• Title/Summary/Keyword: health costs

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Current Situation and Perspectives for Home Care Nursing Research In Korea (한국 가정간호 연구의 현황과 전망)

  • Kim, Soyaja;Kwon, Bo-Eun
    • Journal of Home Health Care Nursing
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    • v.7 no.1
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    • pp.39-57
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    • 2000
  • This study was conducted to identify the current situation of home care nursing research and to propose future research in the area of home care nursing in Korea. The design was a retrospective descriptive study based on 171 studies. The studies were collected from nursing academic magazines, the national library web site and dissertations on home care. The data were classified according to the independent and dependent variables which were represented in the research title. The final category classification was defined by considering the research objectives and content as found in the 171 studies. Eight categories were created to describe the results of home care nursing research in Korea. They included: home care needs. home care services. home care costs. development of home care programs and equipment. management of home care services. effectiveness of home care services, development of an educational curriculum for home care, and recognition of home care services. Based on our research we have identified other future research areas that need to be developed such as community needs assessment, standards and guidelines for home care nursing, quality assurance and quality improvement for controlling home care quality, home care informatics. and a system of home care cost and ethics.

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Impact and Barriers of the Health Insurance Review on Splitting Extended-Release Formulation Drugs (서방형제제 분할처방에 대한 건강보험심사제도의 효과와 장애요인)

  • Jang, Hye-Min;Lee, Eui-Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.4
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    • pp.347-352
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    • 2011
  • Health insurance review & Assessment service (HIRA) has enforced cutting the drug costs when physicians prescribe split extended release drugs, starting from December, 2010. The objective of this study is to analyze extended release and enteric coated drugs on pharmaceutical reimbursement list in Korea, and to investigate the impact and barriers of the health insurance review on splitting extended-release formulation drugs. By using the ingredient code, extended release and enteric coated formulations make up 7.8% of all drugs in April, 2011. The most frequently used drugs are agent affecting circulatory and digestive system. From the extended release and enteric coated formulations (n=112), 34.8% (n=39) were not available in other dosage forms. According to questionnaire survey for 169 pharmacists (response rate: 73.8%), the rate of splitting and crushing of extended release and enteric coated drugs decreased. When pharmacists correct physician's prescription errors, the biggest problem was lack of other dosage forms. So it is necessary to develop variety of other dosage forms, and computerized checking system for splitting extended-release drugs. It is also important to inform physicians and patients in regard to the problems of split prescription of extended release and enteric coated drugs.

Metabolically Obese Normal Weight (MONW) (정상체중 대사비만)

  • Kang, Hyun-Joo
    • Korean Journal of Health Education and Promotion
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    • v.26 no.2
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    • pp.149-155
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    • 2009
  • Metabolically obese but normal weight(MONW) syndrome is characterized, with potentially increased risks for development of the insulin resistance or metabolic syndrome despite their normal body mass index(BMI) < 25 kg/m2. Such characteristics could confer upon MONW individuals a type 2 diabetes mellitus and cardiovascular diseases(CVD) risk however, research on MONW is scarce. MONW individuals have metabolic disturbances typical of obese persons and are identified by having a high amount of visceral fat, a low BMI, a high fat mass, a low lean body mass, low insulin sensitivity, and high triglyceride concentrations. The purpose of this study is to review several markers as potential modulators in individuals displaying the "MONW". Body fat appears to be functionally comparable with a dynamic endocrine organ, producing and secreting various adipocy tokines, such as leptin, adiponectin, CRP, tumor necrosis factor(TNF-), interleukin(IL)-6, all of which play an important role in the onset of cardiovascular disease, and insulin resistance. Otherwise, physical activity and a lower inflammation state might be helped to reduce the number of persons at risk of diabetes, CVD complications, or premature mortality. We should provide a method to optimal treatments resolving the emerging public health problem to prevention of MONW by providing guideline for physical activity as an optimal treatment for the MONW Korean. Furthermore we expect to develop a new strategy to manage MONW Korean in this society in terms of reducing medical costs and enhancing public health care for uprising population with MONW.

Automated Audiometry: A Review of the Implementation and Evaluation Methods

  • Shojaeemend, Hassan;Ayatollahi, Haleh
    • Healthcare Informatics Research
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    • v.24 no.4
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    • pp.263-275
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    • 2018
  • Objectives: Automated audiometry provides an opportunity to do audiometry when there is no direct access to a clinical audiologist. This approach will help to use hearing services and resources efficiently. The purpose of this study was to review studies related to automated audiometry by focusing on the implementation of an audiometer, the use of transducers and evaluation methods. Methods: This review study was conducted in 2017. The papers related to the design and implementation of automated audiometry were searched in the following databases: Science Direct, Web of Science, PubMed, and Scopus. The time frame for the papers was between January 1, 2010 and August 31, 2017. Initially, 143 papers were found, and after screening, the number of papers was reduced to 16. Results: The findings showed that the implementation methods were categorized into the use of software (7 papers), hardware (3 papers) and smartphones/tablets (6 papers). The used transducers were a variety of earphones and bone vibrators. Different evaluation methods were used to evaluate the accuracy and the reliability of the diagnoses. However, in most studies, no significant difference was found between automated and traditional audiometry. Conclusions: It seems that automated audiometry produces the same results compared with traditional audiometry. However, the main advantages of this method; namely, saving costs and increased accessibility to hearing services, can lead to a faster diagnosis of hearing impairment, especially in poor areas.

