• Korean Journal of Occupational Health Nursing
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• v.11 no.2
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• pp.108-120
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• 2002

This study analyzed the managerial efficiency of 11 organizations, the branch centers of a occupational health service organization in Korea, using the Data Envelopment Analysis (DEA) method. The DEA is a good method for evaluating health services since it can handle multiple inputs and outputs simultaneously, and also identify the sources and amount of inefficiency. The author approached this study using two efficient models: the monetary value model and the real value model. The DEA method based on the monetary value model included cost factors, while the real value model excluded cost factors. The input variables used were manpower of physicians, medical technicians, nurses, industrial hygienists and administrators; labor, maintenance, and material expenses. The output variables used were the number of medical examinations, workplace evaluations, group health management services and income from each service. The major results were as follows: First, in the monetary value model, 6 out of 11 organizations (54.6%) showed an efficiency score of 1.0, which means that they have been operating in very efficient ways. However, 5 organizations (46.4%) showed themselves to be relatively inefficient. Second, in the real value model, 7 out of 11 organizations (63.4%) showed an efficiency score of 1.0, which means they have been operating efficiently, while 4 organizations (46.4%) showed themselves to be relatively inefficient. Third, the reliability of DEA method were analyzed by comparing the results of the monetary value model and real value model. The results of 8 out of 11 organizations were same in terms of being efficient or not. Thus, the DEA could be a valid application method for occupational health service organizations. Fourth, the organizations that displayed common inefficiency in both the monetary value model and in the real value model 3, 9, and 10, were also considered to be managed inefficiency from expertise opinion. In summary, this study evaluated the efficiency of occupational health service organizations applying the DEA method with different variables, and found that the results of analysis could be valid in terms of both modeling and expert sense. In the future, the DEA method will be used as a useful tool to identify and evaluate the efficiency of occupational health service organizations through more applications and refinements.

• Journal of Korean Academy of Nursing
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• v.29 no.1
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• pp.183-195
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• 1999

The purpose of this study is to describe the health care status of Korean Immigrants in New Zealand. The sample consisted of 155 Koreans who were randomly selected from the Korean Immigrants telephone book in Auckland, N.Z. They had health problems that required health management both physically (50.3%) and psychologically(70.3%). During the previous year, the average rate of medical contact with a general practitioner was 1$\pm$1.29 times. Korean immigrants who had health problems first attempted to resolve the problem through self medication rather than utilize health care services. They would only visit a general practitioner if they had severe subjective symptoms or no relief from self medication. Even if they think they need to visit the health care service, 41.9% of the subjects did not go back for follow-up care. Generally, the person who demonstrated positive health care behaviors was male, a college level graduate or higher, lived in N.Z. longer than 2 years, had a high score on health status by self assessment, and he placed few demands on health care services. Barriers to a healthy lifestyle are communication difficulties in expressing subjective symptoms, understanding the physician's treatment and medication plans, difficulty in accessing the appointment system and the high cost of service.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.8
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• pp.162-170
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• 2017

This study analyzed the current situation of medium and small-sized hospital nursing staff and related policies, and identified the factors that affect staffing level to provide evidence for planning and adopting policy. By analyzing the statistical data published by public institutions such as the Ministry of Health and Welfare and Health Insurance Review and Assessment Service, the result was viewed based on the understanding of various internal and external health care environments. The number of active nurses was less than 50% of the number of licensed nurses and has decreased every year. This means that the cost-effectiveness of increases in nursing college enrollment should be reconsidered. Inpatient nursing fees by staffing grades has caused nurses to move from medium and small-sized hospitals, where there is a severe lack of staff, to more advanced general hospitals. As a result, the lack of nursing staff in medium and small-sized hospitals has worsened. In conclusion, reexamination is needed to improve effectiveness of inpatient nursing fees by staffing grades as a policy to secure the workforce of medium and small-sized hospitals. Furthermore, the tracking management system of licensed nurses must be able to solve the imbalance between demand and supply of nursing staff.

