• Title/Summary/Keyword: Medical Delivery System

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Equity in the Delivery of Health care in the Republic of Korea (의료이용의 형평성에 관한 실증적 연구 -공.교 의료보험 피부양자를 대상으로-)

  • 명지영;문옥륜
    • Health Policy and Management
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    • v.5 no.2
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    • pp.155-172
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    • 1995
  • This study is an empirical analysis on the equity in the delivery of heatlh care under the Korean Medical Insurance Corporation System. The purposes of this study are to find out effects of income on the health care utiliztion and measure the income-related inequity in the distribution of health care. This study was carried out based on the fact that the health insurance program has been organized to achieve the equity objective, "equal treatment for equal needs". Of 41, 828 insured persons who had been diagnosed in the 1993 Health Screening Test and utilifzation data from 1, January 1993 through 31, December 1993 were derived from the Benefit Managment File. Inequity was measured by means of I) share approach, ii) standardization concentration curve approach, iii) inequity index, iv) test for inequity. The major findings were as follows : 1. The expenditure shares of the top two quintile groups exceeded their morbidity shares, whereas the opposite was true of the bottom three quintile groups, Which showed a positive HI$_{LG}$ inequity index, suggesting the presence of some inequity favoring the rich group. 2. Compared with other residential areas, the rural area showed the highest positive HI$_{LG}$ irrespective of need indicatior applied. 3. Standardized expenditure concentration indices adjusted by age, gender and need structure were also found to be positive, and therefore still indicated that there has been inequity favoring the rich after the standardization. 4. The Loglikelihood Ratio (LR) test for the statistical significance of income-related inequity of medical care utilization was carried out using the logistic regression model. The resulting loglikelihood ratio test statistic value was 176, which did exceed the 0.5 percent critical value of the chi-square distribution with 28 degrees of freedom, which is 50.993. Therefore, the null hypothesis of no income-related inequity of medical care utilization was rejected at the 99.5 percent confidence level. 5. The Regression based F-test has been carried out for analyzing the income-related inequity of medical expenditure in terms of age, gender, morbidity indicators as explanary variables. The hypothesis of the absence of income-relate inequity was rejected for all need indicators at the 95% confidence level.nce level.

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Comparative in vivo biodistributions of nanoparticles and polymers of 177lutetium-labeled hyaluronic acids in mice during 28 days

  • Lin, Chunmei;Jeong, Ju-Yeon;Yon, Jung-Min;Park, Seul Gi;Gwon, Lee Wha;Lee, Jong-Geol;Baek, In-Jeoung;Nahm, Sang-Soep;Lee, Beom Jun;Yun, Young Won;Nam, Sang-Yoon
    • Korean Journal of Veterinary Research
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    • v.57 no.2
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    • pp.105-111
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    • 2017
  • Hyaluronic acid (HA) has been investigated for biomedical and pharmaceutical applications. This study was conducted to determine the distributions of HA nanoparticles (NPs; size 350-400 nm) and larger HA polymers in mice at intervals after application. $^{177}Lutetium$ (Lu)-labeled HA-NPs or HA polymers were intravenously injected (5 mg/kg) into male ICR mice, and radioactivity levels in blood and target organs were measured from 0.25 h to 28 days post-injection. In blood, the radioactivities of HA-NPs and HA polymer peaked at 0.5 h after injection but were remarkably decreased at 2 h; subsequently, they maintained a constant level until 6 days post-injection. HA-NPs and HA polymers were observed in the liver, spleen, lung, kidney, and heart (in ascending order) but were seldom observed in other organs. After 3 days, both the HA-NP and HA polymer levels showed similar steady decreases in lung, kidney, and heart. However, in liver and spleen, the HA-NP levels tended to decrease gradually after 1 day and both were very low after 14 days, whereas the HA polymer level accumulated for 28 days. The results indicate that HA-NPs, with their faster clearance pattern, may act as a better drug delivery system than HA polymers, especially in the liver and spleen.

Challenges and Strategies for Unified Health System of South and North Korea (남북 건강보장공동체 형성을 위한 초기단계의 과제와 전략)

  • Jeong, Hyoung-Sun;Shin, Hyun Woung;Kim, So Yoon
    • Health Policy and Management
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    • v.28 no.3
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    • pp.315-319
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    • 2018
  • This paper aims to make a step-by-step strategy to formulate an unified health system by clarifying and overcoming challenges facing South and North Korea and to estimate costs needed for South Korea to assist North Korea to recover to normal health delivery system. We explored implications through literature review and estimated costs under the assumption that supportive activities be provided for 5 years in three ways: support for the development of health and medical care manpower; support for health and medical facilities; and support for the provision of both preventive and primary health care. Step-by-step strategy is formulated for a unified health system with the cost estimation resulting as follows: in case of basic scenario, a total of 3 trillion and 341 billion won (at present value of the year 2017) is in need for the 5-year period at the initial 'recovery support stage' with 135.9 billion won for the development of health and medical care manpower, approximately 2 trillion won for health and medical facilities, and 1.2 trillion won for the provision of both preventive and primary health care. Step-by-step approach is more realistic and applicable in formulating unified health system. Suggested stages are 'recovery support stage,' 'system homogenization stage,' and 'unified system stage.' Strategies at 'recovery support stage' suggested in this paper need to be pursued and followed by those at 'system homogenization stage' and 'unified system stage.'

