• Health Policy and Management
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• v.34 no.2
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• pp.163-177
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• 2024

Background: This study aims to examine changes in fraudulent claim counts and total reimbursements before and after enhancements in counterfeit claim controls and monitoring of provider claim patterns under the "Proactive self-audit pilot program of fraudulent claims." Methods: This study used the claims data and hospital information (July 2021-February 2022) of the Health Insurance Review and Assessment Service. The data was collected from 1,129 hospitals assigned to the pilot program, selected from the providers who filed a claim for reimbursement for intravenous injections. Paired and independent t-tests, along with regression analysis, were utilized to analyze changing patterns and factors influencing claim behaviors. Results: This program led to a reduction in the number of fraudulent claims and the total amount of reimbursements across all levels of hospitals in the experimental groups (except for physicians below 40 years old). In the control group, general hospitals and hospitals demonstrated some significant decreases based on the duration since opening, while clinics showed significant reductions in specified subjects. Additionally, a notable increase was observed among male physicians over the age of 50 years. Overall, claims and reimbursements significantly declined after the intervention. Furthermore, a positive correlation was found between hospital opening duration and claim numbers, suggesting longer-established hospitals were more likely to file claims. Conclusion: The results indicate that the pilot program successfully encouraged providers to autonomously minimize fraudulent claims. Therefore, it is advised to extend further support, including promotional activities, training, seminars, and continuous monitoring, to nonparticipating hospitals to facilitate independent improvements in their claim practices.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.1
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• pp.28-40
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• 2019

The incidence of pediatric-onset inflammatory bowel disease (IBD) is on the rise, accounting for up to 25% of IBD cases. Pediatric IBD often has extensive bowel involvement with aggressive and rapidly progressing behavior compared to adult IBD. Because IBD has a high morbidity rate and can have a lifelong impact, successful transition from pediatric to adult care is important to maintain the continuity of care. Furthermore, successful transition facilitates appropriate development and psychosocial well-being among patients, as well as comprehensive and harmonious healthcare delivery amongst stakeholders. However, there are various obstacles related to patients, family, providers, and organizations that interfere with successful transition. Successful transition requires a flexible and tailored plan that is made according to the patient's developmental abilities and situation. This plan should be established through periodic interviews with the patient and family and through close collaboration with other care providers. Through a stepwise approach to the transition process, patients' knowledge and self-management skills can be improved. After preparation for the transition is completed and the obstacles are overcome, patients can be gradually moved to adult care. Finally, successful transition can increase patients' adherence to therapy, maintain the appropriate health status, improve patients' self-management, and promote self-reliance among patients.

• Asia pacific journal of information systems
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• v.32 no.4
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• pp.890-915
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• 2022

Although existing studies on e-health have usually focused on e-health services adoption intention, there is a dearth of studies on the barriers that affect e-health services retention intention especially in India. Additionally, although studies have mostly focused on utilizing expectation-confirmation model to understand innovation related barriers, innovation resistance theory (IRT) has been overlooked. As Indian e-health service providers face stiff challenges due to customer's unwillingness to continue using the service, there is a need to bridge the research gap that exists in this context. This mixed-method study, based on responses received from 289 participants and 1154 online negative reviews from e-Health providers in India, examines the barriers from the IRT stance. Results of this study reveal a notable negative association between tradition, value and financial barrier and intention to continue using e-health services. Additionally, continuance intention affects recommendation. The study concludes with various implications and scope for future research.

• Journal of the Korea Convergence Society
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• v.12 no.1
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• pp.369-377
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• 2021

Augmented reality smart-glass enables healthcare providers to use patient and their care related information without interference of workflow. In addition, augmented reality smart-glass simulation had advantages in improving competency via remote collaboration and real-time information sharing. This study investigated perception and attitude regarding augmented reality smart glass based healthcare simulation on three different groups of healthcare major students, computer major students, developers and faculties. Using convenience sampling method, data were obtained from 95 participants and statistical analysis were performed using SPSS 25.0. Developer and faculty group showed the highest scores, followed by healthcare major students. There was the high expectation on augmented reality smart-glass for skill acquisition and the high performance and big screen were essential features of device. The findings of this study revealed that differences between healthcare and computer major students exist and strategies to reduce those gaps are required to adopt augmented reality smart glass in healthcare settings.

• Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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• v.9 no.10
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• pp.407-421
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• 2019

The purpose of this study was to survey the knowledge and practice about preventive behavior for urinary tract infection in caregivers, and ultimately to provide the basic information in terms of urinary tract infection prevention. Participants in this study were caregivers who working at the 7 long-term care facilities in J-city of South Korea. Total 198 were participated in this study. Descriptive statistics, t-test, one-way ANOVA, and scheffe test were performed using SPSS Windows for 21.0 program. The correct answer rate for the knowledge about preventive behavior of urinary tract infection was 79%. The practice of urinary tract infection preventive behavior were significantly differed by the number of nurses, the number of elderly, working time and the experience, perceived importancy, necessity with education for urinary tract infection. The preventive behavior for urinary tract infection in caregivers should be supervised by health care providers. Moreover, it should be needed to educate and apply the basic education program to improve the caregivers' knowledge and practice for preventive behavior in urinary tract infection by healthcare providers. Continuous infection monitor and education by healthcare providers can be contributed the quality of elderly caring services and development of monitoring system for urinary tract infection in long-term care facilities.

