Background: This paper describes the relationship and effect of health examination on personal medical cost by identifying the difference of the cost for medical care in physician visit between the population without and with health examination. Methods: After classifying into three cohorts in which, independent variables were designed according to the Andersen's behavioral model, the association of personal medical cost for medical care and prescription drugs which is dependent variable was analyzed by t-test and Mann-Whitney test for description and gamma regression model for inference. Results: In personal average medical cost, the population with health examination paid significantly more than without health examination, 11.6% more in cohort 2008, 26.6% more in cohort 2009, and 48.0% more in combined cohort. The odds ratio on medical expenditure of outpatients with health examination was 1.067, 1.126, 1.398 significantly in cohort 2008, 2009, and combined cohort respectively, comparing to the group without health examination. In independent variables, that is female, the elderly, never married, non-working, non-metropolitan, the higher family income, the smaller family size, people with disability, the people with chronic disease, and people with health examination have significantly being paid more tendency showing positive association with medical cost. Conclusion: This result showed that medical expenditure in physician visit has been increased after taking a health examination. Therefore reasonable limitation of getting preventive medical service is suggested to avoid medical shopping around and reduce being repeated health examination by unifying control to find out easily the clinical results from various medical facilities.
On the process of research in the plan on oriental medical participation in the industrial health sponsored by BK21 project, we carried out the oriental medical health examination program for workers during former half-year We reached the conclusion as follows, 1. The oriental medical health examination program is contents and formalities that should be determined by present industrial health system, based on the oriental medical system and scholastic character, and included probability of the western and oriental medical cooperation. 2. The oriental medical health examination program can promote capability of individual health management and productive power of workers, and it is capable to manage on the self-conscious symptoms and macroschophically approach to their environment 3. The oriental medical health examination program that we have developed, is flow as questionare, understanding of working environment, information of result and later management. It is composed of three fields as follow , first, use of pulse diagnostic apparatus, understanding of the health promotion life style, and diagnosis of the oriental medical doctor, second, analysis of constitution, third, photographing for understanding of the musculoskeletal disorders, questionare for musculoskeletal self-conscious symptoms, and diagnosis of oriental medical doctor. 4. The oriental medical health examination program that we have developed, progressive from the view point of health, makes the oriental medical doctor's roll more important. It is the first trial at the western and oriental medical cooperation and characterized by excellence about musouloskeletal disorders. But it need to be improved in aspects of time and specialist on the health examination, diagnostic apparatus, control of examinant and later management. So we think that it needs research on the employment of health examination specialist, establishment of later management system, development of significantly diagnosable standard and assessable form on the health examination, and contents of health examination on the western and oriental medical cooperation.
Lee Eun-Kyoung;Jahng Doo-Sub;Song Yung-Sun;Lee Ki-Nam
Journal of Society of Preventive Korean Medicine
1. As a point at issue of occidental medicine examination, followings have been indicated, 1) Occidental medical examination is performed by mainly test and instrument and therefore, role of doctors could be excluded and it could be diagnosed only for target disease and 2) in Korea, it could not be conducted in public medical system and therefore improvement effect of public health promotion could not be made due to increase of total medical expenses and infirmity of post management. These points are substantial limit of paradigm resided in occidental medicine and also problem caused by unique characteristics of medical system of Korea. In Korea, result of occidental medical examination show increased health risk from aged thirties and major diagnosed diseases are circulatory disease or chronic disease such as hepatic, hyperlipemic, hypertensional disease and diabetes, etc. Accounting that those chronic disease make a role as major public health risk, it is difficult that medical examination by only occidental medicine make effect on public health promotion. 2. Characteristics of oriental medicine examination could be summarized as diagnosis (information acquisition based on the facts) and demonstration (speculation based on acquired information) and in addition, quadruple diagnosis, as a medical examination method, include test as well as basic examination. Accounting on oriental medical examination, principally it is performed by independent herbalist and therefore, herbalist could acquire systemic result during first medical examination. Based on the theory of inner-outer examination, oriental medical examination has a principle of universe theory, systemic analysis of quadruple diagnosis, demonstration & reasoning. In addition, root of oriental medical examination could be found in pre-disease theory, a principal theory of oriental medicine. Pre-disease service could prove the advantage of oriental medicine in medical examination activities and therefore, it is needed that content of oriental medical examination should be actualized in current medical system. 