- Medical Expenses by Site of Cancer and Survival Time among Cancer Patients in the Last One Year of Life.
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Jee Jeon Yi, Won Kon Yoo, So Yoon Kim, Kwang Ki Kim, Sang Wook Yi
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J Prev Med Public Health. 2005;38(1):9-15.
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To analyze medical expenses by cancer site and survival time among cancer patients in their last year of life. METHOD: The study subjects were 45, 394 people that had died of cancers in 2002, were registered by the Korea Central Cancer Registry and received National Health Insurance benefit in the last year (360 days) of life. Personal identification data, general characteristics, dates of death and cancer incidence, and site of cancer were collected from the National Statistical Office and the Korea Central Cancer Registry, and merged with the data of the individual medical expenses of the Health Insurance Review Agency. RESULTS: Average monthly cost curves were U-shaped with high costs near the time of diagnosis and death, and lower costs in between. Medical expenses in the last year of life were around 30.3, 16.7, 13.0, and 12.1 million won among leukemia, lymphoma, ovarian cancer, and breast cancer patients, respectively. Digestive organ cancers including stomach, esophagus, liver, pancreas, and colorectal cancers had relatively low medical expenses. Medical expenses in the last year of life were inverse U-shaped with high expenses near one year of survival. Average monthly cost in the 12 months before death among the patients who had survived 10~15 years were more than two-fold greater than the cost before diagnosis among those who had survived for less than one year. CONCLUSIONS: Leukemia was the most expensive cancer. It is possible that once diagnosed as cancer, medical expenses do not return to the level before diagnosis. Further research will be needed to understand the magnitude and change of the medical expenses among cancer patients with long term follow up data.
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- A Relationship of Care Time with Functional Status and Patients Characteristics among Patients in Long-term Care Hospitals.
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Jee Jeon Yi, Sang Wook Yi, Jeong In Kim, Seung Hm Yu, Hyeong Sik Yoo
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J Prev Med Public Health. 2004;37(3):282-291.
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The aim of this study was to investigate the functional status variables related to the care time of health professionals for patients in long-term care facilities. METHODS: The functional stati of 1001 patients in 8 longterm care hospitals were examined by the Resident Assessment Instrument for Long-term Care Facility Version 2.0. The care time of health professionals for patients was calculated using data from a self-reported task survey by nurses, auxiliary nurses, private aides, doctors, physiotherapists and social workers. RESULTS: The average care time per diem was 240.6 minutes. The care time by doctors, nurses and private aides were 11.0, 71.0 and 139.5 minutes, respectively. The lower the function of activities of daily living (ADL) and the greater the symptoms of extensive services, special care and clinical complexity, the more care time was served. On the contrary, the greater the symptoms of nursing rehabilitation, depression, cognitive disorder, behavior problem and psychiatry/mood disorder, the less care time was served. Age and gender were not significantly related to the care time. CONCLUSIONS: Developing a case mix classification system for elderly long term care patients may be helpful for both of patients and health care providers. The ADL, extensive services, special care and clinical complexity of variables should be considered in the development of a case mix system for the long term care of patients in Korea.
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- A Study on the Cost and Proportion of Complementary and Alternative Medicine in Total Healthcare Cost among Elderly in the Last 6 Months of Life.
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Jee Jeon Yi, Heechoul Ohrr, Sang Wook Yi
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J Prev Med Public Health. 2004;37(2):141-149.
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- OBJECTIONS: To evaluate the cost and proportion of complementary and alternative medicines (CAM) in the total healthcare costs among the elderly in the last 6 months of life. METHODS: The care-giving families of 301 persons older than 65 years, who died between July 1st and December 31st of 2001, and were also registered in Self-Employed Health Insurance Programs in Seoul, were interviewed. RESULTS: The cost of CAM was 1.09 million Won, which as a proportion of the total healthcare cost was 38.1%. The elderly aged between 65 and 69 year-old, male, living with their spouse, Buddhist and having cancers had higher CAM costs in an ANOVA and simple regression analysis. After controlling of various factors, age was the only significant factor associated with the cost of CAM. The elderly above 80 years old, female, bereaved and Buddhist had higher proportional CAM costs, and the elderly having cancers or cardiovascular diseases had lower proportional CAM costs in an ANOVA and simple regression analysis. After adjusting for various factors, the elderly above 85 years old, female and Buddhist had higher proportional CAM costs, and the elderly having cancers had lower proportional CAM costs. CONCLUSION: The very old and Buddhist, and/or the ill with no clear diagnosis, may depend more on CAM. Further research will be needed on the meaning and impact of CAM and their costs to public health and the total healthcare system.
