• Journal of Preventive Medicine and Public Health
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• v.44 no.3
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• pp.101-110
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• 2011

Objectives: Screening for colorectal cancer is considered cost effective, but is underutilized in the U.S. Information on the efficiency of "tailored interventions" to promote colorectal cancer screening in primary care settings is limited. The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control (CDC) web-based intervention (screen for life) and to a tailored interactive computer-based intervention. Methods: A randomized controlled trial of people 50 and over, was conducted to test the interventions. The sample was 1224 partcipants 50-70 years of age, recruited from Kelsey-Seybold Clinic, a large multi-specialty clinic in Houston, Texas. Screening status was obtained by medical chart review after a 12-month follow-up period. An "intention to treat" analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects. Analysis of statistical uncertainty was conducted using nonparametric bootstrapping. Results: The estimated cost of implementing the web-based intervention was $40 per person and the cost of the tailored intervention was $45 per person. The additional cost per person screened for the web-based intervention compared to no intervention was $2602 and the tailored intervention was no more effective than the web-based strategy. Conclusions: The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion. The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion. Researchers need to continue developing and evaluating the effectiveness and costeffectiveness of interventions to increase colorectal cancer screening.

• The Journal of the Korea Contents Association
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• v.12 no.12
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• pp.282-290
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• 2012

Today, home health care services needs a linkage plan of the customized home visiting health service in public health center, the medical institute home health care service, and home visiting nursing service based on long term care insurance for the elderly program which acknowledges the independence and professionalism of the home health care services while minimizing overlap through linking the projects. So, this study was performed by applying the Delphi technique, which draws agreement from professional opinion, to determine a method to link home health care services in Korea. The results of this study are as follows. Specialists agreed on 24 important items within the two domains of institutional linkage and medical linkage. And the significance of this study is as follows. The 24 items deduced for the approved nursing service linkage plan are expected to improve the home health care service business system, enhance the quality of home health care service, and bring increased satisfaction for service recipients. Also, seeking ways to minimize overlap in service can increase the effectiveness of health care and public health management at a national level. In addition, it is considered that this will ultimately reduce public medical costs as well as improve home health care service.

• Journal of Family Resource Management and Policy Review
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• v.20 no.3
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• pp.1-23
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• 2016

This study analyzes the effects of caring for grandchildren on Korean grandparents' health, using the Korean Longitudinal Study of Aging from 2006 to 2012. We investigate how caregiving is provided and analyze the effects of caregiving on grandparents' physical health, mental health, and health-related behaviors. As elderly people's health is generally frail, it is unclear whether the provision of childcare affects their health negatively. We control for the endogeneity of caregiving by an individual fixed effect (FE) model and instrumental variable-fixed effect (FE-IV) models. Using these models, we determine the endogeneity of caregiving and show that the significant effects of caregiving on health disappear as we control for endogeneity in the FE and FE-IV models. Even after controlling for endogeneity, we find that caregiving increases the probability of feeling pain as well as the number of different types of pain. Furthermore, caregiving increases the probability of restrictions on daily activities because of pain. On the other hand, caregiving reduces the symptoms of depression. In relation to health-related behaviors, caregiving reduces the probability of physical exercise and regular meals. Our results imply that although caregiving has a positive effect on mental health, the increase in physical pain and in non-healthy behaviors may lead to a deterioration of the caregiver's long-term health, which in turn may increase the medical costs of the elderly. Potential policy alternatives are discussed in the paper.

• 대한예방의학회:학술대회논문집
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• 1999.10a
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• pp.79-80
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• 1999

• Proceedings of the CALSEC Conference
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• 2005.03a
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• pp.125-129
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• 2005

The recent push for healthcare reform has caused healthcare organizations to focus on ways to streamlined processes in order to secure high quality care as well as reducing costs. Healthcare enterprises involve complex processes that span diverse groups and organizations. These processes involve clinical and administrative tasks, large quantities of data, and large number of patients and personnel. We propose the mobile-based workflow system of passable communication as an important factor in the B2B healthcare. Based on the above proposal the workflow system of business process was designed and implemented on the basis of Java, UML and XPDL.

• Journal of Society of Preventive Korean Medicine
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• v.18 no.2
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• pp.47-58
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• 2014

Objective : In Oriental medicine, the concept of Preventive Treatment Disease(治未病, PTD) is intended to actively deal with changes in modern disease patterns due to increase in chronic diseases. In China, preventive health service program based on PTD Theory are being carried out aimed at improving and/or preventing people's health. Method : For the introduction of PTD program based preventive service in Korea for the promotion of people's health, I would like to consider its possibility by reviewing the PTD program being conducted in China. Results : China's preventive health service programs based on PTD Theory started in 2008 for the purpose of promoting people's health and reducing medical expenses by providing medical services tailored to individuals. Regarding the effects of PTD program based preventive health service, improvement of discomforting symptoms comprised 73.04% of responses. As to service items, health guidance, Traditional Chinese Medicinal diagnosis, and preparation of health records were answered as being important. The importance of food and internal medicines for preventing and/or curing PTD Theory are also recognized. Also, as to satisfaction level, 90.64% responded as being satisfied in the order of the level of service providers, their attitudes, service processes, items, costs, and environments. Conclusion : As shown above, according to assessments on China's PTD programs, the PTD Theory is being applied to actual public health programs with highly effective results. Hence, it can be seen that such attempt could also be implemented in Korea as part of a scheme for promoting health by means of Korean medicine health promotion programs. However, further researches into concrete implementation schemes will have to be developed in the future as medical systems are different in Korea from in China.

