• Health Policy and Management
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• v.19 no.2
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• pp.127-134
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• 2009

It is known that socioeconomic status(SES) of the cancer patient is associated with survival in recent studies, performed in other countries. The purpose of this study was to determine whether the association between status of national health insurance and survival is also present in a community in Jeonnam province, South Korea. The Gwangju-Jeonnam Cancer Registry, a population-based cancer registry, provided information to identify the cancer cases of study community diagnosed from 1998 to 2007. Total of 2,046 cases were identified during the period. There were significant associations between the status of national health insurance and survival for total cancer after adjusted by age, geographic accessibility to health care, and stage at diagnosis. However, this differences were not found in the analysis using only stomach and colorectal cancer cases. Despite of some limitations, this results suggest that the policy for reducing the difference according to the SES is required in national cancer management program.

• Journal of Preventive Medicine and Public Health
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• v.28 no.1 s.49
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• pp.153-174
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• 1995

This study was conducted to examine the determinant factors for expenditure of the medical insurance program for self-employeds based on the analysis of 1991 'The Medical Insurance Program for Self-Employeds Statistical Yearbook', and also similar yearbooks in the metropolitan and other provinces. The major findings are as follows : We have divided benefits into these four components such as the utilization rate for out-patients, expenses per claim for out-patients as paid by the insurer, utilization rate for in-patients, and the expenses per claim for in-patients as paid by the insurer, in order to examine the determinant factors for it. The results of the study revealed the following findings, in urban areas, the supply of medical care had more influence on the benefits than other demographic and economic variables, while, in county areas, both the supply of medical care and the rate of those aged over 65 affected the provision of benefits. The determinant factors for financial balance of the medical insurance program for self-employeds are, first, the determinant factor for administrative expenses was the number of households. The more the number of households, the less the administrative expenses per the insured. This shows that the economy of scale is being. And so, the administrative district must be taken into consideration in the incorporation of small regional medical societies and should be re-organized for more efficient management. Second, in urban areas, the supply of medical care had more influence on utilization rate and expenses per claim as paid by insurer, and therefore it is necessary to control it. In county areas, the supply of medical care and the rate of those aged over 65 raised the utilization rate and expenses per claim as paid by insurer. For the financial stability of county areas, a common fund for medical care for the aged and expansion of finance stabilization fund would be necessary. But, in county areas, it would be unnecessary to control the supply of medical care because it was much more insufficient than in urban areas. The vitalization of public health facilities must be carried out in county areas, for they reduced benefits. Sice the more insured in a single household, the less the utilization of the medical insurance program, benefits for habilitation at home should be given consideration. The law of majority and the economy of scale were applied here, and therefore the incorporation of regional medical societies must be taken into consideration. In integrating regional medical societies, it would be absolutely necessary to review the structural differences among all regional medical societies, the medical demand of each region, and also the local characteristics of each region.

• Journal of agricultural medicine and community health
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• v.47 no.3
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• pp.166-180
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• 2022

Objective: This study evaluated the effects of a non-face-to-face obesity management program, implemented during the pandemic. Methods: The non-face-to-face obesity management program used the Intervention mapping protocol (IMP). The program was put into effect over the course of eight weeks, from September 14 to November 13, 2020 in 48 overweight and obese adults, who applied to participate through the Daegu Citizen Health Support Center. Results: IMP was first a needs assessment was conducted; second, goal setting for behavior change was established; third, evidence-based selection of arbitration method and performance strategy was performed; fourth, program design and validation; fifth, the program was run; and sixth, the results were evaluated. The average weight after participation in the program was reduced by 1.2kg, average WC decreased by 3cm, and average BMI decreased by 0.8kg/m² (p<0.05). The results of the health behavior survey showed a positive improvement in lifestyle factors, including average daily intake calories, fruit intake, and time spent in walking exercise before and after participation in the program. A statistically significant difference was seen (p<0.05). The satisfaction level for program process evaluation was high, at 4.57±0.63 point. Conclusion: The non-face-to-face obesity management program was useful for obesity management for adults in communities, as it enables individual counseling by experts and active participation through self-body measurement and recording without restriction by time and place. However, the program had some restrictions on participation that may relate to the age of the subject, such as skill and comfort in using a mobile app.

