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On the Feasibility of a RUG-III based Payment System for Long-Term Care Facilities in Korea
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Eun Kyung Kim, Ha Young Park, Chang Yup Kim
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Journal of Korean Academy of Nursing 2004;34(2):278-289. Published online March 28, 2017
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DOI: https://doi.org/10.4040/jkan.2004.34.2.278
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Abstract
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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.
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Citations
Citations to this article as recorded by 
- Analysis of the Cost and Case-mix of Post-acute Stroke Patients in China Using Quantile Regression and the Decision-tree Models
Mengjia Zhi, Linlin Hu, Fangli Geng, Ningjun Shao, Yuanli Liu Risk Management and Healthcare Policy.2022; Volume 15: 1113. CrossRef - Development of a Web-based Education Program for Nurses working in Nursing Homes on Human Rights of Older Adults
Ki-Kyong Kim Journal of Korean Academy of Nursing.2010; 40(4): 463. CrossRef - Relationship between Resource Utilization and Long-term Care Classification Level for Residents in Nursing Homes
Min Kyung Lee, Eun-Kyung Kim Journal of Korean Academy of Nursing.2010; 40(6): 903. CrossRef - Effects of Case Management using Resident Assessment Instrument-Home Care (RAI-HC) in Home Health Services for Older People
Kyung Ja June, Ji Yun Lee, Jong Lull Yoon Journal of Korean Academy of Nursing.2009; 39(3): 366. CrossRef
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Resource use of the Elderly in Long-term Care Hospital using RUG-III
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Eun Kyung Kim
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Journal of Korean Academy of Nursing 2003;33(2):275-283. Published online March 28, 2017
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DOI: https://doi.org/10.4040/jkan.2003.33.2.275
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Abstract
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Purpose
This study was to classify elderly in long-term care hospitals for using Resource Utilization Group(RUG-III) and to consider feasibility of payment method based on RUG-III classification system in Korea.
Method
This study designed by measuring resident characteristics using the Resident Assessment Instrument-Minimum Data Set(RAI-MDS) and staff time. The data were collected from 382 elderly over sixty-year old, inpatient in the five long-term care hospitals. Staff time was converted into standard time based on the average wage of nurse and aids.
Result
The subjects were classified into 4 groups. The group of Clinically Complex was the largest(46.3%), Reduced Physical Function(27.2%), Behavior Problem(17.0%), and Impaired Cognition(9.4%). The average resource use for one resident in terms of care time(nurses, aids) was 183.7 minutes a day. Relative resource use was expressed as a case mix index(CMI) calculated as a proportion of mean resource use. The CMI of Clinically Complex group was the largest(1.10), and then Reduced Physical Function(0.93), Behavior Problem(0.93), and Impaired Cognition(0.83) followed. The difference of the resource use showed statistical significance between major groups(p<0.0001).
Conclusion
The results of this study showed that the RUG-III classification system differentiates resources provided to elderly in long-term care hospitals in Korea.
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Citations
Citations to this article as recorded by 
- An Overview of International Staff Time Measurement Validation Studies of the RUG-III Case-mix System
Luke A Turcotte, Jeff Poss, Brant Fries, John P Hirdes Health Services Insights.2019;[Epub] CrossRef
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Predictors of Intention to Quit Smoking among Patient with Coronary Heart Disease
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Eun Kyung Kim, Mae Ja Kim, Mi Ryung Song
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Journal of Korean Academy of Nursing 2002;32(3):355-363. Published online March 29, 2017
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DOI: https://doi.org/10.4040/jkan.2002.32.3.355
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Abstract
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PURPOSE: The purpose of this study was to examine the level of intention to quit smoking and to identify factors influencing intention to quit among patients with coronary heart disease.
Method: The subjects consisted of 80 male patients with coronary heart disease (angina pectoris, myocardial infarction) at three hospitals in Seoul. The data were collected with self reporting in a structured questionnaire. Stepwise multiple regression was used to identify predictors of intention to quit. Included variables were attitudes toward smoking cessation, subjective norms, perceived behavioral control, usefulness of smoking cessation, and previous attempts to quit.
