• Health Policy and Management
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• v.32 no.2
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• pp.154-163
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• 2022

Background: The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. Methods: We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. Results: In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. Conclusion: High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

• Journal of agricultural medicine and community health
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• v.19 no.2
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• pp.159-173
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• 1994

Since the establishment of health centers in the 1960s, the centers have been played an important role in providing basic health care for the people. Although the health centers made a great effect to prevent diseases and promote the health status of the people for the last three decades, the function of health centers should be strengthened to meet the health care need of individual, family and community. Over the last ten years, there have been great changes and developments in health related environments, such as population size and age, rapid urbanization, up-grading of the educational level, increase of income, health care demand for promotive health care measures and practical measures for chronic diseases and also practicing healthy life. According to the great changes in health related environments, the health centers should be reformed. The following policy options are recommended as a summary; First, the function of health centers should be converted from providing basic health services into promotive and preventive health care services, to meet changing needs of people. Second, the health center personnel should be reinforced for their competency to provide a qualitative services to people and also the operation of health center should be reactivated. Third, a close linkage of health centers with the private sector is an essential requirement for the operation of the health care delivery system within a health district in order to improve the health status of people. Fourth, type of manpower mix, scope of organization and health care program should be varied, based on the health care needs of people, geographical characteristics and size of population etc. Fifth, a comprehensive health care delivery system should be developed, for maintaining healthy life style of people and also the health and welfare services should be integrated in order n ensure an effective service.

• Health Policy and Management
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• v.30 no.2
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• pp.164-177
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• 2020

This study aims to compare the experience of selected countries in operating separate payment system for new healthcare technology and to find implications for price setting in Korea. We analyzed the related reports, papers, laws, regulations, and related agencies' online materials from five selected countries including the United States, Japan, Taiwan, Germany, and France. Each country has its own additional payment system for new technologies: transitional pass-through payment and new technology ambulatory payment classification for outpatient care and new technology add-on payment for inpatient care (USA), an extra payment for materials with new functions or new treatment (C1, C2; Japan), an additional payment system for new special treatment materials (Taiwan), a short-term extra funding for new diagnosis and treatment (NUB; Germany), and list of additional payments for new medical devices (France). The technology should be proven safe and effective in order to get approval for an additional payment. The price is determined by considering the actual cost of providing the technology and the cost of existing similar technologies listed in the benefits package. The revision cycle of the additional payment is 1 to 4 years. The cost or usage is monitored during that period and then integrated into the existing fee schedule or removed from the list. We conclude that it is important to set the explicit criteria to select services eligible for additional payment, to collect and analyze data to assess eligibility and to set the payment, to monitor the usage or cost, and to make follow-up measures in price setting for new health technologies in Korea.

• Journal of Preventive Medicine and Public Health
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• v.52 no.3
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• pp.200-204
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• 2019

On September 12, 2018, President Jae-In Moon announced the Comprehensive Plan for Lifelong Care for People with Developmental Disabilities, with representatives from the associated government branches (Ministry of Health and Welfare, Ministry of Education, and Ministry of Employment and Labor) in attendance. The goals of this plan are to provide health, medical, rehabilitative, special education, and social welfare services according to the life-stages of the affected individuals; to reduce parental pressure; to promote social interventions; and to enhance community-level participation in order to create a 'welfare society in harmony.' However, in order for the plan to succeed, additional efforts must be made in the following areas. First, an epidemiological survey is needed to understand the scale, prevalence, and incidence of developmental disabilities and to establish an evidence base to support policy development. Second, accurate definitions of developmental disabilities must be established in order to avoid policy discrimination based on impairment type and age. Third, personal evaluations to assess disabled individuals' unmet needs and customized service designs to deliver those needs are required. Fourth, the plan must fulfill the goals of accessibility and fairness that the government intends to provide. Fifth, the government should consider an integrated financial support system and to propose a detailed plan for monetary distributions. Finally, an integrated system that links health, medical, employment, educational, and welfare services must be constructed.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.24 no.2
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• pp.181-188
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• 2017

Purpose: The aim of this study was to compare between performance and requirements of visiting nursing care in long-term care insurance using the OMAHA system. Methods: The subjects were 72 nurses who had worked in a visiting nursing care center in long-term care insurance. Data were collected from December 5, 2016 to January 31, 2017 using self-recorded questionnaires. The collected data were analyzed using descriptive statistics and paired t-tests. Results: Four dimensions of the OMAHA system showed statistically significant differences between performance and requirements of visiting nursing care in long-term care insurance. The requirements of visiting nursing care were higher than was performance on all 40 items of the OMAHA system. The greatest difference was in environmental domain and then the psychosocial domain. Conclusion: Based on the results, we found that the environmental and psychosocial domains were the largest gap areas. Therefore, with the reality of elderly people living alone and the increase in elderly couples, active intervention connected with the community is needed in residential areas. Further, we suggest that the OMAHA system can be utilized as an integrated conceptual framework for developing and enhancing visiting nursing care in long-term care insurance.