3. In this study, oriental medical examination program, comprised of pulse-diagnosis, contrast muscular taking and medical consultation of herbalist is progressed communally with occidental medical examination. As pre-examination, questionary was given of general characteristics, health promoting life style, physical constitution and subjective symptom of musculoskeletal system. In addition, post-examination notification was given to subjects about health promoting control, physical constitution regimen and management of musculoskeletal system. During this study program, verification was conducted for input of acquired information and difference of each information after analysis and in addition, performed was analysis of factor influencing health promoting life style and musculoskeletal subjective symptom and evaluation of relationship of physical constitution and health promoting life study. In addition, it was verified of difference between musculoskeletal subjective symptom and result of muscle contrast picture evaluation. 4. Evaluation of oriental medical examination model is divided into 2 categories of oriental medical examination-consultation and result evaluation -post management. Oriental medical examination-consultation demands establishment of examination system, standardization of examination and establishment of examination form and in addition, it should be admitted as enlarged examination assists systemic quadruple diagnosis of herbalist not a key of oriental medical examination. In addition, information acquisition for research purpose should be performed according to the systemic research plan based on the separation of questionary for examination purpose and research purpose. For evaluation of the result, it was concluded that needed are result evaluation meets oriental medical system and post-notification system, informing health management information, based on examination result. 5. Accounting on satisfaction for oriental medical examination model, affirmative reply was much higher (66%) than negative (8.64%). Satisfaction of each area was in order of consultation of herbalist, systemic muscle contrast taking, pulse examination, post-notification and questionary fill-up and dissatisfaction was in order of post-notification, questionary fill-up, consultation of herbalist, systemic muscle contrast taking and pulse measurement. Satisfaction for collaborative examination of occidental and oriental medicine was over 60% and over 75% hope oriental examination would be included in later medical examination program. Based on this result, collaborative examination including occidental and oriental medicine could increase satisfaction of subjects for medical examination program.
The Korean national health examination provides a tremendous amount of medical services in comparison with other countries. The first national health examination plan from 2011 to 2015 led to a remarkable growth in the number of examinees, the institutions that participate in the program, and financing for health examinations, and the national health examination will be expanded and reinforced through the upcoming second national health examination plan. Primary medical institutions should carry out health examinations related to chronic diseases, evaluate the lifestyles of examinees, counsel them about the results, and simultaneously offer follow-up management, so that the health examination and medical treatment function as parts of a cohesive continuum. For personalized health promotion integrated with information and communication technology, the health risk assessment program should be standardized in the Korean population. This will be a cost-effective strategy for managing overall health risks in comparison to the previous separate management of individual risk factors. Furthermore, whenever scientific evidence for items assessed in the national health examinations is lacking, the items should immediately be revised in accordance with appropriate validation studies, and quaternary prevention should be implemented in health examinations in order to avoid overdiagnosis and overtreatment. Finally, aid for vulnerable social classes should be expanded in order to improve the overall national health status and to address health inequalities.
This study was conducted for investigating the status of management of preemployment health examination and to have an effect on the worker's employment. Health managers of 103 companies in Incheon metropolitan city and Gyeonggi were interviewed by telephone. Of 103 companies, 67(65.1%) said they don't hire the applicants who have an active pulmonary tuberculosis, 80(77.7%) companies said they health HBV carrier is acceptable but active HBV carrier is not 29(28.2%) companies said they don't hire the applicants who have a hypertension or diabetes mellitus, 42(40.8%) companies said they don't hire the applicants who have a hearing disturbance. If HIVD is suspicious in X-ray lumbar-sacral region, 37(78.7% of 47 companies) said they do not hire the applicants. 29(35% of 83 companies) said they cancel the employment of the applicants who are suspicious of noise induced hearing loss on preplacement health examination. From our survey, preemployment health examination was utilizing mainly as a tool for the selection of health employees who don't have a disease. Furthermore, in many companies, additional test items are being included and getting more strict the selection criteria for preemployment health examination. For the right use of preemployment health examination, author suggested that further studies were needed to select the adequate test items and establish the reasonable criteria for preemployment health examination.
