• Title/Summary/Keyword: Medical delivery system

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Current Issues of Healthcare Research and Development in Korea (한국 보건의료 연구개발의 현황과 과제)

  • Kim, Kwangjum
    • Health Policy and Management
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    • v.28 no.3
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    • pp.280-287
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    • 2018
  • There has been much efforts to facilitate healthcare innovation and many desirable outcomes were produced in Korea. However, some structural deficiencies were found. They are misalignment of research and development (R&D) subjects with healthcare system, lack of flexibility of current healthcare system to accommodate the radically innovative products, and lack of cooperation among innovation agent. Some suggestions to correct these deficiencies are discussed. The suggestions are as follows: relating Korean healthcare R&D to healthcare system, enhancement of institutional flexibility to allow innovative application of new technology, improvement of the R&D process, and reexamination of the role of academic medical centers.

Differences between Diabetic Patients' Tertiary Hospital and Non-tertiary Hospital Utilization According to Comorbidity Score (당뇨병 환자의 동반상병 점수에 따른 상급종합병원 이용 차이)

  • Cho, Su-Jin;Chung, Seol-Hee;Oh, Ju-Yeon
    • Health Policy and Management
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    • v.21 no.4
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    • pp.527-540
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    • 2011
  • Some patients tend to visit tertiary hospitals instead of non-tertiary hospitals for minor illnesses, which is a chronic problem within the Korean health care delivery system. In order to reduce the number of patients with minor severity diseases unnecessarily utilizing the tertiary medical services in Korea, the Ministry of Health and Welfare raised the outpatient co-insurance rate for the tertiary hospitals in July, 2009. Another increase in the prescription drug co-insurance rate by the general and tertiary hospitals is scheduled to take place in the second half of 2011. An increase in copayments may discourage the utilization rate of medical services among the underprivileged or patients who require complicated procedures. This study aims to analyze the diabetic patients' utilization rates of tertiary hospitals according to the Comorbidity score. Diabetic patients' data was gathered from the Health Insurance Claims Records in the Health Insurance Review & Assessment Service between 2007-2009. Comorbidity scores are measured by the Charlson Comorbidity Index and the Elixhauser Index. Chi-square and logistic regressions were performed to compare the utilization rates of both insulin-dependents (n=94,026) and non-insulin-dependents (n=1,424,736) in tertiary hospitals. The higher Comorbidity outcomes in the insulin-dependent diabetic patients who didn't visit tertiary hospitals compared to those who did, was expected. However, after adjusting the gender, age, location, first visits and complications, the groups that scored >=1 on the comorbidity scale utilized the tertiary hospitals more than the O score group. Non-insulin-diabetic patients with higher Comorbidity scores visited tertiary hospitals more than patients who received lower grades. This study found that patients suffering from severe diabetes tend to frequently visit the tertiary hospitals in Korea. This result implied that it is important for Korea to improve the quality of its primary health care as well as to consider a co-insurance rate increase.

Analysis of 'Sleep Disease' Medical Service Delivery system Through In-Depth Interview

  • Yu, Tae Gyu
    • International Journal of Advanced Culture Technology
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    • v.8 no.2
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    • pp.1-5
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    • 2020
  • As the world gradually advances to an aging society, the quality of human life is valued. Among them, 'quality of sleep' is very closely related to quality of life. Recently, Korea expanded health insurance coverage for "sleep disorders". Particularly, as the number of sleep multiple tests and prescriptions for sleep aids has increased rapidly, much attention has been focused on the related medical service environment. Therefore, this study looked at an in-depth interview of 11 hospitals to see what treatment delivery system is being established when the government applies health insurance for 'sleep disorders'. In conclusion, the organizations with the most average number of sleep polyp tests per day were found to have more sleep polyp labs (hardware) and more full-time specialists. Also, the polysomnography lab (hardware) and the specialist's full-time status (software) did not necessarily result in a "positive pressure regulator prescription" that can solve "sleep apnea" caused by "sleep ailments". Rather, it was found that the number of days of sleep multiple laboratories (hardware), the number of full-time specialists (software) or the specialty majors (software) had a greater impact. In particular, the higher the specialist's full-time personnel (software) index (=6.000), the higher the sleep-inducing agent prescription rate(=1.000), and the lower the specialist's full-time personnel (software) index (=1.000), the higher the sleep-inducer's prescription rate(= 0.010) Was low. In addition, even if the professional full-time personnel(software) index was the same (=1.000), the hospital type was lower as it was closer to the public hospital(=0.067) and higher at the specialized hospital (= 0.933). In the case of university hospitals, when the full-time specialists (software) are in the same condition (= 1.000), the frequency of use of the sleep laboratory (=1.000) and the sleep test rate (= 1.000) were all the same.

