• Journal of Korean Academy of Nursing Administration
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• v.3 no.2
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• pp.151-165
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• 1997

A cost analysis for hospitalized patients was performed based on the KDRG classification in order to determine an appropriate nursing fee under the PPS(Prospective Payment System). The data was collected from 20 nursing units of three tertiary hospitals and two secondary hospitals from August 26 to September 15, 1996. The study consisted of 148 inpatients diagnosed for lens procedures(KDRG 03900), tonsillectomy &/or adenoidectomy(KDRG 16100), Cesarean section(KDRG 37000), or vaginal delivery(KDRG 37300) without any complications. The direct or indirect nursing hours of each patients were measured. Then, direct or indirect nursing expenditures of four nursing units, operating room and delivery room were computed. Finally, the resources used including average total nursing hours, average length of stay and average nursing cost of each KDRG were estimated as follows; 1) The average total nursing hours were 640 minutes for lens procedures, 403 minutes for tonsillectomy &/or adenoidectomy, 934 minutes for appendectomy with complicated principal diagnosis, 1,094 minutes for Cesarean section and 631 minutes for vaginal delivery. Significant differences were found in average total nursing hours among hospitals. 2) The average length of stay in lens procedures were 5 days, 4 days for tonsillectomy &/or adenoidectomy, 6 days for appendectomy with complicated principal diagnosis, 8 days for Cesarean section and 3 days for vaginal delivery. All results were within normal determined by the Ministry of Health and Welfare although significant differences existed among hospitals, especially with average length of stay for leng procedures between tertiary hospitals and secondary hospitals which was greater than for those of others. 3) The average nursing cost were 87,146 Won for lens procedures, 69,600 Won for tonsillectomy &/or adenoidectomy, 128,337 Won for appendectomy with complicated principal diagnosis, 151,769 Won for Cesarean section and 85,403 Won for vaginal delivery. These costs were 7.6%, 13.0%, 13.0%, 16.0% and 22.0%, respectively, of the official price fixed by the Ministry of Health and Welfare under the prospective payment system. Research for the analysis of nursing costs according to the severity of illness for those KDRGs shoud be carried out within the period of the PPS pilot project. In addition, a proper nursing fee schedule for a new reimbursement system based upon the result of the above research should be prepared in the near future.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.2229-2233
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• 2016

Background: Breast cancer is one of the most common cancers among women in the world. Early detection is necessary to improve outcomes and decrease related costs. The aim of this study was to assess the predictive power of health locus of control as a modifying factor in the Health Belief Model (HBM) for prediction of breast self-examination. Materials and Methods: In this cross- sectional study, 400 women selected through the convenience sampling from health centers. Data were collected using part of the Champion's HBM scale (CHBMS), the Health Locus of Control Scale and a self administered questionnaire. For data analysis by SPSS the independent T test, Chi square test, logistic and linear regression modes were appliedl. Results: The results showed that 10.9% of the participants reported performing BSE regularly. Health locus of control did not act as a predictor of BSE as a modifying factor. In this study, perceived self-efficacy was the strongest predictor of BSE performance (Exp (B) =1.863) with direct effect, while awareness had direct and indirect influence. Conclusions: For increasing BSE, improvement of self-efficacy especially in young women and increasing knowledge about cancer is necessary.

• YAKHAK HOEJI
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• v.51 no.5
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• pp.327-335
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• 2007

This study was to evaluate economic impact of a comprehensive pharmaceutical care intervention provided by community pharmacists on drug-related morbidity and mortality in the elderly population, in a societal perspective. Clinical outcomes of pharmaceutical care included compliance increase, inappropriate medication discontinuation, and subsequent drug-related morbidity and mortality reduction. Economic outcomes included cost savings from direct medical costs reduction such as medication and healthcare resource utilization. Input costs for pharmaceutical care included pharmacist time and computerized prescription review supporting program costs. Model parameters of outcomes were derived from published literatures, and costs were from literatures and health insurance statistical data in Korea. Annual costs and benefits were estimated in the year 2005. Current usual care and standardized pharmaceutical care required 0.3 and 2.0 hours per year respectively, for elderly outpatient using average 4.4 prescription drugs per visit and average annual frequency of 17.8 pharmacy visits. Comprehensive pharmaceutical care provided to overall elderly outpatients at community pharmacies would have cost of \74,994 mil. and benefit of \357,002 mil. per year. Benefit:cost ratio was 4.8:1 and net benefit was \282,008 mil/year. It was corresponded to net benefit of \73,816/year for individual elderly patient. In addition, pharmaceutical care was estimated to reduce 1,531 drug-related deaths/year. Conclusively this study, a first attempt in Korea to evaluate an economic value of pharmaceutical care at community pharmacies, proved that it was a cost-effective intervention having significant economic benefit.

