Insurance Service (NHIS) cohort data to determine the relevant statistics. The incidence rates of severe diseases are derived and compared against standard risks to establish a set of relative risk factors. These incidence rates of standard and substandard risks are then compared. Results: Currently, an individual's cancer history is used in the underwriting process for simplified issue insurance. However, underwriting focusing on hospitalization and procedures related to serious illnesses could lower premiums for substandard risks. Moreover, the statistical results could be used to expand the coverage of health insurance products. Conclusions: This study's relative risk factors can be used to derive simplified issue premium rates for substandard risks. They can also be used to implement discount and loading schemes for medical reimbursement insurance and help insurance companies implement proactive risk management.

• 한국응급구조학회지
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• 제28권1호
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• pp.77-95
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• 2024

Purpose: This study aimed to analyze the counseling status of overseas Koreans using emergency medical counseling services, identify frequently occurring types of diseases, explore approaches to emergency treatment guidance, and protect overseas Koreans from medical blind spots, thereby enhancing the quality of emergency medical counseling services. Methods: This study was approved by the Institutional Review Board of Kongju National University (KNU_IRB_2023-31), and data were collected and analyzed from 10,951 cases of emergency medical counseling services utilized by overseas Koreans from the National Fire Agency from 2018 to 2022. Results: Emergency medical consultation services for overseas Koreans included a majority of non-trauma patients, with medical consultations being predominant. Terrestrial patients commonly seek advice for internal medical symptoms, whereas maritime patients frequently present with trauma-related symptoms, with a higher incidence of cardiac arrest and altered consciousness cases at sea. The development of self-diagnostic tests based on internal medicine symptoms is necessary for terrestrial patients, whereas stakeholder education is required for maritime patients. Conclusion: Due to the different types of diseases occurring in terrestrial and maritime patients, emergency medical consultation services for overseas Koreans should be implemented according to the specific characteristics of each patient. Therefore, it is necessary to develop and disseminate response manuals that are tailored to medical and trauma-related symptoms.

• 대한공간정보학회지
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• 제22권3호
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• pp.107-112
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• 2014

경제가 발전함에 따라 의료서비스의 수요도 높아지면서 한방의료 이용도 해마다 증가하고 있는 추세이다. 특히 65세 이상 노인일수록 양방보다는 한방을 선호하는 추세이며, 고령화 사회에 접어든 우리나라의 경우 한방 의료서비스의 중요성이 더욱 높아지고 있다. 이런 측면에서 지방중소도시 중 진주시를 대상으로 한의원의 밀도분석과 접근성을 분석함으로서 의료서비스의 질을 평가하였다. 그 결과 진주시 전체 의료시설 중 한의원은 27%를 차지하고 있고 주로 중심상업지역에 밀집되어 있어서 동별 한의원서비스 질에 불균형이 존재하였다. 특히 65세 이상 노인 인구의 한의원 접근성분석에서 진주시 전체 동 중 50%이상이 의료사각지역이 발생되어 매우 취약한 상태를 보여주었다. 따라서 고령화가 급속도로 진행되는 우리나라의 인구특성을 고려해 볼 때 지방 중소도시의 한방 의료 서비스 지원에 대한 체계적인 개선대책이 마련되어야 할 것으로 판단된다.

• 대한약침학회지
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• 제26권1호
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• pp.60-66
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• 2023

Objectives: Discussions regarding "medical blind spots" in Korea's "aging society" are continuously rising. In addition, the demand for medical attention and care for the elderly and vulnerable populations continues to increase. Given this, the government is promoting the "home healthcare service" project. This study aims to lay the foundation for promoting this project by investigating the perception of clinical Korean Medicine (KM) doctors in the "community health care" project. Methods: With the cooperation of the Association of Korean Medicine, we sent a questionnaire to all KM doctors through e-mail. The survey included personal information, awareness, appropriate disease and intervention, proper visit location, and pros and cons. Results: A total of 602 responses were collected and analyzed. Approximately 20% of the doctors answered that they were well aware of the service, while 55% responded that they did not know about it. For a visit, a KM doctor selected the appropriate diseases in the order of stroke, dementia and Parkinson's disease, osteoarthritis, and chronic diseases. Among treatments, acupuncture, moxibustion, and herbal medicine exhibited similar results. The most common opinion was that KM doctors should schedule their visits once a week for 6-12 months, which was the most prolonged period among the given options. More than 80% (84.1%) of the doctors replied that care projects were highly essential, and about 63.8% expressed their willingness to participate in these projects. Conclusion: To provide appropriate home health care, we must raise awareness among Korean medicine doctors. In addition, the healthcare budget must be increased to provide the required support.

