• Title/Summary/Keyword: Visit day

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Comparison of Case Management between Tele Care Regions and General Care Regions in Korean Medicaid (의료급여 수급자의 건강관리 및 의료이용에 대한 텔레케어 사례관리의 효과)

  • Lee, Hyun-Joo;Oh, Jin-Joo;Choi, Jeong-Myung
    • Journal of Korean Academy of Nursing Administration
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    • v.16 no.4
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    • pp.381-388
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    • 2010
  • Purpose: The purpose of the study was to compare recipients' health behavior, attitude to using medicaid, medication compliance, and the changes in hospital cost and visit-day of in-patient and out-patient care between tele-care regions (TCR) and general care regions (GCR) in Korean medicaid. Method: The design of the study was ex-post facto comparing recipients in TCR and GCR. The sample included 625 persons in TCR and 410 persons in GCR. To collect materials, the case manager interviewed recipients of medicaid and filled out questionnaires which were analyzed through SAS/PC 9.1. Results: In studying health behavior and medication, compliance was not significant. However, the attitude to using medicaid was significantly more positive in TCR than in GCR. In out-patients, the change of hospital visit-day was not significant between TCR and GCR, but TCR showed a reduction in hospital cost compared to GCR. For in-patient recipients, GCR showed a greater reduction in changes in hospital cost and visit-day compared to TCR. Conclusions: The results of the study show that attitudes to using medicaid via telephone are positive and results are more effective than hospital visit consultation, and the cost of out-patient care could be reduced.

An Analysis of Home Health Care Travel Cost (가정간호 수가 중 교통비 분석)

  • Baek, Hee-Chong;Song, Chong-Rye;Kim, Hae-Young
    • Journal of Home Health Care Nursing
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    • v.10 no.1
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    • pp.52-57
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    • 2003
  • The purpose of this study was to evaluate appropriateness of home health care travel cost. For the evaluation, investigated the operating costs of vehicles used by home care nurses and then were components of home care nurses's annual salaries. Travel costs were then calculated based on actual travel expenses of home health care service. Actual data of 23 hospital-based home care agencies between July, 2002 to December, 2002 were collected for the analysis of the travel costs. The results of this study are : 1) For home visit, 65% of home care agencies turned out to be using only hospital owned cars, and 17.1% be depending purely on home care nurses' cars. On average, 1.9 cars used for home visit. 2) Out of 89 agencies, 23 agencies responded to the travel cost survey. Total maintenance cost of a car per month was 381,457 won. 3) Average per visit personal expenses of home care nurses during travel time turned out to be 7,124won assuming 8 working hours per day, 4 visits per day, and 30 minuets of travel time for each visit. 4) Total home health care travel cost per visit was 12,069 won, which was the sum of actually paid travel cost of 4,945 won and personal expenses during travel time of 7,124. In conclusion. we reckon that current compensation price of home care nurses' travel is inappropriate because total home health care travel costs of 12,069 won per visit turned out to be 2.1 times of currently prevailing standard compensation price of 5,830 per visit.

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A Pilot Clinical Study of the Efficacy and Safety of Phellinus Linteus (Sanghuang) Extract Treatment for Knee Osteoarthritis

