• Health Policy and Management
• /
• v.17 no.2
• /
• pp.52-67
• /
• 2007

Korean government is preparing the long-term care financing and delivery system in order to cope with rapid population aging. The system should be designed to provide demented patients with an appropriate services that the patients want to take, and considered to be necessary for them. In this regard, this study aims to analyse empirically a relationship between the types of long-term care services that demented patients wanted to take and they actually received during 2004. The caregivers of 609 dementia patients, who were randomly selected in a manner of proportional allocation from a nationwide claim database of the Korean National Health Insurance Corporation, were interviewed in September, 2005. Independent variables include socio-demographic characteristics, Activities of Daily Living(ADL) and Instrumental Activities of Daily Living(IADL). To explore the correspondence of the types of long-term care services that demented patients wanted to take and that they actually received, and its affecting factors, we conducted chi-square test and logistic regression analysis. Main findings are as follows. First, while only 20% of study subjects wanted home services as a long-term care services, those who wanted to use the long-term care facilities and general hospital were 37%, 43% respectively. Second, the correspondence rate was just 38% on average, and extremely low in the demented patients who wanted to use long-term care facilities. Third, the demented patients who resided in urban areas and received relatively high level of education showed high correspondence rate. Fourth, the high ADL score was closely related to low correspondence rate.

• Korea Journal of Hospital Management
• /
• v.12 no.2
• /
• pp.1-24
• /
• 2007

The medical fee reimbursement denied by HIRA(Health Insurance Review Agency) amounted to about 1.2% of the total medical fee claim to HIRA for reimbursement. Most of the denials stem from the inappropriate prescriptions of medical staff violating the medical fee review standards issued by HIRA. Considering the significant impacts of the standards observance behavior on the hospitals' financial viability, we attempted to analyze the predisposition factors of medical staffs' review standards observance behavior. The TPB(Theory of Planned Behavior) was adopted as the theoretical framework of the analysis. Data were collected by administrating a survey on the concepts included in TPB model to the 187 medical staff of a tertiary care hospital. Of the 187 questionaries distributed, 150 were responded resulting 80.2% of response rate. The mean differences among the groups classified by age group, years of experience, medical specialty and gender were analysis using ANOVA. The relationships among the TPB concepts were analysed by applying the Structural Equations Modeling method. The TPB model consists of three exogenous concepts (attitude toward the behavior, subjective norm, and perceived behavioral control) and two endogenous concepts (intention and the behavior). The results of ANOVA indicated significant mean differences among the groups classified by the medical staff's age, years of experience, and medical specialty. The older and the more experienced had the higher mean of observance behavior score. The results of Structural Equations analysis showed that the subjective norm and perceived behavioral control had statistically significant influences on intention, but the influence of attitude to intention was not statistically significant. The influences of perceived behavioral control and intention on behavior were significant. Based on these results the theoretical and practical implications were discussed.

• Korean Journal of Occupational Health Nursing
• /
• v.17 no.1
• /
• pp.86-95
• /
• 2008

Purpose: The objectives for this study are to produce the comprehensive management indexes and find their application strategies for appropriate medical care in primary care clinics under workers' compensation insurance. Method: Data of this study was workers' compensation insurance medical fees claim's data from July 2006 to June 2007. Data were analyzed using SAS 9.1 version by applying descriptive statistics and Pearson's correlation. The indexes such as costliness index(CI), standard medical fee were calculated based on the fourth revision of korean classification of diseases(KCD-4.). Results: The CI, visiting index(VI), outliers index(OI), and medical review adjustment percentage were positively correlated in the both inpatient and outpatient medical fees in primary care clinics under workers' compensation insurance. The major medical specialities were neurological surgery, general medicine, general surgery, rehabitational medicine, and orthopedic surgery. The CIs were slightly high in rehabitational medicine among major medical specialities. The CIs were mostly high in diagnosis, test, anesthesia, and rehabitational assistive device fees among major medical specialities. The CIs were slightly high in Kwangju, Daegu, Daejeon, and Busan districts among district management centers of Korea Workers' Compensation and Welfare Service. Conclusions: We suggest the continuous development of appropriate disease classification system and medical care quality indicators to successfully take root the comprehensive management for appropriate medical care under workers' compensation.

• Journal of Digital Convergence
• /
• v.11 no.10
• /
• pp.593-608
• /
• 2013

According to increasing number of injury claims, the challenge is reducing investigation of cases of injuries by selecting them more delicately, while also increasing the redemption rates and the amount of restitution. In this regards, we developed the fraud detection model for injury claims of self-employed insured by using decision tree after collecting medical claim data from 2006 to 2011 of the National Health Insurance in Korea. As a result of this model, subject types were classified into 18 types. If applying these types to the actual survey compared with if not applying, the redumption collecting rate will be increasing by 12.8%. Also, the effectiveness of this model will be maximize when the number of claims handlers considering their survey volume and management plans are examined thoroughly.

