No abstract available.
Methods*

No abstract available.
Delivery of Health Care*

No abstract available.
Cause of Death* ; Korea*

No abstract available.

No abstract available.
Fibronectins* ; Paraffin*

PURPOSE: The purpose of this study was to classify the elderly in long-term care facilities using the Resource Utilization Group(RUG-III) and to examine the feasibility of a payment method based on the RUG-III classification system in Korea. METHOD: This study measured resident characteristics using a Resident Assessment Instrument-Minimum Data Set(RAI-MDS) and staff time. Data was collected from 530 elderly residents over sixty, residing in long-term care facilities. Resource use for individual patients was measured by a wage-weighted sum of staff time and the total time spent with the patient by nurses, aides, and physiotherapists. RESULT: The subjects were classified into 4 groups out of 7 major groups. The group of Clinically Complex was the largest (46.3%), and then Reduced Physical Function(27.2%), Behavior Problems (17.0%), and Impaired Cognition (9.4%) followed. Homogeneity of the RUG-III groups was examined by total coefficient of variation of resource use. The results showed homogeneity of resource use within RUG-III groups. Also, the difference in resource use among RUG major groups was statistically significant (p<0.001), and it also showed a hierarchy pattern as resource use increases in the same RUG group with an increase of severity levels(ADL). CONCLUSION: The results of this study showed that the RUG-III classification system differentiates resources provided to elderly in long-term care facilities in Korea.
Aged ; Female ; Health Resources/*utilization ; Homes for the Aged/*economics ; Humans ; Korea ; Long-Term Care/*economics ; Male ; Nursing Homes/*economics ; Patients/*classification ; *Prospective Payment System

Decentralization to local governments and amending of Health center Law are to promote the efforts of health planning at the level of local agencies. In the health facility planning, it is important to take into account that what to be built, where to be located, how far should be service area and so forth, because health facilities are immovable, and require capital as well as personnel and consumable supplies. The aim of our study, answering to the question of 'where to be located?`, is to determine the best location of urban health sub-center. At the local level, planning is the matter of finding the best location of specific facility, in relation to population needs. We confine the accessibility, which is basic to location planning, to geographic one. Location-Allocation Model is used to solve the problem where the location is to maximize geographic accessibility. To minimize the weighted travel distance, objective function, Rk= aijwidij is used. Distances are measured indirectly by map measure-meter with l:25,000 Suwon map, and each potential sites, 10 administrative Dongs in Kwonson Gu, Suwon, are weighted by each number of households, total population, maternal age group, child age group, old age group, Relief for the livelihood, and population/primary health clinics. we find that Kuwoon-Dong, Seodun-Dong, Seryu3-Dong, according the descending orders, are best sites which can minimize the weighted distance, and conclude that it is reasonable to determine the location of urban health sub-center among those sites.
Child ; Equipment and Supplies ; Family Characteristics ; Gyeonggi-do ; Health Facilities ; Health Facility Planning ; Health Planning ; Humans ; Jurisprudence ; Maternal Age ; Politics ; Urban Health*

OBJECTIVES: Assuring adequate supply of specialist physicians is an important task in national health planning. An over-supply in a given speciality inflates health care cost, while undersupply increases the likelihood that population has a barrier in the access to basic health services needed. Only a few national specialty-specific physician planning studies have been undertaken in Korea. We forecasted the supply of and the demands for psychiatrists in the target year of 2015. METHODS: We adopted alternative projection models combined with demographic method as a supply forecasting method and Health Resources and Services Administration's demographic utilization-based model as a requirements forecasting method. The model uses selected data primarily from National Hospital Discharge Survey, database of the Korean Neuropsychiatric Association (KNPA) survey for certified members of KNPA, and Hospital Accreditation and Teaching Hospital Designation Report. We assumed two alternatives in supply forecasting by the number of medical students enrolled, and three alternatives in requirements forecasting based on future service utilization and physician productivity. RESULTS: Depending on assumptions, total psychiatrist supply ranged from 3,439 to 3,575 and requirements ranged from 1,873 to 4,048 in 2015. We estimated 162 surplus in 2005 and a 162 shortage of psychiatrist in 2015 based on high-level supply estimates and medium level requirements estimates. CONCLUSION: There would be no overt oversupply of psychiatrists in 2015 if the number of new residency positions is maintained at 4.6% of the number of medical students newly enrolled in a year. Further studies would be needed concerning comprehensive economic and institutional factors which could affect the requirements of psychiatrists.
Accreditation ; Efficiency ; Forecasting ; Health Care Costs ; Health Care Surveys ; Health Planning ; Health Resources ; Health Services Needs and Demand ; Hospitals, Teaching ; Humans ; Internship and Residency ; Korea* ; Psychiatry* ; Specialization ; Students, Medical

OBJECTIVES: The Diagnosis Related Group (DRG) payment system, which has been implemented in Korea since 1997, is based on voluntary participation. Hence, the positive impact of this system depends on the participation of physicians. This study examined the factors determining participation of Korean obstetrics & gynecology (OBGYN) clinics in the DRG-based payment system. METHODS: The demographic information, practice-related variables of OBGYN clinics and participation information in the DRG-based payment system were acquired from the nationwide data from 2002 to 2007 produced by the National Health Insurance Corporation and the Health Insurance Review & Assessment Service. The subjects were 336 OBGYN clinics consisting of 43 DRG clinics that had maintained their participation in 2003-2007 and 293 no-DRG (fee-for-service) clinics that had never been a DRG clinic during the same period. Logistic regression analysis was carried out to determine the factors associated with the participation of OBGYN clinics in the DRG-based payment system. RESULTS: The factors affecting participation of OBGYN clinics in the DRG-based payment system were as follows (p<0.05): (1) a larger number of caesarian section (c/sec) claims, (2) higher cost of a c/sec, (3) less variation in the price of a c/sec, (4) fewer days of admission for a c/sec, and (5) younger pregnant women undergoing a c/sec. CONCLUSIONS: These results suggest that OBGYN clinics with an economic practice pattern under a fee-for-service system are more likely to participate in the DRG-based payment system. Therefore, to ensure adequate participation of physicians, a payment system with a stronger financial incentive might be more suitable in Korea.
Adult ; Age Factors ; Ambulatory Care Facilities/economics/*statistics & numerical data ; Cesarean Section/statistics & numerical data ; Costs and Cost Analysis/statistics & numerical data ; Demography ; Diagnosis-Related Groups/economics/*statistics & numerical data ; Fee-for-Service Plans/statistics & numerical data ; Female ; Gynecology ; Humans ; Length of Stay/statistics & numerical data ; Logistic Models ; Male ; Middle Aged ; Obstetrics ; Pregnancy ; *Prospective Payment System ; Republic of Korea ; State Medicine/economics/*statistics & numerical data

No abstract available.
Insurance, Health* ; Medicare*