• Journal of Yeungnam Medical Science
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• v.38 no.4
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• pp.267-274
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• 2021

Sleep plays a critical role in homeostasis of the body and mind. Insomnia is a disease that causes disturbances in the initiation and maintenance of sleep. Insomnia is known to affect not only the sleep process itself but also an individual's cognitive function and emotional regulation during the daytime. It increases the risk of various neuropsychiatric diseases such as depression, anxiety disorder, and dementia. Although it might appear that insomnia only affects the nervous system, it is also a systemic disease that affects several aspects of the body, such as the cardiovascular, endocrine, and immune systems; therefore, it increases the risk of various diseases such as hypertension, diabetes mellitus, and infection. Insomnia has a wide range of effects on our bodies because sleep is a complex and active process. However, a high proportion of patients with insomnia do not seek treatment, which results in high direct and indirect costs. This is attributed to the disregard of many of the negative effects of insomnia. Therefore, we expect that understanding insomnia as a systemic disease will provide an opportunity to understand the condition better and help prevent secondary impairment due to insomnia.

• Journal of Food Hygiene and Safety
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• v.36 no.1
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• pp.68-76
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• 2021

Foodborne outbreaks frequently occur worldwide and result in huge economic losses. It is the therefore important to estimate the costs associated with foodborne diseases to minimize the economic damage. At the same time, it is difficult to accurately estimate the economic loss from foodborne disease due to a wide variety of cost components. In Korea, there are a limited number of analytical studies attempting to estimate such costs. In this study we investigated the components of economic cost used in foreign countries to better estimate the cost of foodborne disease in Korea. Seven recent studies investigated the cost components used to estimate the cost of foodborne disease in humans. This study categorized the economic loss into four types of cost: direct costs, indirect costs, food business costs, and government administration costs. The healthcare costs most often included were medical (outpatient) and hospital costs (inpatient). However, these cost components should be selected according to the systems and budgets of medical services by country. For non-healthcare costs, several other studies considered transportation costs to the hospital as an exception to the cost of inpatient care. So, further discussion is needed on whether to consider inpatient care costs. Among the indirect costs, premature mortality, lost productivity, lost leisure time, and lost quality of life/pain, grief and suffering costs were considered, but the opportunity costs for hospital visits were not considered in any of the above studies. As with healthcare costs, government administration costs should also be considered appropriate cost components due to the difference in government budget systems, for example. Our findings will provide fundamental information for economic analysis associated with foodborne diseases to improve food safety policy in Korea.

• Korea Journal of Hospital Management
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• v.18 no.1
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• pp.59-69
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• 2013

Purpose Patients should have a regular medical check-up, the cost direct and indirect medical expenses to check the results, and revisit the hospital. Some of patients often want to use the telephone for a medical consultation, Method The subjects participating in this study were a selection 485 patients who received outpatient service in Asan Medical Center and Gangbuk Samsung Hospital. The patients's favorite method for medical check-up, time, cost, fatigue, and inconvenience, in regard with the revisit to check the examination results, were researched and analyzed on identical questionnaires about them. Results The average transportation, food expenses and opportunity costs the subjects spent was 90,400 for those from the Seoul and Gyunggi area, and 269,800 from other area. And the average required time per visit was 4.13 hours for those from the Seoul and Gyunggi area, 11.84 hours from other areas, and averagely 7.72 hours for all the subjects. More than 75% of the subjects answered that they felt tired and their work was interrupted. The subjects from both areas preferred the check by phone. Conclusion If the scope of telephone medical consultation is defined and the doctor-patient certification is possible, it can be thought as an efficient alternative of the medical check-up by revisit. It is necessary to discuss an appropriate amount of the medical check-up by phone which the same cost and effort can be allocated in.

