• Title/Summary/Keyword: health services research

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Korean Students' Health and Adjustment in the United States (미국내 한국학생들의 건강과 적응)

  • 최은진
    • Korean Journal of Health Education and Promotion
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    • v.12 no.1
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    • pp.72-82
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    • 1995
  • The purpose of this study was to review health and adjustment issues of Korean students in the context of international students' health in the United States. The number of international students studying in the United States has increased. In addition, more and more Koreans come to the United States for education. Korean students formed the fifth largest international group found on American campuses. As more and more international students study on American campuses, their health needs and problems became a concern to health professionals. Most health problems international students experience are stress related and psychosomatic. These students also have difficulties in using health care services. International students face barriers to obtaining health care because of differences in language and differences in cultural beliefs toward health. Korea manifests an eastern culture which is quite different from the western culture, so many Korean students studying in the United States experience difficulties in adjustment and using health care services. The study on the needs of Korean students in the U.S. reviewed in this research was a survey of 105 Korean students at the Pennsylvania State University, 1990. Korean students' health problems included stress, colds, fatigue, and headaches. Homesickness, financial problems, and academic problems were also important problems the Korean students faced. Korean students usually did not participate in any activities with Americans as much as with Koreans. Most Korean students did not participated in any health education workshops held on campus. This may be because the students had not participated previously in health education workshops conducted on campuses in Korea. Korean student's confidence with the English language appeared to be an important variable in using or not using the university health services. University health professionals in the United States need to develop better information system for international students so that they may better use the health services provided on campus. Also, university health professionals working on campuses in Korea need to put more attention on health of college students and provide on-campus health education workshops which meet the student's needs.

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Association between Weekend Admission and In-hospital Mortality among Cardiovascular Patients in Korea

  • Lee, Sang Ah;Park, Eun-Cheol;Shin, Jaeyong;Ju, Yeong Jun;Lee, Hoo-Yeon
    • Health Policy and Management
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    • v.29 no.2
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    • pp.237-244
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    • 2019
  • Background: Weekend admission is known for having association with increased mortality attributed by poor quality of care and severe patients. We investigated the association between hospital admission on weekends and the in-hospital mortality rates of patients with cardiovascular disease. Furthermore, we examined this association stratified by admission via emergency room or not. Methods: We analyzed claim data provided by the Health Insurance Review & Assessment in 2013. In total, 80,817 cardiovascular patients were included in this study, which treated in-hospital mortality (early and during total length of stay) as a dependent variable. A generalized linear mixed effects model was used. We conducted subgroup analyses stratified by admission via emergency room or not. Results: Patients who admitted on weekend showed higher in-hospital mortality both early (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.23-1.78) and during total length of stay (OR, 1.17; 95% CI, 1.02-1.33) compared to those admitted on weekdays. Patients who were admitted to the hospital on a weekend by emergency room were more likely to experience early in-hospital mortality compared to those admitted on weekdays. Furthermore, we found that patients not admitted to the hospital through the emergency department were more likely to experience both early and total length of stay in-hospital mortality. Conclusion: Our study shows higher in-hospital mortality rates for cardiovascular patients admitted on weekends. Efforts to improve the quality of care on weekend are important to mitigate the 'weekend effect' and improve patient outcomes.

Economies of Scale and Scope in Hospitals (병원의 규모와 범위의 경제)

  • Ham, U-Sang
    • Health Policy and Management
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    • v.18 no.1
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    • pp.21-42
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    • 2008
  • This study investigates economies of scale, cost complementarity and economies of scope for healthcare organizations using econometric approaches. The economies of scale appear to exist in each service provided by a hospital such as inpatient treatment services, outpatient treatment services, and other patient treatment services, respectively. When we test all services in aggregate level, it also indicates that the healthcare industry on average exhibits the economies of scale of 6 percent, which implies that scaling up hospital sizes will bring substantial cost savings to them Evidence shows that cost complementarity exists between outpatient services and other services for patients and, i.e., these other services for patients experience the reduction in marginal costs as the outputs of the outpatient services increase. For the economies of scope, they are present in most service areas; aggregate level services, outpatient services, and other services for patients, respectively. Inpatient treatment services, however, do not show any evidence of the economies of scope. Results show that the economies of scope are achieved by the general hospital type that provides all service areas such as inpatient treatments, outpatient treatments, and other services for patients. The existence of the economies of scope provides the rationale for extending the existing line of business in a hospital into more diverse areas of services where its benefit comes in the form of cost savings. In sum, it overall provides evidence that the M&As in this industry are encouraged to achieve cost reductions from the economies of scale and scope by changing the size and the output mix.

