• Health Policy and Management
• /
• v.23 no.1
• /
• pp.3-18
• /
• 2013

This paper investigates the possibility of expanding pay-for-performance (P4P) program as a provider payment system, in terms of financial, economical, and political sustainability. In order to expand the sustainable P4P, P4P should have usefulness in terms of economic value as well as efficiency in the financial aspects of health care. More importantly, the P4P would be politically sustainable only when both providers and consumers can accept. Korea's healthcare system seems to have logical ground for the P4P program financially and economically. However, how well the P4P can work remains to be proven in its implementation. After 43 tertiary hospitals applied the P4P program for acute myocardial infarction (AMI) and C-section in 2007, the number of hospitals adopting the P4P program for AMI and C-section has increased to 316 in 2011, and an incentive for hospitals applying the P4P has risen to 2% from 1% of health insurance benefits. This shows that the P4P program introduced by Health Insurance Review and Assessment Service is quite successful. In addition, people are aware of the need for improved P4P program and policy alternatives have been already made. Therefore, it is very important to come up with politically supportable strategies that can make providers and consumers accept the P4P program while maintaining the governance of the existing health insurance policy. To this end, there are some tasks to be considered. First, the expansion of the P4P program should be placed on the agenda of the Health Insurance Policy Review Committee, the highest decision-making body, and a separate agency for P4P planning should be established. Second, for more efficient P4P program, the processes of review and assessment, currently carried out separately, should be integrated into a single process. Third, infrastructure to measure the quality of medical services should be sharply expanded. Fourth, the current paradigm for the assessment should be changed. Lastly, a P4P program for consumers should be considered. Given that the consumers in Korea can use medical services freely, the National Health Insurance Corporation could initiate the P4P program for consumers as a means of controlling excessive use of medical services and adjusting consumer's moral hazard.

• Clinical and Experimental Reproductive Medicine
• /
• v.34 no.4
• /
• pp.305-312
• /
• 2007

Objective: To evaluate the efficacy of split insemination method in treatments for non-male factor infertility. Method: Laboratory and clinical data were collected from 505 cycles of split insemination during 2002$\sim$2005 in our center. The subjects were non-male factor infertility such as endometriosis, tubal, uterine, PCOS and idiopathic infertility without any sperm defects. Retrieved oocytes were randomly divided, and inseminated by conventional IVF or ICSI. Fertilized zygotes were cultured for 2$\sim$5 days to ET date, and surplus zygotes and embryos were frozen for subsequent frozen-thawed ET cycles. Clinical outcomes according to insemination method were compared by statistical analysis. Results: The overall fertilization per retrieved oocytes was significantly higher in ICSI than that of conventional IVF in sibling oocytes (62.5$\pm$22.3% vs 52.9$\pm$28.0%, p<0.01). Total fertilization failure occurred only in 2 of 505 cycles (0.4%) in split insemination cycles. Incidence of fertilization failure and poor fertilization rate less than 30% by ICSI were significantly lower than those of conventional IVF (1.1% and 7.5% vs 8.5% and 22.0%, p<0.01). Delivery rates after transfer of fresh and thawed embryos from split insemination cycles were 40.0% (185/462) and 35.0% (55/157), respectively. There was no significant difference in the implantation and delivery rates of ET with embryos from conventional IVF or ICSI. Conclusion: Taken together, the split insemination method improves poor fertilization rates resulting in successful clinical outcomes and thus could be used for non-male factor infertile couples in human ART program.

• Journal of rehabilitation welfare engineering & assistive technology
• /
• v.5 no.1
• /
• pp.1-10
• /
• 2011

Our study is to verify validation of exercise effect that developing exercise and rehabilitation instrument using pneumatic actuators available rehabilitation and healthcare, while at the same time safer and more convenient for the user to select the desired exercise. Shares subject to the usual exercise is conducted in less than a week in the knee extension and flexion at the undergraduate level there is no more than 10 of the 20 patients were female. Subject performed knee exercise 3 set a day with 12times a set using fluid type exercise instrument and pneumatic exercise instrument that build in this study. Experiment has progressed in 4-weeks with 3-days a week. Our exercise load consist of two type. One is active exercise load with developed instrument in our study and the other one is passive exercise load with fluid instrument. Exercise program based on real-time muscle activation patterns and muscle activity before and after exercise by comparing the effects of exercise for rehabilitation has been verified. The results showed that muscular activity is higher in active exercise load than passive load, and improvement of muscle strength more increased too. Equipment more user-centered exercise more effectively exercise may enhance muscle strength was found. This study can adapt rehabilitation program and exercise for patient and weaker. Also our system can provide easily and convenient prescription of rehabilitation for expert related rehabilitation.