• 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.

• Information Systems Review
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• v.17 no.1
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• pp.19-47
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• 2015

The purpose of this research is to represent how ICT relatedness and organization environment influence on interactions between healthcare specialist and patients, and how knowledge sharing influence on healthcare innovation, and how service innovation influence on service performance through structured research model. This research also has applied to resource based view, adaptive structuration theory, service innovation, ICT relatedness to find out performance effect on healthcare service innovation and service performance. In other words, organization structure environment and ICT relatedness are important factors to promote interaction between healthcare service providers and customers like patients each other, moreover, to share the tacit knowledge by creating in the interaction. Moreover in order to verify model fitness, this research has surveyed among healthcare specialists, technicians and other staffs. Model verification result, all hypotheses have been found to give a positive effect on the creation and significantly. Structured organizational environment and ICT association is to promote the organization's functions by influencing the behavior of the service organization and patient interaction and knowledge sharing, and suggests that the major factors influencing the innovation performance of hospitals and health care services.

• The Journal of the Convergence on Culture Technology
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• v.8 no.3
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• pp.405-413
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• 2022

Since the COVID-19 outbreak, the active utilization of new health care service utilizing the ICT technology and data science such as telemedicine, smart hospital, AI dignosis has been increasingly found. In this study we examined the business model of Amazon healthcare which leads disruptive innovation in U.S. health care industry with the introduction of hybrid model of telemedicin, in-person care and customer-centric online drug delivery, home-use diagnostic kit, characterized by the integrated model combining medical care, drug delivery and the use of diagnostic kit. We showed using the multiproduct competition model that the synergy effect between the Amazon's original business areas and the healthcare business area causes the active market penetration and the increase in the customer value from utilization of the Amazon care. Using Hotelling's spatial competition model, we also showed that the competition in the health care market can be greater when consumer's choice of health care providers are available in telemedicine platform. In the long, run the issue of competition being weakened due to the exit of less competent healthcare providers may arise, to which the policymakers in the charge of fair competition in health care industry should pay attention.

• Journal of Korea Entertainment Industry Association
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• v.15 no.8
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• pp.213-231
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• 2021

Due to the absence of rehabilitation sports service systems linked to post-discharge medical measures and rehabilitation, disabled people cannot participate in physical activities suitable for individual disability types, characteristics, and physical functions. In December 2017, the Act on the Rights of Health for the Disabled) was implemented to provide an institutional basis for disable people to address their needs for rehabilitation sports. Based on related studies conducted in Korea, this study aims to collect the results of a demand survey conducted on experts who are rehabilitation sports service providers and analyze the demand for rehabilitation sports services from a policy perspective. This study extracts the needs of experts presented in the literature and presents the extracted content as an inductive content analysis. The criteria for selecting the literature were selected based on studies related to "adaptive physical activity and exercise," "sports for all for the disabled," and "rehabilitation sports" conducted in the Republic of Korea, including the results of a demand survey on experts. The study results were categorized into seven categories (perception of sports activities, programs, leaders, facilities, accessibility, cost/support/financial resources, and others) of field experts who are rehabilitation sports service providers. In a future study, it will be necessary for people with disability, who are consumers who will provide actual services, to identify problems at the disabled sports site and come up with measures to improve them.

• Women's Health Nursing
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• v.18 no.1
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• pp.49-61
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• 2012

Purpose: The purpose of this study was to examine the experiences of the use of external breast prostheses among breast cancer survivors in Korea. Methods: A qualitative descriptive study was conducted, using focus groups. Data were collected from breast cancer survivors who were patients of C women's hospital in Seoul, Korea. Data were analyzed using content analysis in order to identify significant themes. Results: Participants included forty breast cancer survivors who had mastectomy as a surgical treatment. Four themes emerged from the collected data were: 1) concern over the high price of external breast prosthesis, 2) irregular use of external breast prosthesis, 3) unsatisfied with mastectomy bra, and 4) wanting to hide or not to talk about using breast prosthesis openly. Conclusion: Since most participants reported irregular use and negative experiences related to external breast prosthesis or mastectomy bra use, healthcare workers should allow more time for proper fitting and counseling and consulting with breast cancer survivors. In addition, health care providers as well as family and friends should keep in mind that cancer survivors need support that can help them cope by using positive reframing. Furthermore, improvements in the coverage of costs and services are needed for these women. This would be helpful for breast prosthesis users.