• Title/Summary/Keyword: Health Care Program

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Health Care Utilization and Costs for the Disabled Not Included in the Medical Aid Allowance (의료급여 장애인의 비 급여 의료비용 조사)

  • Rhee Seon Ja;Lee Hyo Young;Kim Mi Ju;Jang Soong Nang
    • Journal of Korean Public Health Nursing
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    • v.17 no.2
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    • pp.287-298
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    • 2003
  • This study was conducted to identify the health care utilization, health care costs, and potential health care demands of the disabled in the Medicaid Aid beneficiaries. This study focused on the heath care costs not included in the medical aid allowance such as transportation, informal nursing costs, and ambulatory aids etc. Participants were the 864 subjects who were beneficiaries of the National Medical Aid program living in 10 district of Korea. A questionnaires were distributed to the disabled in the Medical Aid beneficiaries during August to September, 2001 through public offices. Data were collected through a home visiting by social workers working in public offices. Direct and indirect medical costs expended for one month by the participating disabled were examined. They expended 110.748 won $({\$}100)$ for heath care costs, which was not included in the medical aid allowance during the month. The disabled with cerebral diseases or who have level 4 disability expended more health care costs compare to those with other diseases. Gradual expansion of medical aid allowance for the disabled is recommended to alleviate economic burden of the disabled and their family.

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Study on Effective Utilization Strategies of the Home Health Care Program in the Community Care Service of Welfare Policy (재가 복지 봉사 사업의 가정 간호 사업연계 필요 조사)

  • Kim, Sung-Sil
    • Research in Community and Public Health Nursing
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    • v.7 no.2
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    • pp.183-202
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    • 1996
  • This study was designed out to develop a home health care service for nurses working in community care services. This study investigates actual conditions at welfare institutions related to health needs the demands of clients, and the state of home health care services we hope that this study will improve upon the current service system. In Korea home health care services are still developing and only new becoming a part of the health care supply system. The data was collected by recording the client home nursing assessments modified to the situation of UTMB home health agency. In this study 107 clients were selected for home care who needed care for physical and mental deficits. The study lasted from March to November of 1995 at one of the welfare service institutions in Chunchon city. The results show that those who most frequently needed care services were over 50 years old with a health deficit of 80.3%, followed by sex as women who needed care at 59.8%. 50.5% of the clients had very little education. 99.1% of the clients live with their family, and a medical diagnostic analysis reveals that 73.9% of the 5 year period of illnesses were the following : 38.8% - muscular -skeleton system disorder, 24.4% - hypertension and stroke, 25.7% sole disease of arthritis. For behavioral conditions 43.3% of the patients were without care services, 56.6% of the patients were taking treatment that 73.5% of those were taking medication. The most main complaint of patients were 22.4% of pain in the extremities, next were 16.8% of a limitation of body activities, 15.0% was lumbo-sacralgia. According to the investigator who was a senior student nurse, the following suggestions were made: 32.7% for curative medical services, 29.9% for physical exercise, 19.6% for emotional support. Consultation nursing services consisted of 67.2% for physical therapy, 11.2% for the maintaining healing, 9.4% for counseling. The patients at home, required assistance most frequently for muscular-skeleton problems under the category of physical systems (33.3%). But, on the other hand, 49.5% of the patients required care givers at home, 28.2% had a knowledge deficit, 21.0% had malnutrition, 18.4% had bad impaired communication. The character of health problems were devided into chronic disease(67.0%), accidents(I3.1%), and general disease(15.9%). 86% of the disabled client had an impairment of the physical system. Eating (86.9%) , Toileting(77.6%), and personal care showed much the same of ADL condition, the level and range of achievement of mobility, the most frequently self performed was 81.3% only in a room size area, and 40.2% were completely dependent when going out. Although there were a large number of home care services in th community at these welfare institutions, many clients needed a variety of curative services. As policy changes have gathered momentum, responsibility for the development of a more suitable program was demanded by the clients from the community.

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An Operations Study on a Home Health Nursing Demonstration Program for the Patients Discharged with Chronic Residual Health Care Problems (추후관리가 필요한 만성질환 퇴원환자 가정간호 시범사업 운영 연구)

  • 홍여신;이은옥;이소우;김매자;홍경자;서문자;이영자;박정호;송미순
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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    • pp.227-248
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    • 1990
  • The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

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Designing an Effective Pay-for-performance System in the Korean National Health Insurance

  • Jeong, Hyoung-Sun
    • Journal of Preventive Medicine and Public Health
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    • v.45 no.3
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    • pp.127-136
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    • 2012
  • The challenge facing the Korean National Health Insurance includes what to spend money on in order to elevate the 'value for money.' This article reviewed the changing issues associated with quality of care in the Korean health insurance system and envisioned a picture of an effective pay-for-performance (P4P) system in Korea taking into consideration quality of care and P4P systems in other countries. A review was made of existing systematic reviews and a recent Organization for Economic Cooperation and Development survey. An effective P4P in Korea was envisioned as containing three features: measures, basis for reward, and reward. The first priority is to develop proper measures for both efficiency and quality. For further improvement of quality indicators, an electronic system for patient history records should be built in the near future. A change in the level or the relative ranking seems more desirable than using absolute level alone for incentives. To stimulate medium- and small-scale hospitals to join the program in the next phase, it is suggested that the scope of application be expanded and the level of incentives adjusted. High-quality indicators of clinical care quality should be mapped out by combining information from medical claims and information from patient registries.

