• Health Policy and Management
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• v.7 no.1
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• pp.73-99
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• 1997

This study was carried out by using questionnaires with 126 insurance societies from Sept. 30, 1995 to Oct. 18, 1995. The primary data collected bythe survey have been significantly supplemented by secondary data obtained from sources such as health insurance statistical year books and internal data in the Ministry of Health and Wolfare. Major findings were summarized as follows: Two financial coordinating programs have significantly improved financial status of regional health insurance societies: the catastrophic program for high cost medical care that was initiated in 1991 and the program for hospitalization cost of the aged in 1995. Another finding is that there existed ambiguity and inconsistency of equity index that had been used by stabilization programs and its side effects could not be ignored. Regression analyses were made to identify factors that affect financial transfers. Inde pendent variables in the regression include utilization frequency, dependancy ration, insurance contribution per insured and medical expense per insured. All these variables were statistically significant in the equations of applying distribution rate (distribution/contribution) and transfer rate (transfer/contribution) as dependent variables. Policy suggestions for the catastrophic program for high cost medical care are modifying the definition of catastrophic case and setting the maximum amount of subsidies for each society based on distribution rates. To solve the problems of the financial coordinating program for the aged, we could consider reimbursing more than 50% of the copayment incurred by the aged 65 or more and determining the maximum amount of outpatient copayment at 10,000 Won per day or per visit for the elderly. More fundamental improvement could be made by amending the Welfare Benefit Act to establish and expand medical and welfare facilities for the elderly.

• Journal of Korean Clinical Health Science
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• v.2 no.2
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• pp.148-157
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• 2014

Purpose. This study compares and analyzes customer service on customer satisfaction and customer royalty on customer satisfaction targeting the customers visiting a hospital or a clinic which is franchised or not. And it aims at helping business rationalization for a medical institution. Methods. This paper conducts a survey and selects a sample of 670 customers except the missing value targeting the customers of 4 primary health care institutions and 4 bigger health care institutions in Seoul and Gyeonggi province. It conducts frequency analysis for the purpose of investigating the respondents' generic characteristic and factor of their medical institution selection, and factor analysis, reliability analysis and regression analysis for the hypothesis testing. Results. The first hypothesis testing result is significant in level of significance of 0.01. The second one is the same as the first one, but the dummy variable shows a negative regression coefficient(-0.479). The third one is significant in level of significance of 0.01, but the forth one is not significant. And the respondents prioritize website(Home page) and convenience in use of a hospital procedure for selecting a hospital or a clinic. Conclusions. The additional analysis finds that the franchised group has more satisfaction than none franchised group. But in case of their royalty, the average of franchised and none franchised groups are not significantly different. Therefore, the results of this paper reveal to support the results of the advanced researches.

• Korean Journal of Biological Psychiatry
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• v.8 no.1
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• pp.53-61
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• 2001

The authors, in this paper, addressed a variety of problems and difficulties which Korean psychiatrists should cope with. The surprising development of neurosciences, splitting of neuropsychiatry into neurology and psychiatry, easygoing attitude of psychiatrists, changes in the delivery system of health care and ill-balanced education of psychiatry were listed as causes of or contributors to them. Social bias to psychiatry and regulations from outside are also considered as contributors. Psychiatric education, including medical school, residency training, continuing medical education and psychiatric textbooks, need to be changed in order to enlarge the boundary of psychiatry. Reestablishment of identity of psychiatry and psychiatrist is unavoidable, considering far-reaching new knowledge of neuroscience and gradually invisible borderzone between neurology and psychiatry. The other ways worth while to consider are : the expansion of psychiatrists' activities, development of medical behavioral science to a clinical specialty, creation of new psychiatric subspecialties, and additional training of psychiatric residencies in the primary medical care.

• Journal of Korean Critical Care Nursing
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• v.13 no.3
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• pp.62-74
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• 2020

Purpose : This study aimed to investigate the prevalence and risk factors of mental health problems in patients discharged from the intensive care unit (ICU). Methods : This was a secondary analysis study using data from a multicenter prospective cohort of post-ICU patients. We analyzed data of 311 patients enrolled in the primary cohort study who responded to the mental health questionnaire three months after the discharge. Anxiety and depression were measured on the Hospital Anxiety-Depression Scale, and post-traumatic stress disorder (PTSD) was measured on the Posttraumatic Diagnostic Scale. Results : The prevalence of anxiety, depression, and PTSD in patients at three months after ICU discharge were 25.7%, 17.4%, and 18.0%, respectively, and 7.7% of them experienced all three problems. Unemployment (OR=1.99, p=.033) and unplanned ICU admission (OR=2.28, p=.017) were risk factors for depression, while women gender (OR=2.34, p=.009), comorbid diseases (OR=2.88, p=.004), non-surgical ICUs (trauma ICU: OR=7.31, p=.002, medical ICU: OR=3.72, p=.007, neurological ICU: OR=2.95, p=.019) and delirium (OR=2.89, p=.009) were risk factors for PTSD. Conclusion : ICU nurses should proactively monitor risk factors for post-ICU mental health problems. In particular, guidelines on the detection and management of delirium in critically ill patients should be observed.

