• Journal of Korean Academy of Nursing Administration
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• v.23 no.2
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• pp.211-222
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• 2017

Purpose: To develop staffing levels for nursing personnel (registered nurses and nursing assistants) to provide inpatients with integrated nursing care that includes, in addition to professional nursing care, personal care previously provided by patients' families or private caregivers. Methods: A time & motion study was conducted to observe nursing care activities and the time spent by nursing personnel, families, and private caregivers in 10 medical-surgical units. The Korean Patient Classification System-1 (KPCS-1) was used for the nurse manager survey conducted to measure staffing levels and patient needs for nursing care. Results: Current nurse to patient ratios from the time-motion study and the survey study were 1:10 and 1:11, respectively. Time spent in direct patient care by nursing personnel and family/private caregivers was 51 and 130 minutes per day, respectively. Direct nursing care hours correlated with KPCS-1 scores. Nursing personnel to patient ratio required to provide integrated inpatient care ranged from 1:3.9 to 1:6.1 in tertiary hospitals and from 1:4.4 to 1:6.0 in general hospitals. The functional nursing care delivery system had been implemented in 38.5% of the nursing units. Conclusion: Findings indicate that appropriate nurse staffing and efficient nursing care delivery systems are required to provide integrated inpatient nursing care.

• Journal of Preventive Medicine and Public Health
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• v.14 no.1
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• pp.3-12
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• 1981

To identify the changes in professional care patterns after the introduction of medical insurance in Korea, professional care in hospitals and clinics of two succeeding years were compared. The hospitals and clinics selected for this study were those which located in Seoul city. Hospitals were classified into 3 categories: university hospital, general hospital and hospital. The diseases selected for this study were acute appendicitis and normal delivery. They were selected because their disease courses are considered to be fairly stable. The variables used for this study were length of stay, total hospital costs, costs of each components of cares. The information used for this study was obtained from the official forms requested by the medical facilities to the Korea Medical Insurance Corporation. The two periods studied were 3 months of each year from March 1st to May 31st in 1979 and 1980, The total number of normal delivery studied was 289 in 1979, 301 in 1980 respectively and the acute appendicitis was 92 and 111 respectively. In order to compare the quantity of medical care between 2 study periods the insurance price scores of 1979 were converted to prices of 1980. For statistical test of difference between 2 periods T-test and Welch's test were used. The result of the study were briefly summarized in below. 1. No significant difference was observed in the average length of stay of both disease between two study periods in all types of hospitals. 2. No significant difference was observed in the average total hospital costs of both diseases in all types of hospital, but in the private clinic the average clinic costs was rather decreased significantly in 1980. 3. More cost decrease were seen than cost increase in 1980 in all types of facilities, More cost changes by items were seen in acute appendicitis than in normal delivery between two study periods. The total hospital costs can be devided into 2 portions: charges for drug and material and for physician. In normal delivery, costs for physician's charges was significantly decreased in almost all the hospitals and costs for drug and material were not changed significantly in all the hospitals in 1980. In the university hospitals, however, the costs for drug and material were increased significantly in 1980. The cost decrease for physician's charge were mainly due to the decrease in the costs of laboratory test, treatment and physical therapy. The increase in the costs for the drug and material in the university hospitals was mainly due to the increase in the cost for drugs for oral administration and injection. 4. The proportion of components of medical care in the hospital has not been changed significantly, however, the cost for injection in normal delivery was characteristically increased in 1980 in all hospitals studied. In general the proportion of the costs for drug and material was tended to increase and the costs for physician was tended to decrease in 1980. The increase in the costs for drug and material were considered to be due to increase in the cost for drugs for oral administration and injection. The decrease in the costs for physician were due to decrease in the costs of laboratory test, treatment and physical therapy. Above mentioned changes in hospital and clinic care patterns are considered to be mostly influenced by the review criteria set by the K.I.C. for the assessment of the fee request made by clinics and hospitals.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.99-128
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• 2008

Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.14 no.2
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• pp.137-140
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• 2011

Research and development (R&D) is very important to acquire new knowledge in various fields. The significance of public R&D is also increasing, especially related to health policy making, establishing basic databases, and enhancing basic and clinical science. The total budget of general public R&D in Korea was approximately ten billon US Dollars in 2008, but the proportion of health care research was just below 10%. In private sectors, it was three times the amount allocated to the public budget. In this article, recent trends in public R&D in Korea, especially related to health care policy and biotechnology are summarized. A brief overview of the application process for a specific policy fund is also described for early-stage researchers in these fields.

• Health Policy and Management
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• v.15 no.4
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• pp.65-80
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• 2005

This study examines the effects of supplemental insurance on health care utilization and expenditures among cancer patients, who were hospitalized in a general hospital in Korea 2003. We find that those who purchase the supplemental insurance in addition to the social health insurance use more health care services and pay more than those who do not, suggesting insurance effects. This paper, however, cannot distinguish the moral effects of the health insurance from the selection effects due to adverse selection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.4
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• pp.220-224
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• 2019

Maxillary sinus grafting is a dependable procedure that has been in use for a long time. However, clinical complications often arise. To prevent complications of maxillary sinus grafting, it is necessary to know the contra-indications, both for general implantation and for maxillary bone grafting. In addition, presence of various complications requires careful consideration of treatment method; therefore, dentists should be familiar with the treatment protocols. Complications can be divided into postoperative, immediate postoperative, and delayed postoperative complications. Particularly for the outpatient, it is necessary to quickly distinguish between treatable cases and cases for which transfer is required. The purpose of this review is to discuss the contra-indications, complications, and treatment options for complications of maxillary sinus graft.

• Korea Journal of Hospital Management
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• v.13 no.4
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• pp.1-26
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• 2008

This study examines the statistical relationship between medical specialists and managerial performance, using regression analysis with the number of medical specialists per 100 beds as the independent variable and the managerial performance index as the dependent variable. Managerial performance index incorporated the number of out-patients per specialist, the number of in-patients per specialist, the volume of revenue per specialist, the number of beds per specialist, and the average length of stay. To compare different groups of hospitals, dummy variable was applied to five groups of hospitals according to size: 100-299 beds, 300-599 beds, 600-899 beds, 900-1199 beds, and more than 1200 beds. The data consisted of 181 general hospitals with more than 100 beds, which included 28 public hospitals, 73 corporate hospitals, 64 university hospitals and 16 private hospitals. Of those, 87 hospitals were located in big cities and 94 hospitals in medium to small cities. This study used hospitals from the Korean Hospital Association, and data published in 2004. The collected data sample was analyzed using the SPSSWIN 12.0 version, and the study hypothesis was tested using regression analysis. The findings of this study are summarized as follows: Hypothesis 1 predicting a negative effect of the number of medical specialists on the number of out-patients per specialist was supported with statistical significance. The analysis of dummy variable showed causality in all the hospital groups larger than the group of 100-299 beds. Hypothesis 2 predicting a negative effect of the number of medical specialists on the number of in-patients per specialist was supported with statistical significance. The analysis of dummy variable showed causality in the hospital group of 300-599 beds when compared to the group of 100-299 beds. Hypothesis 3 predicting a negative effect of the number of medical specialists on the volume of revenue per specialist was not supported. However, the analysis of dummy variable showed that the volume of revenue per specialist increased in the hospital groups of 600-899 beds, 900-1199 beds, and over 1200 beds, when compared to the group of 100-299 beds. Hypothesis 4 predicting a negative effect of the number of medical specialists on the average length of stay was supported with statistical significance. The analysis of dummy variable showed causality in the hospital group of 300-599 beds, when compared to the group of 100-299 beds. Results of this study show that the number of the medical specialists per 100 beds is an important factor in hospital managerial performance. Most hospitals have tried to retain as many medical specialists as possible to keep the number of patients stable, to ensure adequate revenue, and to maintain efficient managerial performance. Especially, the big hospitals with greater number of beds and medical specialists have shown greater revenue per medical specialist despite the smaller number of patients per medical specialist. Findings of this study explains why hospitals in Korea are getting bigger.