This research seeks opinions and development plan in forceful measures of qualifying examinations analyzing awareness of people in charge of medical tour about the qualifying examination system of international medical tour coordinator. The result of research shows the relatively positive awareness towards the qualifying examination and its system of international medical tour coordinator. Regarding the examination subjects, score about the necessity of subject where medical professionalism is considered marked high(4.01). About whether they would take the test or not, there was careful difference in the awareness of examination system(0.019) and operation method(0.004.). For the qualifying examination to be settled and thus to reinforce the professionalism, it is considered essential to have improvement in the problems of treatment towards acquisitors of certificate and awareness of field regarding the certificate, and review of supplementary subject aimed at the reinforcement of medical professionalism in terms of examination subjects.
This study was conducted to find medical care utilization pattern and to examine the affecting factors on medical facilities utilization using Andersen's medical care service behavioral model. Three hundreds and five public officials with detected disease through the health examination in 1998 were surveyed using self-administered questionnaire. And 230 data were available and analyzed. The results of this study were summarized as follows: Among variables of predisposing factors, knowledge for disease, confidence about periodic health examination program in health insurance, and the attitude toward medical utilization in the usual showed significant relations with the medical utilization. Other variables were not related with the medical utilization. Variables of enabling factors did not show significant relations with the medical utilization. Recognition of family members for detected disease had significant relations with the medical utilization. Among variables of need factors, absence caused by detected disease was significantly related with the medical utilization. The number of non-occupational diseases detected, but untreated people were 75(32.6%) of total subjects, mainly because detected diseases seemed insignificant to them. With multiple logistic regression analysis, the significant variables having an effect on the medical facilities utilization were 'knowledge for disease', 'attitude toward medical utilization in the usual', 'recognition of family members for detected disease' and 'experience of absence caused by detected disease'. On considerations of above findings, counselling for detected disease and its treatment, health education for individuals and program for family support promotion are needed for health management of public officials with diseases detected in health examination.
Purpose: This study was to analyze changes of motivation and health-promoting lifestyle in 3 months after medical examination, and to identify the influencing factors on the change of health-promoting lifestyle. Methods: The subjects of this study were 81 adults who took medical examination at a general hospital health clinic in Cheonan city. The instruments used in this study were the motivation scale and modified HPLP. For data collection, the first survey was conducted from March 16 to April 19, 2001, and the second survey was carried out by mail three months after the medical examination from June 16 to July 19, 2001. Results: 1. The age of the subjects ranged from 26 to 66 years, 71.6% were male, and the major group was office workers(43.2%). 2. The average score of motivation scale was significantly improved in three months to 520.7(SD=82.7). All sub-scales of motivation scale, self-efficacy(t=-4.204, p=.000), perceived benefits(t=-4.263, p=.000), perceived barriers (t=4.305, p=.000), and emotional salience (t=-6.169, p=.000) showed significant improvements in 3 months. 3. The average score of health-promoting lifestyle was significantly increased to 62.5 (SD=9.8) (t=-5.111, p=.000) after 3 months. Health responsibility(t=-6.098, p=.000), eating habit(t=-3.625, p=.001), exercise(t=-2.557, p=.012), and smoking habit(t=-2.157, p=.034) showed significant improvement. But stress management was not changed at the significant level in 3 months(t=-1.832, p=.071). 4. As the result of multiple regression analysis, it was found that perceived barriers, self-efficacy and monthly mean income had a significant influence on health-promoting lifestyle in 3 months after the medical examination. These variables explained 42.4% of variance in health-promoting lifestyle in 3 months after the medical examination. Conclusion: Periodic medical examination and guidance for healthy lifestyle was effective to change the motivation and to improve health promoting lifestyle.