  • Ryu, Hwa yeon;Lee, Hyun;Kang, Jae Hui
    • Journal of Acupuncture Research
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    • v.39 no.2
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    • pp.115-121
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    • 2022
  • Background: To evaluate the efficacy and safety of Phellinus linteus (PL) extract for the treatment of knee osteoarthritis (KOA) a pilot clinical study was performed. Methods: There were 24 patients with KOA who enrolled in this double-blind, randomized, controlled, clinical trial. There were 3 groups: PL 1,000 mg/day (PL 1,000), PL 1,500 mg/day (PL 1,500), and dextrin 3,000 mg/day (placebo). Patients took capsules twice a day, 3 capsules at a time, over 8 weeks. Patients were monitored prior to treatment (Visit 1: Week 0), and followed up every 4 weeks (Visit 2: Week 4 and Visit 3: Week 8) where outcome measurements were taken. The primary outcome measure was the score from the Korean version of the Western Ontario and McMasters Universities from baseline to Week 8. The secondary outcomes were measurements from the visual analog scale, quality of life scale, erythrocyte sedimentation, and c-reactive protein. Adverse events were recorded at every visit. Results: The Korean version of the Western Ontario and McMasters Universities score showed the greatest improvement in symptoms of KOA in the PL 1,500 group compared with the placebo group. The erythrocyte sedimentation tended to decrease in the PL 1,500 group compared with the placebo group (which was within the normal range). The visual analog scale score decreased in all groups, with no significant differences between groups. No adverse events related to PL were reported. There were no abnormal hematological or physical findings. Conclusion: This pilot clinical trial was the first step to assess the efficacy and safety of PL used in the treatment of patients with KOA.

Relationships Between Feed Intake Traits, Monitored Using a Computerized Feed Intake Recording System, and Growth Performance and Body Composition of Group-Housed Pigs

  • Hyun, Young;Ellis, Mike
    • Asian-Australasian Journal of Animal Sciences
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    • v.13 no.12
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    • pp.1717-1725
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    • 2000
  • The objective was to determine the relationship between feed intake levels and patterns, and growth performance and body composition of barrows and gilts using automatic feed intake recording equipment (F.I.R.E.). This system records the time of visits to the feeder and the duration and size of meals for individual animals housed in groups. Ninety-six crossbred pigs were grown from $33.4{\pm}0.51$ to $109.7{\pm}1.39kg$ live weight over a 13-week period. Eight mixed-sex groups of 12 pigs were used and 4 dietary treatments were compared giving 2 pens per treatment. The dietary treatments consisted of corn-soybean meal diets with differing protein levels which ranged from 14.7% to 19% between 30 to 55 kg, from 13.3% to 16.9% between 56 and 85 kg, and from 12.3% to 16.8% for the remainder of the study. Animals were ultrasonically scanned to measure loin-eye area and backfat thickness to estimate carcass fat-free lean content at the beginning and end of the study. Barrows had higher daily feed intake than gilts (2.67 vs. 2.46 kg resp. p<0.05) which was the result of a longer feeder occupation time per visit (4.77 vs. 4.54 min, resp. p<0.05), higher feed consumption rates (30.4 vs. 29.0 g/min, resp. p<0.05), and higher feed intakes per visit (136.9 vs. 126.8 g, resp. p<0.01). Gilts had less backfat and greater loin-eye area than barrows (p<0.05). Diet had no significant effect on growth performance and had limited impact on feeding patterns. Body weight showed high correlations with ADG (r=0.74), feed intake per visit (r=0.51) and feed consumption rate (r=0.69). Positive correlation were also found between daily feed intake and feed intake per visit (r=0.45), feeder occupation time per day (r=0.56), and feed consumption rate (r=0.55), and between daily feed intake and backfat thickness (r=0.32) and feed consumption rate and loin-eye area (r=0.32). There were negative correlations between number of feeder visit per day and daily feed intake (r=-0.54), and between feed intake per visit and number of feeder visits per day (r=-0.43). However, correlations between feed intake traits and carcass traits were generally low. Visits to the feeder were greatest during the morning (0700 to 1100 h) and lowest during the evening and nighttime. These results highlight limited variation among the sexes in feeding patterns and suggest important relationships between feeding behavior and feed intake.