• Korean Journal of Construction Engineering and Management
• /
• v.10 no.5
• /
• pp.85-94
• /
• 2009

For the purpose of analysing the capability (knowledge, experience, and ability) of CM at Risk in the major construction company in korea, this study performed questionnaire survey with experts in the companies. Based on the analysis of the survey, the study was found as follows. 1) It is needed to increase the capability of preconstruction services, such as project management plan/manual, contract documents, value engineering, alternative analysis, time management, and claim. 2) Despite of gap of the capability between the present and the future CM services, the study concluded that the capability is sufficient to perform CM at Risk project in the major construction company.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.11 no.11
• /
• pp.4282-4290
• /
• 2010

Recently, business environment is spreading from singular business to supply-chain problem. SCM(Supply Chain Management) is changing from closed and static to opened and dynamic environment, so these environment changes of SCM require to enterprise different approach than past. As supply chain is becoming opened and dynamic, a claim is being naming that converse of real-time the get reaction from to recognizing the level of supply chain problem, grope of alternative plan to solving this problem and choosing optimum alternative plan raise the enterprise competitive. But until present, the research to deal with these changes of SCM is on insufficient situation. Thus in this paper proposes the agent system by a way of realizing dynamic supply chain. The agent is going to accomplish the management activities in real-time depends on environment and given condition and designed for solving problems development and maintenance. Also, algorithms performance of the agent is tested on TAC SCM environment. Agents in TAC SCM are simulations of small manufacturers, who must compete with each other for both supplies and customers, and manage inventories and production facilities.

• Journal of the Health Care and Life Science
• /
• v.8 no.2
• /
• pp.83-93
• /
• 2020

In this study, a practical model for health information management education using the EMR education system at universities for nurturing health care information managers was studied. Currently, there is no practical training course for health care information management in the standards for evaluation and certification of health care information management education introduced to strengthen the job competency of health care information managers. Accordingly, the program was constructed so that the practice program suggested as an educational environment in the Health and Medical Information Management Education Evaluation and Certification Manual can be practiced in the EMR education system. In addition, a practical model that can be performed according to the on-site practice guidelines for health and medical information management for each program was studied. Using the health care information management education EMR system, master data management, patient registration, doctor prescription, medical cost calculation, health insurance claim management, form management, discharge registration, cancer registration, unrecorded management, health care data management, health care statistics, A practice model was studied so that practice on information protection/security management can be performed. It will be possible to play a role as a health care information management expert by raising the quality level of health care information management education through systematic and standardized health care information management practice courses at universities. Accordingly, it is necessary to cultivate health care information management experts who develop and manage medical services based on medical data analysis through practical training of health care information managers.

• Korea Journal of Hospital Management
• /
• v.11 no.2
• /
• pp.61-86
• /
• 2006

Based on a previous literature about hospital capital structure(Shyam- Sunder & Myers, 1999), this study attempted comparison and analysis on whether the forecast of trade-off and pecking order theory could be validated in hospital's capital structure. First, this study analyzed whether hospitals follow the priority for each capital source as suggested by pecking order theory under lack of capital running in hospital. Next, it analyzed whether debt level is regressed on the average to target debt level so as to verify the validity of trade-off theory. Finally, it also analyzed possible associations between debt level and determinants of capital structure as adopted in static trade-off theory, so as to verify relative advantages of these two theories about hospital capital structure. The analysis over whole period showed that both trade-off theory and pecking order theory isn't supported particularly. This mean that each hospital's financing behaviors is different and that has not dominant financing behaviors. In the midst of separation of dispensary from medical practice, medical institutions in Korea first finances funds required using retained earnings and then use liabilities. however pecking order theory is supported, the preference of long-term liabilities and short-term liabilities is not clear. In addition, considering that debt level is in no average regression to target debt ratio, it is found that hospital capital structure following trade-off theory turns into that subject to pecking order theory via the separation of dispensary from medical practice.

• KSCE Journal of Civil and Environmental Engineering Research
• /
• v.32 no.3D
• /
• pp.239-245
• /
• 2012

The necessity of professional construction management has been increased as a construction project is getting larger, more complex and specialized. Thus, the CM market has steadily expanded since 1996 in Korea. Despite the external expanding of the CM market, experts claim that domestic CM regulations and infrastructures should be revised. Therefore, this paper developed a causal map which consists of elements vitalizing CM market. Then, the simulation model using NUMBER (Normalized Unit Modeling by Elementary Relationships) to predict the size of the CM market is established. As a result, in the case of more regulation related CM, the quantity of CM projects could not reach of construction supervision until 2020. This paper can be used as a baseline providing a prospection of the change of CM market according to causal relation between the improvement as well as the base of revitalization research of CM market based on non-institutional factors change.

• Proceedings of the Korean Institute of Building Construction Conference
• /
• 2005.05a
• /
• pp.141-147
• /
• 2005

Usually, processing whole project or a part of frame work delays due to acceleration, changing orders, management, characters of project. overtime, worker crowding, early occupation in the field of construction. Through a whole project, these factors cause decreasing construction labor-productivity which is the most dependent in business of construction. These kind of decreasing of construction labor-productivity cause many negative effects, just as extension of time, increasing cost in project of construction. Regardless of characters of construction or decreasing labor-productivity, extension of time is a incident which needs acceleration, also it cause a high possibility of claim and dispute. The productivity has just a broad meaning in business of construction. That's why it's difficult to apply in the field of construction. Especially, factors increasing or decreasing labor-productivity is defined by analysis of working as qualitative and outlined evaluation. However, study of the each factor decreasing construction labor-productivity analysis has not researched, because of difficulty of systematic measurement and management. The existed studies about management of productivity are just focused on estimation of productivity, not on evaluation of productivity. It was true that I couldn't examine clearly about the analysis of how much important per each the factor which have influence on labor-productivity because of the characteristic as qualitative that the labor productivity have On this study, i tried to get the factors decreasing of labor- productivity with gathering opinions of panels of expert's studies about the factors decreasing of labor-productivity on project of construction through Delphi method and i evaluated the result factors as quantitatively and subjectively about importance of factors decreasing construction labor-productivity Analysis, using AHP Method by Saaty. Also, using Delphi and AHP method, 1 suggest substantiated method qualitative factors are measured by quantitative criteria.