• 가정간호학회지
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• 제6권
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• pp.5-18
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• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

• 한국운동역학회지
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• 제21권2호
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• pp.253-258
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• 2011

The purpose of this study was to compare metabolic energy expenditure with the computed kinetic energy for different speeds of walking and running over the treadmill and to find the relevance for individual and group equation by performing a statistical analysis, Bland-Altman plot. Seven male subjects participated, and they were required to walk and run on the treadmill with the gas analyzer and triaxial accelerometer. Walking speeds were 3.0, 4.0, 5.0 and 6.0 km/h and running speeds were 7.0, 8.0 and 9.0 km/h respectively. Kinetic energy was calculated by the integration of acceleration data and compared with the metabolic energy measured by a gas analyzer. Correlation coefficients showed relatively good between the measured metabolic energy and the calculated kinetic energy. In addition, a dramatic increase in kinetic energy was also observed at the transition speed of walking and running, and two standard deviations in Bland-Altman plot, derived from the difference between measured and predicted values, were 1.14, 2.53, 2.93, 1.80, 2.80, 0.60 and 2.48 respectively. It was showed that there is no difference for methods of how to predict the kinetic energy expenditure for individual and group even though people had each different physical characteristic.

• 한국노년학
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• 제25권2호
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• pp.109-126
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• 2005

본 연구는 65세 이상 노인에게 공공의 사회보장부문에서 제공하는 사회적 급여를 사회복지비용이라 정의하고, 노인의 농업노동 참여가 사회복지비용 지출에 어떻게 영향을 미치며 농업노동 참여여부에 따라 1인당 그리고 한 해 사회복지비용 지출이 얼마나 차이가 있는지를 파악하고자 하였다. 이를 위하여 노인의 소득·의료보장을 위해 지출된 2003년도 교통수당, 경로연금, 국민기초생활보장 생계급여와 의료급여, 국민건강보험급여 등 생계지원비 및 의료지원비를 37개 동·읍·면사무소와 국민건강보험공단에 자료제공 협조를 요청하여 만 65세 이상 노인 799명에 대한 원자료를 수집·활용하였다. 65~74세, 75~84세, 85세 이상 등 3개 연령집단별로 분석한 결과, 첫째, 생계지원비 및 의료지원비 모두 모든 연령집단에서 농업노동에 참여한 노인보다 농업노동을 하지 않았던 노인에게 더 많이 지출되었다. 노인 1인당 차액은 연령집단에 따라 약간 차이가 있었는데 생계지원비는 113,959~361,132원, 의료지원비는 15,644~51,418원이었다. 둘째, 노인의 농업노동 참여여부는 65~74세, 75~84세 연령집단의 생계비 지출에, 65~74세 연령집단의 의료지원비 지출에 유의미한 영향을 미치는 것으로 나타났다. 이 결과를 기초로 하여 노년기 농업노동 참여에 따른 한 해 사회복지비용 절감액을 산출한 결과, 2003년도 기준 1304억원이었다.

• 보건행정학회지
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• 제31권1호
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• pp.46-55
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• 2021

Background: Patients with the chronic physical illness are more likely to experience depression, and the accompany of chronic physical illness and depression is particularly high in middle-aged and elderly women. Considering that depression is associated with somatization and the decline of therapeutic compliance when accompanied by chronic physical illness, middle-aged and elderly women who experience depression among chronic physical illness may increase their use of medical services. This study is to identify the effect of depression on the use of medical services, especially among middle-aged and elderly women with chronic physical illness. Methods: This study used the 2016 Korean Health Panel. For analysis, it used T-test, negative binomial regression, and multivariate regression combining propensity score matching. Results: First, depressive groups had a higher number of medical service utilization and total medical expenditure than the non-depressive group. Second, depression significantly increased medical service utilization (β=0.17, p=0.04) at the 5% significance level. Also, depression significantly increased total medical expenditure (β=0.37, p=0.08) at the 10% significance level. Conclusion: For those who have chronic physical illness among middle-aged and elderly women, the experience of depression was confirmed to be a factor affecting the use of medical services. In the end, it is important to come up with policy countermeasures for middle-aged and elderly women accompanied by depression and chronic physical illness.