A Study on the Establishment of a Fee System for Hospital based Home Nursing Care (일 종합병원에서의 가정간호수가 체계 방안을 위한 일 연구)

  • Kim, Cho-Ja;Jo, Won-Jeong;Choe, Hae-Seon
    • The Korean Nurse
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    • v.32 no.1
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    • pp.61-76
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    • 1993
  • This study was done in order La provide basic data to a Fee System for hospital based Home Health Care services in Korea in the future. It was done by investigating activities provided to possible Home Health Care clients who could be discharged early from genera] hospitals and then estimating the nursing care fee according to each nursing activity based upon the time used for activity. The subjects of the study were selected by convenience sampling and consisted of 35 clients who might be clients for Home Nursing Care and were presently admitted to a medical- surgical ward of Y University Medical Center located in Seoul, Korea. The data collection period was from September 1, 1991 to September 30, 1991. The research in strum nets utilized for the study were a client selection criterial for Home Health Care developed by Choo(l991) and a check-list of nursing activity developed by researcher. The results of the study were as follows : 1. There were 44 different nursing activities provided in the seven days but the time was calculated for only 25 of the nursing activities. 2. Fees for the 25 different nursing activities were calculated by multipling the median of the average wage of a staff nurse having five years experience in an A grade general hospital to the Lime of the nursing activity. The results were compared with the insurance fee which the government recognized as an appropriate fee for that activity. The nursing activities with a lower calculated fee than the insurance fee were suction, catheterization, exercise education and dressing change. The nursing activities with a higher calculated fee than the government recognized fee were 1M injection and vital sign check. 3. There was a range of 1-15 nursing activities provided daily to the client. For the average number of nursing activities per day of 6.26 events the nursing care fee was calaulated at W 6136 per day. 4. Based upon the results of the study, a recommentdation for a Home Health Care fee per visit based on the nursing activities provided could be formulated for a Home Health Care fee system. It could be formulated as following: 1) Home health Care fee per visit $=[(direct{\;} nursing{\;}fee(direct{\;}nursing{\;}care{\;}time{\;}per{\;}activity{\;}{\times}{\;}average{\;}nursing{\;}wage)+indirect fee]{\times}average$ nursing activity per visit]+management fee+ materials fee+a travel fee In this way a nursing fee could be calculated based upon the result of the study of the nursing fees per visit. 2) Nursing activity fees per visit. = $([direct nursing{\;}care{\;}fee+indirect{\;}nursing{\;}fee]{\times}average$ number of nursing activities provided per visit] (W 6, 136) + travel fee(\ 5, 542) +management fee material $fee({\alpha})\{\;}16, 436+{\alpha}$ The nursing fee per visit as calculated in this research of $\{\;}15, 0000+{\alpha}$ could be adjusted according to the patient's condition or the use of high technology nursing care or according to the amount of time spent for travel. The nursing care fee per visit presented in this study can be validated through a Home Health Care demonstration project.

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Effect of Sa-am Acupuncture Method for Chronic Tension-type Headache;A Randomized Controlled Trial (만성 긴장성 두통 환자에 대한 사암침 치료효과의 Pilot 임상연구)

