• KSII Transactions on Internet and Information Systems (TIIS)
• /
• 제15권12호
• /
• pp.4400-4419
• /
• 2021

In the 4th Industrial Revolution, the healthcare industry is undergoing a paradigm shift from post-care and management systems based on diagnosis and treatment to disease prevention and management based on personal precision medicine. To optimize medical services for individual patients, an open ecosystem for the healthcare industry that allows the exchange and utilization of personal health records (PHRs) is required. However, under the current system of hospital-centered data management, it is difficult to implement the linking and sharing of PHRs in practice. To address this problem, in this study, we present the design and implementation of a patient-centered PHR platform using blockchain technology. This platform achieved transparency and reliability in information management by eliminating the risk of leakage and tampering/altering personal information, which could occur when using a PHR. In addition, the patient-consent system was applied to a PHR; thus, the patient acted as the user with ownership. The proposed blockchain-based PHR platform enables the integration of personal medical information with scattered distribution across multiple hospitals, and allows patients to freely use their health records in their daily lives and emergencies. The proposed platform is expected to serve as a stepping stone for patient-centered healthcare data management and utilization.

• 한국의료질향상학회지
• /
• 제11권1호
• /
• pp.46-60
• /
• 2004

Background : Recently, we have experienced various changes in the healthcare environment. Healthcare organizations are facing a financial crisis due to more competitive relationships among themselves as well with low health insurance fees. The purposes of the current study were: (1) to develop a data warehouse-based system for evaluating and monitoring the case management activities, and (2) to measure and analyze its effects. Methods : In order to collect the data for the study, the database on discharged patients was utilized at a university hospital located in Seoul from June 1, 2002 through December 31, 2002. Initially, a data warehouse was built for the case management system. The case management activities were analyzed using structured methodology to establish the case management system. Results : The findings of this study were as follows: (1) A case management system was developed to make it possible to monitor of healthcare quality and resource utilization. The Case management System included monitoring functions regarding utilization reviews, critical pathways, and clinical indicators. (2) Utilizing the case management system, unplanned readmissions were documented among total discharged patients during two months from November 1, 2002 through December 31, 2002. The unplanned readmission rate was 2.3%(276 patients) in total of 11,960 discharged patients. Among them 81 patients(0.7% of total discharges, 29.3% of unplanned readmission) were readmitted to the same physician in charge under the same diagnosis. No significant differences were found in the demographic variables such as gender and age among the patients. (3) After implementing the case management system, 2.9% of average length of stay reduced. Applying cost-benefit analysis, the 2.9% reduction of length of stay represents net profit of ${\backslash}$ 279,592,000 in the year of 2004. In addition, applying value acceleration analysis, cumulative net benefit of ${\backslash}$ 1,481,000,000 was expected by the year of 2007. Also we were able to expect ${\backslash}$ 247,800,000 of cumulative benefit for the prospective 5 years in value linkage analysis. It represents average ${\backslash}$ 787,700,000 of pure net benefit a year. Conclusion : The value of present study would be not only implementing the knowledge management system into the existing case management activities, but also evaluating its effects and estimating its financial benefits. This study suggested that the case management system would be a supportive tool for monitoring and improving the quality of healthcare, and a cost-effective tool for increment of healthcare organization's financial benefit.

• 의료법학
• /
• 제22권3호
• /
• pp.31-55
• /
• 2021

개정 데이터 3법 중 하나인 개인정보 보호법은 가명정보의 처리에 관한 특례 규정을 신설하였다. 이에 개인정보처리자는 과학적 연구, 통계작성, 공익적 기록보존 등의 목적을 위해서 정보주체의 동의 없이 가명정보를 처리할 수 있게 되었다. 그리고 개정 개인정보 보호법의 후속 조치로 의료 분야의 개인정보 가명처리를 다룬 '보건의료 데이터 활용 가이드라인'이 마련되었다. 가이드라인은 보건의료 데이터의 특성을 고려한 구체적인 해석과 사례를 규정함으로써 수범자들에게 실천적인 기준을 제시한다는 점에서 의미가 있다. 다만 가이드라인은 가명정보 활용 목적을 명확히 하고, 데이터 심의위원회 구성의 공정성을 강화할 필요가 있다. 또한 가이드라인은 보건의료 데이터 보상 체계를 구축하고, 취약 연구대상자의 권리 보호 강화가 요구된다. 아울러 가이드라인은 생명윤리 및 안전에 관한 법률, 의료법과의 부정합성을 정비할 필요도 있다. 본 연구가 보건의료 데이터 활용의 안전한 환경 조성은 물론 관련 법과 제도의 개선에 기여할 것으로 기대한다.

