• Information Systems Review
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• v.9 no.1
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• pp.45-65
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• 2007

In medical industry, health insurance bill audit is unique and essential process in general hospitals. The health insurance bill audit process is very important because not only for hospital's profit but also hospital's reputation. Particularly, at the large general hospitals many related workers including analysts, nurses, and etc. have engaged in the health insurance bill audit process. This paper introduces a case of health insurance bill audit for finding reducible health insurance bill cases using decision tree induction techniques at a large general hospital in Korea. When supervised learning methods had been tried to be applied, one of major problems was data imbalance problem in the health insurance bill audit data. In other words, there were many normal(passing) cases and relatively small number of reduction cases in a bill audit dataset. To resolve the problem, in this study, well-known methods for imbalanced data sets including over sampling of rare cases, under sampling of major cases, and adjusting the misclassification cost are combined in several ways to find appropriate decision trees that satisfy required conditions in health insurance bill audit situation.

• Journal of the Institute of Electronics Engineers of Korea TC
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• v.45 no.1
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• pp.1-7
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• 2008

Today, Korean medical community faces rapid changes in medical environment due to opening of medical market, more emphasis on making profit and introduction of private medical insurance. Therefore, it is apparent that around, major university hospitals, efforts are being made to adapt to such changes by establishing mid to long range strategic plans. We want to keep pace with changing times and diverse demand of patients by introducing state of the art system, utilizing Ubiquitous technologies for improvements. In doing so, we want to distinguish our hospital services from others. However, Hospital Information System that integrates ubiquitous technologies are introduced in limited basis due to problems like standardization and limits on medical use etc. Particularly, problems like absence of tag design suitable for medical environment, compatibility and extension issue with RFID system need to be addressed on application of RFID technologies. In order to solve such problems, this paper implemented RFID tag system, RFID-SIP UA program, location tracking program. This paper provides a comprehensive basic review of RFID and SIP model suggests the evolution direction of further advanced RFID application service. The design of RFID-SIP application offers advance RFID system with drawback and reduction search time of medical object. so there is a improvement of hospital information system in ubiquitous environment.

• Journal of the Economic Geographical Society of Korea
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• v.10 no.2
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• pp.153-166
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• 2007

This study attempts to investigate the spatial characteristics of medical hospital distributions in Korea. For the purpose we examine the inter- and intra regional variations in the distributions of clinics by specialty subject. In particular, we analyze the distribution patterns of Location Quotients of clinics for 12 specialty subjects in Seoul. Medical services tend to be concentrated on the large cities, especially in the Metropolitan Seoul Area. In particular, clinics and medical doctors as well as large scale general hospitals have been strongly concentrated on the Metropolitan Seoul area. These circumstace may be related with the fact that medical hospitals are established and operated by private sector in Korea, and thus they attempt to find their location where they can get maximum profit. The distribution patterns of clinics of 12 specialty subjects can be classified to several characteristic patterns. In particular, clinics of plastic surgeon tend to be strongly concentrated on the Gangnam area in Seoul. Finally, clinics of plastic surgeon tend to be located on the areas near the subway stations along the subway Line 2 and Line 3 in the beginning. The existence of plastic surgeons turns out to have significant role on determining the location for the newly opening plastic surgeons in the later. Therefore, their agglomeration has been getting more strongly.

• Quality Improvement in Health Care
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• v.11 no.1
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• pp.46-60
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• 2004

Background : Recently, we have experienced various changes in the healthcare environment. Healthcare organizations are facing a financial crisis due to more competitive relationships among themselves as well with low health insurance fees. The purposes of the current study were: (1) to develop a data warehouse-based system for evaluating and monitoring the case management activities, and (2) to measure and analyze its effects. Methods : In order to collect the data for the study, the database on discharged patients was utilized at a university hospital located in Seoul from June 1, 2002 through December 31, 2002. Initially, a data warehouse was built for the case management system. The case management activities were analyzed using structured methodology to establish the case management system. Results : The findings of this study were as follows: (1) A case management system was developed to make it possible to monitor of healthcare quality and resource utilization. The Case management System included monitoring functions regarding utilization reviews, critical pathways, and clinical indicators. (2) Utilizing the case management system, unplanned readmissions were documented among total discharged patients during two months from November 1, 2002 through December 31, 2002. The unplanned readmission rate was 2.3%(276 patients) in total of 11,960 discharged patients. Among them 81 patients(0.7% of total discharges, 29.3% of unplanned readmission) were readmitted to the same physician in charge under the same diagnosis. No significant differences were found in the demographic variables such as gender and age among the patients. (3) After implementing the case management system, 2.9% of average length of stay reduced. Applying cost-benefit analysis, the 2.9% reduction of length of stay represents net profit of ${\backslash}$ 279,592,000 in the year of 2004. In addition, applying value acceleration analysis, cumulative net benefit of ${\backslash}$ 1,481,000,000 was expected by the year of 2007. Also we were able to expect ${\backslash}$ 247,800,000 of cumulative benefit for the prospective 5 years in value linkage analysis. It represents average ${\backslash}$ 787,700,000 of pure net benefit a year. Conclusion : The value of present study would be not only implementing the knowledge management system into the existing case management activities, but also evaluating its effects and estimating its financial benefits. This study suggested that the case management system would be a supportive tool for monitoring and improving the quality of healthcare, and a cost-effective tool for increment of healthcare organization's financial benefit.

