• Korea Journal of Hospital Management
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• v.26 no.3
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• pp.1-12
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• 2021

Purpose: This study aims to examine the effect of the copayment reduction policy on the health care utilization of patients under age 15 after the policy started in 2017. (이하는 아래 methodoloty로 이동) Methodology: Data on the ALOS, the average admission cost, and the out-of-pocket expenditure for patients under 15 years of age from 2015 to 2019 were obtained from the National Health Insurance database. Policy effects were measured by analyzing three dependent variables before and after policy: the average length of stay (ALOS), the average admission cost, and the out-of-pocket expenditure for patients under 15 years of age. The collected data were analyzed using the SAS package, and the analysis methods used in this study were the mean difference test and linear regression analysis. Findings: The study results reveal that, after the copayment reduction policy in the year 2017, the ALOS and the out-of-pocket expenditure were significantly decreased, but the average admission cost was significantly increased. Practical Implications: These results imply that the policy of copayment reduction for the patients under the age of 15 has contributed to mitigating the patients' financial burden with little concern about growing medical utilization.

• Health Policy and Management
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• v.28 no.4
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• pp.378-391
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• 2018

Background: People who were born in different years, that is, different birth cohorts, grow in varying socio-historical and dynamic contexts, which result in differences in social dispositions and physical abilities. Methods: This study used age-period-cohort analysis method to establish explanatory models on healthcare expenditure in Korea reflecting birth cohort factor using intrinsic estimator. Based on these models, we tried to investigate the effects of ageing population on future healthcare expenditure through simulation by scenarios. Results: Coefficient of cohort effect was not as high as that of age effect, but greater than that of period effect. The cohort effect can be interpreted to show 'healthy ageing' phenomenon. Healthy ageing effect shows annual average decrease of -1.74% to 1.57% in healthcare expenditure. Controlling age, period, and birth cohort effects, pure demographic effect of population ageing due to increase in life expectancy shows annual average increase of 1.61%-1.80% in healthcare expenditure. Conclusion: First, since the influence of population factor itself on healthcare expenditure increase is not as big as expected. Second, 'healthy ageing effect' suggests that there is a need of paradigm shift to prevention centered-healthcare services. Third, forecasting of health expenditure needs to reflect social change factors by considering birth cohort effect.

• Research in Community and Public Health Nursing
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• v.32 no.1
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• pp.116-129
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• 2021

Purpose: This study aimed to investigate the maternal health effects of internet-based education interventions on parturients during the postpartum period through a systematic review of randomized controlled trials. Methods: An electronic literature search of the Cochrane Library, CINAHL, EMBASE, Eric, PsycINFO, PubMed, RISS, and KISS databases was performed, using the combination of keywords such as 'parenthood education', '*natal education', '*birth intervention', 'internet-based intervention', 'randomized controlled trial'. The inclusion criteria were peer-reviewed papers in English regarding randomized controlled trials of internet-based postnatal education interventions. Educational interventions were delivered through any web, mobile, eHealth, mHealth, virtual reality, short message service, or social networking service platform. Quality appraisal was performed using the Risk of Bias 2 (RoB 2) for randomized controlled trials. Nine articles were yielded, and the intervention effects were analyzed. Results: Internet-based education interventions during the postpartum period affect maternal self-efficacy, postpartum depression, and successive breastfeeding; however, they do not affect maternal satisfaction and parenting confidence. Conclusion: This study demonstrated that internet-based education interventions affect maternal health status in terms of psychological, emotional, and physical wellness. Therefore, maternal health care professionals can utilize remote education using the internet or mobile-based interventions during the postpartum period.

• Health Policy and Management
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• v.31 no.3
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• pp.344-354
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• 2021

Background: The purpose of this study was to analyze the effect of national health insurance coverage of Chuna therapy in April 2019 on the costs and service uses in automobile insurance. Methods: This study used the claim data from Health Insurance Review and Assessment Service. A total of 189,912 inpatients and 1,550,497 outpatients who received Chuna therapy covered by automobile insurance in oriental medical institutions were included. The analysis period was from July 2018 to December 2019, and a total of 18 months before and after April 2019, when Chuna therapy was covered by national health insurance. Interrupted time series analysis was applied to analyze the impact on the costs and service uses of Chuna therapy in automobile insurance before and after April 2019. Results: From July 2018 to December 2019, for 189,912 inpatients the cost and the number of times for Chuna therapy per capita were increased by 22.0% and decreased by 7.3% respectively right after the implementation of the policy. In the case of 1,550,497 outpatients, the cost of Chuna therapy per capita tends to be increased by 0.4% in overall study periods and increased 28.4% immediately after the implementation of the policy. Meanwhile, the number of times and visits for Chuna therapy per capita tends to be increased by 0.4% in overall study periods but decreased by 0.4% after the implementation of the policy. Conclusion: Results suggest that if the national health insurance coverage of oriental medicine services increases according to the policy stance for benefit expansion in national health insurance, the criteria for providing national health insurance benefits should be considered with the comprehensive impacts on the costs and service uses of automobile insurance.