• 보건의료산업학회지
• /
• 제7권3호
• /
• pp.95-109
• /
• 2013

The objective of this study is to assess the utilization and satisfactions about public health centers in Korea. For the analysis, the study utilize the nationwide data of 229,229 person on '2010 Community Health Survey' of Ministry of Health & Welfare. The statistical methodology used in the study is ${\chi}^2$, ANOVA, logistic regression model and multiple regression model. This study have four major findings. First, the significant affecting socio-demographic factors in utilizing public health center were gender, age, region, national basic living secured, married, income, education, job, state of health, chronic disease, unmet medical needs and utilization reason. Second, the most serviced category of health center user was vaccination both city and rural area and the next was certificate, primary care, health screening, other use, the mother and child in city area, primary care, health screening, certificate, home visiting health in rural area. Third, the significant affecting socio-demographic factors in satisfaction degree on health center service were age, region, national basic living secured, income, education, job, state of health, utilization degree and reason. Fourth, the most satisfied service of health service center was home visiting health in city area and mental health service in rural area and the next was nutritive control and the lowest satisfied service was user of certificate. The utilization and satisfaction on health center service were identified as different with residental area and user's characteristics. The politic effort are needed to support socially disadvantaged class and to narrow regional gap.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제24권2호
• /
• pp.65-77
• /
• 2018

Purpose: By identifying the contents of the "Empty Home Utilization & Community Revitalization Model Project" which is a pilot project of empty homes back into use in Kyoto City and analyzing the characteristics of the case housing, the purpose of this study is to find out implications and suggest improvements for the domestic empty home utilization project. Methods: The scope of the survey covers seven project sites in the period from 2014 to 2016. The research method is to derive the physical and operational characteristics of the project, through the literature reviews related to bringing empty homes back into use in Kyoto City and the field survey including the space measurement and the operator interview. Results: First, in order to succeed in bringing empty homes back into use for community revitalization, the selection process of the project and the role of the public in and after supporting the project are important. Second, the important features that are required as a physical characteristic of the project are an advantage in location and an interactive space that is available at all time like a community cafe at the entrance. Third, as an operational characteristic of the empty home utilization project, it is advantageous for the local residents to participate as a business actor or an operator, and it is the continuous use of residents and outsiders by implementing an operating program that is suitable for the characteristics of the local community. Implications: The physical and operational activation factors to bring empty homes back into use need to be included as the project screening standards. And it is necessary for the public to develop the Intermediate Support Organization and to participate in linking with residents in order to carry out the empty homes utilization project effectively.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제5권9호
• /
• pp.47-59
• /
• 1999

With the unparalleled rate of aging and rapid modernization, Korean society faces the situation in which it has to increase the supply of elderly care services dramatically in the near future. Among these services, nursing homes are considered as an essential alternative provision because Korea can no longer rely on traditional familism nor medical facilities for the care of her older population. It is necessary, therefore, to prepare a future plan for the delivery of nursing homes in Korea. This paper has identified elderly care context and analyzed elderly care facilities of Korea in the point of supply and utilization rate of nursing homes according to the region and type of facilities. On the bases of this analysis, the delivery planning of nursing homes in Korea has been proposed in order to increase welfare status of older people and efficient utilization of health care resources.

• 보건행정학회지
• /
• 제15권4호
• /
• pp.65-80
• /
• 2005

This study examines the effects of supplemental insurance on health care utilization and expenditures among cancer patients, who were hospitalized in a general hospital in Korea 2003. We find that those who purchase the supplemental insurance in addition to the social health insurance use more health care services and pay more than those who do not, suggesting insurance effects. This paper, however, cannot distinguish the moral effects of the health insurance from the selection effects due to adverse selection.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제14권3호
• /
• pp.35-42
• /
• 2008

The purpose of this study is to provide the fundamental materials for architectural planning of the Multipurpose Senior Center according to regional characteristics, and to analyze the Multipurpose Senior Center at the view of the program and utilization. For the analysis of the actual condition are surveyed 164 respondents und programs in four facilities in Deajeon. The results of this study are as follows; 1. the characteristics, problems and demands of the section of social education, the counseling, the medical rehabilitation, the sports education, etc. 2. the consideration factors for the planning of the program and volume of the Multipurpose Senior Center on the basic of the rate of increase in population of the Elderly in regions.

• 보건행정학회지
• /
• 제19권4호
• /
• pp.53-65
• /
• 2009

Purpose: This study was conducted to identify the prenatal heath care utilization and expenditure among pregnant women. Method: This was a 5-month follow-up study using a stratified sampling and the data were drawn from the "nationwide claim database of Korean National Health Insurance Corporation". Result: This study found that pregnant women were first diagnosed with pregnancy when they were 7.1 weeks pregnant, received 12.7 times of prenatal examinations and 10.6 times of ultrasonogram. It was revealed that 67.5% of the subjects continued to receive prenatal care at the same medical institutions from the diagnosis of pregnancy to the delivery. The study also showed that the total expenditure of prenatal care per pregnant woman was 700,000 Korean Won (KRW) on average and the insurance coverage rate stood at only 20%. Pregnant women living in metropolitan area spent more on prenatal healthcare expenditure than those who living in medium-sized city or rural area. Conclusion: The results of this study implies that the government needs to provide pregnant women with continuous support by increasing health insurance coverage for prenatal care. Especially, it is considered to provide more support to the pregnant women residing in medically underserved areas.

• 보건의료산업학회지
• /
• 제8권2호
• /
• pp.101-113
• /
• 2014

This paper examined the effects of private health insurance(PHI) on the health care utilization among the Korean. The used data was the three waves of Korea Health Panel (2008, 2009, 2010), and the number of subjects was 13,951 persons. Authors employed two-stage least square panel model where the instrument variables for controlling for endogeneity of PHI were number of insurance planner per 100,000 in resident area and whether subject worked on financial profession. The results showed that healthcare expenditure of outpatients who purchasing PHI was higher than that of outpatients without PHI, and there was no difference in admission between the two groups. This article recommended the Korean government to monitor the effects of PHI on the health care utilization in order to improve the efficiency of health care finance.