RESULT: 1. The mean score for intention to quit was 11.1(+/-6.1) which was lower than median score of the scale. 2. There were significant correlations between the all predictive variables and the intention to quit(r=.24-.48, p<.05). 3. usefulness of smoking cessation, perceived behavioral control, and previous attempts to quit explained 34.6% of the variance for intention to quit.
CONCLUSION: usefulness of smoking cessation, perceived behavioral control, and previous attempts to quit were identified as important variables in explaining the intention to quit smoking among patients with coronary heart disease. Thus, it is necessary to try to enhance this factors for increasing intention to quit among patients with coronary heart disease.
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Citations
Citations to this article as recorded by 
- Factors Influencing Intention to Quit Smoking in Stroke Patients: Based on the Theory of Planned Behavior
Jin-hyun Bae, Eun Su Do, Young Soo Seo Journal of Korean Gerontological Nursing.2014; 16(1): 49. CrossRef - Predictors of Intention to Quit Smoking in Elderly Smokers following a Stroke
Eun Su Do, Young-Sook Seo Journal of Korean Academy of Fundamentals of Nursing.2014; 21(1): 48. CrossRef
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Estimation of Psychiatric Nursing Costs by Using the Resource-Based Relative Value Scale(RBRVS)
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Eun Kyung Kim, Young Dae Kwon, Yoon Kim
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Journal of Korean Academy of Nursing 2000;30(6):1580-1591. Published online March 29, 2017
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DOI: https://doi.org/10.4040/jkan.2000.30.6.1580
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Abstract
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This study was conducted to assess the amount of nursing services for psychiatric inpatients and to estimate psychiatric nursing costs by using the RBRVS.
Full details of medical services, including physician and nursing services, for psychiatric inpatients were surveyed and data of general characteristics of hospitals and patients were also collected. The cost of nursing activities was estimated by the multiple conversion factor which was drawn from the Korean RBRVS Development Project to the RBRVS score of each nursing activities, which was drawn from the results of Korean Nurses Association (KNA)'s projects about nursing RBRVS development and cost of nursing activities.
The data about 89 inpatients from 3 general hospitals with psychiatric departments were analyzed. The total cost of nursing activities for each patient per admission day was from KRW 22,185 to KRW 27,954 by hospital, and KRW 25,220 in average. The percent of nursing cost to the total cost of medical services was from 36% to 48% by characteristics of patients and 41.4% in average.
The cost of nursing activities estimated in this study was between the existing NHI fee schedule and the one suggested by KNA. It is considered as appropriate and acceptable level compared to the total amount of medical services. In the process of KNA's activities to get nursing fee in NHI fee schedule, results of additional studies to estimate the cost of nursing activities balanced with total cost of medical services in every departments should be found and utilized.
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Citations
Citations to this article as recorded by 
- Development of Psychiatric Inpatient Classification System based on Nursing Care Needs
In Ohg Oh, Kyoung A Nam Journal of Korean Academy of psychiatric and Mental Health Nursing.2020; 29(3): 243. CrossRef - Analysis of Psychiatric Nursing Activity and Time for Development of Nursing Cost
Sook Bin Im, Whasoon Chang, Moon Hee Ko, Youngsuk Park, Eun-Kyung Kim Journal of Korean Academy of Psychiatric and Mental Health Nursing.2012; 21(1): 41. CrossRef
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Nutritional Status of Cancer Patients upon Admission
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Eun Kyung Kim, Young Hee Yang, Smi Choi-Kwon
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Journal of Korean Academy of Nursing 1999;29(2):271-280. Published online March 29, 2017
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DOI: https://doi.org/10.4040/jkan.1999.29.2.271
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Abstract
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The purpose of this study was to assess the nutritional status of cancer patients and non-cancer patients who were admitted to an internal medical department and to determine the degree of malutrition among these patients. The study was performed from May to July 1996 with 151 subjects recruited from the general medical department at D University Hospital. For nutritional assessment the anthropometric and biochemical assessment were performed. Biochemical measurements included serum hemoglobin, albumin, and lymphocytes. For anthropometric assessment, patient's body weight, skinfold thickness in four areas, body mass index, and percent of body fat were measured.