• Environmental Analysis Health and Toxicology
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• v.30 no.sup
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• pp.6.1-6.4
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• 2015

Objectives This study is conducted to estimate the cost paid by the public suffering from disease possibly caused by chemical and to examine the effect on public health. Methods Cost-benefit analysis is an important factor in analysis and decision-making and is an important policy decision tool in many countries. Cost-of-illness (COI), a kind of scale-based analysis method, estimates the potential value lost as a result of illness as a monetary unit and calculates the cost in terms of direct, indirect and psychological costs. This study estimates direct medical costs, transportation fees for hospitalization and outpatient treatment, and nursing fees through a number of patients suffering from disease caused by chemicals in order to analyze COI, taking into account the cost of productivity loss as an indirect cost. Results The total yearly cost of the diseases studied in 2012 is calculated as 77 million Korean won (KRW) per person. The direct and indirect costs being 52 million KRW and 23 million KRW, respectively. Within the total cost of illness, mental and behavioral disability costs amounted to 16 million KRW, relevant blood immunological parameters costs were 7.4 million KRW, and disease of the nervous system costs were 6.7 million KRW. Conclusions This study reports on a survey conducted by experts regarding diseases possibly caused by chemicals and estimates the cost for the general public. The results can be used to formulate a basic report for a social-economic evaluation of the permitted use of chemicals and limits of usage.

• Journal of Korean Academy of Rural Health Nursing
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• v.3 no.2
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• pp.104-115
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• 2008

Purpose: A study of the family planning and Maternal-Child Health Services that disciplined itself in primary health care post form 1980 to 2009. Method: Investigation studies family planning in primary health care post and a change process of a Maternal-Child Health Services into case by case until 2009 from 1980. Results: Our country family planning business began at economic development dimensions in order to solve a poverty issue. This business goal were childbirth decrease of pregnancy possibility couple aged 19~49 and improve to mother and child health. For this goal, all kinds of health education included sex education and contraception education, contraception service, comprehensive maternal and child health service that management of front and back of childbirth etc. are provided. According to fail down a birthrate from 6.0(1962) to 1.25(2009), the nation reached to a dilemma called childbirth encouragement policy. Conclusions: Decrease of labor supply by low birthrate, decrease numerical an employed person by aging was brought a labor shortage and decrease of productivity of labor of industrial manpower. Deterioration phenomenon of financial income and expenditure by consumption and investment contraction caused decrease of slowdown of economic growth and potential growth rate, and a social cost burden is increased by deterioration financial old man support burden increase by this and pensions and health insurance, a sharp increase of social welfare cost etc. Now, in order to solve a low birth issue, the government establishes a whole nation forwarding system and establishes basic plan social low birth and advanced age, and to prepare for childbirth fault factors removal and advanced age society shall endeavor.

• Journal of Convergence for Information Technology
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• v.9 no.8
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• pp.102-109
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• 2019

Despite of advanced plans from Korean government to encourage Korean medical tourism, the medical tourism in Korea is still under competitive compared to the countries including Thailand, Singapore, and India, in which the government has been driving the development in industries of medical tourism, Moreover, the studies identifying the factors affecting tourists' satisfaction has not been actively performed up to date. Therefore, this study attempts to investigate the influences of quality of medical service, accessibility, cost adequacy, and quality of tourism of Korean medical tourism on Chinese tourists' satisfaction and revisit intention. For the purpose of empirical study, a survey has been conducted to Chinese medical tourists. Findings are as follows. First, the factors of medical tourism attributes including quality of medical service, cost adequacy, and quality of tourism have turned out to have positive effects on medical tourists' satisfaction. Second, tourists' satisfaction has a positive effect on revisit intention.

• Journal of Korean Academy of Nursing
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• v.26 no.4
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• pp.768-781
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• 1996

The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

• Journal of Korean Academy of Nursing
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• v.30 no.4
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• pp.932-947
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• 2000

The purpose of this study was to suggest directions for developing a Health Promotion Program for the elderly in Korea for the future. For this, twenty previously developed & implemented health promotion programs were reviewed and analyzed in terms of target population of the program, components of the program, measurement variables for effects of program, the effects of the program. The results were as follows. 1. Most of the target populations were older adults living independently in the community. 2. Components of the program were health education, health assessment and counseling and exercise program. - Health education was done in most of programs. The topics of health education that were often included in the programs were life style changes, medical knowledge, independent living, the concept of health promotion and changes related to aging. - In health assessment and counseling, health professionals discovered their health problems through health assessment or health risk appraisal. Then they developed health recommendations on each health problem and encouraged the elderly to implement the recommendations. 3. Variables measuring the direct effects of the program were health behavior, knowledge, attitude, skill, use of medical/health reference book. Variables measuring the indirect effects, biometric outcome, health status, functional status, medical service utilization, medical cost and wellbeing. 4. The analysis showed that health education was effective for changing health behaviors, improving knowledge, skill and attitude in the elderly. Those results were suggested to be used as guidelines for developing a health promotion program for the elderly in Korea for the future.