• 한국노년학
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• v.28 no.4
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• pp.773-784
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• 2008

This paper is to suggest policy issues to be done in the future health policy for the elderly, analyzing contents of results suggested in academic papers published in Journal of the Korean Gerontological Society. Number of Papers published in the Journal is 61, occupying most of papers related with chronic disease, medical expenditures and health delivery system except dental and psychiatric health. Method used to be analyzed is mostly random sampling among community inhabitants or hospital patients. Policy issues are as follows in case of being based in the above analysis results. Firstly, it is necessary that the development of health promotion specialized for the elderly be developed and activated. Secondly, it is necessary that the primary health care system specialized for the elderly be constructed. Thirdly, it is necessary that the subacute care system specialized for the elderly be constructed after acute care services. Finally, it is necessary that the health care system specialized for the elderly in need of long-term care be constructed also.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.13 no.2
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• pp.425-430
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• 2009

In medical area, lots of information has been digitized and the desire of personnel health became a matter of primary concern. To satisfy this desire it requires the high-speed handhold Healthcare monitering platform for building U-health system. This paper represents that the implementation of s3c6000 platform with s3c6400 CPU using up-to-date ARM11 technology. This parer also represents building of network system with wireless LAN based on 802.11 in order to transmit medical data. Transmitting and monitoring personnel medical data will be possible in any place with wireless LAN network.

• The Korean Society of Law and Medicine
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• v.23 no.2
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• pp.171-209
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• 2022

There were also many medical-related rulings in 2021, among which the rulings reviewed in this paper are as follows. The first relates to a case in which the medical record, which is the primary judgment data regarding the presence or absence of medical negligence, has been modified. The court judged whether there was negligence on the basis of the first written medical record without considering the contents of the medical record that was later modified. Next, the ruling on the case of asking for liability for damages for prescription of anti-obesity drugs recognized negligence related to prescription, but denied liability for property damage by denying a causal relationship, and recognized only alimony for violation of the duty of explanation. The a full-bench ruling on the scope of subrogation of the National Health Insurance Corporation, which subrogates the claims for compensation for medical expenses against the perpetrator of the patient, changed the existing precedent that had taken the 'deduction method after offsetting negligence' and judged it as 'the method of offsetting negligence after deduction'. In addition, in the ruling on whether or not there was negligence, the court was not bound by the medical record appraisal result. Lastly, in relation to the National Health Insurance Service's disposition of reimbursement for medical care benefit costs, we reviewed the ruling that discretion should be exercised even when a non-medical person makes a refund to a medical institution opened by a non-medical person. And we also reviewed the ruling that the scope of reimbursement for medical institutions jointly using facilities and manpower specifically should be determined.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2557-2561
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• 2013

Background: Chemoradiation (CRT) using cisplatin-based regimens has become the standard of care in the treatment of squamous cell head and neck cancers (SCHNC). The impact of taxanes as radiosensitizing agents with concurrent CRT regimens is unknown. We therefore retrospectively evaluated the efficacy and tolerability of a weekly cisplatin+docetaxel combination with CRT in locally advanced SCHNC. Methods: Sixty-six patients with locally advanced SCHNC (39.4% stage IV, 53% stage III, and 7.6% stage II) were assessed retrospectively. Total radiation dose to the PTV of gross disease (primary and/or node) was 70 Gy/35 fractions, 5 fractions per week. Minimum doses of 60 Gy and 50 Gy were administered to PTVs of elective high risk and low risk disease, respectively. Chemotherapy (CT) consisted of weekly cisplatin (20 $mg/m^2$)+docetaxel (20 $mg/m^2$) concurrently with RT. Results: The median age of the patients was 58 years (range, 32-77). Objective response rate was 83.3%. The 2-year progression-free survival (PFS) and overall survival (OS) were 75.7% and 78.3%, respectively. The most common grade 3 and 4 toxicities were mucositis (36.4%), nausea and vomiting (12.1%), neutropenia (4.5%). Conclusion: Weekly cisplatin and docetaxel concurrent with RT for locally advanced SCHNC was found tolerable with high efficacy.

• Journal of Korean Traditional Oncology
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• v.22 no.1
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• pp.23-35
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• 2017

Backgrounds: The demand of complementary and alternative medicine (CAM) including Korean Medicine (KM) is increasing worldwide. But cancer patients (CP) still have a difficulty in gathering CAM information or communicating with their doctors, and clinical status in cancer care is unclear in the field of KM in Korea especially. The aim of this study is to examine clinical status of KM for cancer symptom care by KM doctors in medical service institutions. Methods: Total forty nine KM doctors completed the site survey questionnaire. The questionnaire items were to list chief symptom complaints of CP treated with KM and effective KM therapies. Results: The majority of the respondents were general physicians without KM specialist board (67.4%) who have 10-20 years clinical experience with CP (55.1%). Primary cancer lesion, diagnostic status, and treatment period were not different in KM clinical service institutions. In chief symptom complaints of CP treated with KM, gastrointestinal (32.9%), musculoskeletal (19.9%), circulatory & respiratory (16.2%), psychiatric (14.1%), urinary (5.8%) symptoms were in turn. In effective KM therapies assessed by KM doctors, xerostomia (45.7%) and cancer-related fatigue (44.8%) were more effective with herbal treatments. Peripheral neuropathy (43.4%), depression, insomnia (38.2%), and cancer pain (31.9%) were preferred to treat using acupuncture. Conclusion: The CP treated with KM used evenly KM medical service institutions regardless of hospital size, and there will be further survey for CP treated KM in the future.

• 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.