• 한국사회복지학
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• 제48권
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• pp.150-178
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• 2002

The elderly have higher potential for contracting chronic diseases and suffering from development of a complication. Also, the extended old age period leads the elderly to demand more medical services. All those facts indicate that the elderly need more medical services than any other age groups. Consequently, medical care for the elderly with chronic diseases causes high costs burden. However, there is few studies researching the financial burden of chronic illness of the elderly. This study aimed to 1) understand how much the elderly with chronic diseases pay for medical expenses; 2) find out some specific factors related to health care financial burden; 3) suggest the alternative policies to decrease excessive financial burden of caring for the elderly with chronic illness. National Health and Nutrition Survey, which was surveyed by the Korea Institute for Health and Social Affairs in 1998, was used in this study. 4,707 persons with chronic diseases out of 5385 persons over age 60 were selectively sampled. Using SPSSWIN, correlation analysis, T-test, ANOVA and Regression were used as statistical methods in this study. Stepwise multiple regression was employed to analyze the data with a ratio of health care expenditure to income(financial burden) as a dependent variable. Out of Korean old people, 87% had the chronic diseases and their health care financial burden rate showed the average of 17.9%, which meaned they expended almost 20% income to buy medical services. The variables having a great influence on financial burden were monthly income, activity, limitation and single household of an old person. The excessive financial burden was experienced by people who had more than 4 activity limitations(37.1%) and were in the lowest Income level(32.6%), and single household of an old person(31.4%). The new policies should be considered to 1) reduce the financial burden in these groups and to develop the sliced medical cost system considering the characteristics of chronic illness and income level; and 2) develop the medical management system to care for the elderly with chronic illness.

• 한국엔터테인먼트산업학회논문지
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• 제15권1호
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• pp.199-206
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• 2021

초고령 사회가 임박함에 따라 노인성 질환자 또한 증가하고 있으며 이로 인한 사회적 문제로 시설과 정책의 부족이 제기되고 있다. 의료보장의 현실적 대안으로 국민건강보험이 이야기되고 있으며, 요양병원은 급성기 병원과 장기요양시설 사이로 분류되며 의료비 절감의 대체재로 작용하고 있다. 그러나 유지기 재활의 핵심인 요양병원은 서비스의 질적 문제가 심각히 제기되고 있고, 현 의료체계의 문제로 재활 난민이 양산되는 문제가 있다. 특히 2015년 선행연구에서 전라북도의 요양병원 현황이 가장 열악하였으며 이에 공공데이터를 활용하여 전라북도 요양병원 일반현황, 다빈도 상병 현황, 재활서비스 관련 현황, 재활서비스 중 작업치료 관련 현황에 대하여 탐색하고자 한다.

• 한국인공지능학회지
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• 제9권2호
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• pp.15-21
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• 2021

This paper conducted a feasibility study by applying an Internet of Things and Artificial intelligence-based management system for the elderly living alone in an aging society. The number of single-person families over the age of 50 is expected to increase, and problems such as health, safety, and loneliness may occur due to aging. Therefore, by establishing an IoT-based care system for the elderly living alone, a stable service was developed through securing a rapid response system for the elderly living alone and automatically reporting 119. The participants of the demonstration test were subjects under the jurisdiction of the "Seongnam Senior Complex," and the data collection rate between the IoT sensor and the emergency safety gateway was high. During the demonstration period, as a result of evaluating the satisfaction of the IoT-based care system for the elderly living alone, 90 points were achieved. We are currently in the COVID-19 situation. Therefore, the number of elderly living alone is continuously increasing, and the number of people who cannot benefit from care services will continue to occur. Also, even if the COVID-19 situation is over, the epidemic will happen again. So the care system is essential. The elderly care system developed in this way will provide safety management services based on artificial intelligence-based activity pattern analysis, improving the quality of in-house safety services.

• 한국응급구조학회지
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• 제3권1호
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• pp.91-101
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• 1999

The medicolegal problem can be occurred in all medical field. Especially pre-hospital stage can be more exposed to the legal claims due to the very nature of EMT business and characteristics of ER patient or their family member. All Emergency Medical Technician should be concerned about the law associated with emergency care for handling the medicolegal problem, so the legally risky situations that may be occurred in pre-hospital stage and ER practice. This study reviewed malpractice claim of emergency patients filed in at Association of malpractice patients' family and two tertiary level hospitals. Problems related to treatment and misdiagnosis. Especially issues concerning emergency medical service system including of inadequate transport, delay in triage and transport accounted for many cases of all claims. This alerts us to the seriousness of medical accidents of emergency patient. This paper suggests several items that all E.M.T and every member of ED health care team always have to remember the medicolegally risk situations, must be trained in understanding the patients' wants and desires and should have the knowledge of the law associated with emergency health care. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care institutes.

• 한국응급구조학회지
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• 제24권1호
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• pp.25-36
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• 2020

Purpose: We analyzed the characteristics and differences in patients' medical benefits and health insurance based on disease severity classification. Methods: We examined 29,139 patients who visited the emergency medical center of K Hospital from January 1,2016 to December 31, 2016. Survey items included the Korean Triage and Acuity Scale (KTAS) classification of emergency and non-emergency situations ratio and type of insurance. Results: According to KTAS classification, 76.2% of patients exhibited an emergency condition and 23.8% exhibited a non-emergency condition. Emergency patients exhibited more trauma than non-emergency patients. According to the type of insurance coverage, the duration of stay in the emergency room was longer for patients with medical care than for patients with health insurance. Additionally, 119 ambulances use was significantly higher among patients with medical care. Conclusion: Policy discussions should address alternative ways to replace the 119 ambulances used by patients in this study. Additionally, health care administrators should identify alternative care agencies as potential alternatives to emergency room visits.