• The Korean Journal of Applied Statistics
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• v.29 no.1
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• pp.145-155
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• 2016

In this paper, we compare forecasting models for disease occurrences in elderly patients due to the weather. For the analysis, the medical data of aged patients released from Health Insurance Review and the weather data of the Korea Meteorological Administration are weekly and regionally merged. The ARMAX model, the VARMAX model and the TSCS regression model are considered to analyze the number of weekly occurrences of some diseases attributable to climate conditions. These models are compared with MSE, MAPE, and MAE criteria.

• Proceedings of the Korea Information Processing Society Conference
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• 2013.11a
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• pp.786-789
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• 2013

개인정보가 포함된 데이터가 많은 기관에서 다양한 목적을 위해 배포되고 있다. 이러한 공개 데이터는 프라이버시 문제를 야기할 수 있기 때문에, 배포에 앞서 항상 데이터에 대한 프라이버시 보호가 고려되어야 한다. 그러나 현재 배포되는 많은 데이터는 충분하지 못한 프라이버시 보호 과정을 거쳐 배포되고 있다. 이 논문에서는 개인정보를 포함하는 데이터의 프라이버시 안전성을 분석한다. 이를 위해 우리는 건강보험심사평가원에서 배포한 2011년 진료정보 통계자료(HIRA-NPS)를 실험에 사용한다. 분석을 위해 기존에 널리 쓰이는 프라이버시 보호 모델 k-익명성(k-anonymity)과 l-다양성(l-diversity)을 차용하여 안전성 판단의 척도를 정의한다. 또한 실제 데이터에 이 척도를 적용하여 프라이버시 안전성을 측정하고, 그 결과가 갖는 의미를 분석한다.

• Proceedings of the Korea Information Processing Society Conference
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• 2022.05a
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• pp.452-455
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• 2022

4차 산업혁명의 확산으로 의학계에서도 딥러닝 기술을 이용한 질병의 치료결과 예측 연구가 활발하다. 이와 관련, 일부 연구에서 국소적인 환자 데이터의 활용으로 인해 도출된 연구 결과의 일반화가 어려웠으며 예측률 제고를 위해 특정 딥러닝 알고리즘을 중심으로 한 실험이 추진되어 다양한 알고리즘별 예측률의 비교·분석 결과를 제시하는 연구도 미흡하였다. 이에, 건강보험심사평가원의 대규모 진료 정보와 다종의 알고리즘을 제공하는 AutoML을 이용, 사망률이 높은 80대·90대 노령자 대상 폐암 진단 후 84개월간의 사망률을 예측하는 Decision Tree 등 5개 알고리즘별 모델을 생성하고 이를 활용, 사망률의 예측 성능을 비교하고 사망률에 영향을 미치는 요인에 대한 분석 결과를 도출하였다.

• Journal of Digital Convergence
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• v.10 no.1
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• pp.407-412
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• 2012

From Jan. 1 2009 to Mar. 31 2009, a study surveyed 295 national clinic medical institutions that was newly enrolled in Health Insurance Review and Assessment Service to identify the factors depending on whether the administrative personnel influences on the management of the clinic medical institutions. The survey showed that the medical institutions with administrative personnels affected more adjustments than those without administrative personnels and it appeared to be statistically significant except one time(p<0.01). The result of the survey tells whether the administrative personnel is or not in medical institutions has important effects on the reduction. So, it is considered that the placement of administrative specialists in the hospital is very important for medical institutions.

• Korean Journal of Clinical Pharmacy
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• v.21 no.2
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• pp.156-160
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• 2011

서론: 본 연구는 불필요한 소화기관용 약제의 처방이 한국에서의 처방전 당 약물 개수를 증가시키는 것과의 연관성을 검토하고자 수행되었다. 연구방법: 연구를 위한 자료로 건강보험심사평가원의 처방전 데이터와 환자의 기타 모든 의료보험 청구데이터를 이용하였고, 두 데이터셋을 연결하여 처방전들을 소화기관용 약제의 필요성에 따라 소화기관질환 그룹, 관절염질환 그룹,소화기관용 약제 처방이 불필요할 것으로 그 외 질환 그룹으로 구분, 분리하였다. 결과: 처방전 당 약물의 평균 개수의 분포는 세 그룹에서 비슷한 양상을 보였는데, 관절염질환 그룹과 그 외 질환 그룹의 거의 절반 이상은 한 개의 소화기관용 약제를 포함하였다. 세 그룹 모두 처방전 당 약물 개수와 처방전 당소화기관용 약제의 개수가 1차 선형관계를 보였다. 그 외 질환 그룹에서는 처방전 당 전체 약물이 평균 6개를 넘는 경우, 적어도 한 개의 소화기관용 약제가 포함되었다. 본 연구는 불필요한 소화기관용 약제를 처방하는 것은 다제처방의 매우 유의한 예측인자임을 보였다. 결론: 향후, 약제 처방전의 질을 향상시키기 위해서는 각각의 약물을, 특히 소화기관용 약제를, 처방 시 약제의 불가피한 필요성에 대해 판단할 수 있어야 할 것이다.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.195-218
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• 2017

The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system.