• Title/Summary/Keyword: 비용보험

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A Study on Medical Expenses of Modern and Korean Medicine for Dementia Patients Under National Health Care (한국 치매 환자의 건강보험 의·한의 진료 비용에 관한 연구)

  • Lee, Jung Bae;Kang, Hyung Won;Kim, Jaeuk;Kim, Gahye;Kim, Nam-Kwen
    • Journal of Oriental Neuropsychiatry
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    • v.30 no.1
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    • pp.31-38
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    • 2019
  • Objectives: To identify the cost effectiveness of early dementia diagnosis using the 2014 Health Insurance Review & Assessment Service-National Patients Sample (HIRA-NPS). Methods: The medical costs of dementia between Western medical care and Korean medical care were compared through the reimbursement and non-reimbursement item code for dementia examination. In addition, the medical expenses of patients with dementia and mild cognitive impairment were compared and analyzed with respect to Western and Korean medical care. Results: There were 87,434 claims, of which 16,101 patients were diagnosed with dementia and 38,680,789,560 won was found to be the medical expenses. 12,881 patients (80.0%) with dementia, 3,144 patients (19.5%) with mild cognitive impairment, and 76 patients (0.5%) progressing from mild cognitive impairment to dementia. The proportion of medical expenses was 97.6% for dementia patients, 2.3% for mild cognitive impairment, and 1% for patients progressing from mild cognitive impairment to dementia. 86,070 claims (98.4%) were from Western medical care, with16,824 patients (98.2%), and the medical expenses was 38,546,895,400 won (99.7%). 1,361 claims (1.6%) were from Korean medical care, with 303 patients (1.8%), and the medical expenses was 133,894,160 won (0.3%). Conclusions: This study compared and analyzed the medical costs of dementia patients and the diagnosis of both Korean and Western medical care. The results of this study are expected to be used as basic research data for investigating cost effectiveness of developing early diagnosis of dementia.

Analysis of Hospital-based Home Care Service Utilization Using National Health Insurance Claim Data from 2008 to 2017 (건강보험 자료를 이용한 전국 의료기관 가정간호 실시 및 이용 현황 분석: 2008년-2017년)

  • Ko, Jeong Yeon;Yoon, Ju Young
    • Journal of Home Health Care Nursing
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    • v.26 no.1
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    • pp.36-50
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    • 2019
  • Purpose: The purpose of this study is to analyze the status quo of hospital-based home care utilization in Korea from 2008 to 2017. Methods: Data from a total of 1,396 medical institutions, 350,390 patients, and 3,563 home care nurses were analyzed using claim data from the Health Insurance Review & Assessment Service. Results: The number of hospital-based home care agencies decreased from 177 in 2008 to 115 in 2014. This number started to increase in 2015 and reached 179 in 2017. The number of hospital-based home care patients declined from 35,056 in 2008 to a low of 26,848 in 2013. This number started to increase in 2014 and reached 67,863 in 2017. Essential hypertension was the most common disease among hospital-based home care patients from 2008 to 2015. The number of hospital-based home care visits declined from about 500,000 in 2008 to a low of 362,000 in 2013. This number started to increase in 2014 and reached 658,000 in 2017. Conclusion: It is necessary to vigilantly monitor hospital-based home care agencies, patients, and the utilization of services. This may help establish platforms for providing community and home-based nursing services for the super-aged society in Korea.

Demand and willing to pay for oral hygiene service in long-term care insurance of elderly (노인장기요양보험 재가급여 수급자의 구강위생서비스 요구도와 비용지불의사)

  • Kim, Han-Nah;Kim, Gi-Yon;Noh, Hie-Jin;Kim, Nam-Hee
    • Journal of Korean Academy of Oral Health
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    • v.42 no.4
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    • pp.204-209
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    • 2018
  • Objectives: This study was conducted to identify the demand and willingness to pay for oral hygiene services among elderly people with long-term care insurance. Methods: Our study was a cross-sectional analysis. Subjects comprised 126 elderly individuals from long-term home-care centers. A total of 28 centers were selected through convenience sampling from among 78 centers in ${\bigcirc}{\bigcirc}$. For analysis, semi-structured questionnaires that required about 20-30 minutes to complete were used. Analysis was performed using SPSS 23.0 software. Results: The overall demand for oral hygiene services was 44.4%, and willingness to pay was 31.0%. Thirty-three people (58.9%) of elderly those who have demand for an oral hygiene service were willing to pay for the service, and 64 people (91.4%) who did not have a demand were not willing to pay for it. Among those with partial dependence on brushing, 65.6% had demand for oral hygiene services and 50.0% were willing to pay costs. Among basic livelihood beneficiaries, 69.6% were willing to pay for oral hygiene services; general subjects and relievers were less willing to pay. Conclusions: The overall demand for oral hygiene services among elderly people was 44.4%, and the willingness to pay was as low as 31.0%.