• Journal of Preventive Medicine and Public Health
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• v.33 no.4
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• pp.393-401
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• 2000

Objectives : To evaluate the impacts of the DRG payment system on the behavior of medical insurance claimants. Specifically, we evaluated the case-mix index, the numbers of diagnosis and procedure codes utilized, and the corresponding rate of diagnosis codes before, during and after implementation of the DRG payment system. Methods : In order to evaluate the case-mix index, the number of diagnosis and procedure codes utilized, we used medical insurance claim data from all medical facilities that participated in the DRG-based Prospective Payment Demonstration Program. This medical insurance claim data consisted of both pre-demonstration program data (fee-for-service, from November, 1998 to January, 1999) and post-demonstration program data (DRG-based Prospective Payment, from February, 1999 to April, 1999). And in order to evaluate the corresponding rate of diagnosis codes utilized, we reviewed 820 medical records from 20 medical institutes that were selected by random sampling methods. Results : The case-mix index rate decreased after the DRG-based Prospective Payment Demonstration Program was introduced. The average numbers of different claim diagnosis codes used decreased (new DRGs from 2.22 to 1.24, and previous DRGs from 1.69 to 1.21), as did the average number of claim procedure codes used (new DRGs from 3.02 to 2.16, and previous DRGs from 2.97 to 2.43). With respect to the time of participation in the program, the change in number of claim procedure codes was significant, but the change in number of claim diagnosis codes was not. The corresponding rate of claim diagnosis codes increased (from 57.5% to 82.6%), as did the exclusion rate of claim diagnosis codes (from 16.5% to 25.1%). Conclusions : After the implementation of the DRG payment system, the corresponding rate of insurance claim codes and the corresponding exclusion rate of claim diagnosis codes both increased, because the inducement system for entering the codes for claim review was changed.

• Research in Community and Public Health Nursing
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• v.21 no.3
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• pp.351-361
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• 2010

Purpose: This study was done to analyze the effects of tele-care case management services using secondary data. Methods: A descriptive research design was utilized, and the participants were 134 medical aid beneficiaries who were in either the high-risk group or the preventive group. Casemanagement services were delivered by 8 care managers. Data were analyzed using PAWS Statistics 17 through descriptive statistics and paired t-test. Results: After the case management intervention, the participants' health quality of life, self-care competency, and reasonable medical care utilization increased significantly for the high-risk group. However there were no significant changes in the preventive group. Conclusion: The results showed that the tele-care case management services were effective for high-risk medical aid beneficiaries. Further studies with controls for constitutional variables and a comparison group are required to validate the robustness of the effectiveness of the case management program in the present study.

• Journal of agricultural medicine and community health
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• v.49 no.3
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• pp.179-193
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• 2024

Objectives: This study aimed to determine the time-series changes in provincial diabetes management indices using by results of the 2008-2022 Korea Community Health Survey. Methods: We collected diabetes diagnosis experience rate, treatment rate for people diagnosed with diabetes, annual screening rate for diabetic eye disease complications, and annual screening rate for diabetic kidney disease complications with age-standardized rates from the Regional Health Statistics. The unit of analysis was the nation and 17 provinces and the time-series trend analysis was performed by joinpoint regression using the Joinpoint Regression Program, and the annual percent change (APC) and average APC (AAPC) were estimated, and statistical significance was tested using 95% confidence interval (CI). Results: From 2008-2022, the national AAPC (95% CI) for diabetes diagnosis experience rate steadily increased to 2.77 (2.25-3.27), increasing in all regions, excluding Sejong. The national AAPC for treatment rate for people diagnosed with diabetes was 0.75 (0.47-1.04), with a slight but steady trend toward improvement, excluding Daejeon, Sejong, and Jeonbuk, which showed significant improvement. The national AAPCs for annual screening rates for diabetic eye disease and kidney disease complications were 1.82 (0.99-2.66) and 1.95 (0.60-3. 41), respectively, and the area with the largest change was Sejong. Conclusions: In Korea, the diabetes management indices tended to increase and improve, but the trends among provinces varied. Therefore, efforts are needed to address regional disparities in diabetes management.

