• Title/Summary/Keyword: Korea Health Insurance Cooperation

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The Supply and Demand Analysis of the Oriental Medical Doctor and Its Uses in Assisting Policy Making (한의사인력 수급 추계 및 정책 활용방안)

  • Choi, Eun-Young;Kim, Jin-Soo;Lee, Jong-Soo;Lee, Woo-Baik
    • The Journal of Korean Medicine
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    • v.20 no.2
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    • pp.27-36
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    • 1999
  • This study was performed to investigate the supply and demand of the oriental medical doctor(OMD) based on the supply and demand analysis of OMD up to the year 1997. The baseline projection and demographic methods were considered to examine the supply of OMD. On the contrary, for the demand analysis, two different approaches were conducted with the nonlinear regression model. The findings of this study indicate that the OMD will be oversupplied before the year 2012 with decreasing rate. However, when we consider the demand of OMD in the future. it is anticipated that the demand of oriental medicine will be increased rapidly with two major aspects. The first is the expansion of insurance benefits. The second is the increasing number of adult diseases because of the aging of the population structure. Therefore, the effective cooperation system and mutual exchange between western and oriental medicine is required for the future. Also. it is necessary to make the oriental medicine of the pharmaceutical services in more scientific way for the appropriate policy of the demand and supply of OMD. For the future study, the students who study abroad, especially China should be considered. These students will be the key element for the future supply of OMD.

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A Study on the Development of Readmission Predictive Model (재입원 예측 모형 개발에 관한 연구)

  • Cho, Yun-Jung;Kim, Yoo-Mi;Han, Seung-Woo;Choe, Jun-Yeong;Baek, Seol-Gyeong;Kang, Sung-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.4
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    • pp.435-447
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    • 2019
  • In order to prevent unnecessary re-admission, it is necessary to intensively manage the groups with high probability of re-admission. For this, it is necessary to develop a re-admission prediction model. Two - year discharge summary data of one university hospital were collected from 2016 to 2017 to develop a predictive model of re-admission. In this case, the re-admitted patients were defined as those who were discharged more than once during the study period. We conducted descriptive statistics and crosstab analysis to identify the characteristics of rehospitalized patients. The re-admission prediction model was developed using logistic regression, neural network, and decision tree. AUC (Area Under Curve) was used for model evaluation. The logistic regression model was selected as the final re-admission predictive model because the AUC was the best at 0.81. The main variables affecting the selected rehospitalization in the logistic regression model were Residental regions, Age, CCS, Charlson Index Score, Discharge Dept., Via ER, LOS, Operation, Sex, Total payment, and Insurance. The model developed in this study was limited to generalization because it was two years data of one hospital. It is necessary to develop a model that can collect and generalize long-term data from various hospitals in the future. Furthermore, it is necessary to develop a model that can predict the re-admission that was not planned.

A Study on the Implementation of Global Medical Budget Model for Hospital based on Sustainablity and Efficiency (지속가능성과 효율성을 고려한 병원 총액예산 설계와 배분에 관한 연구)

  • O, Dongil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.6
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    • pp.3534-3547
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    • 2014
  • Although there are many positive sides of the current fee-for-service payment schedule, there is a strong necessity to control the rapidly increasing national healthcare expenditure. The global budget is often mentioned as one prominent alternative for solutions. In this article, both microscopic and macroscopic approaches are considered to set the hospital medical expenditure budget. In a macroscopic aspect, the SGR model, which considers the financial limit of the healthcare system, is used to set the next year target budget. In addition, the DEA model is used to measure the inefficiency and cost recognition. In this article, the national medical target expenditure is distributed to an individual hospital based on the level of efficiency. By combining the SGR and DEA, it will be possible to set a real world applicable target medical expenditure budget model.

Factors Affecting on Medical Satisfaction in Multicultural Members (다문화 구성원의 의료만족도에 영향을 미치는 요인)

  • Ahn, Seong sin;Jang, Mi-Hwa
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.9
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    • pp.199-209
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    • 2020
  • This study was a descriptive study performed to identify factors affecting medical satisfaction in multicultural members. The survey participants were 301 multicultural members in A city. The data were analyzed using descriptive statistics and Independent t-tests, One-way ANOVA, and Stepwise multiple regression analysis with the SPSS 14.0 program. Stepwise multiple regression analysis revealed that the predictors of satisfaction among the medical staff were satisfaction with age and health insurance, which accounted for 28% of all variance. Predictors of satisfaction with the medical environment were age and jobs, which accounted for 17% of all variance. Predictors of satisfaction with medical expenses were multicultural form, educational level, and jobs, which accounted for 33% of all variance. These results suggest that we need to develop and implement strategies and programs that can enhance satisfaction with medical use among multicultural members.