  • Hong, Kwon-Eui;Park, Yang-Chun;Jo, Jeong-Hyo;Jo, Hyun-Gyeong;Jeong, In-Cheol;Kang, Wee-Chang;Lee, Sang-Bong;Choi, Sun-Mi
    • Journal of Acupuncture Research
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    • v.24 no.1
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    • pp.13-28
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    • 2007
  • Objectives : Clinical character of chronic tension-type headache is bilateral, moderate intensity, persistent and chronic, repeating disease and CTTH is a common prevalent disease, but pathophysiology and likely mechanism remain unclear. It impedes subjective quality of life. The purpose of this research is to examine the effect of sa-am acupuncture method for chronic tension-type headache. Methods : In this randomized, single blind, placebo-controlled study, we compared active acupuncture with sham acupuncture for the treatment of chronic tension-type headache. Volunteers who satisfied the requirements were enrolled in study. Evaluation of chronic tension-type headache was measured by VAS and Headache Disability Inventory(HDI), Six point Linkert Scale before and after treatments. Results : 26 subjects finished study. There were not difference between two groups on age, sex, weight, height, blood pressure, pulse, respiratory rate, Byeonjeung, sunrise of treatment. In change of VAS, there were not difference between two groups on before treatment. Before treatment per visit, VAS of 6th and 7th visit were significantly decreased in active acupuncture(each p=0.039, p=0.008) and were not decreased in sham acupuncture. In change of VAS on a withdrawing needling after treatment, VAS of 1st, 2nd, 6th and 7th visit were significantly decreased in active acupuncture (each p=0.001, 0.038, 0.035, 0.008) and VAS of 2nd, 4th and 5th, 6th visit were significantly decreased in sham acupuncture(each p=0.033, 0.032, 0.035, 0.031). In change of VAS on 2hrs after treatment, VAS of 4th and 5th, 6th visit were significantly decreased in active acupuncture(each p=0.014, 0.023, 0.027) and 5th visit were significantly decreased in sham acupuncture(each p=0.004, 0.009). In change of VAS on 4hrs after treatment, VAS of 4th and 5th, 6th visit were significantly decreased in active acupuncture(each p=0.018, 0.011, 0.015) and 5th, 6th visit were significantly decreased in sham acupuncture(each p=0.020, 0.015). In change of VAS on the next day after treatment, VAS of 3th and 4th and 5th, 6th visit were significantly decreased in active acupuncture(each p=0.032, 0.011, 0.005, 0.012) and 4th, 5th visit were significantly decreased in sham acupuncture(each p=0.001, 0.012). In change of VAS according to a current time(before treatment, after a withdrawing needling, 2hrs, 4hrs, the next day), total score of VAS was decreased more active acupuncture group than sham acupuncture group, but there were no statistical significance compared with sham acupuncture group. In change of HDI score, after treatment was decreased than before treatment in two group, but there were no statistical significance compared with two group. In change of Six point Linkert scale score, after treatment was decreased than before treatment in two group on 6th, 7th visit(active acupuncture 6th 7th each p=0.002, 0.003, sham acupuncture 6th 7th each 0.003, 0.009), but there were no statistical significance compared with tow group. Conclusion : Sa-am acupuncture treatment is effective to improve the symptoms and quality of life in patients with chronic tension-type headache.

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A study on changes in physician behavior after enforcing pre-review system (사전심사제도 도입에 다른 의사의 진료행태 변화)

  • Kim Sera;Kim Jin Hee
    • Health Policy and Management
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    • v.14 no.4
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    • pp.88-113
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    • 2004
  • Starting from April, 2003, new pre-review system has been introduced and implemented to reduce unnecessary conflict with medical care organizations caused by current retrospective claim review system and to enhance efficiency of review system. The main purpose of pre-review system is to educate doctors to contrive adequacy of medical services. This research mainly focuses on effectiveness of pre-review system's influence on physicians' behavior changes. The analysis-participants were drawn from 1,449 clinics which implemented pre-review system, since April of 2003. The research results are as followings. First, the amount per claim has reduced by $\\3,154$, days of visit per claim by 0.1 day, and amount per visit by $\\412$, which were statistically significant. Second, anesthesiologists have decreased in three indicators the most, and the internists had least of changes. Third, the amount per claim and days of visit per claims has dropped significantly on physicians with less periods of practice and physicians with more ages. Fourth, the clinics without the expensive medical equipments, the city clinics showed significant decrease on days of visit per claim. Fifth, in intervention methods, the one-to-one education showed more significant decrease on amount per visit rather than information feedback by paper. In conclusion, the pre-review system have an impact on self-imposed physician behavioral change. The outcome of this research may be utilized for future extension implementation of pre-review system. Furthermore, it is showed that ability of transitions in medical services review system according to the future transition of payment system and context of health service policy.

