• 보건행정학회지
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• 제30권1호
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• pp.72-81
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• 2020

Background: The out-of-pocket maximum is one of the distinctive healthcare systems which sets a ceiling on co-payment in order to reduce the burden of households from the unpredictable medical expenditure. However, this leads to an increase in the demand for healthcare services especially in long-term care hospitals (LTCHs) in Korea. Methods: This study analyzed the influence factor of medical service overuse of 165,592 inpatients in LTCHs which out-of-pocket maximum is applied, by utilizing data from the National Health Insurance Service (2016). Based on Anderson Model, the medical service overuse, as a dependent variable, was defined as long-stay admission more than 180 days at the LTCHs. Independent variable was comprised of predisposing factors (gender, age), enabling factors (income level, types of out-of-pocket maximum) and need factors (illness level, patient use of tertiary hospital). Results: The most powerful factor of medical service overuse in LTCHs was availability of pre-payment for the out-of-maximum (odds ratio [OR], 191.66; p<0.001). This tendency was found in high income level status (p<0.001). Furthermore, mild inpatients (OR, 1.50; p<0.001) which had no experience with the tertiary hospitals (OR, 2.06; p<0.001) were more relevant to the medical service overuse in LTCHs, compared to the severe inpatients. Conclusion: It is suggested that a separate standard of out-of pocket maximum with regards to LTCHs is required to secure the beneficial functions of long-term hospitals and prevent unnecessary financial leakage to achieve sustainable and financially sound National Health Insurance.

• 보건행정학회지
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• 제28권4호
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• pp.339-351
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• 2018

Background: The purpose of this study is to estimate empirically whether there is a difference in medical use among income groups, and if so, how much. This study applies econometric model to the most recent year of Korean Medical Panel, 2015. The model consists of outpatient service and inpatient service models. Methods: The probit model is applied to the model which indicate whether or not the medical care has been used. Two step estimation method using maximum likelihood estimation is applied to the models of outpatient visits, hospital days, and outpatient and inpatient out-of-pocket cost models, with disconnected selection problems. Results: The results show that there was the inequality favorable to the low income group in medical care use. However, after controlling basic medical needs, there were no inequities among income groups in the outpatient visit model and the model of probability of inpatient service use. However, there were inequities favorable to the upper income groups in the models of probability of outpatient service use and outpatient out-of-pocket cost and the models of the number of length of stay and inpatient out-of-pocket cost. In particular, it shows clearly how the difference in outpatient service and inpatient service utilizations by income groups when basic medical needs are controlled. Conclusion: This means that the income contributes significantly to the degree of inequality in outpatient and inpatient care services. Therefore, the existence of medical care use difference under the same medical needs among income groups is a problem in terms of equity of medical care use, so great efforts should be made to establish policies to improve equity among income groups.

• The Journal of Asian Finance, Economics and Business
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• 제9권1호
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• pp.373-385
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• 2022

Due to the lack of information, medical tourists are regarded to be at high risk. Prior medical tourism research has found that various types of perceived risks have a significant impact on medical tourists' purchase behavior. Even though medical tourism is predicted to increase, there is a lack of behavioral research to explain how perceived risks affect medical tourists' purchase behavior. In the context of Korean medical tourism, this study attempts to evaluate the effects of multi-level (macro, organizational, and personal) factors on medical tourists' perceived risks and purchase intentions. A conceptual model and hypotheses were built and empirically validated to investigate links between multi-level characteristics, perceived risks, and purchasing intentions. The data for this study was collected from Chinese tourists using a questionnaire. The impact of cognitive country image, affective country image, and medical service quality on fundamental risk is confirmed by statistical testing. Surprisingly, expectancy discrepancy risk is influenced only by cognitive country image and information search capabilities. Both fundamental and expectation discrepancy risks lower medical tourists' purchase intentions. The findings of this study show that a multi-level strategy is required to investigate the links between perceived risks and medical tourism purchasing intentions based on macro, organizational, and personal factors.