Effects of Skin Anti-Aging Wellness Program on Factors Related to Wellness Index and Skin Health (피부건강 웰니스 프로그램이 웰니스지수 및 피부건강지표에 미치는 영향)

  • Kim, Hyunjun
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.4
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    • pp.223-230
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    • 2019
  • Purpose : Wellness tourism is defined as travel for the purpose of promoting health and well-being through physical, psychological, or spiritual activities. The development and verification of a comprehensive wellness program for health care for workers is needed. The purpose of this study is to investigate the wellness and skin health effects of skin health programs in order to develop high-value health care services. Methods : The subjects were 15 middle-aged women who understood the research and volunteered and participated in the two-day skin health wellness program. Participants were measured to determine their wellness index and skin health twice: before and after participating in the program. Wellness index measures include comprehensive wellness, physical wellness, mental wellness, emotional wellness, social/cultural wellness, financial wellness, and environmental wellness. Skin health measurement items consisted of skin oil, skin water, skin pore, skin elasticity, skin wrinkle, and skin pigment. The skin wellness program included aerobic exercise, endurance exercise, functional food, cosmetics, herbal tea, massages, spa treatments, meditation, and marine leisure sports. The t-test analysis was used to compare the difference between wellness index and skin health measurement items before and after the program. Results : Among the wellness index items, the comprehensive wellness index (p<.05), mental wellness index (p<.05) and environmental wellness index (p<.05) showed statistically significant differences. Among skin health items, skin oil (p<.05), skin elasticity (p<.01) and skin wrinkle (p<.01) all showed statistically significant differences. There was no statistically significant difference in physical wellness, emotional wellness, social/cultural wellness, financial wellness, skin water, skin pore and skin pigment. Conclusion : This study confirmed that the two-day complex wellness program is an effective program for some items of wellness index and skin health.

Stakeholder Survey on the Incentive Program to Promote the Adoption of Health Information Exchange (진료정보교류 인센티브사업에 대한 이해관계자 조사연구)

  • Park, Hayoung;Ock, Minsu;Park, Jong Son;Lee, Hye Rin;Kim, Soomin;Lee, Sang-il
    • Journal of Information Technology Services
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    • v.16 no.3
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    • pp.17-45
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    • 2017
  • Health Information Exchange (HIE) is expected to improve the quality and efficiency of care by allowing providers online access to healthcare information generated by other providers at the point of care. However, the adoption of the technology in Korea has been slow since its pilot program in 2007~2010 at Seoul National University Bundang Hospital. The objective of this study was to survey stakeholders on the incentive program for the facilitation of HIE adoption. We surveyed 39 experts representing 6 categories of stakeholders-provider, insurer, government, information service firms, customers, and medical informatics experts for the interviews. Interview questions included program objectives, program participation requirements, incentive payment method, and administrative burden for program participation. Experts indicated that the quality of care was the most important value the program should aim to achieve through the HIE adoption. They suggested that the requirements and administrative burden for participation should be kept at minimum to recruit a large number of providers to the program, which is an indicator of program success. Experts were divided on the payment method whether the incentive should be paid as a part of the fee payment scheme operated by the National Health Insurance (NHI) or should be a payment made independent of the NHI. The source of the divide was conflict of interest among stakeholders as to who pays for the program, and the insurer and consumer groups were against the NHI taking the financial burden. It appeared to be the most significant factor for the successful program launching to resolve the gap in perceptions about benefits of the technology among stakeholders and to win the willingness to pay for the program.

A Systematic Review on Oral Health Care Programs for the Elderly in Korea (2009~2020)