The results were as follows :
1) Of the 151 patients who were studied, 47 patients had cancer while 104 patients had non cancer related disease. The mean age of the cancer patients was 57 and 52 for non cancer patients. The percentage of patients who had lost body weight during the last 6 months was 29.8% in cancer patients and 15.4% in non cancer patients. This percentage difference between the 2 groups was statistically significant. However, there was no statistical significance between the 2 groups in gastrointestinal symptoms which lasted more then 2 weeks.
2) There was a statistically significant difference in nutritional status(lympocyte : p=.002 ; skinfold thickness in four areas : p<0.05) between the cancer and the non-cancer patients. The percentage of the patients who had the possibility of malnutrition was 65.5% in cancer patients and 6% in non-cancer patients.
3) There was correlation between the weight loss during the last 6 months before admission and body mass index and skinfold thickness.
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Citations
Citations to this article as recorded by 
- Effects of Continuous Nutrition Care on Nutritional Status and Dietary Habits of Patients With Colorectal Cancer Receiving Adjuvant Chemotherapy After Surgery
Jina Son, Ha I Kang, Eun young Jung, Hae won Ryu, Kyung-Ha Lee Clinical Nutrition Research.2023; 12(2): 99. CrossRef - Muscle Flap Closures in Spine Surgery
Meghan J. Price, Rose Tillis, Elizabeth P. Howell, Luis Ramirez, Tara Dalton, César Baëta, Vikram Mehta, Muhammad M. Abd-El-Barr, Isaac O. Karikari, C. Rory Goodwin, David A. Brown Clinical Spine Surgery: A Spine Publication.2022; 35(1): E248. CrossRef - Study on the Improvement of Dietary Life of Cancer Patients during Treatment by Nutrition Counseling
Keeyoun Hong, Yunjin Choi, Wanqin Yan, Hyunsook Lim, Jonghee Chyun Korean Journal of Community Nutrition.2016; 21(1): 93. CrossRef
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Lifestyles Effects on Stroke Risk in Different Regions in Korea
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Smi Choi-Kwon, Eun Kyung Kim, Mi Yang Jeon
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Journal of Korean Academy of Nursing 1998;28(3):729-738. Published online March 29, 2017
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DOI: https://doi.org/10.4040/jkan.1998.28.3.729
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Abstract
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BACKGROUND AND PURPOSE: Stroke is a leading cause of death in Korea. Early measurement to prevent stroke are extremely important since it has no cure. Korean might have different risk factors since their dietary habit and socio-economical status differ from most western countries. However, the risk factors for stroke in Korea have not yet been identified. Moreover, the lifestyle of health Korean adults has not been investigated. In this study we investigate the life of health adults living in Seoul and rural areas and compare the life style of the two.
METHODS: One hundred seventy one subjects were studies. Among the subjects studied, 128 were from Seoul, the other 43 were from the country area. The age of the subjects was limited to over 40 years. Blood pressure, fast blood sugar, and cholesterol were measured. The subjects' height, weight, body mass index total body fat, skinfolds thickness of triceps, subscapular and abdomen were measured to determine obesity. Using a structured interview, we assessed : sodium intake, physical activity and exercise, consumption of vegetables, fat, fish and fruits. The results of the two groups were compared.
RESULTS: There were no statistical differences in age and education between the two groups of subjects. The mean age of the subjects were 66 years old. The subjects residing in rural areas had a higher intake of sodium(p<0.05), lower physical active(P<0.05), and higher BMI and body fat(p<0.05) as compared to the subjects in Seoul. Subjects with hypertension were between 24% and 33% and the prevalence of hypertension was the highest was the highest when compared to the prevalence of DM, or hypercholesterolemia. However, the prevalence of hypertension, DM, hypercholesterolemia, were not significantly different in these areas.