• The Korean Journal of Franchise Management
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• v.3 no.2
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• pp.20-38
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• 2012

After being introduced into franchises industry, franchise has made a phenomenal growth in a short time and a substantial contribution to job creation and economic revitalization. Nevertheless, franchise business operators failed a business or low profit because of a lack of information and indiscriminate foundation. Therefore the first object of this study is characteristics of franchise's factors on disclosure agreement in franchise associate website. second is examinations about casual relationship between factor and franchise performance with using Excel and SPSS 18.0 versions. The findings of present study were as follows. First, franchises manage small business mostly(financial data, scale so on) and franchise's type focused the food service industry. Specially, a business district select unprotected contract. Second, in franchise's factors, we could find statistically significant effect on annual average sales and annual average net profit. However growth rate of franchise don't have statistically significant effect. Third, we could find statistically significant difference on analysis both franchises' factors and financial data. In conclusion, we must consider of franchise industry environment and success effect on performance in starting one's business. Furthermore franchises plan ways for their sustained growth and protection of rights and interests. Finally business operator draw up their information and upgrade continuously for franchises industry growth. Discussion and theoretical and managerial implications of the results were described along with future franchise research suggestions.

• The Korean Society of Law and Medicine
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• v.20 no.3
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• pp.143-174
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• 2019

Our Constitution obliges the state to protect the health of the people, and the Medical Law, which embodied Constitution, sets out in detail the matters related to open the medical institution, and one of them is to prohibit the operation of multiple medical institutions. By the way, virtually multiple medical institutions could be opened and operated because the Supreme Court had interpreted that several medical institutions could be opened if medical activities were not performed directly at the additional medical institution which was opened under the another doctor's license. However, some health care providers opened the several medical institutions with another doctor's license for the purpose of the maximization of profit, and did illegal medical cares like the unfair luring of patients, over-treatment, and commission treatment. Also, realistic problems such as the infringed health rights have arisen. Accordingly, lawmakers had come to amend the Medical Law to readjust the system of opening for medical institution so that medical personnel could not open or operate more than one medical institution for any reason. For this reason, the Constitutional Court recently declared a constitutional decision through a long period of in-depth deliberation because the constitutional petition and the adjudication on the constitutionality of statutes had been filed on whether Article 33 paragraph 8 of the revised medical law is unconstitutional. The Constitutional Court acknowledged the "justice of purpose" in view of the importance of public medical institutions, of the prevention from seduction of for-profit patients and from over-treatment, and of the fact that health care should not be the object of commercial transactions. Given the risk that medical personnel might be subject to outside capital, the concern that the holder of the medical institution's opening certificate and the actual operator may be separated, the principle that the human body and life should not be just a means, and the current system's inability to identify over-treatment, it also acknowledged the 'minimum infringement'. Furthermore, The Constitutional Court judged it is constitutional in compliance with the principle of restricting fundamental rights, such as 'balance of legal interests'. In this regard, legislative complements are needed in order to effectively prevent the for-profit management and the over-treatment the Constitutional Court is concerned about. In this regard, consumer groups actively support the need for legislation, and health care providers groups also agree on the need for legislation. Therefore, the legislators should respect the recent Constitutional Court's decision and in the near future complete the complementary legislation to reflect the people's interests.