A Study on the Legislation of Telemedicine in France (프랑스 원격의료 법제에 관한 고찰)

  • JUNG, Kwanseon
    • The Korean Society of Law and Medicine
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    • v.23 no.2
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    • pp.141-169
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    • 2022
  • Article 34 of 'Medical Service Act' of Korea provides telemedicine service between medical personnel. Telemedicine between medical personnel and patients, therefor, in principle, is not recongnized. Increasing demand for telemedicine fueled by COVID-19 pandemic and accumulation of telemedicine experience lead a change in stubborn opposition of the medical community, tenuous though it may be. This article focuses on the telemedicine legislation in France, which can be used as a reference for the telemedicine legislation premised on telemedicine between medical personnel and patients. The legislation stipulates the concept, types, and conditions of telemedicine performance through 'Code de la santé publique'. The principle that telemedicine shall be performed alternately with direct medical treatment to a patient and details relating to such telemedicine performance as telemedicine costs, medical fees, and telemedicine equipment support are stipulated through an agreement between the medical community and health insurance organizations. From this point, the implications for our legal system were presented.

Domestic polysomnography operation status and problem analysis -Focusing on the characteristics of each type of medical institution- (국내 수면다원검사 운영현황 및 문제점 분석 -의료기관 유형별 특징을 중심으로-)

  • YU, TAE GYU
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.1
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    • pp.443-448
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    • 2023
  • Over the past five years, the number of patients with sleep disorders has increased by about 250,000 from 840,000 in 2017 to 1.09 million in 2021. In addition, sleep disorder is a factor that causes dementia risk factors, and furthermore, the population with sleep disorder is a very important policy issue in terms of stable health insurance financial management in the future in terms of national health management in the super-aging trend. Therefore, this study aims to establish an efficient treatment environment in medical institutions responsible for the current status of polysomnography and effective reimbursement policies for the recently increasing population with sleep disorders, and appropriate sleep management policies for future sleep disorders through correct implementation. We are trying to find out the actual condition and improvement plan through interviews with related organizations and experts.

A Study on Effect of B/L's Exemption Clauses Relating to the Governing Law of English Law (영국법의 준거법과 관련한 선하증권 면책약관의 효력에 관한 연구)

  • Han, Nak-Hyun;Jung, Jun-Sik
    • Journal of Korea Port Economic Association
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    • v.22 no.4
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    • pp.1-17
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    • 2006
  • In the Bill of Lading of The Irbenskiy Proliv is not subject to the Hague-Visby Rules in accordance with paragraphs (A) and/or (E) of cl.1 or to the Hague Rules in accordance with paragraphs (B) and/or (D) of cl.1. The Irbenskiy Proliv is very rare case that is effective to exempt the carrier as literal words of Bill of Lading. The action concerns cargoes of perishable goods shipped from Brazil to Japan, under Bills of Lading each of which contained an extensive carrier's exemption clause. A preliminary issue was ordered to be determined on the question whether c1.4 is effective to exempt the ralliers from any potential liability for the claims in this case. The court held that there is no reason to reject c1.4 as part of each of the contracts contained in or evidenced by the bills of lading; and it protects the carrier where damage to the goods shipped results from such causes. It is therefore effective to exempt the carriers from any potential liability for those claims.