• Journal of Korean Public Health Nursing
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• v.2 no.2
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• pp.21-44
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• 1988

In Korea, fee-for service reimbursement has been adopted from the begining of medical insurance system in 1977, and the importance of the relative value unit is currently being investigated. The purpose of this study was to find out the level of propriety of the difference in the fees for different surgical services, and the appropriateness of the classification of the insurance fee schedule. For the purpose of this study, specific subjects and the procedural methodology is shown as follows: 1. The propriety of the Relative Price System(RPS). 1) Choice of sample operations. In this study, sample operations were selected and classified by specialists in general surgery, and the number of items they classified were 32. For the same group of operations the Insurance Fee Schedule(IFS) classified the operations into 24 separate items. In order to investigate the propriety of the RPS, one of the purpose of this study, was to examine the 24 items classified by the IFS. 2) Evaluation of the complexity of surgery. The data used in this study was collected The data used in this study was collected from 94 specialists in general surgery by mail survey from November I to 15, 1986. Several independent variables (age, location, number of bed, university hospital, whether the medical institution adopt residents or not) were also investigated for analysis of the characteristics of surgical complexity. 3) Complexity and time calculations. Time data was collected from the records of the Seoul National University' Hospital, and the cost per operation was calculated through cost finding methods. 4) Analysis of the propriety of the Relative Price System of the Insurance Fee Schedule. The Relative Price System of the sample operation was regressed on the cost, time, comlexity relative ,value system (RVS) separately. The coefficient of determination indicates the degree of variation in the RPS of the Insurance Fee Schedule explained by the cost, time, complexity RVS separately. 2. The appropriateness of the classification of the Insurance Fee Schedule. 1) Choice of sample operations. The items which differed between the classification of the specialist and the classification of medical, Insurance Fee Schedule were chosen. 2) Comparisons of cost, time and complexity between the items were done to evaluate which classification was more appropriate. The findings of the study can be summarized as follows: 1. The coefficient of determination of the regression of the RPS on-cost RVS was 0.58, on time RVS was 0.65, and on complexity RVS was 0.72. This means that the RPS of Insurance Fee Schedule is improper with respect to the cost, time, complexity separately. Thus this indicates that RPS must be re-shaped according to the standard element. In this study, the correlation coefficients of cost, time, complexity Relative Value System were very high, and this suggests that RPS could be reshaped I according to anyone standard element. Considering of measurement, time was thought to be the most I appropriate. 2. The classifications of specialist and of the Insurance Fee Schedule were compared with respect to cost, time, and complexity separately. For complexity, ANOVA was done and the others were compared to the different values of different classifications. The result was that the classification of specialist was more reasonable and that the classification of Insurance Fee Schedule grouped inappropriately several into one price unit.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.1
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• pp.123-135
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• 2002

Purpose: In this study, the critical pathway for laparoscopic cholecystectomy patients was developed and applied for clinical study. The effectiveness of the critical pathway was analyzed. Method: The subjects with no critical pathway services of this study were 30 laparoscopic cholecystectomy operation patients, who were hospitalized in B General Hospital in Busan from Nov. 28. 2000 to May 2. 2001. The subjects with critical pathway services of this study were 30 laparoscopic cholecystectomy operation patients, who were hospitalized in B General Hospital in Busan from June. 11. 2001 to Oct. 31. 2001. Results: 1. Development for critical pathway Preliminary critical pathway for the laparoscopic cholecystectomy patients was developed though analysis of the reference and 34 case of medical record. The items on the y-axis were assessment, test, treatment, diet, fluid, consult, medication, activity and education and the items on the x-axis were till 3days after operation. The developed critical pathway was applied in clinical field. 2.　Effectiveness of application on developed critical pathwayPost operational complication was not found in neither the critical pathway using Group nor Non-using Group. Hospitalization period mean was 4.63 days for the using Group and 5.93 days for the Non-using Group(P=.001). The mean cost for medical examination and treatment for the using Group was 786,270 won, 117,454 won(12.9%) less than that of the Non-using Group, 903,724 won(P=.000). The degree of satisfaction for the using group was 3.7 points, for the Non-using Group, 3.15 points. The degree of satisfaction for the used Group was 0.55 points higher than that for the Non-using Group and there was a statistically significant difference(P=.000). Concousion: From results of this study, Using the critical pathway in the laparoscopic cholecystectomy operational patients was effective in decreasing the hospitalization period and cost, and increasing the satisfaction about the medical service.