• Title/Summary/Keyword: 총 진료비

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Medical Expenditure Attributable to Overweight and Obesity in Adults with Hypertension, Diabetes and Dyslipidemia : Evidence from Korea National Health and Nutrition Examination Survey Data and Korea National Health Corporation Data (성인의 고혈압, 당뇨병, 이상지질혈증으로 인한 총 진료비 중 과체중 및 비만의 기여분 : 국민건강영양조사자료와 국민건강보험공단 자료를 중심으로)

  • Kang, Jae-Heon;Jeong, Baek-Geun;Cho, Young-Gyu;Song, Hye-Ryoung;Kim, Kyung-A
    • Journal of agricultural medicine and community health
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    • v.35 no.1
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    • pp.77-88
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    • 2010
  • Objectives: This study was conducted to estimate medical expenditure attributable to overweight and obesity in adults with hypertension, diabetes and dyslipidemia using Korea National Health and Nutrition Examination survey data and Korea National Health Corporation data. Methods: The medical expenditure of hypertension, diabetes and dyslipidemia related to overweight and obesity were composed of inpatient care costs, outpatient care costs and medication costs. The population attributable risk (PAR) of overweight and obesity was calculated from national representative data of Korea such as the National Health Insurance Corporation cohort data and 2005 Korea National Health and Nutrition Examination survey data. Results: The medical expenditure attributable to overweight and obesity of hypertension were 456 billion won (men : 215 billion won, women : 241 billion won). Those of diabetes were 282 billion won (men : 148 billion won, women : 135 billion won), and of dyslipidemia were 17 billion won (men : 9 billion won, women : 8 billion won). Consequently, these costs corresponded to 33.3% of total medical expenditure due to hypertension, diabetes and dyslipidemia. Conclusions: We found a substantial medical expenditure due to overweight and obesity of hypertension, diabetes and dyslipidemia were very high. In order to reduce these costs, effective national strategies for prevention and management of overweight and obesity should be established and implemented.

Study of Management and Environmental Factors Affecting Medical Expense Reduction (의료기관 운영요인과 환경요인이 진료비 삭감율에 미치는 영향에 관한 연구)

  • Yang, Yu-Jeong
    • Journal of Digital Convergence
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    • v.10 no.11
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    • pp.493-502
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    • 2012
  • This study aimed to determine the management and environmental factors affecting medical expense reduction. For analysis, medical expenses were divided into hospitalization expenses and outpatient treatment expenses, and the rate of medical expense reduction was classified into initial and final reduction rates. Data were collected through a direct survey among 205 directors of independent health insurance review departments of hospital-level medical institutions in Korea. The results of the study are discussed below: In the analysis, differences in the initial and final reduction rates of hospitalization expenses and outpatient treatment expenses were compared. The results showed that, in hospitalization expenses, the initial and final reduction rates were both significantly affected by the following management factors: number of beds, number of departments, number of personnel reviewing health insurance cases, and total number of employees. Further, in outpatient treatment expenses, the initial and final reduction rates were both affected significantly by the following management factors: management of medical records, number of beds, number of departments, number of personnel reviewing health insurance, and total number of employees. The management factors significantly affecting both the initial and final reduction rates were higher number of beds for hospitalization expenses and electronic medical record management for outpatient treatment expenses. The environmental factors significantly affecting both the initial and final reduction rates of hospitalization expenses were a highly cooperative work environment, better implementation of indicator management systems, and overtime pay. Better implementation of indicator management system and a committee for handling medical expenses had significant effects on the initial reduction rate for outpatient treatment expenses. A highly cooperative work environment, better implementation of indicator management system, and overtime pay had significant effects on the final reduction rate for outpatient treatment expenses.

Trend of Medical Care Utilization and Medical Expenditure of the Elderly Cohort (노인 코호트의 의료이용 및 입원진료비 변화 추이 -공.교 의료보험 대상자를 대상으로-)

  • Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.2 s.57
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    • pp.437-461
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    • 1997
  • Because of a significant improvement in the economic situation and development of scientific techniques in Korea during the last 30 years, the life expectancy of the Korean people has lengthened considerably and as a result, the number of the elderly has markedly increased. Such an increase of the number of aged population brought about many social, economic, and medical problems which were never seriously considered before. This study was conducted to assess the trend of medical care utilization and medical expenditure of the elderly. The data of each patient in the study were taken from computer database maintained for administrative purpose by the Korea Medical Insurance Corporation. The study population was 132,670 who were 60 years old or more and registered in Korean Medical Insurance Corporation from 1989 to 1993. The study subjects were predominantly female(56.3%) and 10,000-20,000 Won premium group(50.6%). The following are summaries of findings : The total increase of the number of inpatient cases was 40.5% from 1989 through 1993. The average annual increase was 3.7% in inpatient medical expenditures per case, 4.4% in inpatient medical expenditures per day and 0.08% in length of stay per case from 1989 through 1993. Cataract was the most prevalent disease of 10 leading frequent diseases in all ages from 1989 through 1993. The case mix in 1993 compared to 1989 revealed that cataract and ischemic cerebral disease were increased whereas essential hypertension and pulmonary tuberculosis were decreased . The average annual increase of medical expenditures was 3.8% in general hospitals, 6.3% in hospitals and 2.4% in clinics. From 1989 through 1993, medical expenditures used by high-cost patients accounted for about 14% to 20% of all expenditures for inpatient care, while they represented less than 2.5% of the elderly population. Time series analysis revealed that total medical expenditures and doctor's fee for inpatient will be progressively increased whereas drug expenditures for inpatient will be decreased. And there will be no change in length of stay. Based on the above results, the factors increasing medical cost and utilization should be identified and the method of cost containment for the elderly health care should be developed systematically.