CONCLUSION: our results show that subjects living in rural areas eat more salty food, exercise less and tend to be obese. The finding of this study lead to speculation that Korean living in rural areas have less information about the effects diet of diet on health than city dwellers do. General health and nutrition education programs aimed at the prevention of stoke and other such conditions for rural area Korean may close the risk factor gap between rural and urban dwellers.
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Citations
Citations to this article as recorded by 
- Evaluation of the Korean Version of Physical Activity Scale for the Elderly (K-PASE)
Myoung-Ae Choe, Jeungim Kim, Mi-yang Jeon, Young-Ran Chae Korean Journal of Women Health Nursing.2010; 16(1): 47. CrossRef - Echocardiographic Plains Reflecting Total Amount of Epicardial Adipose Tissue as Risk Factor of Coronary Artery Disease
Jung-Won Hwang, Un-Jung Choi, Sung-Gyun Ahn, Hong-Seok Lim, Soo-Jin Kang, Byoung-Joo Choi, So-Yeon Choi, Myeong-Ho Yoon, Gyo-Seung Hwang, Seung-Jea Tahk, Joon-Han Shin, Doo-Kyung Kang Journal of Cardiovascular Ultrasound.2008; 16(1): 17. CrossRef
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Changes in Nutritional Status of General Medical Patients During Hospitalization
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Young Hee Yang, S Mi Choi-Kwon, Eun Kyung Kim
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Journal of Nurses Academic Society 1997;27(1):49-60. Published online March 30, 2017
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DOI: https://doi.org/10.4040/jnas.1997.27.1.49
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Abstract
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The purpose of this study was to determine the incidence of malnutrition among patients on admission to hospital, to monitor changes in their nutritional status during hospitalization, and to determine the factors which might affect changes in nutritional status. The subjects for the study were patients who were admitted to general medicine for more than one week. Patients suffering from cardiovascular, renal disease, or dehydration were excluded. Nutritional assessment of the patients was performed on admission and nutritional status was reassessed one week and two weeks after admission. The nutritional assessment tool consisted of subjective history taking and anthropometric measurements. Biochemical measurements were performed only on admission. For anthropometric assessment ; patients' body weight, subcutaneous skinfolds thickness, % of body fat, body mass index, and lean body mass were measured using caliper or Bio impedance Analyzer. Factors which might influence current nutritional status, like dietary intake, anorexia, nausea, vomiting, diarrhea, sleep disturbance, and number of day of NPO for diagnostic examinations were analyzed. The results are as follows : 1. Of the 59 patients who were studied, 61% were male and 39% female. The nutritional status of all of the 59 subjects was reassessed one week after admission, but it was only done for 22 subjects at two weeks. 2. The anthropometric measurements, including weight, body mass index, lean body mass, body fat, and skin fold thickness, were all significantly decreased at one week after admission compared to the values at admission. On the other hand, two weeks after admission, only body weight and abdominal skinfolds thickness were decreased. 3. The subjects reported anorexia for an average of two days, sleep disturbance for two days, and no food intake due to diagnostic test for one day. In the second week of hospitalization almost none of the patients complained of gastrointestinal symptoms or sleep disturbance except anorexia Food consumption which was measured based on rice intake was 60% of the food served during the first week of hospitalization, and 66% during the second week of hospitalization. 4. There was no correlation between the subjective nutritional assessment and anthropometric assessment. 5. There was no statistical significance in anthropometric measurements among the patients with various diseases whereas sleep disturbance and no food intake due to various diagnostic test was prominent in patients with gastrointestinal diseases.
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Citations
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- Risk Factors for Nutritional Status in Patients with Chronic Obstructive Pulmonary Disease
Jun Hee Jang, Hye Sook Min, Jin-Han Park Korean Journal of Adult Nursing.2019; 31(6): 585. CrossRef - Pre- and Post-Transplant Nutritional Assessment in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation
Mi Young Park, Jeong Yun Park Asian Oncology Nursing.2012; 12(1): 110. CrossRef
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