• Title/Summary/Keyword: Current Health expenditure

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A Study on the Implementation of Global Medical Budget Model for Hospital based on Sustainablity and Efficiency (지속가능성과 효율성을 고려한 병원 총액예산 설계와 배분에 관한 연구)

  • O, Dongil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.6
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    • pp.3534-3547
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    • 2014
  • Although there are many positive sides of the current fee-for-service payment schedule, there is a strong necessity to control the rapidly increasing national healthcare expenditure. The global budget is often mentioned as one prominent alternative for solutions. In this article, both microscopic and macroscopic approaches are considered to set the hospital medical expenditure budget. In a macroscopic aspect, the SGR model, which considers the financial limit of the healthcare system, is used to set the next year target budget. In addition, the DEA model is used to measure the inefficiency and cost recognition. In this article, the national medical target expenditure is distributed to an individual hospital based on the level of efficiency. By combining the SGR and DEA, it will be possible to set a real world applicable target medical expenditure budget model.

Distributional changes in Physicians' Medical Care Expenses from the National Health Insurance and its Determinants After the Separation of Prescription and Dispensing (의약분업 전후 의원의 건강보험 진료비 분포변화 및 결정요인분석)

  • Lee Ae Kyoung;Jeong Hyun Jin
    • Health Policy and Management
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    • v.14 no.3
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    • pp.20-44
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    • 2004
  • The National Health Insurance Expenditure has been increased rapidly since the introduction of the separation of prescription and dispensing in 2000, and this trend of rapid growth in overall spendings rate has been observed predominantly among medical practitioners. This study was conducted to investigate the growth rate and distributional changes in private medical practitioners' expenses from 1999 to 2002 and its determinants using the National Health Insurance claims data. The total increasing rate of all medical practitioners' expenditure paid by the National Health Insurance between 1999 and 2002 was $41.71\%$, which exceeding that of general hospitals by $20\%$p. But the income distribution among each practitioner was improved as the changes in Gini coefficient(from 0.40 to 0.38) and decile distribution ratio(from 0.25 to 0.29) during the same period showed. However, this improvement in distributional patterns is not enough since even in 2002 it turned out that the highest $10\%$ income group earned 33times more than the lowest $10\%$ income group did. Also, higher Gini coefficient was observed in larger cities and some department like plastic surgery, obstetrics and gynecology. The major causes of this differentials in medical practitioners' expenses were factors related to medical demand like proportion of old population, residential economic status in a given area. In addition, providers' economic incentives also played an important role in determining their income distribution. The large income differentials among physicians may imply a skewed distribution of patients and thus long waiting time, inefficient utilization of resources and potential inadequate quality of care. In this sense, unreasonable distributional gaps should be reduced, so effective measures as well as ongoing monitoring would be necessary to correct current distributional problems.

An Exploratory Study on the Utilization of Information Systems Outsourcing (정보시스템 아웃소싱의 활용에 관한 탐색적 연구)

  • 천면중;김영달
    • The Journal of Information Systems
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    • v.8 no.1
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    • pp.5-26
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    • 1999
  • In recent years there has been an increasing amount of attention paid to outosourcing of information systems (IS) functions in organizations. The changing and more strategic role of outsourcing in business firms has been given much coverage in academic and trade publications. Trying to remain competitive and up-to-date in the rapidly developing world of computer technology is becoming a financial burden to many organizations in fields such as banking and financial services, health care, and manufacturing. Hiring outsiders to handle part or even all of its information services helps an organization provide better services and maintain a competitive advantage. This paper attempts to provide a benchmark of current IS outsourcing utilization in Korea. A detailed descriptive analysis of survey responses from 78 Korean companies indicates the usage, length of experience, expenditure of outsourcing, and kinds of IS functions being outsourced. The study also analyzes the effects (strategic, economic, and technological) of IS outsourcing with respect to the length of experience, expenditure of outsourcing, and kinds of IS functions being outsourced As a result of the analysis there are significant differences in the strategic, economic and technological effects of IS outsourcing with respect to the expenditure of outsourcing, kinds of IS functions being outsourced and firm size.

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Riboflavin Status of Obese and Nonobese Children in Primary School (학령기 비만아동과 정상아동의 리보플라빈 영양상태 비교)

  • 김난희
    • Journal of Nutrition and Health
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    • v.25 no.2
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    • pp.150-161
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    • 1992
  • The purpose of this study was to evaluate the riboflavin status of primary school children. Fiftyone subjects were selected as obese group and fiftyfive subjects were selected as control group according to Body Mass Index(BMI) of fifth-graders at a primary school in Taegu. For each subject information on nutrient intake and daily activity pattern were obtained by questionnaire. The riboflavin status was evaluated by urinary riboflavin exvretion The daily energy expenditure per kilogram of body weight was significantly lower in obese group(=47kcal/day) than in control group(=58kcal/day) (p<0.001) However the entire energy consumption was siginificantly greater in the obese children(=2005kcal/day) than their nono-baser peers(=1837kcal/day)(p<0.001). Riboflavin intake was 0.67mg/100kcal in the control group and 0.61mg/1000kcal in the obese group. Thus intakes for both groups met the current group and control group were 86.9$\mu\textrm{g}$/day and 98.7$\mu\textrm{g}$/day. repectively. There was no significnat Assesment of clinical signs of riboflavin deficiency indicated that angular lesion was 4.7% and glossitis was 6.6% of all subjects. Thirty one percent of subjects excrete riboflavin below 78$\mu\textrm{g}$/g creatinine which is defined as deficient. Therefore this group would be considered at high risk for developing riboflavin deficiency. From this study current recommendation of 0.6mg/1000kcal of riboflavin intake may not be adequate during growth and associated stress.