• Health Policy and Management
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• v.11 no.3
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• pp.71-88
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• 2001

The purpose of this study is to analyze the cost-effectiveness of four medications for treating and preventing osteoporosis -HRT therapy(conjugated equine estrogen 0.625mg for 25 days and medroxyprogesterone acetate 5mg for 01112 days), Alendronate(10mg and 5mg), Active Vitamin D(Calcitriol), and Calcium. Total costs include the direct medical cost -examination fee, consultation fee, prescription fee, fee for preparing medications, and the price of pharmaceuticals- and the indirect cost of patients such as traffic expenses and time cost. In addition, the costs of monitoring in adverse reactions are added. The effects of four medications are expressed as BMD(Bone Mineral Density) percent change measured by DEXA(Dual Energy X-ray Absorptiometry) in lumbar spine(L2-L4) and femoral neck site. A mixed model based on meta analysis provides the estimates of effectiveness, which are then appled to the hypothetical cohort consisting of postmenopausal women at the age of 50-59. HRT therapy is the most cost-effective medication at 172,433.64 won (lumbar spine site) and 546,328.28 won (femoral neck site) per BMD percent change for osteoporosis. Alendronate 10mg is more cost-effective than Alendronate 5mg as 345,971.23 won and 378,441.63 won per lumbar BMD percent change at 0.991ｇ/$cm^2$, respectively. Alendronate 10mg is more cost-effective than Alendronate 5mg as 1,329,257.89 won and 1,467,291.23 won per femoral neck BMD percent change at 0.834ｇ/$cm^2$, respectively.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.2
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• pp.283-293
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• 2002

Purpose: The purpose of this study was to define cost-countable perioperative nursing activities and to analyze the cost of each nursing activities based on the Resource-Based Relative Value Scale (RBRVS). Method: Researcher and 3 research assistants observed and documented the 83 operating patients in order to measure nursing time for each of the perioperative nursing activities. And then, 35 operating room nurses with at least one year of perioperative nursing experience were observed for the RBRVS of perioperative nursing activities. Finally, the direct and indirect nursing costs were estimated. Result: Nursing costs of 25 nursing activities were estimated using the RBRVS. Most expensive nursing activities were delivery of the instrument and implement for OP team (9,780 won per hour) and behavior of wash, pack, disinfect the instrument (6,770). Conclusion: Based on the relative values of each perioperative nursing activities estimated in this study, proper medical reimbursement system should be established in a near future.

• Korean Medical Education Review
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• v.16 no.3
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• pp.132-140
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• 2014

Higher education is under unprecedented pressure for quality improvement and cost containment/reduction due to global competition and ever-increasing tuition costs. These twin challenges require an unconventional approach, and massive open online courses (MOOCs) and flipped learning have recently emerged as two promising educational alternatives not only to address the current problems but also to direct the future of education. This paper discusses the rapidly changing environment for education, MOOCs, and flipped learning as learning alternatives, the relationship between MOOCs and flipped learning, and course redesign for the implementation of flipped learning. The case of Ulsan National Institute of Science and Technology (UNIST) is also discussed for benchmarking purposes since it has been pioneering an innovative educational methodology for teaching and learning IT-enabled active learning methods from its inception in 2009. It has redesigned almost 70 courses (20% of all the courses to offer) for flipped learning. The objectives of UNIST's educational experiment are three-fold: improving the quality of education for students, improving teaching productivity for the faculty, and containing/reducing education costs for the university.

• Journal of Preventive Medicine and Public Health
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• v.35 no.4
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• pp.340-350
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• 2002

Objectives : To evaluate the annual visit days, the annual prescription days and the medical costs of hypertensive patients. Methods : The medical insurance records of 40,267 incident patients with the diagnostic code of hypertension from September 1998 through August 1999 in Daegu city were reviewed. Results : The proportion of the most proper medical care pattern group (Group VIII) who visited for 6-15 days with 240 prescription days or more a year was only 6.2%. The proper care group (Group IX) who visited for more than 16 days with 240 prescription days or more a year was 9.3%. The overall proper care group (Group VIII+IX) was therefore 15.5%. The proportion of the insufficient care group (Group I, IV) in both the number of visiting days and prescription days was 57.4%. The mean prescription day of the most proper group (Group VIII) was 29 days; the mean annual medical expenses,453,587won; the mean annual amount paid by patients, 218,013won; and mean medical expenses per prescription day, 1,483won. The proportion of the overall proper care group (Group VIII+IX) was significantly higher in adults aged 50-59, those who were enrolled in industrial workers health insurance as well as government employees and private school teachers health insurance, and those who made a higher contribution per month (p<0.01). According to the type of medical facilities, the proportion of the most proper medical care pattern group was highest in the general hospitals (9.3%) but the overall proper care group was higher in the public health centers (22.1%) and private clinics (17.1%). Conclusions : The management system of hypertension should be reinforced urgently. Therefore, it is necessary to develop guidelines including the number of visiting days per year and prescription days per visit day, and make the system provide medical facilities to more properly care for hypertensive patients.