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A study of the impacts of medical institution information on daily medical expenses and medical expense reduction rate in convergence age (융복합시대에 의료기관 정보가 일당진료비와 삭감율에 미치는 영향에 관한 연구)

  • Yang, Yu-Jeong;Lee, Hye-Seung
    • Journal of Digital Convergence
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    • v.13 no.7
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    • pp.259-268
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    • 2015
  • This research grasped the difference of between the daily medical expenses and the medical expenses reduction rate also the cause of change. In the centre, it was conducted in order to offer the necessary basic data to a recuperation pay management solution's establishment. This research surveyed across the country's urban region 50-general hospital's the infective enteritis disease for a year. Then it was conducted the average daily medical expenses and the average medical expenses reduction rate as a distinguishable survey that is a hospitalization and an outpatient the result is followed. The inpatient daily medical expenses correlated with the total number of medical institution personnel, and the outpatient daily medical expenses correlated with the number of beds.. Inpatient medical expense reduction rate was correlated with number of beds and the total number of medical institution personnel. The interaction between medical institution information and daily medical expenses was found to have a positive (+) effect on the total number of medical institution personnel, as well as the numbers of inpatients vs. outpatient. This research about the medical expense reduction rate and daily medical expense help medical institution's efficient, rational decision making and it will be an important basis of a priority recuperation pay's policy.

Association of Lifestyle with Blood Pressure (생활양식과 혈압의 관련성)

  • Joo, Ree;Chung, Jong-Hak
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.497-507
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    • 1997
  • This study was conducted to evaluate the association of various lifestyle with blood pressure. The data were obtained from the individuals who got routine health examination in Department of Occupational Medicine, Yeungnam University Hospital from June to September, 1996. Among these people, we selected 130 cases of hypertensives (97 males, 33 females) and 150 normotensives(70 males, 80 females) and study was conducted. The authors collected the information of the risk factors related to hypertension such as age, family history of hypertension, fasting blood sugar, serum total cholesterol, alcohol consumption(g/week), smoking history, relative amount of salt intake (low, moderate, high), the frequency' of weekly meat consumption, BMI, daily coffee consumption(cups/day) and the frequency of regular exercise(frequency/week) through questionnaire and laboratory test. By simple analysis, BMI was significantly associated with hypertension in male(p<0.05), and the frequency of weekly meat consumption was significantly associated with hypertension in female(p<0.05). Using logistic regression model, elevated odds ratio was noted for fasting blood sugar, serum total cholesterol, family history of hypertension, alcohol consumption, salt intake and BMI, and reduced odds ratio was noted for coffee consumption and exercise in male but fasting blood sugar(odds ratio=1.022, 95% CI=1.000-1.044), family history in both of parents(odds ratio=3.301, 95% CI=1.864-4.738), salt intake(odds ratio=1.690, 95% CI=1.082-2.298) and BMI(odds ratio=1.204, 95% CI=1.065-1.343) were statistically significant(p<0.05). In female, elevated odds ratio was noted in serum total choles terol, family history of hypertension, BMI and meat consumption. Of all these variables, the family history of hypertension in either of parents(odds ratio=4.981, 95% CI=3.650-6.312), family history in both of parents(odds ratio=16.864, 95% CI=14.577-19.151), BMI(odds ratio=1.167, 95% CI=1.016-1.318) and meat consumption(odds ratio=2.045, 95% CI=1.133-2.963) showed statistically significant association with hypertension in female(p<0.05).

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Impact of Competition on Physician Behavior Clinics - Focused on Acute Otitis Media in Children - (의원급 의료기관 간 경쟁이 진료행태에 미치는 영향 - 유·소아 급성중이염 중심 융합연구 -)

  • Lee, Chae-Kyung;Suh, Won-Sik
    • Journal of the Korea Convergence Society
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    • v.9 no.1
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    • pp.151-159
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    • 2018
  • This study analyzes the impact of competitions clinics on the total treatment cost and anti-biotics prescription rate. The result of implementing the basic statistics, correlations, and regression analysis by facilitating the evaluation data by Health Insurance Review & Assessment Service in 2015 for acute otitis media in children is shown as follows. First, there is a significant difference for each si-gun-gu for the competition index between total treatment cost and clinics, but there is almost no significant difference for the anti-biotics prescription rate. Second, competition in clinics has statistically important impact on the total examination cost And, third, competition in clinics has no statistically important impact on the anti-biotics prescription rate. There is a need for additional studies on re-examination rate, treatment cost per visit and so forth in order to clarify other factors of competition for medical institutions impacting on the physician behavior in the future studies.

