• 보건행정학회지
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• 제14권1호
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• pp.44-64
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• 2004

As of 1 July 2000 a big reform was introduced into the Korean health care system: the separation between prescribing and dispensing of drugs (SPD reform). There was, however, a big financial stake associated with pharmaceuticals, particularly before the reform, because physicians as well as pharmacists were allowed to purchase drugs at much lower costs than the insurance reimbursement. In this respect, this study focuses on the change in income and profit of both doctor's clinics and pharmacies after the reform. Data from National Health and Nutritional Survey by the ministry of health and welfare were used to estimate the income or expenditure that are financed by out-of-pocket payment of the patients, while national health insurance data etc. were used for the estimation of the income or expenditure that is financed by insurers. Average annual income per doctor's clinic increased from 299 million won to 338 million won for the three years between 1998 and 2001, whereas average annual income per pharmacy increased enormously from 60 million won to 305 million won for the same period. Average annual 'profit' increase per each doctor's clinic caused by the reform itself was estimated to range from 50 to 83 million won, while that per each pharmacy, from 23 to 87 million won. In sum, while both doctor's clinics and pharmacies are beneficiaries of the SPD reform, its positive impact is particularly prominent on the latter.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제14권1호
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• pp.437-454
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• 2020

According to the privacy regulations of the health insurance portability and accountability act (HIPAA), patients' control over electronic health data is one of the major concern issues. Currently, remote access authorization is considered as the best solution to guarantee the patients' control over their health data. In this paper, a new biometric-based key management scheme is proposed to facilitate remote access authorization anytime and anywhere. First, patients and doctors can use their biometric information to verify the authenticity of communication partners through real-time video communication technology. Second, a safety channel is provided in delivering their access authorization and secret data between patient and doctor. In the designed scheme, the user's public key is authenticated by the corresponding biometric information without the help of public key infrastructure (PKI). Therefore, our proposed scheme does not have the costs of certificate storage, certificate delivery, and certificate revocation. In addition, the implementation time of our proposed system can be significantly reduced.

• 지역사회간호학회지
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• 제27권3호
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• pp.272-283
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• 2016

Purpose: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. Methods: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. Results: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. Conclusion: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.

• 비파괴검사학회지
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• 제22권3호
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• pp.239-245
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• 2002

현재까지 다양한 토목구조물들은 여러 가지 요인에 의한 노후화와 축척된 손상에도 불구하고 별다른 조치 없이 계속해서 사용되고 있었다. 따라서, 이러한 구조물들의 효율적인 유지관리를 유해 계측관리가 중요시되었다. 이에 본 논문에서는 비파괴계측에 의해 사장교의 실시간 계측모니터링시스템을 개발하고자 하며 이를 통해 교량의 안전관리를 하고자 하였다. 계측모니터링시스템은 교량의 유지관리를 도모하고, 교량 관리의 경제적 비용을 줄이게 되며 사장교의 새로운 설계 및 분석방법을 개발하는데 중요한 데이터를 제공할 것이다.

• 지역사회간호학회지
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• 제25권3호
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• pp.159-169
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• 2014

Purpose: The purpose of this study was to evaluate the effectiveness of case management for patients with hypertension on their health status and medical service utilization. Methods: This study was a secondary analysis of data collected for a larger study of chronic disease management in 2008 using the National Health Insurance Corporation database. A total of 12,944 patients who received case management for hypertension were included in this analysis. The subjects of case management were classified into subgroups, namely, over-use, under-use, and non-use groups according to the amount of medical service utilization. To compare the medical service utilization, a control group was selected randomly. The data were analyzed through descriptive statistics, McNemar test, and ANOVA. Results: All the subgroups displayed significant differences in blood pressure, self-management, social support, and their characteristics of medical service utilization. The total medical expense of the under-use and non-use groups increased after case management. However, there was no decrease in the medical expense of the over-use group. Conclusion: This finding suggests that there is a need to re-examine why patients overuse medical services and to supplement specific strategies for encouraging appropriate medical service utilization, and enhancing case management efforts for the over-use group.

• 보건의료산업학회지
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• 제12권1호
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• pp.81-93
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• 2018

Objectives : This cross-sectional study aims to investigate the differences in general health status (GHS) and physical care burdens (PCB) of inpatient groups in long-term care hospitals (LTCH). Methods : The data of 228 patients were analyzed by integrating the electronic medical record (EMR) data of 2016, recorded by the nurses of hospitalized patients in the hospital. Results : There was a statistically significant difference in the GHS between the high-medical demand group and the other groups, but there was no difference in the GHS among other groups. The overall PCB was higher in the high-medical demand group than in the middle-medical demand, and cognitive impairment groups, but not in the problem behavioral group. Conclusions : The current classification of patient groups has shown limitations in terms of the basis of differential benefits of the groups. In particular, the PCB of the problem behavior group was not different from that of any group; hence, it should be adjusted through further study. To control the surge of medical care costs, it is necessary to improve the irrationality of the LTCH pay system in terms of the integration and continuity for elderly care.