• 한국학교보건학회지
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• 제13권2호
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• pp.341-347
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• 2000

Background : One-quarter of Koreans are either students or school employeeS. Therefore, school health programs for them have high levels of cost-benefit. School health programs, though, are focused on services such as vaccination and physical examination according to administrational regulations without systemic planning. Futhermore, college health programs run autonomously, not under the supervision of the Ministry of Education. It is my intention to analyse the current status of college school health service centers and use the basic data so generated to model how they might operate at an optimal level of efficiency. Methods : I intended to investigate all 29 colleges in Seoul except some specialized colleges such as theological schools in the two-month period of August and September, 1999. I used the telephone interview method to ask questions relating to personal composition, medical equipment in use, annual expenditure and the provision of school health services. School health services were composed of three items; health servies, health education and a healthy school environment. Results : 27 college health service centers were surveyed. The median number of medical personal in each center was 2, the range was 1-31. 7 centers(25.9%) have only nurses with no doctors. Annual expenditures of 11 centers(50.1%) was less than 10 million won, 19 center(70.4%) were maintained by support from their college. Thirteen centers(48.1%) provided doctor's examinations, 6 centers(22.2%) provided dental care services, laboratory services were provided by seven centers(25.9%). Some 81.5% of the centers had vaccination programs and 44.5% had health education programs. There was no school environment program except insecticide provisions. College health service centers with school doctors differed from centers without school doctors in terms of medical equipment range, annual expenditures and annual case loads. Conclusion : The structure and function of college health service centers in Seoul are diverse. However, no center has a well-organized school health plan.

• 산업진흥연구
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• 제3권2호
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• pp.21-31
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• 2018

본 연구는 간호 간병 통합서비스 품질이 의료서비스 성과에 미치는 영향을 알아보기 위해 가설 검정을 실시했다. 연구 결과는 간호 간병 통합서비스 품질의 반응성, 확신성, 공감성, 계산적 몰입, 신뢰성, 감정적 몰입은 의료서비스 성과의 지각된 성과, 충성도, 지각된 성과, 성과의 충성도와 의료서비스 성과의 지각된 성과는 충성도에 긍정적인 영향은 채택으로 나타났다. 즉, 통합서비스 품질은 의료서비스 역량에 매우 중요함을 검증하였다. 이를 위해서는 간호팀원의 인력확충을 위한 제도적 노력이 우선되어야 하며, 우수한 간호팀원 양성을 위해서 전문적 간호능력 외에도 환자와의 공감을 통해 긍정적 관계 형성을 위한 인성 교육에도 중점을 두어야 할 것이다. 본 연구에서 통합서비스 품질이 의료서비스 성과에 미치는 영향을 검중 하였다는데 연구의 의미를 찾을 수 있다.

• 지역사회간호학회지
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• 제9권2호
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• pp.249-261
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• 1998

During the past decade or so in Korea, 119 relief squad members were supposed to respord first urgent or emergency cases. The primary purpose of this study was to assess what levels of knowledge and techniques in prehospital care the 119 relief squad members showed. Data regarding the knowledge and technique levels were collected from both the 119 relief squad members (n=63) and the emergency room nurses(n=46). The Results indicated that the 119 relief squad when compared to emergency nurses, showed higher scores for knowledge and techniques in some areas of prehospital care but not in other areas, However, no differences in knowledge and technique were found when the ANOVAs were calculated with two covariates : duration of their career in emergency medical services and frequency of their exposure to lectures on emergency medical technology. In addition, many respondents in the 119 relief squad group rated themselves poorly in knowledge and techniques of prehospital care, The findings imply that qualitatively better curricula should be given to the 119 relief squad members before they are allowed to play an important role in the emergency medical service system. These findings are also discussed in the context of improving the emergency medical service system.