Digital workflow of single visit full contour monolithic zirconia restoration with CEREC Omnicam intraoral scanner and fast zirconia sintering process (구강스캐너와 급속 지르코니아 소결을 이용한 당일 풀지르코니아 보철수복)

  • Lee, Soo Young
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.25 no.2
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    • pp.79-87
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    • 2016
  • Single visit monolithic restoration can be proceed with digital workflow which consist of intraoral scanning, dental CAD(computer aided design) and restoration milling with CAM(Computer aided manufacturing). While zirconia has more than 900MPa of flexural strength compared with 400MPa for lithium disilicate, shortened fabricating time of lithium disilicate is considered to be a better choice for fabricating single visit full contour monolithic restoration. However, new zirconia materials which are TZI C(Dentsply Sirona) and LUXEN Enamel(Dental Max), new induction heating method of sintering furnace, and new sintering protocols for MoSi2 heating elements sintering furnace offer significantly reduction of full contour monolithic zirconia restoration fabrication time with greater translucency. These new developments lead single visit zirconia restoration in reality.

Difference of Prescription Services between the Health Center and the Private Clinic (일부 보건소와 일반의원에서의 투약서비스 비교연구)

  • 이선희;조공민;손명세;김한중
    • Health Policy and Management
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    • v.2 no.2
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    • pp.131-151
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    • 1992
  • The contents of prescription service were comparatively analysed between health centers(HC) and private clinics(PC). Medical chart review was done for 330 otu-patients diagnosed with upper respiratory tract infection(UR) of 120 adults and 90 children, and gastritis or duodenitis of 120 adults. Emphasis on comparison was the prime cost of medication which used in prescription service. The results were as follows; 1. The prime costs fro the medication per visit of HC group were significantly higher than PC group in all three diseases, and the out of pocket payments of patients per visit were significantly lower in the HC group than PC group. 2. The reason for high prime costs of medication per visit of HC in adult case of URI were due to the idverse use of medication and long prescription period per visit. And high medication costs in children cases of URI in HC group were due to the longer prescription day. In cases of gastritis, the prime cost of medication was also higher because of longer prescription period and the higher prime cost of medication. The proportions of medications for injection in the HC and PC groups showed similar features. 3. In depth analysis of the prescription services showed the differences of the contents of medication. In adults cases of URI, the averaged cost of oral medication was significantly lower in HC group, but that of medication for injection was higher in HC group. In children cases of URI, the averaged cost of oral medication and medication for injection was lower in HC group than in PC group. But in the cases of gastritis it was was higher in HC group than in PC group. The prescription periods were longer in HC group than in PC group in all three diseases. As a conclusion prime medication cost and quality of prescription services of HC group were higher than PC group. In terms of health care the cost containment and quality assurance in physician visit for common disease, public sector utilization is good option for those perspectives. But it should not be generalized unless future study about structure and outcome research for quality assurance.

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Factors influencing consultation time and waiting time of ambulatory patients in a tertiary teaching hospital (일개 종합병원 외래환자의 진료시간 및 진료대기시간 영향요인 분석)

  • Hwang, Jee-In
    • Quality Improvement in Health Care
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    • v.12 no.1
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    • pp.6-16
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    • 2006
  • Objectives : The purpose of this study was to identify the characteristics influencing consultation and waiting time in ambulatory patients. Methods : This study was conducted in a tertiary teaching hospital. Subjects were a total of 10,383 ambulatory patients. Consultation time was measured by time spent for meeting with his/her physician per patient. Waiting time was defined as the time difference between each patient's reserved time and time to meet with his/her physician for ambulatory care. Multiple regression analyses were performed to determine the factors influencing consultation and waiting time. Results : Consultation time was different according to patient' age, previous experience of clinic visit, recent admission history, medical department, specialist care, type of reservation, and day of the week. Significant factors influencing waiting time were patient' age, residential area, previous experience of clinic visit, recent admission history, medical department, specialist care, time spent after ambulatory care begins, and day of the week. Conclusions : The medical department was the strongest factor affecting both consultation time and waiting time. The ambulatory reservation management systems should take into account patient characteristics as well as care-related features.

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