Analysis on prehospital care of emergency labor pain, vaginal bleeding and sexual assault patients by 119 emergency medical technicians (진통 분만, 질출혈과 성폭행 환자에 대한 119구급대원의 병원전 응급처치 분석)

  • Baek, Mi-Lye
    • The Korean Journal of Emergency Medical Services
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    • v.17 no.2
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    • pp.9-20
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    • 2013
  • Purpose: The purpose of this study is to provide basic data to improve prehospital emergency care for patients with labor pain, vaginal bleeding and rape experience by analyzing the reports of 119 emergency medical technicians. Methods: Data were prehospital reports of 190 patients having chief complaints of labor pain, vaginal bleeding and rape in Chungcheongnam-do from January 1, 2012 to December 31, 2012. Data were analyzed using SPSS 21.0 descriptive statistics and $x^2$-test. Results: From the 190 cases of labor pain, vaginal bleeding and rape, labor pain accounted for 57.9% including 75.5% of normal delivery; vaginal bleeding accounted for 35.8% including 26.5% of postpartum hemorrhage; and rape victims accounted for 6.3%. Cases with more than one vital sign accounted for 94.2%, but cases without primary assessment of the obstetrics and gynaecology accounted for 38.4% from gestation weeks, 78.0% from parity, and 87.4% from history taking relating to event. Patient care including emotional support was the first priority care accounted for 78.4% and 60% of care was keeping the patients warm. Conclusion : In order to handle various emergency situations properly, the records must be supplemented by obstetrical and gynaecological rape checklist and rape victims supporting system should be established.

Patient Information Transfer System Using OAuth 2.0 Delegation Token (OAuth 2.0 위임 Token을 이용한 환자정보 전달 시스템)

  • Park, Jungsoo;Jung, Souhwan
    • Journal of the Korea Institute of Information Security & Cryptology
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    • v.30 no.6
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    • pp.1103-1113
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    • 2020
  • Hospitals store and manage personal and health information through the electronic medical record (EMR). However, vulnerabilities and threats are increasing with the provision of various services for information sharing in hospitals. Therefore, in this paper, we propose a model to prevent personal information leakage due to the transmission of patient information in EMR. A method for granting permission to securely receive and transmit patient information from hospitals where patient medical records are stored is proposed using OAuth authorization tokens. A protocol was proposed to enable secure information delivery by applying and delivering the record access restrictions desired by the patient to the OAuth Token. OAuth Delegation Token can be delivered by writing the authority, scope, and time of destruction to view patient information.This prevents the illegal collection of patient information and prevents the leakage of personal information that may occur during the delivery process.

The Clinical Implementation of 2D Dose Distribution QA System for the Patient Specific Respiratory-gated Radiotherapy (호흡동조 방사선치료의 2차원 선량 분포 정도관리를 위한 4D 정도관리 시스템 개발)

  • Kim, Jin-Sung;Shin, Eun-Hyuk;Shin, Jung-Suk;Ju, Sang-Gyu;Han, Young-Yih;Park, Hee-Chul;Choi, Doo-Ho
    • Progress in Medical Physics
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    • v.21 no.2
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    • pp.127-136
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    • 2010
  • Emerging technologies such as four-dimensional computed tomography (4D CT) is expected to allow clinicians to accurately model interfractional motion and to quantitatively estimate internal target volumes (ITVs) for radiation therapy involving moving targets. A need exists for a 4D radiation therapy quality assurance (QA) device that can incorporate and analyze the patient specific intrafractional motion as it relate to dose delivery and respiratory gating. We built a 4D RT prototype device and analyzed the patient-specific 4D radiation therapy QA for 2D dose distributions successfully. With more improvements, the 4D RT QA prototype device could be an integral part of a 4D RT decision process to confirm the dose delivery.

Temporal and subcellular distributions of Cy5.5-labeled hyaluronic acid nanoparticles in mouse organs during 28 days as a drug carrier

  • Lin, Chunmei;Kim, Saet Byeol;Yon, Jung-Min;Park, Seul Gi;Gwon, Lee Wha;Lee, Jong-Geol;Baek, In-Jeoung;Lee, Beom Jun;Yun, Young Won;Nam, Sang-Yoon
    • Korean Journal of Veterinary Research
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    • v.57 no.4
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    • pp.215-222
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    • 2017
  • Temporal and subcellular distributions of hyaluronic acid (HA) as a degradable nanoparticle (NP) in animals were investigated to determine if HA-NP could be utilized as an appropriate drug delivery system. After mice were intravenously injected with 5 mg/kg of Cy5.5-labeled HA-NP sized 350-400 nm or larger HA-polymers, the fluorescence intensity was measured in all homogenized organs from 0.5 h to 28 days. HA-NP was greatly detected in spleen, liver and kidney until day 28, while it was maintained at low levels in other organs. HA-polymer was observed at low levels in all organs. HA-NP quantities in spleen and liver were reduced until day 3, but increased sharply between days 3 and 7, then decreased again, while their HA-polymers were maintained at low levels until day 28. In kidneys, both HA-NP and HA-polymer showed high levels after 0.5 h of administration, but steadily decreased until day 28. According to ultrastructural analyses, HA-NP was engulfed in Kupffer cells of liver and macrophages of spleen and kidney at day 1 and was accumulated in the cytoplasm of kidney tubular cells at day 7. Overall, these findings suggest that HA-NP could be considered a desirable drug carrier in the liver, kidney, or spleen.