Moon Jae-in Government's Plan for Benefit Expansion in National Health Insurance (문재인 정부의 건강보험 보장성 강화대책)

  • Park, Eun-Cheol
    • Health Policy and Management
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    • v.27 no.3
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    • pp.191-198
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    • 2017
  • Moon Jae-in Government announced the Government's 5-Year Plan on July 19, 2017, President Moon directly announced the Government's Plan for Benefit Expansion in National Health Insurance on August 7, 2017. The main contents of the announced expansion include benefit coverage for all medically necessary services with control over non-covered service occurrence, a decrease in the cost-sharing upper limit, and monetary support for catastrophic medical costs. Although past governments have been continuously striving for benefit expansion in the last 15 years, this plan has its breakthrough aspect in that all medical services will be covered by the National Health Insurance. In alignment, there are important tasks to solve: attaining a proper fee schedule, reforming the healthcare delivery system, and improving healthcare quality. This plan is a symptom oriented action in that it is limited in reducing patients' out-of-pocket money, unlike the systematic approach of the National Health Insurance. The sustainability of the National Health Insurance is being threatened due to South Korea's low birth rate, rapidly aging society, and low economic growth, in addition to the unification issue of the Korean Peninsula, medical utilization of the elderly, management of non-communicable diseases, and so on. Therefore, the Government needs to plan the National Health Insurance system reformation including actions addressed toward medical consumers.

A Study on Cooperative Medical Treatment System between Oriental and Western Medical Practitioners (한.양방 협진체계 개발에 관한 연구)

  • Yi, Dong-Heui;Yoo, Kyu-Soo
    • Korea Journal of Hospital Management
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    • v.3 no.1
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    • pp.34-61
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    • 1998
  • A study on cooperative medical treatment system between oriental and western medical practitioners was conducted from March through August 1997 in order to determine a productive model of cooperation of two medical parts for treatment of patients. Questionnaires were distributed to 195 medical doctors(M.D.) and 195 doctors of oriental medicine(O.M.D.) working in clinics and hospitals in six major cities. Statistical analysis tools used for this study were frequency, t-test and multiple regression by using SPSS/P.C package. The results are summarized as follows: 1. The respondents were composed of male docotors(78%) and female doctors(22%) and 68.2% of M.D. and 97% of O.M.D. were interested in the other medical part. The doctors of both disciplines had some limitation on treatment of patients but they were reluctant to refer their patients to other doctors in different discipline. 2. M.D assumed that oriental medicine was more effective for chronic diseases, and O.M.D. thought that western medicine was more effective for acute diseases. 92.3% of O.M.D.s responded that even though they do not utilize western medical technology for diagnosis, they believed the results of diagnoses by western medical technology. 3. 60.5% of O.M. and 93.3% of O.M.D. said that cooperative medical treatment system could be necessary for patients and it would be effective for control of diseases and 69% of western medical doctors and 99% of oriental medical doctors agreed that oriental medical practice would be more effective for cerebellar vascular accidents than other diseases. 77.4% of western medical doctors and 92.3% of oriental medical doctors responded that the students of two different disciplines have to be taught on the other disciplines. 82.6% of western medical doctors and 83.3% oriental medical doctors agreed that it would be necessary to have collaborative research between scientists in two disciplines. 81.5% of M.D.s and 93.3% of O.M.D.s believed that they had prejudice and distrust on other discipline 4.90% of the doctors were not satisfied with the government medical policies on health insurance, legal matters, and health delivery system. 5. 75.4% of M.D.s and 50.2% of O.M.D.s said that two medical disciplines should be integrated, but they were skeptical on that. 75.3% of M.D.s thought that western hospitals should employ O.M.D.s Finally this study recommended that western medical students study oriental medicine and the vice versa, and M.D.s and O.M.D.s should have seminars and workshops to exchange knowledge, and experiences. It is also recommended that medical laws be revised to allow medical doctors refer the patients whom they can not handle to oriental medical doctors and the vice versa.

