• Health Policy and Management
• /
• v.32 no.2
• /
• pp.154-163
• /
• 2022

Background: The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. Methods: We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. Results: In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. Conclusion: High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

• The Korean Journal of Health Service Management
• /
• v.5 no.2
• /
• pp.187-197
• /
• 2011

The purpose of this study is to analyze factors related to the job stress experienced by call center employees at public institutions, so as to provide basic data to relieve work-related stress and enhance the job satisfaction of such employees. To promote objectivity and representation, the study was conducted by way of survey, the subjects being call center employees in 8 public institutions that operate call centers, which are located in the Busan and Seoul areas. Of the 240 surveys distributed, 196 were collected and 173 of those were used for analysis after eliminating 25 with insufficient responses. The results of this study are as follows. First, in terms of general properties, it was determined that employees with higher levels of education and families to support had greater job stress. second, in terms of job-related properties, employees who were unsatisfied with the job, HR policies, and their relationship with superiors and/or colleagues had greater job stress. In terms of the group that was satisfied compared with the group that was unsatisfied with the job, HR policies, and their relationship with superiors and/or colleagues, regular workers had less job stress than irregular workers.

• Korea Journal of Hospital Management
• /
• v.23 no.2
• /
• pp.28-41
• /
• 2018

Purpose: This study purposed to analyze the spatial accessibility of mental health institutions in Ganwon-Do using Geographic Information System and to suggest policy implications. Methodology: Network analysis was applied to assess the spatial accessibility of mental health institutions in Gangwon-Do. To perform the network analysis, network data set was built using administrative district map, road network, address of mental health institutions in Gangwon-Do. After building network data set, Two network analysis methods, 1) Service area analysis, 2) Origin Destination cost matrix were applied. Service area analysis calculated accessive areas that were within specified time. And using Origin Destination cost matrix, travel time and road travel distance were calculated between centroids of Eup, Myeon, Dong and the nearest mental health institutions. Result: After the service area analysis, it is estimated that 19.63% of the total areas in Gangwon-Do takes more than 60 minutes to get to clinic institutions. For hospital institutions, 23.08% of the total areas takes more than 60 minutes to get there. And 59.96% of Gangwon-do takes more than 30 minutes to get to general hospitals. The result of Origin-Destination cost matrix showed that most Eup Myeon Dong in Gangwon-Do was connected to the institutions in Wonju-si, Chuncheon-si, Gangneung-si. And it showed that there were large regional variation in time and distance to reach the institutions. Implication: Results showed that there were regional variations of spatial accessibility to the mental health institutions in Gangwon-Do. To solve this problem, Several policy interventions could be applied such as mental health resources allocation plan, telemedicine, providing more closely coordinated services between mental health institutions and community mental health centers to enhance the accessibility.

• Anxiety and mood
• /
• v.13 no.2
• /
• pp.108-114
• /
• 2017

Objective : A pilot project entitled '50s mental health screening project' was conducted in Seoul. As a part of this project, we conducted surveys to obtain the opinions of psychiatrists regarding mental health screenings. Methods : A questionnaire was mailed to members registered with the Korean Neuropsychiatric Association, which enquired about the '50s mental health screening project'. Results: A majority (90.9%) of the subjects agreed on the purpose and implementation of the project. However, there were fewer individuals that actually showed the intent to participate (65.8%). The mean age of the group with the intention to participate was higher compared to the group with no intention to participate. The factors that negatively affected the intent to participate included prejudice and discrimination against psychiatry (3.795), low health insurance reimbursement (3.784), and inconvenience of reporting to public health centers (3.664). The most appropriate method that scored the highest for screening mental health was face-to-face consultation with a psychiatrist (3.889). Most of the participants agreed on the method of a self-reported survey along with an interview of psychiatrist (84.9%). Conclusion : Subjects were concerned about prejudice and discrimination against psychiatry, low health insurance reimbursement, and inconvenience of reporting to public health centers. These problems need to be supplemented. Face-to-face consultation with a psychiatrist may be considered an appropriate method for future mental health screening.