• 보건행정학회지
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• 제12권1호
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• pp.125-143
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• 2002

The objectives of this study were analysis of patient\`s characteristics and market segmentation in oriental medical care and western medical care. This study focused on medical utilization using Anderson's health utilization model. The source of data was 1998 National Health and Nutrition Survey which Korean Institute For Health and Social Affairs carried out. A stratified multistage probability sampling design was used in this survey. The analysis was conducted using the statistical software package SPSS version 10.0 and Answer Tree 2.1 which is one of data mining methodology. The results were as follows ; 1) 44.9% of respondents reported visiting oriental medical center within recent two weeks. 3.4% of them used oriental medical care. The group of age, kind of disease and medical expenditure are associated with the difference western and oriental medical utilization rate. 2) There were several factors related to utilization of oriental medical care according to decision tree. Especially, important factors that patient chose his medical center were kinds of disease, kinds of common medical use, and expenditure. 3) in the results of CART analysis, market of oriental medical care were classified by seven categories. The major groups who have a preference for oriental medicine were those musculo-skeletal, cerebra-vascular disease, or chronic headache patients, and they had a preference fur oriental medical care in common use. These results show that oriental and western medical market were divided into various areas by market segmentation.

• 한국보건간호학회지
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• 제24권1호
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• pp.61-70
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• 2010

Purpose: This study analyzed outcomes of a Telecare case management service pilot project for Korean Medicaid Program Clients in Seoul. Outcome data for provided services and medical aid cost data were analyzed. Methods: Case management services were delivered by 10 medical aid managers. The period of the project was from July to December 2007. Results: The total number of the objects was 9714, representing 43.4% of the total medical aid clients in the area. The average number of consults was 2.58. Consults were most frequently via letter and telephone, with in- person visits being least common. Of the total, 213 cases were referred to community services, 87.8% were transacted successfully. The medical expenditure was less than that from January-June, 2007. Conclusion: Telecare service via mail or telephone allows contact with many clients in a short time which can enable the discover and monitoring of high risk clients. This can be accomplished at a cost savings to the Korean Medicaid Program.

• 한국CDE학회논문집
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• 제21권1호
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• pp.69-77
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• 2016

The purpose of this study is to estimate the energy expenditure of working in a clean room for manufacturing embedded needles by ergonomic programs. Embedding needle is one of medical devices and it should be manufactured in a clean room. 3D static strength prediction program was used to analyze the slow movements during embedding needle manufacturing in a clean room. Also the energy expenditure prediction program was used to estimate energy expenditure rates for materials handling tasks to help assure worker safety and health in clean room. The energy expenditures of the tasks were calculated using prediction equations derived from empirical data. The energy expenditure rate of 3.09 kcal/min in a clean room didn't exceed the 3.5 kcal/min action limit guideline for an average 8-hour day set by the National Institute for Occupational Safety and Health (NIOSH). Energy consumption was calculated on the same working conditions as EEPP program, using an average body weight of female 20 years old to 59 years who would be the candidates of the real workers.

• 한국치위생학회지
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• 제20권2호
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• pp.129-137
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• 2020

Objectives: Using the annual data from the 2016 Korean Health Panel, this study aims to identify the factors that affect the dental utilization and expenditure of patients with chronic diseases, and to provide basic data to explain the inequality gap in dental utilization. Methods: The dental utilization and expenditure of 3,557 patients with chronic diseases were analyzedfor frequency using the SPSS Windows version 23.0 (SPSS Inc. IL, USA). Analysis of the factors that affect dental utilization and expenditure were performed using a multiple regression analysis. The level of statistical significance was 0.05. Results: The frequency of dental utilization in patients with chronic diseases was high for subjects who were younger than 65 years and those whose education level was below high school. The frequency of dental utilization was relatively lower for subjects who did not have disabilities and those with healthier subjective health status. The dental expenditure of patients with chronic diseases was higher in subjects who were younger than 65 years and those with greater household income. Conclusions: The above findings suggest that a plan is needed to control dental utilization by efficiently managing chronic diseases, and that a policy-based plan is needed to devise ways to supplement the uninsured medical expenses of dental care.