A Study of the Analysis of Treatment Expenses of Selected Common Diseases Covered by Medical Care Inserance System (흔한 질병(疾病)의 진료비분석(診療費分析))

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.14 no.1
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    • pp.16-29
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    • 1989
  • The general objective of this study is to grasp the treatment expenses of common diseases by character of medical care institutions. The specific objective is to find out the treatment expenses for selected common diseases by type of medical care institutions and also by level of symptom. A record review method was employed to obtain required information for the analysis of expenses. A total of 40,000 cases treated by 85 medical care institutions were selected by the study team during the period 22 June to 14 July 1988. The 85 medical care institutions were sampled by stratified proportionate random sampling method. The major findings obtained from the information collected by the study team are as follows ; 1) Treatment expenses were composed of physical examination, medication, injection anesthesia, rehabilitation surgical intervention, lab test, X-ray and diagnosis. The highest expenses was for medication, accounted for 36.7% of the total: 13.9%, injection; Lab, tests respectively: 10.5%, physical examination : 8.6% surgical intervention; 7.9% admission : 6.3%, X-ray and diagnosis: 1.5%, rehabilitation. 2) Treatment expenses per case of common diseases were quite different from not only type of medical care institutions, such as university hospital, general hospital, hospital and clinic, but also from level of symptom. 3) Treatment expenses per case for the aged were higher than that of the young. The treatment cases for over 60 years of age accounted for 19.4% of the total, however the proportion of treatment expenses accounted for 23.8% of the total. 4) Duration of treatment and visits for same diseases varied from type of medical cara institutions. Based on these study findings, the following further research should be conducted: (1) Establishment of health care delivery system. (2) Feasibility of the development of health care programme for the aged. (3) Strengthening for primary health care approach.

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A Strategy for the Improvement of Health Care Inequality in the Southwestern region of Korea - Around the island area (서남권 의료불평등 개선을 위한 방안 -도서 지역을 중심으로-)

  • Moon, Ji Hyun
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.3
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    • pp.385-392
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    • 2022
  • The purpose of this study was to identify the degree of medical inequality in medical vulnerable areas, especially in the southwestern islands, and to prepare improvements. As a research method, 14 pieces were analyzed by systematic literature review with keywords such as 'medical vulnerability', 'medical inequality', and 'island area', and a focus group or in-depth interview (FGI) was conducted on 9 medical personnel in the public medical delivery system to identify the current status and demand. As a result of the study, medical inequality in the southwest region, especially in island areas, was confirmed, and the lack of professional manpower and administrative support system were confirmed through FGI. As a result of the study, it was confirmed that realistic measures should be prepared to increase the efficiency of public health care as well as active administrative support to improve the vulnerability of island areas.

Electronic Risk Assessment System as an Appropriate Tool for the Prevention of Cancer: a Qualitative Study

  • Amoli, Amir hossein Javan;Maserat, Elham;Safdari, Reza;Zali, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8595-8598
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    • 2016
  • Background: Decision making modalities for screening for many cancer conditions and different stages have become increasingly complex. Computer-based risk assessment systems facilitate scheduling and decision making and support the delivery of cancer screening services. The aim of this article was to survey electronic risk assessment system as an appropriate tool for the prevention of cancer. Materials and Methods: A qualitative design was used involving 21 face-to-face interviews. Interviewing involved asking questions and getting answers from exclusive managers of cancer screening. Of the participants 6 were female and 15 were male, and ages ranged from 32 to 78 years. The study was based on a grounded theory approach and the tool was a semi-structured interview. Results: Researchers studied 5 dimensions, comprising electronic guideline standards of colorectal cancer screening, work flow of clinical and genetic activities, pathways of colorectal cancer screening and functionality of computer based guidelines and barriers. Electronic guideline standards of colorectal cancer screening were described in the s3 categories of content standard, telecommunications and technical standards and nomenclature and classification standards. According to the participations' views, workflow and genetic pathways of colorectal cancer screening were identified. Conclusions: The study demonstrated an effective role of computer-guided consultation for screening management. Electronic based systems facilitate real-time decision making during a clinical interaction. Electronic pathways have been applied for clinical and genetic decision support, workflow management, update recommendation and resource estimates. A suitable technical and clinical infrastructure is an integral part of clinical practice guidline of screening. As a conclusion, it is recommended to consider the necessity of architecture assessment and also integration standards.