당뇨병 치료의 미래

  • Kim, Sin-Gon
    • The Monthly Diabetes
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    • s.286
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    • pp.10-15
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    • 2013
  • 당뇨병은 이제 하나의 사회적 유행병으로 우리에게 다가오고 있다. 지난 30여년간 당뇨병으로 인한 유병률이 6-7배 증가하였는데, 이 증가 속도는 선진국들의 그것 보다 훨씬 빨라 조만간 우리나라의 당뇨병 유병률이 OECD 국가 중 최고 수준에 이를 수도 있음을 보여준다. 또한 우리나라 당뇨병의 합병증은 무척 흔해 새로 신대체요법을 받는 환자들의 70.5%에서 당뇨병이 동반되어 있을 정도이다. 당뇨병으로 인한 사망도 급속히 늘어 최근 20년간 3배가 증가하였으며 이제 우리나라 사망원인의 4위를 차지하게 되었다. 그 결과로 당뇨병으로 인한 의료비용 지출도 늘어 최근 10여년간 당뇨병 관련 총 진료비가 7배 증가하였으며, 전체 건강보험 총 진료비의 5분의 1을 점유할 정도가 되었다.

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Factors Affecting Medical Treatment and Expenses for the Inpatients under Coverage of Car Insurance by Traffic Accident (교통사고로 인한 자동차보험 입원환자의 진료현황과 진료비 특성 분석)

  • Ko, Min-Seok;Choi, Joon-Young;Kim, Seung-Hee
    • The Journal of the Korea Contents Association
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    • v.11 no.11
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    • pp.274-285
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    • 2011
  • This study deals with an analysis into the details of medical treatment and expenses by items of treatment as well as the factors related to the ratio between the medical treatment and expenses for 1583 patients who were hospitalized in and discharged from 2 general hospitals located at a city under the coverage of car insurance during the year 2009. As a result, there was statistically significant difference in the details of medical treatment and expenses by items of treatment as well as their composition ratio depending on the individual characters as sex, age and the number of days staying in hospital. Each medical institution should conduct a close analysis of its patients under the car insurance program as well as the factors related to medical expenses with a view to utilize them as basic data for mapping out plans for effective operation of its organization in consideration of the characters as a medicalinstitution.

Changes in the Hosptal Length of Stay and Medical Cost between before and after the Applications of the DRG payment system using Health Insurance Big Data (건강보험 빅 데이터를 활용한 종합병원에서의 포괄수가제 적용 전·후 재원일수와 진료비의 변화)

  • Jeong, Su-Jin;Choi, Seong-Woo
    • The Journal of the Korea institute of electronic communication sciences
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    • v.12 no.2
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    • pp.401-410
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    • 2017
  • This study aimed to identify appropriateness and efficiency in the DRG payment system by analysing the hospital length of stay and changes in fees before and after the application of DRG payment system. The subjects of the study were a total of 398 patients consisting of 204 for the fee for service system and 194 for the DRG payment system. They received surgery in the Obstetrics and Gynecology (OBGY) department of a general hospital in G metropolitan city between January and December 2013. The mean hospital length of stay was significantly decreased after application of the DRG payment system(p=0.013). Total fees, insurance charges, and deductions increased significantly(p<0.001), and non-payment charges and total deductions decreased significantly(p<0.001). Application of the DRG payment system reduced length of stay, non-payment charges and total patient's cost sharing and increased out-of-pocket, insurance charges, and total fees.

Differences of Cancer Patient's Health Care Utilizations between Medical Aid Program and National Health Insurance in the Elderly (노인 암환자의 건강보험과 의료급여 이용차이 분석)

  • Lee, Yong-Jae
    • The Journal of the Korea Contents Association
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    • v.11 no.5
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    • pp.270-279
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    • 2011
  • This study to analyze differences of cancer patient's health utilizations in medical aid program and national health insurance by analysing health insurance claims data, and identify effects of health care systems. The majors results of the research were as follows. First, cancer patients in medical aid program more used total medical expenditures than in national health insurance mostly by many outpatient visits and long term hospitalization. Second, results of multiple regression, cancer patients in medical aid program more used total expenditures and inpatient expenditures. But, outpatient expenditures weren't different, cancer patients in medical aid program more visited medical institutions and hospitalized long term periods than in national health insurance. Therefore, it is too early to conclude that moral hazard is in health utilizations of medical aid program, because cancer patients in medical aid program many use in benefits for many nonbenefit burdens.