• Korean Journal of Health Education and Promotion
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• v.31 no.4
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• pp.63-72
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• 2014

Objectives: The current study reviews the implementation and evaluation of the Chronic Disease Self-Management Program (CDSMP) in the United States (U.S.) to illustrate the program's potential contribution to improving health among Korean adults with chronic conditions while saving healthcare costs. Methods: This study examines existing literature on the history, theoretical background, essential elements, and delivery outcomes of CDSMP with special focus on the successes and challenges to be faced in the implementation of CDSMP to Koreans with chronic conditions. Results: CDSMP is designed to empower people with chronic conditions to develop skills necessary for medical, social role, and emotional management of chronic conditions. Recent studies show the utility of CDSMP in achieving the Triple Aim health reform goals (i.e., better care, better health, better value). Lessons learned from the U.S. experience emphasize the importance of establishing evidence-based studies, collaborating with community partners, and diversifying funding sources to make CDSMP more sustainable. Conclusion: The current study demonstrates the replicability of CDSMP and potential for expansion in Korea. More concerted efforts among academia, government, and communities are needed to deliver CDSMP to Korean adults and identify its effectiveness within the Korean context in terms of meeting the Triple Aim goals of better care, better health, and better value.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1227-1232
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• 2014

Background: Given that there are many Iranian women who have never had a Pap smear, this study was designed to develop and validate a measurement tool based on the Protection Motivation Theory to assess factors influencing the Iranian women's intention to perform first Pap testing. Materials and Methods: In this psychometric research, to determine the Content Validity Index (CVI) and the Content Validity Ratio (CVR), a panel of experts (n=10) reviewed scale items. Reliability was estimated through the Intraclass Correlation Coefficient (n=30) and internal consistency (n=240). Also, factor analysis (exploratory and conformity) was performed on the data of the sample women who had never had a Pap smear test (n=240). Results: A 26-item questionnaire was developed. The CVI and CVR scores of the scale were 0.89 and 0.90, respectively. Exploratory factor analysis loaded a 26-item with seven factors questionnaire (perceived vulnerability and severity, fear, response costs, response efficacy, self-efficacy, and protection motivation (or intention)) that jointly accounted for 72.76% of the observed variance. Confirmatory factor analysis indicated a good fit for the data. Internal consistency (range 0.70-0.93) and test-retest reliability (range 0.72-0.96) of sub-scales were acceptable. Conclusions: This study showed that the designed instrument was a valid and reliable tool for measuring the factors influencing the women's intention to perform their first Pap testing.

• The Journal of the Korea Contents Association
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• v.11 no.2
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• pp.331-340
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• 2011

The purpose of this research is to target the health examination examinees to compare and analyze the common elements that influence prevention and preventive medical services and to analyze the share of the physical examination categories desired following the analysis by element. Likewise, this research was attempted to provide base data so that it is possible to reduce cost required for the prevention and treatment of each examination. This research targeted health examination examinees and conducted survey from April 1to May 31, 2010. The key findings after conducting analysis on 707 examinees are as follows. In case of men, those who are older and who live their spouses tended to be subjected to health examination, cancer examination and preventive injections. Those who had subscribed to the medical policy from the private sector, those with healthy state, those with higher educational level, tended to get health examination, cancer examination and preventive injections less. In case of women, those who are older, tended to get health examination and cancer examination more while those who had subscribed to the medical policy from the private sector and those with higher educational level tended to get health examination, cancer examination and preventive injections less. Those who are healthy and who live their spouse tended to get more cancerexamination and preventive injections.

• Journal of Korean Academy of Nursing
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• v.35 no.5
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• pp.774-786
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• 2005

Purpose: The purpose of this study was to measure home health resource utilization using a Case-Mix Adjustor Model developed in the U.S. Method: The subjects of this study were 484 patients who had received home health care more than 4 visits during a 60-day episode at 31 home health care institutions. Data on the 484 patients had to be merged onto a. 60-day payment segment. Based on the results, the researcher classified home health resource groups (HHRG). Result: The subjects were classified into 34 HHRGs in Korea. Home health resource utilization according to clinical severity was in order of Minimum (C0) < 'Low (Cl) < 'Moderate (C2) < 'High (C3), according to dependency in daily activities was in order of Minimum (F0) < 'High (F3) < 'Medium (F2) < 'Low (Fl) < 'Maximum (F4). Resource utilization by HHRGs was the highest 564,735 won in group C0F0S2 (clinical severity minimum, dependency in daily activity minimum, service utilization moderate), and the lowest 97,000 won in group C2F3S1, so the former was 5.82 times higher than the latter. Conclusion: Resource utilization in home health care has become an issue of concern due to rising costs for home health care. The results suggest the need for more analytical attention on the utilization and expenditures for home care using a Case-Mix Adjustor Model.