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A Case Study on Forecasting Inbound Calls of Motor Insurance Company Using Interactive Data Mining Technique (대화식 데이터 마이닝 기법을 활용한 자동차 보험사의 인입 콜량 예측 사례)

  • Baek, Woong;Kim, Nam-Gyu
    • Journal of Intelligence and Information Systems
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    • v.16 no.3
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    • pp.99-120
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    • 2010
  • Due to the wide spread of customers' frequent access of non face-to-face services, there have been many attempts to improve customer satisfaction using huge amounts of data accumulated throughnon face-to-face channels. Usually, a call center is regarded to be one of the most representative non-faced channels. Therefore, it is important that a call center has enough agents to offer high level customer satisfaction. However, managing too many agents would increase the operational costs of a call center by increasing labor costs. Therefore, predicting and calculating the appropriate size of human resources of a call center is one of the most critical success factors of call center management. For this reason, most call centers are currently establishing a department of WFM(Work Force Management) to estimate the appropriate number of agents and to direct much effort to predict the volume of inbound calls. In real world applications, inbound call prediction is usually performed based on the intuition and experience of a domain expert. In other words, a domain expert usually predicts the volume of calls by calculating the average call of some periods and adjusting the average according tohis/her subjective estimation. However, this kind of approach has radical limitations in that the result of prediction might be strongly affected by the expert's personal experience and competence. It is often the case that a domain expert may predict inbound calls quite differently from anotherif the two experts have mutually different opinions on selecting influential variables and priorities among the variables. Moreover, it is almost impossible to logically clarify the process of expert's subjective prediction. Currently, to overcome the limitations of subjective call prediction, most call centers are adopting a WFMS(Workforce Management System) package in which expert's best practices are systemized. With WFMS, a user can predict the volume of calls by calculating the average call of each day of the week, excluding some eventful days. However, WFMS costs too much capital during the early stage of system establishment. Moreover, it is hard to reflect new information ontothe system when some factors affecting the amount of calls have been changed. In this paper, we attempt to devise a new model for predicting inbound calls that is not only based on theoretical background but also easily applicable to real world applications. Our model was mainly developed by the interactive decision tree technique, one of the most popular techniques in data mining. Therefore, we expect that our model can predict inbound calls automatically based on historical data, and it can utilize expert's domain knowledge during the process of tree construction. To analyze the accuracy of our model, we performed intensive experiments on a real case of one of the largest car insurance companies in Korea. In the case study, the prediction accuracy of the devised two models and traditional WFMS are analyzed with respect to the various error rates allowable. The experiments reveal that our data mining-based two models outperform WFMS in terms of predicting the amount of accident calls and fault calls in most experimental situations examined.

Effect of the Mixing Ratio of Pot Media on the Germination and Early Growth in Vegetable crops (배양토 조성비율이 채소작물의 발아 및 초기 생장에 미치는 영향)

  • Oh, Tae-Seok;Kim, Chang-Ho
    • Korean Journal of Organic Agriculture
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    • v.15 no.3
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    • pp.319-330
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    • 2007
  • This study analyzed physical and chemical characteristics of peat soil to use peat soil as the materials fur pot media and investigated seedling quality of horticultural plants in order to use peat soil as the raw materials fur pot media. The summary of the results is as follows; The chemical characteristics of peat soil, which is main ingredient of pot media are as follows; pH was 4.9, EC was less than $2.0ds{\cdot}m^{-1}$, which interferes the growth of the plant and organic ingredient was 33%. When looking into the germination characteristics of plants according to the mixture of pot media, red pepper showed 54.2% speed of germination and 97% germination rate in peat soil single treatment. Therefore the peatsoil was appropriate for the pot media for red pepper. In case of cucumbers, in the 50 : 50 treatment of main ingredient (peat soil) and auxiliary ingredients (vermiculite, peat moss and perlite) they showed 100% speed of germination and 100% germination rate. Therefore 50 : 50 treatment was appropriate fur the pot media for cucumbers. In case of chinese cabbage, peat soil, perlite and peat moss mixture (50 : 25 : 25) treatment showed the highest speed of germination (77.5%), while the germination rate was a little lower (92.15%) than comparative soil. However, it was appropriate for the pot media for chinese cabbage. In case of watermelon, germination was bad because of the influence of EC when the teat soil ingredient is over 80%. However, in the mixture of peat soil and vermiculite (50:50) treatment, they showed 91.6% speed of germination and 100% germination rate. Therefore it was appropriate for the pot media for watermelon. When looking into the growth of the plants according to the mixture of ingredients, peat soil and perlite (50:50) mixture showed excellent seedling quality for cucumbers, peat soil and perlite (50:50) mixture showed excellent seedling quality and it was proven to be appropriate for the pot media for cucumbers. In case of watermelon, peat soil, peat moss and perlite (80 : 10 : 10) mixture showed excellent seedling quality and it was proven to be appropriate for the pot media for watermelon.