• Journal of Digital Convergence
• /
• v.18 no.2
• /
• pp.351-360
• /
• 2020

This study was designed to develop an online education program of elderly care service for the senior caregivers. Online survey was conducted senior caregivers who attended K cyber university from November 28, to December 15, 2019. Data were analyzed using chi-square, ANOVA and post test by scheffe method. The results showed that needs of the online education program for senior caregivers were significantly higher than nursing assistants. Social workers were significantly higher than the nursing assistants in the elderly care service online education demand. In terms of performance, 'understanding and counseling for the elderly' and 'practice of the elderly play program' were social workers, senior caregivers and nursing assistants. In conclusion, it is necessary to develop a specialized online education contents for each group according to the necessity of elderly professional care and the demand of online education for elderly care service.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.15
• /
• pp.6521-6526
• /
• 2015

Background: This study aimed toanalyze the risk behavior for cervical cancer (CC) and the human papillomavirus (HPV) prevalence and resolution among women who received care through the private healthcare network of a municipality in southern Brazil. Materials and Methods: This descriptive and retrospective study was conducted with 25 women aged 20 to 59 years who received care through the private healthcare network and were treated at a specialty clinic in the period from January to December 2012 in a municipality in Northwest Parana, Southern Brazil. Data from medical records with cytological and HPV results were used. Following treatment, these women were followed-up and reassessed after 6 months. Data were statistically analyzed using the t-test and chi-squared test at a 5% significance level. Results: The mean age of the studied women was $27.8{\pm}7.75$ years old, and the majority were married, with paid employment and were non-smokers. The mean age at menarche was $13.0{\pm}0.50$ years old, and the mean age at first intercourse was $17.5{\pm}1.78$ years, with only 8.0% (2) initiating sexual activity at an age ${\leq}15$ years old. The majority had 1 to 2 children (60.0%), while 88.0% reported having had one sexual partner in their lifetime, and all the women were sexually active. A total of 68.0% used a hormonal contraceptive method. All the women had leukorrhea and pain and were infected by a single HPV type. Regarding the lesion grade, 80.0% showed high risk and 20.0% low risk. The most prevalent high-risk HPV strain was 16. Conclusions: These findings provide relevant information on HPV risk factors and infection, as well as the treatment and 6-month follow-up results, in economically and socially advantaged women with no traditional risk factors, corroborating previous reports that different risk factors may be described in different populations. Thus, this study reinforces the fact that even women without the traditional risk factors should undergo HPVmonitoring and assessment to determine the persistence of infection, promoting early diagnosis of the lesions presented and appropriate treatment to thus prevent the occurrence of CC.

• Journal of Digital Convergence
• /
• v.11 no.2
• /
• pp.355-363
• /
• 2013

The study conducted an employment capability reinforcement program targeting health-related college students, and then carried out positive analysis to find out how satisfaction affects adjustment to college life and academic achievement. An employment capability reinforcement program was conducted which targeted health related majors at a university located in Cheongbuk, and information on satisfaction, adjustment to college life, and academic achievement was collected through a self-administered questionnaire. The analysis results revealed that the higher the satisfaction for the employment capability reinforcement program, the better the adjustment to college life, while increased adjustment to college life affected academic achievement. Although the employment capability reinforcement program had no direct relationship of influence to academic achievement, the study shows that it does lead to increased academic achievement by way of adjustment to college life, which ends up as a positive affect for future employment. Therefore, active efforts are necessary to revitalize employment related programs that suit the characteristics of each department in order to establish an environment for revitalizing employment and increasing adjustment to college life.

• Korean Journal of Health Education and Promotion
• /
• v.24 no.4
• /
• pp.41-64
• /
• 2007

