• 농촌의학ㆍ지역보건
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• 제8권1호
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• pp.35-43
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• 1983

Health institutions in Korea include a wide range of traditions, most notable of which are hospitals, clinics, pharmacies and health centers as foci for the dispension of western medicine care ; and herb clinics and shamans acting as centers for traditional medicine. Health consumers have pluralistic conceptions of illness(or disease) and act accordingly, using what they consider as appropriate medical practices. The research conducted surveyed residents of Jeomdong-Myon(a rural farming district), Guro 6-Dong(an urban district) and the Banwol(a semiurban district) area on attitudes about health institutions and their utilization of them. The results indicate that the hospital is considered the most reliable health institution, however, the most widely known and commonly used institution was the pharmacy. Hospitals and clinics were found to be utilized more frequently by those residents who were familiar with them than by others less familiar with them. In addition respondents with higher education, those with medical insurance, and those living in urban areas tended to utilize hospitals and clinics more frequently than their less educated, uninsured, or rural counterparts. Converse to the ranking of western medical institutions, traditional health institutions were rated low with regards to reliability, familiarity and utilization. This indicates that western medical care has pervaded the Korean medical system.

• 보건행정학회지
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• 제16권2호
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• pp.77-95
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• 2006

The present study was conducted to examine the degree of variation in length-of-stay (LOS) among health care institutions participating in 17 diagnosis-related groups (DRGs) payment system and to find out hospital characteristics affecting the variation. Electronic medical claims data for treatments of severity classification '0' of 17 DRGs provided for two $years(2003{\sim}2004)$ were collected. For each DRG, the degree of variation in average LOS among health care institutions were analyzed using the random effect model. For DRGs showing significant differences in LOS, multiple regression analyses were performed to find out factors associated with LOS. Significant variations in LOS were observed 9 DRGs including unilateral/bilateral lens procedures, adult/child tonsilectomy, other anal procedures, bilateral adult/child herniorraphy, unilateral child herniorraphy, and hysterectomy, and hysterectomy using laparoscopic procedure. Among the 9 DRGs, five DRGs were selected to investigate the factors explaining for the variation. It was observed that the location of institution was significant predictors for all five DRGs. Within the same DRGs, LOS was significantly shorter among the institutions located in Seoul than those in other areas. As compared to clinics, hospitals and general hospitals/tertiary care institutions showed significantly longer LOS for DRGs of lens procedures, tonsilectomy, and other anal procedures. It is recommended that the institutions located in other than Seoul area benchmark the strategies of the institution in Seoul in efficiently managing LOS. Also, significant variation within the same severity classification such as other anal procedures implies the imminent need for improvement of patient classification system.

• Journal of Hospice and Palliative Care
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• 제26권2호
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• pp.42-50
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• 2023

Purpose: The purpose of this study was to identify barriers to effective conversations about advance care planning (ACP) and palliative care reported by health care and community-based service providers in Massachusetts, USA. Methods: This qualitative research analyzed open-ended responses to two survey questions, inquiring about perceived barriers to having conversations about ACP and palliative care with patients and consumers. Data were collected between November 2017 and June 2019 from nine organizations in Massachusetts, including health care provider organizations, health insurers, community-based organizations, and a nursing education institution. Two researchers reviewed and coded the responses and identified common themes inductively. Results: Across 142 responses, primary barriers to ACP included hesitation and lack of understanding and knowledge, discomfort and resistance among service providers, lack of staff knowledge, difficulties with followup, and differences in ACP policies across regions. Common barriers to palliative care were misconceptions about palliative care and lack of knowledge, service providers' lack of preparedness, and limited policy support and availability. Challenges relevant to both ACP and palliative care were fear and discomfort around serious illness discussions, lack of knowledge and awareness, discussions that occur too late, and cultural and language barriers. Conclusion: Health care practitioners and community-based professionals reported consumer-, service provider-, and system-level barriers to facilitating conversations about ACP and palliative care with patients experiencing serious illness. There is a need for more tools and support to strengthen service providers' ACP and palliative care competencies and to promote a structured approach to health care planning conversations.

• Journal of Preventive Medicine and Public Health
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• 제34권4호
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• pp.389-398
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• 2001

Objectives : To investigate the information searching behavior of health care consumers according to sociodemographic characteristics. Methods : A questionnaire survey was conducted of 1,507 persons who were selected through a multi-stage stratified area cluster sampling of the Republic of Korea, excluding the province of Jeiu-do. Personal were conducted through a door-to-door survey between 27 July and 10 August 1999. Results : 80.5% of respondents used more than one source of information and those $40\sim59$ years of age, female, a housewife or student and those who claimed a religion demonstrated more active information searching behavior. A personal informer was used significantly more in those $20\sim39$ years old, female, and those who claimed a religion. Clerical workers, those with post-secondary education and a monthly income greater than 2,000,000 won ($1500) were more actively used a public informer. Low socioeconomic status and older persons used an experimental informer when they chose a health care institution. Conclusion : Regardless of the sociodemographic characteristics, personal and experimental informers were the most useful source of information. Because appropriate information was not easy to obtain, the health care consumer was dependent upon word-of-mouth communication(personal informer) when using health care services.