The Current State of Hospital-based Home Care Services in Korea: Analysis of Data on Insurance Claims for Home Care from 2007 to 2012 (의료기관 가정간호의 현황(2007-2012): 가정간호 급여청구자료 분석)

  • Song, Chong Rye;Lee, Mi Kyoung;Hwang, Moon Sook;Yoon, Young Mi
    • Journal of Home Health Care Nursing
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    • v.21 no.2
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    • pp.127-138
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    • 2014
  • Purpose: The objectives of this study were to analyze the state of hospital-based home care (HC) services annually and to provide basic information for research and policy regarding home care. Methods: This study is a secondary analysis of the yearly state of HC services from the Health Insurance Review & Assessment Services from 2007 to 2012. Results: The decreased by 34.6%, from 214 agencies in 2007 to 140 in 2012. The annual average number of active home care nurses was 440, which included 6.7% of the licensed home care nurses until 2012. The annual average number of HC patients were 32,000, and this number decreased by 21% in 2012, compared to that of 2008. Of the HC patients, about 70% were over 60 years of age. The chronic diseases among HC patients have been decreasing steadily since 2007. Seventy to eighty percent of the home visits were made in general hospitals or higher level hospitals. The total medical cost for HC services was 21 billion won in 2007, which consisted of 0.06% of the national medical costs, and it was 22 billion won and 0.03% in 2012. Conclusion: Based on the results of this study, further research on HC services is necessary to frame policies for the expansion of HC agencies.

Comparison of Elementary Students' Health Behaviors by Geographical Regions (우리나라 초등학생들의 지역별 건강생활실천 비교)

  • Lee, Jung-Yul;Lee, Kyu-Yung;Houng, Yun-Mi
    • Korean Journal of Health Education and Promotion
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    • v.24 no.4
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    • pp.87-98
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    • 2007
  • Background: Health promotion services should be provided based on clients' health promotion needs. To provide health promotion services for elementary students in Korea, health promotion needs by geographical regions should be analyzed. Purpose: To analyze elementary students' health behaviors by regions. Method: Elementary students of 4018 from large cities, 1636 from medium sized cities, 328 from rural areas were included. Data collection was done using items from National Health and Nutrition Survey and was collected by mail from schools. For data analysis, Chi-square test and multiple logistic regression were utilized. Result: From comparison of health behaviors, there were no significant differences between large cities and medium sized cities. However, there were significant differences between urban students and rural students in terms of fast food intake, breakfast, soft drink intake, sleeping hours, tooth brush, and obesity. Conclusion: Health promotion services, especially correcting unhealthy eating behaviors for rural elementary students should be focused.

Health Problems and Health Services Utilization of Infants Born Prematurely in the U.S.

  • Lee, Hye-Jung;Rosemary, White-Traut;Park, Chang-Gi
    • Child Health Nursing Research
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    • v.14 no.2
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    • pp.146-154
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    • 2008
  • Purposes: The purposes of this study are to describe the health problems experienced by VLBW premature infants and their health care services utilization during the first year of life Method: Eighteen mothers of VLBW premature infants completed a survey questionnaire, asking socioeconomic/demographic information, health/developmental problems experienced by their infants, and their use of health care services. Results: Of the 18 infants, 78% experienced respiratory problems such as cold/running nose and wheezing during the first year and 33% experienced gastrointestinal problems such as vomiting, diarrhea and constipation. Twelve (67%) infants visited the emergency department at least one time and 10 infants (56%) were hospitalized at least once during their first year of age. Interestingly, infants without chronic lung disease visited the emergency department more than infants without chronic lung disease (p=.213). Infants living in non-disadvantaged neighborhoods were hospitalized more than infants living in disadvantaged neighborhoods (p=.000). Conclusions: Health care providers should initiate educating mothers, particularly those living in disadvantaged neighborhoods, about post-NICU discharge health care needs of their VLBW premature infants while their infants were still in the NICU so that unnecessary visits to the emergency department and rehospitalizations can be possibly prevented.