• Korea Journal of Hospital Management
• /
• v.21 no.2
• /
• pp.37-49
• /
• 2016

The purpose of this study is to investigate the level of competition between Public Health Centers (PHCs) and private clinics (PCs) by examining the number of patients that used PHCs vs. PCs, estimating the total amount of revenue generated from outpatient services at both PHCs and PCs, thereby analyzing the financial impacts on PCs derived from the PHCs. We utilized 2011 National Inpatient Sample data (NIS). Using the 20 table containing general information on each individual claims, we integrate it with the 40 table which contains all the diagnostic codes for each claim. Then, we disaggregate the bundled claims into the original individual claims. Overall, 3.1% of outpatient visits are made at PHCs while the rest was made at the PCs (96.9%). Among the total claim costs of 6.34 billion USD (as of 2011), PHCs occupy 2.0% (124 million USD), and 98.0% are contributed to PCs (6.21 billion USD). The estimated economic losses of PCs due to PHCs are summarized as follow; the maximum potential loss is estimated at 198 million USD in total and 7,099 USD per clinic when we include all patient types; the minimum loss is estimated at 71 million USD in total and 2,540 USD per clinic where Medical Aid recipients and the elderly (aged 65 and over) are excluded. Our results confirm the potential economic effect on PCs due to PHCs providing outpatient services. PCs and PHCs are the most important players providing primary care in Korea. Unnecessary competition between PCs and PHCs is not desirable. Health authorities should carefully examine the healthcare services currently provided by PHCs and their impacts on PCs.

• The Korean Journal of Health Service Management
• /
• v.1 no.1
• /
• pp.138-153
• /
• 2007

As the level of the national income has been improved and the whole nation health insurance project has been spread, medical demand for dental health is also increasing. To cope with the increased medical demand, the need of dental health education and preventive dental care is recognized, and the number of dental hygienists is being increased with increase in dental clinics and hospitals. While more weight is actually given to treatment than prevention in hospitals, emphasis is placed on prevention in public health centers of state-run organizations and dental hygienists are performing the duty. According to this, dental hygienists shall be treated and recognized as professionals, who instruct people in dental health and assist the dentists in hospitals. Therefore to suggest vision to the students of department of dental hygiene, give them a solid motive, and inspire them with professional sense so that they can devote themselves to their duty with pride and self-confidence in the field can lead to contribution to dental health of each individual and the whole nation, in order to train them to be dental hygienists who are active and strive for change and development as professionals and capable of adapting themselves to the field of dental medicine. In this study, the professional sense and the recognition of the way of students belonging to department of dental hygiene were examined and based on this, a new direction for department of dental hygiene of three-year college was suggested.

• Journal of agricultural medicine and community health
• /
• v.23 no.2
• /
• pp.175-192
• /
• 1998

This study was performed investigate the opinion of civil servants in Health center about Rural Health Service Improvement Project The survey by mail was carried out for 447 servants of 25 health centers in Kyungsangbuk-do and the data were collected through self-administered questionnaires to servants about need, participation, concern, and comprehension for the project and satisfied with current facility and equipment of health center. The results were as follows. Generally considered, 48.2% of the improved health center servants was satisfied with health center building and 14.0% or 24.1% of the improving or unimproved center was. About the location of health center, 37.7% of the improved health center servants was satisfied, 25.9% of the unimproved center was. Of the improved health center servants, 43% was satisfied with the medical equipment but in unimproved place, the dissatisfaction was appeared higher than any other place. 49.7% of respondents was participated in making out the Rural Health Service Improvement Project. 50.6% was interested in this project. In the improved area. 65.5% of health center servants replied that the mayor's or county executive's concern about this project was high and 46.5% in councilors but in the unimproved area. their concern was low. About the contents of the project. 24,6% of the servants in the improved center, only 15.2% in unimproved center replied that they had known well. After making out the plan, 13.6% of respondents was unsatisfied with this plan and 17.1% replied that the estimating method of selecting the project area was not good. After the improvement of institution and equipment, 86.1% of health center servants answered that the medical service provided by health center would increase but 59.2% replied that the residents' utilization rate of private medical facility would decrease. The servants of the improved health center replied that the recognition about the developing will of health service(91.2%), the efficiency(91.2%), the quality of health and medical service(93.0%), the amount of health project(91.2%) were improved. In health center which had already improved the institution and equipment, 88.5% of servants replied that the residents' utilization for health center was increased. So, this project should be continuously carried out for health center and health center must develope new project to fit region condition.