• Health Policy and Management
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• v.28 no.3
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• pp.251-256
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• 2018

The origin of hospital accreditation in Korea is the Hospital Standardization Program of the Korea Hospital Association. Current accreditation program implemented by the Korea Institute for Healthcare Accreditation has succeeded in stimulating quality improvement activities of participating hospitals since its launching in 2010. However it has been criticized due to some unintended consequences of accreditation. In order to fully enjoy the benefit of the accreditation program in Korea, national efforts to expand accreditation scheme and coverage, upgrade accreditation standards, insure substantiality of accreditation process, provide consumers with more useful information, and strengthen the professional capacity of accreditation organization will be needed.

• The Journal of Korean Medicine
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• v.31 no.4
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• pp.141-150
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• 2010

Objectives: The study evaluated efficacy of the Gigong program in health promotion service programs using oriental medicine. Methods: The data were collected from 31 female participants who completed the Gigongprogram from February to May of 2009 in Eumsung-Gun. The questionnaires to measure efficacy of the Gigong program were composed of demographic items, past history, family history, why they joined the program, satisfaction with the Gigong program, lipid profile, etc. The lipid profiles were collected before and after the Gigong program. Results: Satisfaction with the Gigong lectures and program was 88.4%. Improvement of daily life after the Gigong program was 92.2%. Mood and exercise habits of daily life significantly improved. Conclusions: From these results, the Gigong program is worthwhile for promoting health, so further study is needed to determine its efficacy.

• Health Policy and Management
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• v.6 no.1
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• pp.144-162
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• 1996

This study was conducted to identify the problems related to operation of the committee system in university hospitals and to propose the direction for reforming it. Data were collected by surveying 138 working-level administration managers of committees from 12 university hospitals in Seoul in October, 1995. The results were as follows: 1. The purposes of the committee were to promote the reasonable dicision making in the hospitals, to satisfy the requirement of Hospital Accreditation Program and, to execute the administrational instructions in due order. The sort of job which was charged of chairmen and the majority of committee member was doctor. 2. The committees which were to be held the meeting frequently in a year were general management committees(8.25 times/year). But in case of operation rate, medical care-related committees showed the most frequent meeting(90.15%). Most of committees made the regulations and reported the results of their meeting to the CEO of their hospitals by written documents. 3. Most doctors thought the medical care-related committees useful. Medical technicians regarded education and research-related committees as useful, while administrators favored the general management committees. 4. The factors related to the perceived performance of the committee were the kind of job, the class of job and the kind of committee. Also, the perceived performance of the committee was positively related to the usefulness in efficient management of work, and negatively to uncertainties in responsibility and a nominal role of the committee. 5. Most of the respondnts thought that the concern of the top manager about the committee was the most important factor for the improvement of committee system at hospitals. They also regarded that formalization of the objectives and regulation rule and composition of committees with members which work in various fields as essential. Further studies on the organizational and operational cjharacteristics which include general hospitals in various areas are required.

• Journal of Preventive Medicine and Public Health
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• v.44 no.2
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• pp.74-83
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• 2011

Objectives: This study aimed to identify and assess the factors related to the awareness, treatment, and control of hypertension based on jurisdictional areas of primary health care posts in a rural community of Korea. Methods: This study was performed on 4598 adults aged over 30 years in a rural community and we measured their blood pressure (BP) from October. 2007 to August. 2009. Hypertension is defined as a condition characterized by a systolic BP ${\geq}$ 140 mmHg, a diastolic BP ${\geq}$ 90 mmHg or reported treatment with antihypertensive medications. We analyzed the factors related with the prevalence, awareness, treatment and control of hypertension using chi-square test and multivariate logistic regression analysis. Results: The age-adjusted prevalence of hypertension was 34.7%. The age-adjusted rates of hypertension awareness, treatment and control were 50.6%, 93.9% and 64.1%, respectively. Awareness of hypertension was related with increasing age. Higher awareness was found among men who were felt more stress, were obese and had hypercholesterolemia, and among women who were regulary taking medicine for hypertension, were obese and had diabetes mellitus. In women, the hypertension treatment was related a Medical aid and education for hypertension management. Controlled hypertension was more common among men who were educated about the management of hypertension and among women who had hypercholesterolemia. Conclusions: The awareness of hypertension was low and the control of hypertension was high compared with the nationwide data (KNHANES 2005). The results suggest that understanding the characteristics of hypertension in a community is important to perform a community based hypertension control program.