Journal of Korean Academy of Community Health Nursing
The Purpose of this study was to explore the condition of periodic medical examination and the health care services of industries in order to offer some basic data on developing industrial nursing care. To achieve this goal a self - administered questionnaire (developed by the academic affairs of community health nursing) was provieded to the nurses in 56 industries from Dec. 10, 1992 to Jan. 20, 1993. The statistical computer package, SPSS, was used to manipulate the data along with T-test and ANOVA. The results were as follows : 1. General characteristics: The greater part of the industries were manufacturing company, and below 300 employees of industry were 55.4%. The shift system was mostly one shift(66.1%) and three shift(23.2%), and 50.0% them organized the Industrial Safety and Health Commitee. Average a number of employees was 631 person. 2. Periodic Medical Examination: Most of the workers were receiving periodic medical examination from the designated hospital (95.71%). From the about 12.89% were gone through a colse medical examination. In colse medical examination 58.41% were decided 'C' and 36.73% were decided 'D'. About 6.23% off those who had any clinical findings were work-time shortening(7.84%), work-transition(8.12%), recoverating at home. The majority of the workers receive the result of the periodic medical examination individually (78.5%). 3. Special medical examination: The rate of those who are receiving special medical examination were 76.82% and about 8.24% were decided 'C' and 1.23% were decided 'D' Those who had any health problems were receiving follow-up checking (9.10%) and medical treatment while working (15.04%). The health managers in the company can consult (85.7%) those who had any suspicious sign and symptoms of occupational disease. 4. Health care services: The average score of health care services were 17.57 point out of 28 point, and the score was lower in health assessment and environmental hygiene than medical diagnosis and health education. There were significant differences in environmental hygine (F=3.72, P=0.017), health care services(F=3.94, P=0.013) according to the size of the size of the industries The other's significancy is not shown by any type of industrial nurse. The level of health care services were higher in the wokers who had better health and showed no singificant differences(T=-0.73, P=0.470).
Journal of Korean Academy of Community Health Nursing
The purpose of this study was to explore the condition of periodic medical examination, and health care services in industries. This will offer some basic data in developing industrial nursing care requirements. To achieve this goal a self-administered questionnaire (developed by the academic affairs of community health nursing) was provided to the nurses working in 40 industries from Dec 20, 1992 to Jan 20, 1993. The statistical computer package SAS, along with t-test, and ANOVA was used to manipulate the date. The results were as follows : 1. General Characteristics: The greater part of the industries studied were manufacturing company, with over 500 employees. The shift system was used with most companies using one or three shifts, and 75.0% of them were organized with Industrial Safety and Health Committees. 2. Periodic Medical Examination : Most of the workers were receiving periodic medical examination from a designated hospital (96.7%). Of those 15.8% had a close medical examination. In the medical examination 9.4% were evaluated at 'C' and 3.8 were evaluated at 'D'. About 55.0% of those workers received the result of the periodic medical examination individually(95.0%). 3. Special Medical Examination : The rate of those who were receiving special medical examination was 98.4% and about 11.7% were evaluated at 'C' and 3.9% were evaluated at 'D'. Those who had any health problems (54.2%) were receiving follow-up care, 52.4% of them had medical treatment while working. The health care managers in the company consulted 97.1% of them who had any suspicious signs and symptoms of occupational diseases. 4. Health Care Services : The average score of health care services was 13.8 out of a possible 28 point. The score of health education and health assessment, was lower than medical diagnosis and environmental hygiene. There were no significant differences in health care services according to the size of the industries(F=.95, P=.429). The score of health care services was higher in the worker who had better health and showed significant differences (F=4.50, p=.025).
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