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Evaluating the Performance of the Emergency Medical Services Index

  • Eun, Sang Jun;Lee, Jin-Seok;Kim, Yoon;Jung, Koo Young;Park, Sue Kyung;Lee, Jin Yong
    • Health Policy and Management
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    • v.23 no.2
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    • pp.176-187
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    • 2013
  • Background: In 2006 Emergency Medical Services Index (EMSI), which summarizes the performance of regional emergency medical services system, was developed. This study assesses the performance of the EMSI to help determine whether EMSI can be used as evaluation tool. Methods: To build a composite score of the EMSI from predefined 24 indicators, 3 normalized values were calculated for each indicator, the normalized values of each indicator were weighted using 4 weighting methods, and the weighted values were aggregated into the final composite score using 2 aggregation schemes. The performance of EMSI was evaluated using 3 criteria: discrimination, construct validity, and sensitivity. Discrimination was the proportion of regions that did not include the overall median rank in the 5th to 95th percentiles rank interval, which was calculated from Monte Carlo simulation. Construct validity was a correlation among the alternative EMSIs. Sensitivity of EMSIs was evaluated by total shift of quartile membership and changes of 5th to 95th percentile intervals. Results: The total discrimination performance of the EMSI was 50.0%. Correlation coefficients between EMSIs using standardized values and those using rescaled values ranged from 0.621 to 0.997. Variation of the quartile membership of regions ranged from 0.0% to 75.0%. The total change in the 5th to 95th percentile intervals ranged from -19 to +17 places. Conclusion: The results suggested that the EMSI could be used as a tool for evaluating quality of regional EMS system and for identifying the areas for quality improvement.

Reexamination of Patient's Cost-sharing System for Oriental Medical Services in the Korean National Health Insurance (한방의료의 건강보험 적정 본인부담률 추계)

  • Kim, Jin-Hyun;Yoo, Wang-Keun;Seo, Dong-Min
    • Health Policy and Management
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    • v.17 no.1
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    • pp.1-27
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    • 2007
  • This study is designed to estimate an appropriate level of patient's cost-sharing for oriental medical services in the Korean National Health Insurance. The findings of this study can be summarized as follows: 1) The current co-payment system for oriental medical services does not reflect its cost structure in clinical practice due to inconsistency of cost-sharing plan in the NHI. 2) Both oriental medical institutions and their patients, as a result, are at a relative disadvantage in financial burden, compared with other services. 3) The substantial proportion of patients' cost-sharing depends on the amount of co-payment and the range of medical cost that a flat rate is applied to. 4) The extension of the range doesn't make any substantial decrease in patient's cost-sharing. 5) The fixed amount of co-payment is more sensitive than a range to total variations of patient's cost-sharing. Based on the above, the budget impacts of a new co-payment system were estimated for each co-insurance rate, according to given scenarios. The results range from -59 billion Won (-8.5%) to 16 billion Won(2.3%).

Analysis of external environmental factors affecting patient transport time

  • LEE, Hyeryeong;PARK, Sang Woong;YUN, Eunjeong;KIM, Dakyeong;CHOI, Hea Kyung
    • The Korean Journal of Food & Health Convergence
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    • v.8 no.6
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    • pp.11-17
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    • 2022
  • Emergency transport is directly related to the life of the patient, and rapid transport to the hospital is crucial. However, external environmental factors such as traffic or weather, interfere with hospital transport. In this study, we investigated the external environment affecting hospital transport time. We examined the transfer time and patient treatment time of emergency patients in an area of northern Gyeonggi-do from 2018 to 2020. Diagnosis after arrival at the hospital was used, and on-site treatment time was measured from paramedic arrival time at the scene to departure. Furthermore, we examined whether there was a correlation between the time paramedics left the scene and hospital arrival time through the reason for the delay as recorded in the emergency log. Traffic jams had the greatest impact on patient transport, while transport delays occurred due to heavy rain, but not snow. Among injured patients, electrical accidents were the most problematic in terms of on-site treatment time. This was because a lot of first aid is needed in electrical accidents. It must be necessary to mobilize two ambulances in an emergency through the expansion of infrastructure, prepare a plan for rapid transport in heavy rain, and implement strong laws against transport obstruction.