  • Choi, Eun-Seo;Jung, Im-Hee;Kim, Do-Ah;Lee, Eun-Som;Lim, Hee-Jung
    • Journal of dental hygiene science
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    • v.21 no.4
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    • pp.199-212
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    • 2021
  • Background: Various oral health management programs in Korea affect the oral health improvement in the elderly Several studies have been conducted to date; however, those studies have not shown uniform results due to the differences in research methods or designs. Hence, this study aimed to review the overall research trends of the reported oral health care programs for the elderly in Korea, verify their effects, and clarify them based on the systematic literature review. Methods: The literature search selected intervention studies that applied the oral health care program for the elderly in Korea from 2001 to 2020. Following the COre, Standard, and Ideal (COSI) models presented by the US National Library of Medicine, we selected databases including Korean studies Information Service System (KISS), ScienceOn, Research Information Sharing Service (RISS), DBpia, PubMed, and Google Scholar. Of the 1,335 studies searched using keywords, titles, and abstracts, 21 were finally selected based on primary and secondary exclusion criteria. Results: The most frequent intervention period was 4 weeks, and the number of interventions varied between 2 and 90 times. As for the type of intervention, 14 studies that conducted both theory and practice were the most frequent. Significant differences in the clinical indicators, such as calculus, halitosis, salivation rate, swallowing function, and dry mouth, were found in most oral health care programs. Conclusion: Based on the results of this study, the intervention program needs further verification using multiple indicators in future studies. In addition, a study extending the intervention period and the number of samples is considered necessary for verifying continuous effectiveness of the intervention program.

Necessity of Oral Health Care for Patients with Hypertension and Diabetes Related to Gwangju Community Care Project

  • Hyun Joo Kang
    • Biomedical Science Letters
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    • v.30 no.2
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    • pp.56-64
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    • 2024
  • In this study, 293 middle-aged and elderly people in Gwangju·Jeonnam were analyzed for prevalence of hypertension and diabetes and health behavior index using composite logistic regression analysis using SPSS ver 21.0. The prevalence of hypertension was significant in age, education level, and household type, and the prevalence of diabetes was significant in education level. The prevalence of hypertension according to health behavior related indicators was significant in subjective health awareness, prosthesis repair, and discomfort chewing, and the prevalence of diabetes was significant in subjective health awareness, oral examination, discomfort chewing. The variables affecting the prevalence of hypertension were age and prosthetic repair, and the variables affecting the prevalence of diabetes were age, prosthetic repair, discomfort chewing, and annual drinking frequency. The purpose of this study was to investigate the relationship between hypertension, diabetes mellitus prevalence and health behavior indicators of middle-aged and elderly people, and to help the importance of Community Care and oral health care improvement program.

Development and effects of basic cardiopulmonary resuscitation education program for trainee care workers (요양보호사 교육생을 위한 기본심폐소생술 교육프로그램 개발 및 효과)

  • Lee, Sung Hee;Choi, Jeong Sil
    • Journal of Home Health Care Nursing
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    • v.23 no.2
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    • pp.224-232
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    • 2016
  • Purpose: This study set out to use a one-group pretest-posttest experimental design to develop a highly motivating CPR program for help care workers who lack CPR education, and to evaluate its effects on their knowledge about program application, attitude, and self-efficacy. Methods: For this purpose, 140 questionnaires were administered to subjects who underwent training at an educational institution for care workers in S city and G province. The program was developed from April, 25 to May, 15 in 2016, and the evaluation period was from May to July, 15. The collected data were analyzed through SPSS version 23, and a paired t-test was conducted. Results: The program spanned 240 minutes, including 80 minutes on theoretical education and 160 minutes on practical education. Knowledge of CPR in the post-test proved to be higher than that in the pre-test, from 6.4 to 9.2 (t=-15.72, p<.001),; the score on attitude increased from 38.4 to 41.7 (t=-5.89, p<.001),; and self-efficacy increased from 41.0 to 66.7 (t=-21.83, p<.001). Conclusion: The basic CPR education program emphasizing motivation was effective for the care worker trainees and could be used for other curriculum by expanding the scope of the subject.

A Research on Actual Conditions of Visiting Nursing Program on Busan (부산지역 방문간호사업 실태에 관한 연구)

  • Kim, Young-Suk;Park, Jung-Ran;Park, Hyoung-Sook;Lee, Yun-Mi
    • Journal of Home Health Care Nursing
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    • v.11 no.1
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    • pp.23-32
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    • 2004
  • Purpose: The purpose of this research is to give basic data about a way of connection to individual centers and vitalization of visiting nursing program on Busan. Method: The research is done with survey for eight hospitals. sixteen public heath centers, forty-six social welfare centers to be practised visiting nursing program on Busan for actual condition of that. Results: 1. The average nursing career is below 5-10 years. But visiting nursing career is below 3 years(70%) in hospital. public, public heath center, and heath center. 2. Hospitals coverage of visiting nursing service is city as a whole. Whereas public heath center and social welfare center covered some local area. 3. Client of visiting nursing service possess in order of alone lived elderly, person in uncomplete movement, a disabled person, and a chronic disease person. 4. The main service in visiting is patient assessment, basic nursing activity, and treatment nursing activity with medication care, B.P check, dressing, bedsore care, catheter care and exchange, fluid therapy. Particularly, the hospital runs parallel to basic care and treat care in 100%. The social service center has 65.0% in a patient assessment and basic nursing activity. 5. The concern about services connecting with other center is very high. Conclusion: Actual conditions of visiting nursing program on Busan, which is presented in this study. The results of this study will become the pillar of visiting nursing program planning and application.

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