• Journal of Oriental Neuropsychiatry
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• v.35 no.2
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• pp.191-203
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• 2024

Objectives: To evaluate the effectiveness of an integrated medical service model for a fibromyalgia patient and their caregiver, focusing on reducing pain and improving quality of life. Methods: A single-case study design was employed, involving a fibromyalgia patient and their primary caregiver treated at W University Hospital. The integrated medical service program, based on the Ministry of Health and Welfare's model, included medical consultations and complementary therapies such as psychological counseling, art therapy, music therapy, horticultural therapy, yoga, and meditation. The program was conducted weekly for 8 weeks, with each session lasting up to 100 minutes. Data collection involved both quantitative and qualitative assessments. Quantitative data included demographic surveys, psychological tests, health-related quality of life measures, pain indices, and sleep quality indices. Qualitative data were gathered through feedback evaluations and emotional assessments. Results: The patient showed improvements in mobility, self-care, daily activities, and anxiety/depression, with EQ-VAS scores increasing from 20 to 40 and pain perception decreasing from 67.41 to 42.58. The caregiver reported reduced anxiety/depression and an increase in EQ-VAS scores from 95 to 98. Both patient and caregiver exhibited emotional changes, with decreased depression and increased happiness. However, the patient showed an increase in fear and anger. Conclusions: The integrated medical service model positively impacted the emotional and psychological well-being of the fibromyalgia patient and their caregiver. Despite the limitations of a small sample size and a single-case study design, the findings suggest that an integrated approach can be beneficial. Larger-scale studies are needed to confirm and generalize these results.

• Journal of Preventive Medicine and Public Health
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• v.35 no.3
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• pp.236-244
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• 2002

Objective : To empirically investigate the relationship of internal and external customer satisfactions, service quality, and customer loyalty in medical services. Methods : This essay proposes an integrated model to explain the causality of internal and external customer satisfactions, service quality, and customer loyalty. To this end, a structural model was developed, consisting of the following factors: internal and external customer satisfactions, service quality, and customer loyalty. The study included 214 sets of data, with 107 sets being collected for both out-patients and in-patients. The data were analyzed using AMOS 4.0. Results : We found the greater the internal customer satisfaction, the greater the out-patient quality of service quality. Secondly, the greater the service quality, the greater the external customer satisfaction of both in- and out-patients. The service quality of doctors, compared to that of the nurses, had a greater effect on external customer satisfaction. Thirdly, the service quality of doctors and nurses affected both internal and external customer satisfactions, which ultimately affected the customer loyalty. Finally the greater the external customer satisfaction, the greater the customer loyalty. Conclusion : This Study confirms the positive relationship among the internal and external customer satisfactions, service quality, and customer loyalty, which proves the doctors quality of service is the primary factor for external satisfaction, and customer loyalty relating to medical services.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.25 no.2
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• pp.127-138
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• 2018

Purpose: This study aimed to provide an overview of the present status of start-up literacy. Methods: The study selected literature from KoreaMed, RISS (Research Information Sharing Service), KISS (Korean studies Information Service System), KISTI (Korea Institute of Science and Technology Information), Ovid-MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase, and Cochrane Library DB. Start-up curricula were collected from the homepage of nursing schools in Korea and the USA. Their contents were searched using Massive Open Online Course (MOOC) platforms; KOCW, K-MOOC, and Coursera. Results: Fifteen articles were selected through a systematic literature review. The main themes of nursing start-up were "driver," "barrier," "required competency," and "importance of education." The courses contained business planning, finance, marketing, leadership, and entrepreneurship. The main contents of MOOCs were similar. Conclusion: The results indicate the necessity to develop multi-scope nursing start-up education programs. Nursing start-up models integrated with appropriate business knowledge and skills in health care settings are needed. This study can be used as a guideline to design start-up education programs in nursing.

• Journal of Convergence for Information Technology
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• v.10 no.6
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• pp.200-208
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• 2020

The purpose of this study was to investigate and compare health, medical and welfare service providers' and local residents' perception on community care. The participants were 68 service providers and 95 local residents. The data were analyzed using independent t-test and chi-square test. The results showed that the degree of agreement of service providers on the need for policy, and visiting services were higher. Service providers' ability to link local residents with a need for care to community resources was higher, but in the activation of self-help group in community, local residents agreed more. In add budget of policy to health insurance, local residents agreed less. In perception on priority for community care policy, high priorities were preparation of financial resources and care culture. To effectively operate community care policy, it is necessary to establish a care culture through active exchanges for reducing differences in policy and opinions of recipients.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.16 no.2
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• pp.23-32
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• 2012

Objectives : The purpose of this research is to develop the clinical pathway for optimizing the integrative medical service (oriental-western integrated medical service) and to analyze the clinical pattern of the integrative patients who received the oriental-western integrated medical service. Methods : This research developed the clinical pathway by interviewing with doctors, nursing and experts at K Medical Center. To analyze the clinical patterns, this research used 860 integrative patients and 6345 non-integrative patients at K Medical Center since 2007. Results and Conclusions : 1. We developed the clinical pathway for optimizing the integrative medical service. 2. Comparing the clinical pattern of the integrative patients with the non-integrative patients, the results indicated that the interval and frequency of the integrative patients is shorter than that of the non-integrative patients. 3. Comparing the medical treatment type, the integrated patients take much more medical care and more frequently participate in medical treatment. 4. In conclusion, it is different that the clinical pathway of the integrative medical service from the non-integrative medical service and the integrative medical treatment is more effective than the non-integrative medical treatment.