• 대한치위생과학회지
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• 제4권2호
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• pp.1-7
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• 2021

Background: To identify the factors that affect the current status and satisfaction of people with disabilities at community oral care centers. Methods: A structured self-administered survey, including five questions on facility environment, five on usage procedure, four on medical skill, four on care cost, three on friendliness, and three on satisfaction, was administered to 218 residents of the G-disabled community care center. It comprised a Likert 5-point scale (strongly agree, 5 points; agree, 4 points; moderate, 3 points; disagree, 2 points; not at all, 1 point). The reliability of the measurement tool was 0.932 for Cronbach's α. Results: The evaluation of community oral care centers for the disabled showed that the environment was hygienic (4.42±0.73), reservation system was well maintained (4.18±0.95), and the dentist-in-charge was satisfied with the treatment (4.37±0.62). The participants agreed that the details were sufficiently explained (4.29±0.71). However, in terms of medical expenses, the score of "have fully heard the explanation of medical expenses and reductions" was 3.88±0.92. The factors affecting satisfaction were sex, final educational background in the facility environment, usage procedure, and medical skill. Conclusion: To increase the satisfaction of people with disabilities at community oral care centers, it is necessary to establish a facility environment and service according to the patients' need and increase the reduction or exemption benefits between different treatment cost categories. Oral health management policies for the disabled should be developed based on these factors, so that the oral care of vulnerable groups in blind spots can be maintained.

• 농촌의학ㆍ지역보건
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• 제49권2호
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• pp.132-145
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• 2024

본 연구는 국내 의료기관 중심 보건의료·복지통합 서비스 활성 방안을 모색하기위하여 대구의료원 달구벌건강주치의사업, 삼척의료원 301 네트워크 사업, 부산의료원 3 for 1 사업 을 프로그램 논리모형을 적용하여 사례 비교하였다. 상황적 측면에서 세 사업 모두 보건의료·복지 서비스의 분절과 의료사각지대 문제를 해결하기 위해 고안되었으며, 투입 요소 중 인력은 모두 다학제 팀 구성 현황은 유사하였으나 구체적인 구성 분야, 채용 규모, 고용 형태, 에서는 기관별 차이가 있었다. 예산을 지원받는 재원 출처의 차이로 각 사업은 지역사회와 협력하고 지원하는 방식과 향후 방향성에서의 차별성도 확인할 수 있었다. 산출은 수혜대상자 수와 진료 건수에 차이가 있었으며, 투입인력 또는 운영비 대비실인원 수, 수혜대상 1인당 사업비 비교시 다른 결과를 확인하였다. 의료기관 중심의 보건의료·복지 통합제공체계의 설계 시 우선적으로 권고하는 상황은 안정적인 기금마련 기전을 확보하고 이에 합당한 대상자와 서비스 전달체계를 구축하라는 것이다. 또한, 의료기관 내 사례관리 전담기구로서 각 부문의 활동을 연계할 수 있도록 위탁이 아닌 전담부서 설치, 적정 규모의 채용, 안정적 고용 체계가 필요하며, 민·관 협력 및 경증부터 중증까지 제공할 수 있는 포괄적 제공체계 구축을 제안한다. 이를 통해 의료기관 중심보건의료복지 통합 서비스 제공 사업은 지역사회에서 풀리지 않는 난제였던 보건의료 서비스 강화와 촘촘한 연계를 가능하게 함으로 궁극적인 지역사회 건강안전망 역할 강화를 기대한다.