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Key Issues on Long-Term Care Hospitals in Korea (요양병원의 성장과 운영상의 주요 이슈)

  • Oh, Eun-Hwan
    • Health Policy and Management
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    • v.28 no.3
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    • pp.257-262
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    • 2018
  • This study reviews the advent of long-term care (LTC) hospitals and its key issues in Korea. For analysis, enforcement ordinances and enforcement rules related to LTC hospitals were reviewed. Official statistic data were used for quantitative analysis and Organization for Economic Cooperation and Development data were utilized for comparative analysis. Various references and expert interviews were conducted for status analysis. As of 2016, the number of LTC hospitals was 1,386 and the number of beds were 246,373. It showed the trend of increasing medical care costs and the cost of care at LTC hospitals increasing from 998.8 billion Korean won in 2008 to 4,745.6 billion Korean won in 2016, accounting for 7.3% of the total National Health Insurance expenditure. From the societal perspective, several issues were pointed out within the current health care system related to LTC hospitals: establishment of roles, concerns about the increase in medical expenses, and the quality of medical personnel.

The Current Status of College Health Service Centers in Seoul (서울시내 대학 내 보건의료시설의 현황)

  • Park, Hyun-Ah
    • Journal of the Korean Society of School Health
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    • v.13 no.2
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    • pp.341-347
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    • 2000
  • Background : One-quarter of Koreans are either students or school employeeS. Therefore, school health programs for them have high levels of cost-benefit. School health programs, though, are focused on services such as vaccination and physical examination according to administrational regulations without systemic planning. Futhermore, college health programs run autonomously, not under the supervision of the Ministry of Education. It is my intention to analyse the current status of college school health service centers and use the basic data so generated to model how they might operate at an optimal level of efficiency. Methods : I intended to investigate all 29 colleges in Seoul except some specialized colleges such as theological schools in the two-month period of August and September, 1999. I used the telephone interview method to ask questions relating to personal composition, medical equipment in use, annual expenditure and the provision of school health services. School health services were composed of three items; health servies, health education and a healthy school environment. Results : 27 college health service centers were surveyed. The median number of medical personal in each center was 2, the range was 1-31. 7 centers(25.9%) have only nurses with no doctors. Annual expenditures of 11 centers(50.1%) was less than 10 million won, 19 center(70.4%) were maintained by support from their college. Thirteen centers(48.1%) provided doctor's examinations, 6 centers(22.2%) provided dental care services, laboratory services were provided by seven centers(25.9%). Some 81.5% of the centers had vaccination programs and 44.5% had health education programs. There was no school environment program except insecticide provisions. College health service centers with school doctors differed from centers without school doctors in terms of medical equipment range, annual expenditures and annual case loads. Conclusion : The structure and function of college health service centers in Seoul are diverse. However, no center has a well-organized school health plan.

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The Development Path of China's Private Health Insurance and Its Role in the Health Care System (중국 민간의료보험의 발전경로와 의료보장체계에서의 역할)

  • Jung, Kee Taig;Fan, Jian Cheng;Chen, Wan Yun
    • Health Policy and Management
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    • v.31 no.4
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    • pp.423-436
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    • 2021
  • This article summarizes the structure of China's current social health insurance system and reviews the development status of China's private health insurance (PHI). China's medical security system is mainly composed of two parts: basic medical insurance (BMI) and PHI. Among them, the BMI provides reimbursement of basic medical expenses for the insured persons according to different proportions. PHI is a necessary supplement to the BMI and provides assistance to the insured persons in the event of illness or accident. By having PHI, people can obtain medical protection outside the coverage of BMI. In the development of PHI in China, the total medical cost is high and the insurance market size is large, but the proportion of PHI expenditure is low and the personal burden is high. Through this Chinese case, it will be helpful for mutual development between Korean PHI and national health insurance, for Korean insurance companies to enter the Chinese market, and for removing the medical burden on the people.