One-Step Engineering of a Stable, Selectable Marker-Free Autoluminescent Acinetobacter baumannii for Rapid Continuous Assessment of Drug Activity

  • Jiang, Huofeng;Gao, Yamin;Zeng, Sheng;Wang, Shuai;Cao, Zhizhong;Tan, Yaoju;Yin, Huancai;Liu, Jianxiong;Zhang, Tianyu
    • Journal of Microbiology and Biotechnology
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    • v.29 no.9
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    • pp.1488-1493
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    • 2019
  • The rising cases of multidrug-resistant Acinetobacter baumannii (Ab) and the lack of effective drugs call for quick attention. Here, based on a Tn7 transposon and Xer/dif system, we constructed a stable, selectable marker-free autoluminescent Ab capable of producing visible light without extra substrates. Utilization of this autoluminescent reporter strain has the potential to reduce the time, effort and costs required for the evaluation of activities of anti-Ab drug candidates in vitro.

Population Aging and Health Promotion Activities in Korea (한국에서의 인구 고령화 추이와 건강증진사업의 중요성)

  • Maeng, Gwang-Ho
    • Journal of Korea Association of Health Promotion
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    • v.2 no.3
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    • pp.31-46
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    • 2004
  • Owing to continuous economic growth, an increased standard of living, and improvements to health care in Korea, the life expectancy of Koreans rose from 69.0years in 1985 to 71.3 years in 1990 It continued to rise throughout the 1990s, and, by2002, had reached 76.5 years for the general population and 80.0 years for Korean females. Similarly, the percentage of the Korean population that is 65 years of age or older Increased from 3.1 In 1970 to 7.1 In 2000, and is expected to reach approximately14.0 in 2019. Thus, according to this estimate, Korea will have evolved from an 'aging society 'to an "aged society" in only 19 years. In the case of other countries, this same transformation has generally taken 2 to 5 times longer. One of the major issues related to Korea's rapid1y aging population relates to the health problems of the elderly According to the 2002 National Health Survey Report,87.6 percent of the elderly were reported to have at least one chronic disease. In other words, almost 9 out of evert 10 elderly persons in Korea were suffering from a chronic illness. This, clearly, places a significant economic burden on Korean society in the form of increased health care costs. This paper examines the increasing prevalence of chronic diseases within Korea's rapidly aging population and offers some possible short- and long-term solutions to cope with the increased burden being placed on Korea's health care system. These Include the basic services at local health centers for the elderly and the national life-long health promotion programs that aim to correct unhealthy behavior, such as smoking, the excessive use of alcohol, and poor eating and exercise habits.

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Prediction of Health Care Cost Using the Hierarchical Condition Category Risk Adjustment Model (위계적 질환군 위험조정모델 기반 의료비용 예측)

  • Han, Ki Myoung;Ryu, Mi Kyung;Chun, Ki Hong
    • Health Policy and Management
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    • v.27 no.2
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    • pp.149-156
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    • 2017
  • Background: This study was conducted to evaluate the performance of the Hierarchical Condition Category (HCC) model, identify potentially high-cost patients, and examine the effects of adding prior utilization to the risk model using Korean claims data. Methods: We incorporated 2 years of data from the National Health Insurance Services-National Sample Cohort. Five risk models were used to predict health expenditures: model 1 (age/sex groups), model 2 (the Center for Medicare and Medicaid Services-HCC with age/sex groups), model 3 (selected 54 HCCs with age/sex groups), model 4 (bed-days of care plus model 3), and model 5 (medication-days plus model 3). We evaluated model performance using $R^2$ at individual level, predictive positive value (PPV) of the top 5% of high-cost patients, and predictive ratio (PR) within subgroups. Results: The suitability of the model, including prior use, bed-days, and medication-days, was better than other models. $R^2$ values were 8%, 39%, 37%, 43%, and 57% with model 1, 2, 3, 4, and 5, respectively. After being removed the extreme values, the corresponding $R^2$ values were slightly improved in all models. PPVs were 16.4%, 25.2%, 25.1%, 33.8%, and 53.8%. Total expenditure was underpredicted for the highest expenditure group and overpredicted for the four other groups. PR had a tendency to decrease from younger group to older group in both female and male. Conclusion: The risk adjustment models are important in plan payment, reimbursement, profiling, and research. Combined prior use and diagnostic data are more powerful to predict health costs and to identify high-cost patients.