• Health Policy and Management
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• v.11 no.1
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• pp.107-130
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• 2001

During the last year, we had a very severe situation with the strike of physicians working in medical facilities. From that time, many politicians and scholars insisted on the expansion of public hospitals to enhance the public role in the medical care sector. They think that private medical facilities work for profit motivation and that the high proportion of private to whole facilities is an obstacle to the public function of medical care under social insurance system. They found that one of the reasons for failing to prevent the physicians' strike was the high proportion of private facilities. Others insisted that the strike was not a good reason for the expansion of public hospitals. The physicians' strike was a very rare case, and it is not a good basis for generalization of the discussion of public hospitals. Last year almost all apprentice physicians in public facilities took part in the strike, and consequently the public hospitals also lost the role of public function. They view this increasing involvement of government in the medical sector as improper and the cause of inefficiencies. In this paper we review the debate over the expansion of public facilities. To clarify the debate, we review traditional criteria for the role of government in a market system and to apply these criteria to medical care. There are two traditional areas where government Is acknowledged to have a role in a market system: market imperfections and market failure. Where market imperfections and market failure exist, there may be a role for government. The justifications for government intervention are consumer protection and the existence of externalities. One of externalities is to provide medical care for the poor. The appropriate measures to provide medical owe to the poor can be sought in both demand and supply side subsidies. National health insurance is a method of demand subsidies and establishment of public hospitals is a method of supply side subsidies. Under the National Health Insurance System, the expansion of public hospitals is not an appropriate subsidy policy.

• Journal of the Korean Medical Association
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• v.61 no.12
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• pp.702-705
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• 2018

Advances in technology lead to advances in medical devices, and these advances have the positive effect of creating opportunities for beneficial developments in healthcare, such as innovating traditional healthcare processes or expanding opportunities for diagnosing and treating diseases. Nonetheless, device developers, suppliers, users, insurers, and patients all face the challenge of balancing patient safety and health effectiveness with a reasonable profit. In Korea, the New Health Technology Assessment system aims to introduce safe and effective health technology, but this is only effective for the entry of devices onto the healthcare market. This system is not enough for creating a healthy ecosystem in which high-quality technologies and devices survive in the market and naturally exit from the market if not successful. The nation must not lag in the rapid development of medical devices, but the concomitant requirement for patient safety is like two rabbits moving in different directions. There is not enough time to resolve each source of uncertainty for both developers and users. The early adoption of health technologies, including medical devices, offers new opportunities for treatment and diagnosis, but also poses unexpected health risks. Thus, we need to design a plan to generate scientific evidence related to medical devices after they introduced into practice. Additionally, regarding the use of individual medical devices, we believe that the creation of a healthy ecosystem for medical devices by implementing medical device surveillance culture is a way to manage the opportunities and risks of the early introduction of innovative medical devices.

• Journal of Preventive Medicine and Public Health
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• v.52 no.2
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• pp.72-81
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• 2019

Objectives: The current study presents a new conceptual framework for physician-induced demand that comprises several influential components and their interactions. Methods: This framework was developed on the basis of the conceptual model proposed by Labelle. To identify the components that influenced induced demand and their interactions, a scoping review was conducted (from January 1980 to January 2017). Additionally, an expert panel was formed to formulate and expand the framework. Results: The developed framework comprises 2 main sets of components. First, the supply side includes 9 components: physicians' incentive for pecuniary profit or meeting their target income, physicians' current income, the physician/population ratio, service price (tariff), payment method, consultation time, type of employment of physicians, observable characteristics of the physician, and type and size of the hospital. Second, the demand side includes 3 components: patients' observable characteristics, patients' non-clinical characteristics, and insurance coverage. Conclusions: A conceptual framework that can clearly describe interactions between the components that influence induced demand is a critical step in providing a scientific basis for understanding physicians' behavior, particularly in the field of health economics.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.4
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• pp.614-623
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• 2017

The purpose of this study is to analyze the impact of the financial performance of regional public hospitals on their efficiency. In addition, the analysis of their efficiency using environmental factors, such as the market share, operating mode, and size of the regional public hospitals, as well as the factors influencing their efficiency, are selected by selecting the input and output factors of the hospitals and some differences were found between them. The DEA index and financial performance of the 31 regional public hospitals were calculated for the three years from 2012 to 2014. ANOVA and hierarchical regression analysis were used. As a result, there was a significant difference in their efficiency according to the environmental factors, such as the city scale of the regional public hospital, the number of hospital beds, and their business performance, productivity, and publicness. The medical profit margin (p<0.05), labor cost investment efficiency (p<0.05) and HHI (p<0.05) were found to affect the efficiency. In order to identify the inefficiencies of the regional public hospitals and increase their efficiency, it is necessary to measure the efficiency of the input resources and to reduce their cost. In addition, if the regional public hospitals were to provide specialized services, such as specialized functions of medical care that would give them a competitive advantage over private hospitals, their operational efficiency would be enhanced and they would be able to fulfill their role as public medical institutions.