Factors influencing metabolic syndrome perception and exercising behaviors in Korean adults: Data mining approach (대사증후군의 인지와 신체활동 실천에 영향을 미치는 요인: 데이터 마이닝 접근)

  • Lee, Soo-Kyoung;Moon, Mikyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.12
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    • pp.581-588
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    • 2017
  • This study was conducted to determine which factors would predict metabolic syndrome (MetS) perception and exercise by applying a machine learning classifier, or Extreme Gradient Boosting algorithm (XGBoost) from July 2014 to December 2015. Data were obtained from the Korean Community Health Survey (KCHS), representing different community-dwelling Korean adults 19 years and older, from 2009 to 2013. The dataset includes 370,430 adults. Outcomes were categorized as follows based on the perception of MetS and physical activity (PA): Stage 1 (no perception, no PA), Stage 2 (perception, no PA), and Stage 3 (perception, PA). Features common to all questionnaires for the last 5 years were selected for modeling. Overall, there were 161 features, categorical except for age and the visual analogue scale (EQ-VAS). We used the Extreme Boosting algorithm in R programming for a model to predict factors and achieved prediction accuracy in 0.735 submissions. The top 10 predictive factors in Stage 3 were: age, education level, attempt to control weight, EQ mobility, nutrition label checks, private health insurance, EQ-5D usual activities, anti-smoking advertising, EQ-VAS, education in health centers for diabetes, and dental care. In conclusion, the results showed that XGBoost can be used to identify factors influencing disease prevention and management using healthcare bigdata.

A Study on Burden, Stress and Social Support of Family Caregivers in Intensive Care Unit Patient (중환자 가족원의 부담감, 스트레스 및 사회적 지지)

  • Shim, Moon-Sook;Youn, Hye-Wook
    • Proceedings of the KAIS Fall Conference
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    • 2009.12a
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    • pp.934-936
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    • 2009
  • This study was to identify the correlation between the degree of burden, stress and social support of family caregivers in ICU patient. The subjects were 146 family care givers observed at a general hospital at D city. The level of stress that family caregivers experience the average points of 2.18, which is considered less than average. The level of burden that average point of 2.51. Points for level of subjective feeling ranged from 1.74 to 3.90. The average point of 3.03 is higher than that for objectively recognized feeling. The points for social support that average point of 3.03 for social support proves that families feel positive about the social support they are receiving. The level of stress which shows that the lower the income, the higher the stress. The effect on stress shows significance in subjective feelings of burden, social support, and employment, indicating that they have correlations with stress. Both the feeling of burden and social support have an impact upon the stress that patient families experience.

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A Study on Self-sufficiency for Hospital Injury Inpatients in Korea (우리나라 의료기관 입원손상환자의 자체충족도에 관한 연구)

  • Lee, Hee-Won;Park, Jong-Ho;Kang, Sung-Hong;Kim, Won-Joong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.12
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    • pp.5779-5788
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    • 2011
  • This study was conducted to comprehend the current status of regional self-sufficiency of Hospital injury inpatients and, based on this, to prepare some measures for improving the self-sufficiency. For this purpose, 2005 & 2008 Patient Survey data, regional medical utilization data of National Health Insurance Corporation, yearbook of Central Emergency Medical Center and evaluation results of emergency medical institutions were obtained. Frequency analysis, cross-tabulation, decision tree and logistic regression techniques were used in the analysis of data. Self-sufficiency in 'metropolitan city/Do' area was lowest for Chungcheongnam-do for the year 2005 and 2008, followed by Gyeongsangbuk-do, Gyeonggi-do and Jeollanam-do. As for the self-sufficiency in 'Si/Gun/Gu' area with regard to local medical supply, for both 2005 and 2008, It was higher when general hospital, district emergency medical center, regional emergency medical center and regional emergency medical institution existed in the residential area. It was also found that, the higher the quality level of local emergency medical institution, the higher the self-sufficiency. It was confirmed that, when promoting the national policy for injury patients, priority should be placed on 'Do' area where the level of emergency medical supply was low, and that enhancing the quality level of emergency medical institutions was helpful for the improvement of self-sufficiency.