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- Association of Drinking Patterns and Health Characteristics with Beverage Preference.
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Jee Jeon Yi, Heechoul Ohrr, Sang Wook Yi, Woo Jin Chung
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J Prev Med Public Health. 2004;37(2):133-140.
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To investigate the association between the type of preferred alcoholic beverage and drinking pattern and health characteristics. METHODS: A Cross-sectional study was conducted from 22 April to 3 May in 2002. 301 females and 699 males aged 13 to 59 were personally interviewed. Data on sociodemographic characteristics, drinking pattern and health characteristics were collected. 735 drinkers who were 19 year-old or over were included in analysis. Beverage preference was classified 3 categories: Beer drinker, wine drinker (including wine, makguly, chungju and yakju) and soju drinker (including soju and spirits). RESULTS: Beer drinkers were likely to be females. Compared to wine or soju drinkers, beer drinkers were less frequently drank, and consumed less total alcohol per week and less alcohol per 1 drinking among both male and female. Controlling for various confounders, beer drinker had significantly less total alcohol consumption per week, and alcohol consumption per 1 drinking than wine and soju drinker. CONCLUSION: Beer drinking were associated with less smoking in males and healthy drinking pattern in both gender than soju drinking.
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- A Study on the Association between Healthcare Utilization and the Burden of Families Caring for the Elderly in the Last 6 Months of Life.
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Jee Jeon Yi, Hee Na Lee, Heechoul Ohrr, Hye Young Jung, Sang Wook Yi
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Korean J Prev Med. 2003;36(4):332-338.
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To investigate the relationship between medical expenses and the burden of families caring for the elderly in the last 6 months of life, and to evaluate the factors relating to the burden of family caregivers. METHODS: The families of 301 persons older than 65 years, who died between 1 July and 31 December 2001, and were registered in Resident-based- Health Insurance Programs in Seoul, were interviewed. The medical expenses and length of stay among the elderly were collected from Korean Health Insurance Corporations. RESULTS: 31 percents of the elderly had no medical expenses in the last 6 months of life. On average, the objective burden (4.92) was higher than the subjective burden (3.35). Families caring for male elderly had a higher burden. With increasing age at death, the objective burden was significantly increased. The burden on a family seemed to be influenced more by the family income than the property of the elderly. With increasing total health care costs, the objective burden on the family caregivers was significantly increased, but with increasing medical expenses, the subjective burden was significantly decreased. CONCLUSION: An association between healthcare utilization and burden on families was observed. The reason for the decreasing subjective burden when medical expenses were decreased was unclear. Further research will be needed.
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- Medical Service Utilization and Trends among Korean Elderly in the Last One Year of Life.
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Jee Jeon Yi, Ki Soon Park, Seung Hum Yu, Jeong In Kim, Jae Yong Park, Wang Kun Yoo, Sang Wook Yi
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Korean J Prev Med. 2003;36(4):325-331.
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To analyze medical service utilization and trends among the elderly in the last year of life. METHOD: The subjects of this study were people that had died at the age sixty-five and above between January 1st and June 30th 2000 The names of the deceased and their dates of death were collected from the data of the funeral-expenses-receivers of the National Health Insurance Corporation (NHIC). This data was merged with that of the individual medical expenses of the NHIC. RESULTS: In the first half of 2000, 84.2% of the funeral-expenses-receivers (53, 063) utilized medical services during the year prior to their death; 51.0% (27, 042) were female and 49.0% (26, 021) male. In the last twelve months of life, the medical fees, the number of days receiving medical services and the number of days receiving medicine were 3, 107, 935 Won, 47.88 and 153.21, respectively, for each person. As the age of the groups increased, the level of medical service utilization decreased; the change was more obvious in female group. The level of medical service utilization during the twelve months prior to death drastically increased around the time of death. CONCLUSIONS: This study, from an analysis of the level of medical service utilization prior to death, shows a concentrated volume of medical services during a certain time period prior to death.
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KSPM