• Journal of Korean Public Health Nursing
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• v.7 no.2
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• pp.67-76
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• 1993

This study was conducted to investigate the nurses' recognition extent of nursing power and related factors. It was performed in a private university hospital using questionaire papers from Jul. 11 to Jul. 20, 1993. The collected data were in number of 209, and they were handled and analyzed by computer program (SPSS). Through above process, we got meaningful results as follow. 1. The factor concerned with whether the nursing department show its independent power or not was 4.1 on an average. Consequently above results showed that the independent power roles as a important factor. The factor concerned with study and research was 3.9 on an average. So that the extension of learning was also a comparatively important nursing power. But ensuring good material environment was merely 1.6 on an average. So it was understood as less important nursing power. 2. Between the factor concerned with enforcement of independence of nursing department and the factor concerned with extension of learning, there was positive correlation of 0.32 Pearson's Correlation Coefficent. It can be interpreted as the effort of extension of learning go side by side with the showing of independent power of nursing department. As a result the power of nursing become strong. And between the factor concerned with enforcenment of independence of nursing department and the ensuring o(good material environment, there was negative correlation of -0.28 Pearson's Correaltion Coefficint. It can be interpreted as the stronger the independent power of nursing, the more overlooked the recognized of material environment of nurses.

• Journal of Korean Academy of Nursing
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• v.22 no.3
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• pp.352-361
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• 1992

This study was designed to identify the relation between the perceived family support and social adjustment of discharged patients with chronic mental illnesses. The subjects for this study were 50 patients with chronic mental illnesses receiving out-patient treatment at one general hospital and one private hospital in Seoul. The data were collected during the period from April 25, 1991 to May 27, 1991. The perceived family support was measured by the Family Support Scale developed by Hyun Sook Kang. A questionnaire which was developed by Weissman was modified by the author of this study to measure the Social Adjustment. The data were analyzed by descriptive statistics and Pearson Correlation Coefficients, using the SPSS program. The results of this study can be summarized as following ; 1) For the perceived family support, the mean was 2.63 points and the source of family support was almost always the mother. 2) For the social adjustment level, the mean was 2.62 points, and the results showed the best social adjustment was in the area of parental role and family adjustment, and the poorer adjustment was in the area of work and leisure. 3) The relationship between the perceived family support and social adjustment revealed a significant correlation.(r＝.38, p＜.05) Therefore the hypothesis “the higher the level of perceived family support, the higher the social adjustment level” was accepted. In conclusion, the study revealed that family support is an important factor related to the social adjustment level in patients with chronic mental illnesses.

• Korean Journal of Occupational Health Nursing
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• v.24 no.4
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• pp.259-269
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• 2015

Purpose: The study is to identify a correlation among hospital nurses' emotional labor, social support and organizational commitment and to analyze the effects on organizational commitment. Methods: The participants are 300 nurses working at two general hospitals located in Gyeonggi-do, who agreed to join the study. Data collection were done from July to September in 2014. The collected data are analyzed a descriptive statistic, t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson's correlation coefficient, and multiple regression and SPSS/WIN 15.0 Program was used in the process. Results: Organizational commitment was negatively correlated with emotional works but it was positively correlated with social support. The factors affecting organizational commitment were informational support and evaluative support which were sub-domain of social support as well as level of emotional expression which was a sub-domain of emotional works, their positions and level of education. Conclusion: To increase the level of an organizational commitment, a method of coping in difficult situations and information relating to private assessments is recommended. Also, the organization should prepare a plan that members can properly manage their emotions face-to-face with clients.