A Study on Characteristics of Medical Expenses and the Hospitalization Period of Hospitalized Patients Using Diem Payment System at Convalescent Hospitals (요양병원 일당정액제 입원환자의 입원일수 및 진료비 특성에 관한 연구)

  • Roh, Ock-Hee;Lee, Chong Hyung;Park, Arma;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.407-414
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    • 2016
  • This study was conducted to provide basic data to evaluate the appropriateness of convalescent hospitalization treatment by investigating the number of hospitalization days and the total treatment expenses of a total of 44,037 monthly billing statements requested from the Health Insurance Review and Assessment Service. Evaluated data consisted of medical care expenses of patients of the diem payment system hospitalized at convalescent hospitals in Daejeon, Chungnam, Chungbuk and Sejong from January through December of 2014. According to the analysis result of the general characteristics of the study objects and the canonical correlation analysis of the top 15 main diagnosis names, 7 canonical functions have been deducted. Among them, six canonical functions were shown to be statistically significant (p<0.001), and canonical function 1 had a chi-squared value of 5955.49 and 98 degrees of freedom at p<0.001 level. Overall, the results indicated that if health and welfare service in the regional society is magnified, social hospitalization can be reduced.

Hospice-Palliative Care Activities of personnel in a Long-Term Care Hospital; a retrospective chart review (일개요양병원 호스피스·완화의료의 서비스의 직종별 행위 분석; 후향적 의무기록 중심으로)

  • Cho, Hyun;Lim, Heeyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.4
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    • pp.570-577
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    • 2017
  • The purpose of this study was to provide a basis for the development of a health insurance payment system by exploring inpatient hospice & palliative care activities in a long-term care hospital by occupational personnel. The contents and frequency of inpatient hospice-palliative care activities were obtained retrospectively from the chart review of 12 terminally ill patients who died during the 6 months before their deaths. According to their occupational personnel, doctors were doing blood transfusion, family counseling, and medication guidance. Nurses' main activities were airway suction, oxygen supply, EKG monitoring, observing patient's status, helping medication and tube feeding. Other workers' activities are as follows: social workers were applying individualized programs, physical therapists were doing electrostimulation, nutritionists were giving nutrition evaluation and meal rounding, and careworkers were assisting with meals and nutrition. Although certain nursing activities, like emotional support, were performed by nurses, the hospice-palliative activities from doctors, social workers and physical therapists were largely unavailable for terminally ill patients in a long-term care hospital. And some terminally ill patients were receiving too intensive and invasive medical cares for end end-of-life care. The results highlight the importance of valid measures of hospice-palliative care quality and the need for establishing an adequate reimbursement system for ensuring and improving end-of-life care.

Incidence rates of injury, musculoskeletal, skin, pulmonary and chronic diseases among construction workers by classification of occupations in South Korea: a 1,027 subject-based cohort of the Korean Construction Worker's Cohort (KCWC)

  • Seungho Lee;Yoon-Ji Kim;Youngki Kim;Dongmug Kang;Seung Chan Kim;Se-Yeong Kim
    • Annals of Occupational and Environmental Medicine
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    • v.35
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    • pp.26.1-26.15
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    • 2023
  • Background: The objective of this study is to investigate the differences in incidence rates of targeted diseases by classification of occupations among construction workers in Korea. Methods: In a subject-based cohort of the Korean Construction Worker's Cohort, we surveyed a total of 1,027 construction workers. As occupational exposure, the classification of occupations was developed using two axes: construction business and job type. To analyze disease incidence, we linked survey data with National Health Insurance Service data. Eleven target disease categories with high prevalence or estimated work-relatedness among construction workers were evaluated in our study. The average incidence rates were calculated as cases per 1,000 person-years (PY). Results: Injury, poisoning, and certain other consequences of external causes had the highest incidence rate of 344.08 per 1,000 PY, followed by disease of the musculoskeletal system and connective tissue for 208.64 and diseases of the skin and subcutaneous tissue for 197.87 in our cohort. We especially found that chronic obstructive pulmonary disease was more common in construction painters, civil engineering welders, and civil engineering frame mold carpenters, asthma in construction painters, landscape, and construction water proofers, interstitial lung diseases in construction water proofers. Conclusions: This is the first study to systematically classify complex construction occupations in order to analyze occupational diseases in Korean construction workers. There were differences in disease incidences among construction workers based on the classification of occupations. It is necessary to develop customized occupational safety and health policies for high-risk occupations for each disease in the construction industry.