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A Model of Activation in Physical Therapy of Public Health Center (보건소 중심의 물리치료 활성화 모델)

  • Bae Sung-Soo;Kim Chung-Sun;Lee Han-Suk
    • The Journal of Korean Physical Therapy
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    • v.11 no.3
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    • pp.123-131
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    • 1999
  • The purpose of is study deals with the physical therapy and the delivery system of public health center, as a center, in community based rehabilitation and delivery system. We hope that the system of physical therapy of public health center in community based rehabilitation spreads all over the country and contributes to the promotion of national health and social welfare. There are many public health center in the country because it can serve inhabitants with the medical benefits in the Erst line. public health center continuously provides poor inhabitants who cant pay medical expenses care of health. It has the public health center branches that take care of inhabitants who live a remote village and hiterland. Additionally, many people want to receive physical therapy. Therefore, the physical therapy of public health center becomes the central paint in community based rehabilitation so that we supply the inhabitants with superior rehabilitation service. We can approach them as a team that be constituted with physical therapist speech therapist, psychologist, nurse, social work. Also the role of physical therapist is divided into two parts, which are home visiting part that individually takes can of patients nod public health part that takes care of patient, family, home, community. We connect with both self-governing body and the government so that we may receive government subsidies. Also, we must prepare regular school education for community based rehabilitation

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Factors related to the acceptance of Attending Physicians on ophthalmologist (개원의의 개방병원제도에 대한 수용도 관련 특성 분석 -안과개원의를 중심으로-)

  • Chang, Dong-Gune;Kim, Hee-Sun;Shin, Eui-Chul
    • Korea Journal of Hospital Management
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    • v.16 no.4
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    • pp.67-84
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    • 2011
  • The open Hospital Attending Physician System has been discussed and operated for developing the efficiency and the substitutes for an increase in medical expenses, for overlapping investment in medical resources, and for normalization of medical delivery system. This study assessed the related factors to the acceptance and introduction of Attending Physicians on ophthalmologist. Data was collected mail response to 179 ophthalmologists in 2005. Applying multilevel logistic regression, we examined the relationship between their acknowledgment, attitude and acceptance of the open Hospital Attending Physicians System. The percentage of participation in Hospital Attending was indicated to be 3.9%. The 44.7% of all participants agreed to adopting the Hospital Attending, 33.5% of doctors are willing to participate in the future. The positive and normal attitude of physician toward the Hospital Attending is 6.6 times (95%CI 1.315, 33.138) and 55.2 times(95%CI 11.352, 268.347) more than that of negative after adjustment for other variables. Attitude was found to be the important factor influencing physicians' participation in the Attending Hospital. Thus, it is need to development and implication for the strategies that lead the practical necessity and positive attitude toward the Attending Hospital.

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Power-Efficient Wireless Neural Stimulating System Design for Implantable Medical Devices

  • Lee, Hyung-Min;Ghovanloo, Maysam
    • IEIE Transactions on Smart Processing and Computing
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    • v.4 no.3
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    • pp.133-140
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    • 2015
  • Neural stimulating implantable medical devices (IMDs) have been widely used to treat neurological diseases or interface with sensory feedback for amputees or patients suffering from severe paralysis. More recent IMDs, such as retinal implants or brain-computer interfaces, demand higher performance to enable sophisticated therapies, while consuming power at higher orders of magnitude to handle more functions on a larger scale at higher rates, which limits the ability to supply the IMDs with primary batteries. Inductive power transmission across the skin is a viable solution to power up an IMD, while it demands high power efficiencies at every power delivery stage for safe and effective stimulation without increasing the surrounding tissue's temperature. This paper reviews various wireless neural stimulating systems and their power management techniques to maximize IMD power efficiency. We also explore both wireless electrical and optical stimulation mechanisms and their power requirements in implantable neural interface applications.

Development of Surgical Two-wavelegth Nd:YAG Laser (수술용 2파장 펄스형 Nd:YAG 레이저 개발)

  • 윤길원;김홍식
    • Journal of Biomedical Engineering Research
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    • v.17 no.4
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    • pp.491-498
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    • 1996
  • The development of a compact two-wavelength Nd:YAG laser for dental and ENT applications is presented. The Nd:YAG resonator generates either 1.06$\mu$m or 1.32$\mu$m. The wavelength selection is made at the control panel. The Nd:YAG laser parameters at 1.06$\mu$m are ; the maximum pulse duration of 150$\mu$s, repetition rates of I-100Hz, and the maximum average power of 25W. At 1.32$\mu$m, the pulse duration is the same where the repetition rates and the maximum average power are I-30Hz and lOW respectively. High voltage power supply consists of a simmer module and two identical high voltage DC converters. In order to make a complete medical laser system, an optical fiber delivery unit, foot pedal and water spray handpiece are also developed. The wavelength selection is reliable since no movement of optical or mechanical components is required. The high voltage power supply is compact, easy to be maintained and applicable for other laser systems due to its modular design.

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Group Antenatal Care: A Paradigm Shift to Explore for Positive Impacts in Resource-poor Settings

  • Gaur, Bhanu Pratap Singh;Vasudevan, Jyothi;Pegu, Bhabani
    • Journal of Preventive Medicine and Public Health
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    • v.54 no.1
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    • pp.81-84
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    • 2021
  • The delivery of high-quality antenatal care is a perennial global concern for improving maternal and neonatal outcomes. Antenatal care is currently provided mainly on a one-to-one basis, but growing evidence has emerged to support the effectiveness of group antenatal care. Providing care in a small group gives expectant mothers the opportunity to have discussions with their peers about certain issues and concerns that are unique to them and to form a support system that will improve the quality and utilization of antenatal care services. The aim of this article is to promote group antenatal care as a means to increase utilization of healthcare.