• Clinics in Shoulder and Elbow
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• 제17권3호
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• pp.120-126
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• 2014

Background: To compare the treatment of the proximal humerus fracture using a Polarus nail or Philos plate, we aimed to analyze the functional recovery and the factors affecting the selection between the two types of surgery. Methods: The study included 107 patients with proximal humerus fracture who underwent surgery at our institution. Of these patients, 67 underwent surgery with Polarus nails (G1) and 40 with Philos plates (G2). In G1, the cases of two- and three-part fractures were 60 and 7 cases, in G2, the cases of two-, three-, and four-part fractures were 28, 10, and 2 cases, respectively. The average age was 61 years old, and the average follow-up period was 32.5 months. We compared radiological results, the functional recovery retrospectively. Results: The radiological union time was 6.8 weeks and 8.7 weeks on average in G1 and G2 (p < 0.05). At the one-year follow-up period, these were visual analogue scale (VAS) 1.355, forward flexion (FF) 130.968, external rotation (ER) 50.161, internal rotation (IR) L2 in G1, and VAS 0.781, FF 135.806 ER 51.25, IR L1 in G2, respectively, showing no significant differences between the two groups (p > 0.05). Similar observations were made at the final follow-up. In terms of functional recovery, no significant differences were seen at the one-year or at the final follow-up period (p > 0.05). Conclusions: For the surgical treatment of proximal humeral fracture, the selection of the type of surgery is affected by the fracture pattern. However, both methods give satisfactory outcomes and do not show significant differences in the functional outcome after the surgery.

• 한국병원경영학회지
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• 제4권2호
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• pp.21-40
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• 1999

One Diagnosis Related Group(DRG) pilot study participating hospital was measured and analyzed to see if there were any changes after the DRG program. It was implemented in consideration of medical service utilization, hospital charges, and non-covered medical service charges by insurance in all Cesarean section cases by reviewing medical records for 3 years, including 1 year before pilot study as well as 1 and 2 years after, respectively. The results were as follows: First, the use of intramuscular antibiotics decreased statistically significantly, whereas intravenous use did not. Second, the administration period and charges of antianemic medication decreased significantly, where the prescription was appropriate. Third, the length of hospital stay decreased statistically significantly. Fourth, there were significant statistical differences in cost sharing between the insured and the insurer: cost sharing of the insured was reduced, whereas the share of the insurer increased. However, there was no change in the quality of care. Fifth, there were no statistically significant changes in the Cesarean section rate. As a result, if the fee schedule is reasonably high, hospitals can provide quality care. This DRG pilot study resulted expected outcomes: by paying a higher fee schedule than fee-for-service, then hospitals can provide quality care to their patients and increase hospital profits.

• 웰빙융합연구
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• 제7권3호
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• pp.43-53
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• 2024

Purpose: his study aims to explore how healthcare provider service characteristics in telemedicine services, which have become more common since the pandemic, affect rapport formation and service satisfaction with healthcare providers. Research design, data and methodology: A group of actual telemedicine users underwent data collection and empirical analysis. After analyzing reliability and validity, hypotheses were tested using a structural equation model. Results: Key perceived attributes of healthcare providers in telemedicine services were identified as doctor effort, doctor listening, and doctor expertise. Each of these variables had a significant positive impact on trust in telemedicine. Moreover, these attributes significantly positively impacted rapport formation and user service satisfaction, which was mediated by trust. However, the direct impact of rapport formation on service satisfaction was not supported. Conclusions: The study's findings have academic and practical implications for expanding telemedicine services. As an initial empirical study on telemedicine services, it confirms the importance of trust and rapport formation even in non-face-to-face medical situations. In order to overcome the limitations of non-physical contact, telemedicine services should strive to develop UI/UX designs that are more interoperable and boost trust in service apps.

• 한국학교ㆍ지역보건교육학회지
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• 제19권1호
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• pp.99-109
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• 2018

Objectives: The study was conducted to understand job stress and fatigue conditions by dividing nurses in a polyclinic-level public medical institution, Seoul with more than 600 beds into ward nurses and non-ward nurses and to comprehend sub-areas of job stress that affect fatigue. Methods: A survey was conducted from August 18 2014 to September 12 2014, so 216 cases were analyzed by using PASW statistics 18.0. Results: Job stress of ward nurses is significantly high in the psychological burden of nursing service area and medical limit. Fatigue of ward nurses is also higher. As a result of multiple Linear regression, nursing service area affects fatigue of ward nurses and there is no significant influence factors in non-ward nurses. Conclusion: Therefore, mental health education and interest of hospital in nursing service area are more needed for ward nurses with high job stress and fatigue among nurses.