Has the Copayment Ceiling Improved Financial Protection in the Korean National Health Insurance System? Evidence From the 2009 Policy Change

  • Lee, Tae-Jin;Cheong, Chelim
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.6
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    • pp.393-400
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    • 2017
  • Objectives: To relieve the financial burden faced by households, the Korean National Health Insurance (NHI) system introduced a "copayment ceiling," which evolved into a differential ceiling in 2009, with the copayment ceiling depending on patients' income. This study aimed to examine the effect of the differential copayment ceiling on financial protection and healthcare utilization, particularly focusing on whether its effects varied across different income groups. Methods: This study obtained data from the Korea Health Panel. The number of households included in the analysis was 6555 in 2008, 5859 in 2009, 5539 in 2010, and 5372 in 2011. To assess the effects of the differential copayment ceiling on utilization, out-of-pocket (OOP) payments, and catastrophic payments, various random-effects models were applied. Utilization was measured as treatment days, while catastrophic payments were defined as OOP payments exceeding 10% of household income. Among the right-hand side variables were the interaction terms of the new policy with income levels, as well as a set of household characteristics. Results: The differential copayment ceiling contributed to increased utilization regardless of income levels both in all patients and in cancer patients. However, the new policy did not seem to reduce significantly the incidence of catastrophic payments among cancer patients, and even increased the incidence among all patients. Conclusions: The limited effect of the differential ceiling can be attributed to a high proportion of direct payments for services not covered by the NHI, as well as the relatively small number of households benefiting from the differential ceilings; these considerations warrant a better policy design.

Influencing Factors for and Medical Expenditures of Metabolic Syndrome among Public Officials (공무원의 대사증후군 관련 요인 및 대사증후군에 따른 의료비 지출)

  • Kim, Ahrin;Kwak, Chanyeong;Yim, Eun Shil
    • Korean Journal of Occupational Health Nursing
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    • v.21 no.3
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    • pp.209-220
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    • 2012
  • Purpose: This study examined the influencing factors for metabolic syndrome and the annual medical expenditures of metabolic syndrome among public officials. Methods: The National Health Insurance data in 2009 were collected for 364,932 public officials and the heath examination results and annual medical expenditures were analyzed using PASW 18.0 program. Results: The prevalence of metabolic syndrome is 17.6%, and it was higher in male officials than that of females in all age groups. In men, the influencing factors for metabolic syndrome were: age, family history of stroke, cardiovascular disease, hypertension, and diabetes mellitus, smoking, alcohol consumption, exercise, and obesity. However, in women, health-related behaviors such as smoking, alcohol consumption and exercise did not affect metabolic syndrome. People who had metabolic syndrome showed significantly higher medical expenditures than those without metabolic syndrome. The odds ratios of having the highest quartile in medical expenditures were 1.372 (95% CI 1.252~1.504, p<.001) in women with metabolic syndrome and 1.213 (95% CI: 1.184~1.243, p<.001) in men. Conclusion: The results implied that health-related behaviors were associated with metabolic syndrome, and resulted in higher medical expenditures. In order not only to decrease the risk of metabolic syndrome but also reduce medical expenditures, nurses should plan health promotion strategies to educate public officials about healthy life strategies.

Effects of Smoking on Cost of Hospitalization and Length of Stay among Patients with Lung Cancer in Iran: a Hospital-Based Study

  • Sari, Ali Akbari;Rezaei, Satar;Arab, Mohammad;Majdzadeh, Reza;Matin, Behzad Karami;Zandian, Hamed
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4421-4426
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    • 2016
  • Background: Smoking is recognized as a main leading preventable cause of mortality and morbidity worldwide. It is responsible for a considerable financial burden both on the health system and in society. This study aimed to examine the effect of smoking on cost of hospitalization and length of stay (LoS) among patients with lung cancer in Iran in 2014. Materials and Methods: A total of 415 patients were included in the study. Data on age, sex, insurance status, type of hospitals, type of insurance, geographic local, length of stay and cost of hospitalization was extracted by medical records and smoking status was obtained from a telephone survey. To compare cost of hospitalization and LoS for different smoking groups, current smokers, former smokers, and never smokers, a gamma regression model and zero-truncated poisson regression were used, respectively. Results: Compared with never smokers, current and former smokers showed a 48% and 35% increase in hospitalization costs, respectively. Also, hospital LoS for current and former smokers was 72% and 31% higher than for never smokers, respectively. Conclusions: Our study indicated that cigarette smoking imposes a significant financial burden on hospitals in Iran. It is, however, recommended that more research should be done to implement and evaluate hospital based smoking cessation interventions to better increase cessation rates in these settings.