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The Clinical and Cost Effectiveness of Medical Nutrition Therapy for Patients with Type 2 Diabetes Mellitus (제2형 당뇨병환자에서 임상영앙치료의 임상적 효과와 비용효과 연구)

  • Cho, Youn-Yun;Lee, Moon-Kyu;Jang, Hak-Chul;Rha, Mi-Yong;Kim, Ji-Young;Park, Young-Mi;Sohn, Cheong-Min
    • Journal of Nutrition and Health
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    • v.41 no.2
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    • pp.147-155
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    • 2008
  • Medical nutrition therapy (MNT) is considered a keystone of medical treatment of chronic diseases. However, only few studies have evaluated medical and economical outcome of MNT. The study was performed on the patient with type 2 diabetes mellitus to evaluate the effect of clinical and cost-effective outcomes of MNT. Subjects from two general hospitals were randomly assigned to two different groups; One receiving basic nutritional education (BE) (n = 35), and the other receiving intensive nutritional education (IE) (n = 32) for a 6-month clinical trial. The group which received BE had a single visit with a dietitian, while the other group which received IE had an initial visit with a dietitian addition to two visits during the first 4 weeks of the study periods. Anthropometric parameters, blood components, and dietary intake were measures at the beginning of study period and after 6 month. Cost-effective analysis included direct labor costs, educational materials and medication cost difference during 6 months. After 6 month, subjects from IE group showed significant reduction of body weight (p <0.05) and systolic blood pressure (p <0.05), whereas BE group did not show any significant changes. Result from biochemical indices showed glycated hemoglobin concentration was significantly reduced by 0.7% (p <0.05) only in the IE group. The ratio of energy intake to prescribed energy intake decreased significantly in both groups (p <0.05). Mean time taken for a dietitian to educate the subject was 67.9 ${\pm}$ 9.3 min/person for BE group, while 96.4 ${\pm}$ 12.2 min/person for IE group. Mean number of educational materials was 1.9 ${\pm}$ 0.7/person for BE group and 2.5 ${\pm}$ 0.7/person for IE group. Change in glycated hemoglobin level along the 6 month period of study can be achieved with an investment of \88,510/% by implementing BE and \53,691/% by implementing IE. Considering the net cost-effect of blood glucose control and HbA Ic, IE which provides MNT by dietitian had a cost efficiency advantage than that of BE. According to this study, MNT provided by dietitian had a significant improvements in medical and clinical outcomes compared to that of BE intervention. Therefore, MNT protocol should be performed by systemic intensive nutrition care by dietitian in clinical setting to achieve good therapeutic results of DM with lower cost.

Study on Influence of Water Fluoridation Program on the Economic Benefit (상수도수불화사업의 경제적 편익에 대한 조사연구)

  • Park, Myung-Suk;Yoo, Wang-Keun
    • Journal of dental hygiene science
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    • v.6 no.2
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    • pp.133-138
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    • 2006
  • To find out influence of water fluoridation program on the economic benefit effect, this study analyzed comparatively dental treatment indicators obtained from dental clinics at Sangdang-gu in Chenongju City, fluoridated community and Manan-gu in Anyang City, non-fluoridated community, from January 1, 2003 to the end of June, and the results are as follows: 1. If water fluoridation program is carried out in Anyang, non-fluoridated community, the number of treatment from caries and disease of tissues around dental pulp and root apex from age 6 to 18 for the first half of year 2003 is expected to decrease by 1,272, 636 for low estimation, and 1,908 for high estimation. And the treatment cost is expected to decrease by 40,888,000 Wons, 20,444,000 Wons for low estimation, and 61,333,000 Wons for high estimation. 2. Assuming that water fluoridation program is spread to all over the country, the number of treatment per year is expected to decrease by 2,492,018, 1,246,009 for low estimation, and 3,738,027 for high estimation. And the treatment cost is expected to decrease by 80,105,075,000 Wons, 40,052,537,000 Wons for low estimation and 120, 157,612,000 Wons for high estimation respectively. 3. For Yeong-un water supply management office which has 48,925 water supply personnel, the benefit/cost rate was 2.9 times, and for Jibuk water supply management office which has 239,751 water supply personnel, the benefit/cost rate was 9.0 times. As the water supply personnel increased, the cost increase of water fluoridation program was little and as the scale got large, the economic effect was very large. Improving national oral health is thought to be associated with expense retrenchment of oral health insurance financial. So it may need to extend using tap water to all the area of the country and additionally establish confidence through an active public relations and education of water fluoridation program.

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