Estimated Food Cost to Maintain Basic Living Expenditure (기본생계비를 위한 식품비 산정에 관한 연구)

  • Mun, Hyeon-Gyeong
    • Journal of the Korean Dietetic Association
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    • v.4 no.2
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    • pp.245-253
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    • 1998
  • In this study, the food cost for the urban worker's living expenses was estimated for the Korea Labor Union. The urban workers living expenses are minimum of healthy and decency level expenses with allowances for minimum quality of life. Thus, the food cost should be enough for purchasing proper kinds and amount of foods which can supply sufficient nutrient to maintain health and which should reflect current food consumption patterns. To estimate the food cost, the Korean Recommended Dietary Allowances was used to calculate the amount of nutrients which should be supplied. The National nutrition survey and the Food balance sheet, were used to estimate the current consumption patterns for the kind and amount of food. To estimate price for each food item, the market survey was executed in six large cities. Also, to verify the estimated food cost, actual food costs were surveyed. For 5 kinds of model household, dietary allowances were calculated for the each nutrient. Using the Korean food guides, the number of serving for each food group were decided for the model households. In each food group, the amount and kind of foods were decided by the current food consumption pattern. The kind and amount of food were adjusted by the amount of calculated nutrient. When the amount of nutrient was between 90% and 110% of the recommended dietary intake, it was accepted. With these amount and kinds of foods, the food cost were calculated using the market survey. Considering extra expenses for the eating-out and processed foods, extra expenses are added. As a results, for single person family, the estimated food cost was 149,210won per month. For two, three, four and five person family, the estimated food costs were 245,179won, 381,182won, 501,669won and 687,980won per month, respectively. The estimated food cost were lower in the single and two person family than the actual food cost by the survey. The cost for eating-out gave major differences. In the future, to estimate food cost, the food consumption patterns for the different kind of household, sex and age should be studied carefully. Also, the pattern of eating-out should by analyzed.

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Smoking Habits and Neuropeptides: Adiponectin, Brain-derived Neurotrophic Factor, and Leptin Levels

  • Kim, Ki-Woong;Won, Yong Lim;Ko, Kyung Sun;Roh, Ji Won
    • Toxicological Research
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    • v.30 no.2
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    • pp.91-97
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    • 2014
  • This study aimed to identify changes in the level of neuropeptides among current smokers, former smokers, and individuals who had never smoked, and how smoking habits affect obesity and metabolic syndrome (MetS). Neuropeptide levels, anthropometric parameters, and metabolic syndrome diagnostic indices were determined among male workers; 117 of these had never smoked, whereas 58 and 198 were former and current smokers, respectively. The total sample comprised 373 male workers. The results obtained from anthropometric measurements showed that current smokers attained significantly lower body weight, body mass index, waist circumference, and abdominal fat thickness values than former smokers and those who had never smoked. Current smokers' eating habits proved worse than those of non-smokers and individuals who had never smoked. The level of brain-derived neurotrophic factor (BDNF) in the neuropeptides in the case of former smokers was $23.6{\pm}9.2pg/ml$, higher than that of current smokers ($20.4{\pm}6.1$) and individuals who had never smoked ($22.4{\pm}5.8$) (F = 6.520, p = 0.002). The level of adiponectin among former smokers was somewhat lower than that of current smokers, whereas leptin levels were higher among former smokers than current smokers; these results were not statistically significant. A relationship was found between adiponectin and triglyceride among non-smokers (odds ratio = 0.660, ${\beta}$ value=-0.416, p < 0.01) and smokers (odds ratio = 0.827, ${\beta}$ value=-0.190, p < 0.05). Further, waist circumference among non-smokers (odds ratio = 1.622, ${\beta}$ value=0.483, p < 0.001) and smokers (odds ratio = 1.895, ${\beta}$ value=0.639, p < 0.001) was associated with leptin. It was concluded that cigarette smoking leads to an imbalance of energy expenditure and appetite by changing the concentration of neuropeptides such as adiponectin, BDNF, leptin, and hsCRP, and influences food intake, body weight, the body mass index, blood pressure, and abdominal fat, which are risk factors for MetS and cardiovascular disease.

The way to achieve Universal Health Coverage: Focusing on the Historical and Cultural Context of Health Care Sector in Vietnam (보편적 건강보장을 향한 노정 : 베트남 보건의료 부문의 역사·문화적 맥락을 중심으로)

  • BEAK, Yong Hun
    • The Southeast Asian review
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    • v.28 no.1
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    • pp.173-218
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    • 2018
  • This study focuses on the healthcare sector in Vietnam which is promoting universal health insurance for the achievement of Universal Health Coverage (UHC) under Sustainable Development Goals (SDGs). The purpose of this study is to examine the characteristics of the reform process of the health care system and the law on health insurance through the historical and cultural contexts and its implications from the perspective of development. Based on the three dimensions of UHC - extension of protection for population, provision of various medical services, and financial protection, the current status of the Vietnam healthcare sector is summarized respectively as follows. First, according to the revised Health Insurance law which came into effect in 2015, the mandatory health insurance premiums are calculated based on household units. Second, there is a medical network that can provide preventive and healthcare services centered on primary health care facilities, for example commune health stations (trạm y $t{\hat{e}}$ $X{\tilde{a}}$). Third, out-of-pocket expenditure is still a large proportion although public spending has increased and private spending has decreased since the enforcement of the health insurance law and various schemes. Vietnam is currently striving towards a universal health care system. The development of institutions and systems should be designed in a way that is appropriate for the members of the society rather than efficiency. This article findings shed light on the role of social values, family culture, and informal institutions.