• Title/Summary/Keyword: Blind Spots in Medical Service

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Comparison of Severe Disease Incidence among Eligible Insureds to Expand Coverage for Substandard Risks (유병자 보험의 보장성 확대를 위한 유병자들의 중증질환 발생률 비교)

  • Baek, Hyeyoun;Son, Jihoon;Shin, Jimin
    • Journal of health informatics and statistics
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    • v.43 no.4
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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.

Current status and improvement strategies of emergency medical counseling service for overseas koreans (재외국민 응급의료상담 서비스의 이용 실태 및 서비스 향상방안)

  • Hyeon-Jeong Ko;Eun-Sook Choi
    • The Korean Journal of Emergency Medical Services
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    • v.28 no.1
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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.

Geospatial Analysis for Oriental Medical Services of Jinju (진주시 한의원 의료서비스 공간특성분석)

  • Kim, Mi Song;Yoo, Hwan Hee
    • Journal of Korean Society for Geospatial Information Science
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    • v.22 no.3
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    • pp.107-112
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    • 2014
  • In keeping with the increasing demand for medical services in accordance with the economic development, the use of oriental medicine is on the rise year by year. In particular, it is a tendency that the elderly over age 65 prefer the oriental medicine to the western medicine in Korea. Under the circumstance, changing into an aging society, the importance of oriental medical services has been growing. In this regard, this study evaluated the quality of medical services by conducting the density analysis and the accessibility analysis of oriental medical clinic targeting Jinju, which is one of local small and medium-sized cities. The study results reveal that oriental medical hospitals accounted for 27% of the entire medical facilities in Jinju, and there was an imbalance in the quality of the oriental medical services according to districts(called dong) because oriental medical hospitals were mainly concentrated in the central commercial areas. In particular, in terms of the analysis on the accessibility of an aging population over age 65 to the oriental medical hospitals, over 50% of the whole districts (dongs) in Jinju were blind spots in medical services, showing a very vulnerable condition. Accordingly, it is judged that systematic measures for improvement in support of the oriental medical services in local small and medium-sized cities should be provided in Korea when we consider the characteristics of Korea where an aging population is rapidly increasing.

Home Healthcare Service Awareness Survey for Korean Medicine Doctors: a survey study

  • Hye In Jeong;Taegwang Nam;Minhui Hong;Kyeong Han Kim
    • Journal of Pharmacopuncture
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    • v.26 no.1
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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.

Factors affecting the satisfaction of persons with disabilities at community oral care centers (일부지역 장애인구강진료센터 이용 만족도에 미치는 요인)

  • Yoon, So-Ra;Lee, Jae-Ra;Choi, Eun-Young
    • Journal of Korean Dental Hygiene Science
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    • v.4 no.2
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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.

Comparison of Integrated Health and Welfare Service Provision Projects Centered on Medical Institutions (의료기관 중심 보건의료·복지 통합 서비스 제공 사업 비교)

  • Su-Jin Lee;Jong-Yeon Kim
    • Journal of agricultural medicine and community health
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    • v.49 no.2
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    • pp.132-145
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    • 2024
  • Objectives: This study compares cases of Dalgubeol Health Care Project, 301 Network Project, and 3 for 1 Project based on program logic models to derive measures for promoting integrated healthcare and welfare services centered around medical institutions. Methods: From January to December 2021, information on the implementation systems and performance of each institution was collected. Data sources included prior academic research, project reports, operational guidelines, official press releases, media articles, and written surveys from project managers. A program logic model analysis framework was applied, structuring the information based on four elements: situation, input, activity, and output. Results: All three projects aimed to address the fragmentation of health and welfare services and medical blind spots. Despite similar multidisciplinary team compositions, differences existed in specific fields, recruitment scale, and employment types. Variations in funding sources led to differences in community collaboration, support methods, and future directions. There were discrepancies in the number of beneficiaries and medical treatments, with different results observed when comparing the actual number of people to input manpower and project cost per beneficiary. Conclusions: To design an integrated health and welfare service provision system centered on medical institutions, securing a stable funding mechanism and establishing an appropriate target population and service delivery system are crucial. Additionally, installing a dedicated department within the medical institution to link activities across various sectors, rather than outsourcing, is necessary. Ensuring appropriate recruitment and stable employment systems is needed. A comprehensive provision system offering services from mild to severe cases through public-private cooperation is suggested.