• 한국병원경영학회지
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• 제25권4호
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• pp.76-93
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• 2020

Purpose: In this study, the general characteristics of subjects who spent more than a certain amount of cost for general medical examination at the general hospital health promotion center, and the characteristics of disease, family history, and lifestyle (smoking, alcohol, physical activity, oral care) significantly differed in cost expenditure. We intend to provide basic data for establishing an appropriate marketing strategy for comprehensive examination. Method: It was conducted for users who received comprehensive checkups at a health promotion center at a general hospital in Seoul. The research data collection period is for 979 people who performed comprehensive examinations from January 2019 to December 2020. In order to carry out a comprehensive examination, a questionnaire before the examination was distributed to the subjects who visited the hospital to prepare, and the investigation was conducted in a way that the subjects of the investigation directly filled in. Results: There was a significant influence on the difference in expenditure for comprehensive examination according to the gender, age, and type of health insurance of the subject. In addition, there were significant differences in expenditure according to the presence or absence of disease and the type of family history. Weight loss, smoking history, smoking period, smoking frequency, drinking history, and drinking frequency all had significant effects on cost expenditure. Also, strength training and oral treatment management showed a significant effect on the cost of comprehensive examination. The number of flossing and interdental brushing was also found to have a significant effect. According to the results of multiple regression analysis, disease history (t=2.683, p<.01) and mean smoking frequency (t=4.315, p<.001) appeared to have the most significant effect on expenditure statistically. In other words, when the subject has a history of disease and when the average number of smoking is large, it means that the comprehensive examination cost is remarkably large. Conclusion: By using these contents, hospitals can further refine the marketing of the examination center. In addition, a more convenient and specialized process should be used by patients by linking the general medical department and the examination center well. In terms of management of operating medical institutions, this can be expected to create patients and increase profits.

• 국제지역연구
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• 제21권2호
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• pp.21-44
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• 2017

2007년 이후 중국경제는 고속성장에서 중 고속성장으로 변화되면서 "신창타이"시대에 진입함과 더불어 경제 사회적으로 큰 변화를 나타내고 있으며 새로운 패러다임 하에 취업문제가 큰 관심을 받게 되었다. 따라서 국가경제의 발전과 조절에서 중요한 역할을 하고 있는 재정지출이 취업에 대하여 어떤 영향을 미치고, 지역별로 어떤 차이를 보이며, 그 영향이 어떻게 변화되는지를 파악하는 것이 본 연구의 목적이며, 31개 성 시 패널자료를 이용하였다. 신창타이기간(2008-2015년)과 전체기간(1998-2015년)으로 구분하여 분석한 결과, 신창타이기간에서 재정지출이 도시취업률에 미치는 영향이 총취업률보다 더 크고, 고소득지역에 미치는 영향이 저소득지역보다 더 크게 나타났다. 의료위생 과학기술지출은 총취업률에 긍정적 영향을 주고, 사회보장 및 취업 교육지출은 도시취업률에 긍정적 영향을 주는 것으로 나타났다. 전체기간에서는 재정지출이 취업에 미치는 영향패턴이 신창타이기간 분석과 비슷하게 나타났지만 탄력성측면에서 큰 차이를 보였다. 따라서 "신창타이"시대에 진입하면서 재정지출이 취업에 미치는 효과는 긍정적인 것으로 나타났다. 사회보장 및 취업 교육 의료위생 과학기술부문 지출을 확대하고 경제건설, 일반행정과 같은 지출의 감소 등 재정지출 구조를 변화시켜야 "신창타이"시대에 있어서 재정지출의 취업에 대한 효율성을 증가시킬 수 있을 것이다.