Objectives: The purpose of this study was to verify the validity of the evaluation indicators on safety and health education programs provided to Korean industrial workers, by developing further. Methods: To develop the early evaluation indicator, the secondary analysis was made on 'Survey on Industrial safety & health trends', the national wide survey data product by Korea Occupational Safety & Health Agency, as well as the various examinations on literatures. To validate such developed evaluation indicator, 13 safety and health managers in Focus Group discussion to prove the reliability of the contents were composed. To confirm the face validity, the interview with 6 industrial safety and health education experts was held to study the appropriateness of the content. With the cooperation from Korea Occupational Safety & Health Agency, the structured survey was performed with the safety and health managers from 588 businesses who participated in the education program for the later half of 2006. In this study, the number of responses was randomly divided into 1:1 two groups, in which one group was for the Exploratory Factor Analysis and the other group was for the Confirmatory Factor Analysis. Results: The results were as follows. First, for the Structure category, 18 evaluation indicators were developed into 4 evaluation categories such as a preliminary examination, education staff and organization, education environment and rules/ regulation. Secondly, the Activity category was comprised of 10 evaluation indicators with respect to 2 areas of curriculum satisfaction and program evaluation. Finally, for the Output category, 9 evaluation indicators were developed into 2 evaluation areas such as documentation and information share and education effects. Conclusions: The evaluation indicators developed through this study will possibly develop and be applied to evaluation tools on safety and health education program, which may further become the standardized indicators to better operate the industrial safety and health education programs.

• Research in Community and Public Health Nursing
• /
• v.21 no.3
• /
• pp.362-373
• /
• 2010

Purpose: The purpose of this study is to evaluate the costs and benefits of individual home visiting health care using secondary data and literature review. Methods: The total number of subjects was 1,008,837. A specific program was classified into disease management, care of infant, child and women, or elderly care. The costs and effects of a program were identified from a societal perspective, and the effects were converted into monetary terms or benefits. The total cost was calculated in the way that medical expenses, travel costs and productivity losses were offset by the decrease in benefits and thus only the program budget was included in the total cost. Results: The total program cost was 47.6 billion won per year and the total annual benefit was estimated at 435.6 billion won. The benefits of arthritis management were the biggest among disease management programs. The net benefit was 388.0 billion won per year and the benefit/cost ratio was 9.16. Conclusion: Home visiting health care was validated to be economically effective. It made a positive contribution to improving the health status of vulnerable populations and reducing medical expenses. These results suggest that home visiting care should be extended more broadly to vulnerable populations.

• Culinary science and hospitality research
• /
• v.22 no.8
• /
• pp.172-181
• /
• 2016

This study evaluated the satisfaction and healthy eating index of nutrition-plus program providing nutritional supplements to pregnancy, lactating women, infant and children. This program was carried out at Public Healthcare Center, Seodaemun-gu in Seoul from February 2014 to June 2014. The subject selected among applicants for low income family financing of the government included 159 subjects. There was no statistically significant difference for degree of satisfaction with supplementary food by age, but the degree tends to get higher at lower age. Degree of satisfaction with supplementary food by the duration for participation was shown higher as the duration gets longer. For questions of 'Do you check nutrition label?' and 'Do you preserve food as described at food label?' in healthy eating index evaluation, the scores appeared higher at younger age group as they check the nutrition label more. Also as the duration for participation gets longer, the scores appeared higher which can be interpreted as effect of nutrition education from Nutrition-Plus. Frequency of having breakfast gets lower at higher age of subjects. And it gets higher as the duration for participation gets longer even though that there's no difference between '3 to 4 months' and '5 to 8 months' of the duration of participation. For evaluation of food security in recent 1 year, 86.8% of subjects responded 'Food sufficiency' and 'Enough but not always the kinds of food we want', and there is no difference by age and the duration of participation. As a result of this research, it is shown that the subjects of nutrition support project are relatively satisfied with the support. And healthy eating index gets improved as the duration of participation gets longer which can be considered as effect of nutrition education. It seems to be necessary to keep nutrition education as well as food support so to perform food life education on appropriate purchase and consumption of food.

• Health Policy and Management
• /
• v.26 no.4
• /
• pp.373-381
• /
• 2016

Background: The purpose of this study is to evaluate the outcomes of clinical education program for nurses in regional public hospital, utilizing the Kirkpatrick's model. Methods: Kirkpatrik's 4-level model was applied to this study. Trainees were asked to fill out questionnaires in the middle and at the end of the program. Also administrators of excellent trainees were asked to fill out the questionnaires regarding nursing management performance after 1-2 months from the end of the training course. Results: All trainees had positive reactions to the clinical education program. Not only the results of individual level (satisfaction and achievement scores, academic achievement scores, practical application rate, and educational transition factors) but also the scores of organization level (nursing management performance scores) are improved. Conclusion: By showing a correlation between the effectiveness factors we need to verify the relationship between these factors in a future study. In addition, development of quantitative and qualitative performance indicators are needed. To establish a long-term education system, it is required to applying the excellent trainee's successful experiences.