• 한국병원경영학회지
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• 제9권2호
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• pp.76-101
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• 2004

The primary purpose of this study was to provide the basic information for improving collaborating care of Korean traditional medicine and western medicine by surveying utilization and attitude on it among cerebral apoplexy(CA) patients hospitalized at a general hospital with both the western and Korean traditional medical department in Busan metropolitan city, Korea. The survey was conducted on 170 patients, 80 from Korean traditional medical department, and 90 from western medical department. The major results of this study were as below: First, CA patient's medical utilization patterns including selecting medical institution, term of treatment and type of medical institution at first-aid were significantly variated by their socio-demographic characteristics such as religion and job. Second, the perceptions of collaborating care, such as effectiveness and reduction of treatment period, were better at respondents who were hospitalized at oriental medical department and had been experienced with collaborating care. Third, the major contents of collaborating care which utilized by respondents in side of western medicine were physical therapy, x-ray, pathologic diagnosis, and medication, and in side of Korean traditional medicine were acupuncture, herbal medication, moxa cautery, cupping a boil therapy. Fourth, overall satisfaction on collaborating care was good(3.5 of 5.0) and was significantly variated by age and religion. Fifth, respondents perceived that collaborating care was most helpful for rehabilitation and the major problem of current duplicate medical system was increasement of medical expenditures, and the major obstacle of collaborating care was prejudice against each other medicine. The results of this study imply that effective marketing for collaborative care suitable for age and religion of customers and patient satisfaction strategy is needed to activate collaborating care.

• 근관절건강학회지
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• 제21권1호
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• pp.11-18
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• 2014

Purpose: The purpose of this study was to understand care workers' fall-related knowledge and caring behaviors for fall prevention in nursing home. Methods: This study was a descriptive survey study. Data have been collected from 125 care workers in 5 nursing homes. Data were analyzed using frequency, t-test, one-way analysis of variance (ANOVA), and Pearson correlation coefficients. Results: 1) The average percentage of correct answers for care workers' fall-related knowledge was 72.2%. There were significant differences in fall-related knowledge by age, experiences of re-education about care for fall injuries, and experiences to transfer fall patients to another hospital. 2) The average level of care workers' caring behaviors for fall prevention was 3.81 points out of 4. There were significant differences by experiences of education about care for fall injuries in nursing home and concern of fall injury prevention. 3) There was a significant correlation between fall-related knowledge and caring behaviors for fall prevention (r=.320, p<.001). Conclusion: The level of fall-related knowledge is positively correlated to the level of caring behaviors for fall prevention. Therefore, nurses should prepare education programs to increase care workers' fall-related knowledge and caring behaviors for fall prevention.

• 동서간호학연구지
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• 제25권2호
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• pp.157-165
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• 2019

Purpose: This study aims to provide basic data for the development of measures and promoting home health nursing by examining the current status and trends in home health nursing for long-term care (LTC) insurance beneficiaries. Methods: Secondary data, including annual LTC insurance statistics reports for 2010-2017 and LTC manpower data, were used to compute current status and trends in the provision of home health nursing. Results: Beneficiaries of home health nursing under LTC insurance, insurance-covered costs for home health nursing, home health nursing provider, and home health nursing providing institution only accounted for 3% of all insurance-covered home care services, and were on a consistent decline since 2010. In particular, vulnerable rural regions with high proportion of individuals had poor infrastructure in terms of home health nursing institutions and manpower, but had a higher home health nursing utilization rate compared to urban regions. Conclusion: In addition to measures to support home health nursing service beneficiaries, policy measures are needed to support home health nursing service personnel and institutions. Furthermore, programs to cultivate the expertise of home health nurses and improve quality of home health nursing services should be developed in order to promote home health nursing utilization in vulnerable rural regions.

• 성인간호학회지
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• 제26권5호
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• pp.543-552
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• 2014

Purpose: The purpose of this study was to develop integrated evaluation indicators of home care services in the hope that the increasing group of long-term home care patients could receive quality care services. Methods: The development involves a methodological study on a development phase and a verification phase. The main survey at a verification stage was conducted by the staffs at 146 institutions who agreed to participate on this study. Results: The evaluation index for the integrated home visit care consisted of five categories and 57 indicators including Managing Institution (12), Environment and Safety (3), Right and Responsibility (7), Process of Care (31) and Results of Care (4). The criterion-related validity was verified in regard to the participation in the 2010 evaluation of long-term home-care institutions by the National Health Insurance Corporation. Conclusion: The evaluation index of the integrated home visiting care developed in this study is considered suitable to utilize as evaluating indicators in managing and evaluating the way of how institutions integrate and provide home visit care services as well as home nursing care services.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2002년도 제54차 추계 학술대회 연제집
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• pp.184-185
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• 2002

• 보건행정학회지
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• 제19권2호
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• pp.51-70
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• 2009

Background : Previous studies have reported that enhanced continuity of care prevented a sudden worsening in progress among chronic disease patients, and as a result was favorable for efficient spending of health care funds. This study aims to estimate the continuity of care of Korean with diabetes and to identify factors affecting the continuity of care. Methods : This study used the Korean National Health Insurance Claims Database which includes E11 (ICD-10) as a primary or secondary disease as of 2006. Study population is 1,160,725 type 2 diabetics (20-84 years). Continuity of Care Index (COC), Modified, Modified Continuity Index (MMCI), and Most Frequent Provider Continuity (MFPC) were used as indexes of continuity of care. Results : The continuity of care in the study population was $0.94{\pm}0.10$ as calculated by MMCI, $0.91{\pm}0.16$ as calculated by MFPC and $0.86{\pm}0.23$ as calculated by COC. The lower continuity of care was shown in the patients who were female, 65 and over years old, Medical Aid recipients, 13 times or more visitors, hospital users as main attending medical institution, patients experienced hospitalizations or comorbidities. Conclusion : The continuity of care for adult patients with type 2 diabetes was high in Korea, and showed variation according to patients' characteristics. This result provides empirical evidence for policymakers to develop or strengthen programs for managing patients showing low continuity of care.