• 대한간호학회지
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• 제31권4호
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• pp.619-630
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• 2001

Purpose: The purpose of this study was to analyze the differences in terms of services and cost between CVA without typical diseases (Group I), and CVA with typical diseases (Group II), in their Hospital-based home health care. Method: The subjects of this study were 308 CVA patients who used home care nursing during the second phase demonstration project of their hospital-based home health care. Results: The results of the study was as follows 1. Group II had more home visit (15.3/12.7) (p>0.05), and cases of death when home care (16.8/11.4) (p<0.05). 2. Group II needed more services than Group I such as bladder irrigation, skin care, bed sore care, glycerin enema, finger enema, lung care, urine sugar test, monitoring and surveillance of fluid infusion and R.O.M exercise (p<0.05). 3. The variables that showed statistical significance in the regression analysis were family style, OPD visit, level of consciousness, patient's state on termination of home care, and some extend of home health care services (R2=0.373, 0.205). Conclusion: Home nursing care needs to be planned by severity in Hospital-based home health care for CVA patients.

• 한국보건간호학회지
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• 제30권3호
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• pp.512-525
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• 2016

Purpose: Ageing in place may improve the quality of life of frail elderly and decrease their costs of services. The purpose of this study was to examine the factors that influence the institutionalization of elderly using home care services in a Korean long-term care insurance system. Methods: This study used the data of '2009 Satisfaction survey of Korean long-term care system'. The survey proceeded to use a sampling data based on region, level of long-term care need, and insurance type among the beneficiaries between August and September 2009. The onset dates of institutionalization of 1,095 participants were ascertained from long-term care insurance claim data. This study calculated the hazard ratio through the Cox Proportional Hazard Model. Results: A total of 176 subjects who were institutionalized in nursing homes were included. There were higher risks in the group that included those who were 85 years and over, had dementia or fracture, used home-visit nursing service, and were not supported by direct family. Conclusion: The results of this study have policy implications to supplement the home care service system and postpone nursing home institutionalization of elderly.

• 한국산업보건학회지
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• 제22권1호
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• pp.32-41
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• 2012

Objectives: Information of chemical in electronics industry has not been known enough, although workers' health hazards by chemicals in this industry have been regarded serious. The who always contribute to reveal and control the health hazards and risks in electronics industry have not been the industry but the occupational or environmental victims and grassroot organizations. The similar phenomena can be observed in Korea. Methods: The experiences of individual workers on the occuapational safety and health in semiconductor factory were heard separately and integrated with related literatures. Results:: The first part of this article is largely based on the memories and experiences of individual workers of semiconductor factories, mainly from S semiconductor. Common features of those experiences can be a good resource for detail understanding of the workplace, especially under the situation without any transparent disclosure of information by the governments or the companies. The second part of this article deals with several factors to be considered for control of exposure in workplace; characteristics of workplace and workforce, types of chemicals used, and the way of using the chemicals. Then the current social issues on work-relatedness of cancers of S semiconductor workers are presented briefly. Conclusions: As a conclusion, current OSH situations and issues in Korean electronics industry raise the need of changes in OSH culture. General adaptation of precautionary principle, internalization of costs, and extended responsibility of producers are needed urgently. The OSH professionals both in public and private sectors should support these agendas under their social obligation to protect workers' health.

• 보건행정학회지
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• 제11권2호
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• pp.29-57
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• 2001

Since the inauguration of the medical insurance system in 1977, the increasing medical expenses which can be menace to tile finance of the medical insurance system, have become major concern in the medical insurance field In Korea. This study focuses on the determinants of the medical expenses in the health insurance in Korea and analyzes the impact of these factors on the increase in the medical expenses. The empirical work is done using the pooled cross-section and time-series data of the medical insurance for the self-employeds and the industrial workers from the year 1995 to 1997. The result of this study shows that the main determinants of the medical expenses in the health insurance are the ratio of the population of the aged to the total population, the frequency of the utilization, number of doctors per capita and the regime changes. Although the increasing trend in the medical expenses seems to be unavoidable, we probably need to add some efficiency to the medical expenses by suppressing the supply and the utilization of the unnecessary medical services. The fee-for-service reimbursement system of today can't suppress the supply of the unnecessary medical services effectively. So we need to convert the present fee-for-service system into DRG's which is known to reduce the medical costs. The increase in the medical expenses comes from a lot of factors. Therefore, we should develop more systematic and comprehensive measures to control the soaring medical expenses in consideration of the various factors such as demand, supply, and the organizational side of the medical system.