- Changes in Quality of Care for Cesarean Section after Implementation of Diagnosis-Related Groups/Prospective Payment System.
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Jun Yim, Young Hun Kwon, Du Ho Hong, Chang Yup Kim, Yong Ik Kim, Young Soo Shin
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Korean J Prev Med. 2001;34(4):347-353.
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 Abstract
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- OBJECTIVES
To determine the impacts of Diagnosis-Related Groups/Prospective Payment System (DRG/PPS) on the quality of care in cases of Cesarean section and to describe the policy implications for the early stabilization of DRG/PPS in Korea. METHODS: Data was collected from the medical records of 380 patients who had undergone Cesarean sections in 40 hospitals participating in the DRG/PPS Demonstration Program since 1999. Cesarean sections were performed in 122 patients of the FFS(Fee-For-Service) group and 258 patients of the DRG/PPS group. Measurements of quality used included essential tests of pre- and post-operation, and the PPI(Physician Performance Index) score. The PPI was developed by two obstetricians. RESULTS: Univariate analysis demonstrated significant differences in PPI scores according to the payment systems. With respect to the mean of PPI scores, a higher score was found in the DRG/PPS group than in the FFS group. However, the adjusted effect did not show significant differences between the FFS group and the DRG/PPS group. CONCLUSION: This study suggested that the problem of poor quality may not be related to the implementation of DRG/PPS in Cesarean section. However, this study did not consider the validity and reliability of the process measurement, and it did not exclude the possibility of data omission in medical records.
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Summary
- Health Behaviors Related to Hypertension in Rural Population of Korea.
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Chang Yup Kim, Kun Sei Lee, Young Ho Khang, Jun Yim, Yong Jun Choi, Hae Kook Lee, Kyung Ho Lee, Yong Ik Kim
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Korean J Prev Med. 2000;33(1):56-68.
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Abstract
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- OBJECTIVES
To describe health behaviors related to hypertension in rural population of Korea and focused to identify inappropriate awareness, treatment, and control of hypertension. METHODS: We surveyed 5,517 adults (2,288 males, 3,229 females) older than 30 years in 58 rural areas, purposely sampled nationwide from December 1996 to February 1997. Blood pressure was checked twice at the time of the first visit. For those who showed high blood pressure using the JNC-6 criteria at their initial visit, we followed up their blood pressure one week later. Also information on the health behavior related to hypertension was collected through the person-to-person interview using structured questionnaire at the first visit. RESULTS: For the past one year, females had more experiences of checking their blood pressure than males (77.3% versus 69.5%, p=0.001). Through the results of consecutively checked blood pressure, only 51.7% of the hypertensives were aware of their condition. Of the hypertensives who aware of their condition, 44.4% did not receive any medication and/or recommendation. And 50.4% of the hypertensives who had anti-hypertensive medication were classified as still having hypertensive blood pressure by 160/95 mmHg criteria. Of the medicated, 54.8% were found to take medication regularly for the past six months. Among the medicated, only 11.4% knew the name of anti-hypertensive drug they had. CONCLUSIONS: 'Rule of halves', which works in the situation of no special efforts for hypertension control, was identified. This study showed that much efforts to control hypertension would be required in the rural population of Korea.
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