• 가정∙방문간호학회지
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• 제26권3호
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• pp.253-264
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• 2019

The aim of this review is to present a German system of an outpatient care center under the German Health Insurance Act and home care (integration of medical care, basic care, bathing) under the Long-Term Care Insurance Act. This idea of a German integrated home care system should contribute to the development of a Korean home care model. Prior the introduction of long-term care insurance (1995), and with the of the health insurance law (1989), German outpatient care centers already provided medical and basic care services for patients with acute and chronic symptoms. Since 1995, patients with acute symptoms and rehabilitation periods under the Health Insurance Act have been eligible for home care. The Long-Term Care Insurance Act is intended for all citizens who are unable to carry out their daily activities for more than six months. In 2017, 13,657 (97%) of 14,050 outpatient care centers provided home care services after long-term care and health insurance. In other words, patients in Germany can use home care in both the acute and chronic phase at the same home care center, or 'integrated home-care center'.

• 한국보건간호학회지
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• 제30권3호
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• pp.556-569
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• 2016

Purpose: This study aimed to provide baseline data on the health care of children and the demand for visiting health care services in one region in efforts to support the implementation of visiting health care services for vulnerable children. Methods: Seventy-three children and their caregivers from the vulnerable social group and 82 children and their caregivers from the general group were selected as research participants. The data were collected through home visiting survey by professional nurses. Results: Children from the vulnerable social group were at higher risk of poor health care than the general group. Regarding home safety, vulnerable children were more likely to be exposed to unsafe conditions. With respect to nutrition, developmental play, developmental screening test, and home safety, visiting health care services were in demand for caretakers. Conclusion: These results indicate that to promote health care and safety conditions for vulnerable children, it is necessary to implement visiting health care programs that include the management of vaccination, medical check-up, growth and development, home safety, and nutrition. These findings can be used as the baseline data for the development of visiting health care programs for vulnerable children.

• 한국응급구조학회지
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• 제16권2호
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• pp.53-66
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• 2012

Purpose : Emergency medical services in China are increase in demand by people and under the greater pressure than ever before. So it is, necessary to advance the pre-hospital system in order to promote the development of emergency medical services. Methods : This is based on China-related articles, books, journals, reports, statistical data and other literature. Results : First, pre-hospital emergency medical care with the introduction of specialist training program should be established. Second, to strengthen pre-hospital emergency services and to develop the EMS guidelines. Third, the "120" reporting systems unification and awareness activation. Fourth, the preparation of the EMS facilities equipment system. Fifth, the rapid transport system establishment to the selected medical institutions. Conclusion : It is necessary to strengthen the emergency medical personnel at the scene, rapid transport, rapid patient triage and to improve the survival rate of the patients.

• 보건행정학회지
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• 제3권2호
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• pp.130-158
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• 1993

This study was written to discover the changes that may exist in the contents of medical services after introduction of health insurance system, and to identify the net-effect of health insurance system on medical services. Uncomplicated nornmal delivery and appendectomy patients were divided into 4 groups, the non-insured in pre-NHI periods(group A), the insured of health insurance for employees in pre-NHI periods(group B), the insured of regional health insurance for city residents in post-NHI periods(group C) and the insured of health insurance for employees in post-NHI periods(group D). The mehtod of matching was applied to control for major demographic differences among these 4 groups of each disease. In pre-NHI period, the medical services and the variation of medical services of the non-insured were compared with those of the insured. The difference between the change of medical services from group A to those of group C, and the change of medical services from group B to those group D is defined as the net-effect of health insurance. The results are as follows. First, in length of stay after delivery or operation, total length of stay, some laboratory examination, amount of several drugs used in appendectomy patients, frequency of sitz bath in delivery patients, there was net-effect of health insurance in increasing direction. Second, length of stay after delivery or operation, total length of stay, some laboratory examination, amount of several drugs used in appendectomy patients and frequency of sitz bath in delivery patients were significantly more in the insured than in the non-insured group in pre-NHI period. Third, the variation of medical services of post-NHI period was not less then those of pre-NHI period. Fourth, antenatal care on which the third party does not pay and the patient pays for all, was diffrerent by socioeconomic and educational level of patients.

• 도시과학
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• 제8권1호
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• pp.51-58
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• 2019

본 연구의 목적은 노인들의 응급의료이용에 영향을 주는 요인들을 알아보고 의료접근의 형평성을 조사하는 데 있다. 2014년 한국의료패널조사 자료를 사용하여 기술분석과 로지스틱회귀분석이 행하여졌으며 인터뷰에 참여했던 1,313명의 노인들이 표본으로 선정되었다. 연령, 성별, 교육수준 등의 인구변수들이 응급의료이용의 중요한 결정요인이었다. 의료요구는 노인 계층 간 응급의료이용의 차이를 충분히 설명하지 못한 걸로 나타났으나 건강상태는 응급의료서비스를 사용하는 노인들의 중요한 결정요인이었다. 의료비지출은 응급의료서비스이용의 계층 간 차이를 개선하지 못했으나 응급의료이용의 중요한 예측요인으로 남았다. 한국에서 의료개혁은 의료요구를 가진 노인들이 효과적인 진료혜택을 받을 수 있도록 전국민 응급의료 보장을 확대하는 방향으로 계속 이루어져야 한다. 앞으로 연구도 75세 이상의 교령노인과 여성 및 교육수준이 낮은 노인, 그리고 높은 의료비 지출을 하는 노인과 같은 인구계층들에게 혹시 있으지 모르는 의료접근의 장애들을 허무는 방향으로 이루어질 필요가 있다.