• Women's Health Nursing
• /
• v.17 no.1
• /
• pp.21-30
• /
• 2011

Purpose: This study was done to investigate the types of breastfeeding visits by mothers twenty-four months after birth and to identify the factors that increased breast feeding rates. Methods: The subjects of this study totaled seven hundred and seventy-four mothers with infants aged 2 years or less who had visited national medical institutions including Sanhujori service facilities, breastfeeding care service facilities, and community health centers. Data was collected from June 22 to July 31, 2009. Data was analyzed using descriptive statistics, $x^2$ test, ANOVA with a post hoc Scheffe test, and multiple logistic regression. Results: Major findings of this study were significant differences of planned length of breastfeeding and breastfeeding self-efficacy in relation to the differing types of breast feeding community visits by mothers. In multivariate logistic regression, baby's age, exclusive breastfeeding at hospital, utilization of breastfeeding care service facility, planned length of breastfeeding, and breastfeeding self-efficacy were independent predictors of the feeding type. Conclusion: In order to increase breastfeeding rates, programs provided by public health care services and medical facilities should start education on breast feeding in the hospital before mothers are discharged and then continue through the use of Sanhujori service facilities and workplace at 3 month and 6 month postpartum.

• Journal of agricultural medicine and community health
• /
• v.36 no.1
• /
• pp.36-46
• /
• 2011

Objectives: To investigate the experience and competence of physicians providing emergency medical services at public health sub-centers on remote Korean islands. Methods: This study enrolled 79 doctors who work at public health sub-centers on remote Korean islands. Data were collected in December 2009 via self-administered e-mail questionnaires. The response rate was 44.3%. Results: Emergent situations occurred at most (58.68%) of the public health sub-centers that were surveyed in December 2009. An average of 1.92 cases required treatment by public health physicians. Only 20.25% of the physicians were specialists in emergency medicine, while the remainder were general practitioners (GPs) without clinical experience as emergency doctors. We also found that the physicians we surveyed had insufficient knowledge of emergency medical care. At some health centers only one doctor was available, and there was no medical team in holiday, although most of the physicians indicated that the ideal number of doctors per center was two or three. In cases of emergency, patients were often sent to the mainland by ship without receiving first-aid treatment. The public health sub-centers lacked the necessary medical equipment to save lives in emergencies and lacked escort systems for emergency patients. Conclusions: The Korean government should address the importance of providing emergency care in remote areas. Health administrators should provide suitable manpower, medical equipment, guidelines for emergency medicine, and education for public health physicians on remote islands.

• Research in Community and Public Health Nursing
• /
• v.11 no.1
• /
• pp.67-79
• /
• 2000

In recent years, the recipients of the services of the health centers in Korea have been shifted from individual sick persons to families as a unit. As a result, the home visiting care records which are all filled out manually, will be increased. Since there is virtually no increase in the number of community health nurses, the CHNs are required to work more efficiently. One of the ways to make the CHNs' work more efficient is to reduce recording time by using a computer. However, a computer system that can manage the families as a unit has not yet been developed. In response to this need, we developed a database system that can be utilized in home visiting care service. The family assessment data is collected. diagnosed. and evaluated according to the family diagnosis classification. The system for family diagnosis consists of seven areas. Those areas are family structure. maintenance of the family system, interaction and interchange. support. coping and adaptation, health management. and housing environment. The areas of the family diagnosis consists of 99 items in all. We expect the following from this system. First. the CHNs will be able to identify family problems more easily. Second. the community's health level can be confirmed by the statistics the system produces. Thirdly, the CHNs' nursing services will be cost effective via reduced recording time. Finally, the family problems of the sick individuals which have been neglected under the health system oriented on individual persons can be effectively managed.