• 한국임상약학회지
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• 제25권4호
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• pp.280-285
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• 2015

Objectives: To suggest direction for improving policies by understanding current management of narcotics or psychotropic drugs and analyzing their distributions and usage. Method: We conducted a comparison analysis between health insurance claims and the amount supplied to health care institutions for narcotics or psychotropic drugs through health insurance claims data and drug distribution supply data from 2010 to 2012 collected from Korea Pharmaceutical Information Service Center (KPIS). Furthermore, we carried out literature investigation and online search to comprehend the current management of narcotics drugs in Korea. Results: The amount supplied to medical institutions for all drugs in 2012 was 19.4 trillion won, which increased from 19.5 trillion in 2011 by 0.54%. For narcotic drugs, the amount supplied was 318.4 billion won in 2011 and increased to 335.1 billion won by 5.3% in 2012, which exceeded the rate of increase for the amount supplied for all drugs. The proportion of amount claimed in the total amount supplied to medical institutions for all drugs was 60.5% in 2012, whereas the proportion of amount claimed for narcotic drugs was 55.6%, which showed that narcotic drugs were used relatively less within health insurance. Furthermore, management of the current domestic distribution supply data focuses on manufacturing and medical institution supply stages. Conclusion: Hereafter, the management of narcotics or psychotropic drugs needs to be improved by reinforcing active monitoring in optimal prescription and usage in patients by collecting and analyzing information on drug usage of patients.

• Journal of Digestive Cancer Research
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• 제11권2호
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• pp.104-107
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• 2023

The Ministry of Health and Welfare of Korea has implemented various social security programs to ensure a basic standard of living and raise overall quality of life for all citizens. The Korean social security system provides social insurance, public assistance, and social welfare services. To achieve adequate drug benefits, the Drug Management Department of Health Insurance Review and Assessment Service (HIRA) implement drug management duties including drug listing, upper price limit setting, scope of benefits, and post-factum management. When a manufacturer or an importer wants to apply for National Health Insurance (NHI) coverage of the drug that has obtained safety and efficacy approval, the pharmaceutical benefit assessment committee of HIRA evaluates the drug's clinical efficacy and cost-effectiveness to determine whether or not to include the drug into the benefit package. The benefit standards for a listed drug (ingredient) are set either for the whole permitted range or a part of range with conditions. To increase the coverage rate for new drugs, the listed drugs are regularly reviewed for their value. The status of listed drugs can be adjusted or eliminated from the benefit package if the clinical efficacy turns out to be insignificant. Therefore, through these pharmaceutical management procedures, high-quality drugs are provided at reasonable prices, which save healthcare expenditure by price determination and selective coverage in consideration of economic evaluation.

• 보건의료산업학회지
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• 제9권3호
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• pp.1-11
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• 2015

Objectives : The aim of this study was to identify the relationship between Organizational Citizenship Behavior (OCB) and quality of service (QoS) on pay satisfaction for employees at small-and medium-sized hospital that adopted an annual salary system. Methods : The subjects were 136 employees working at 2 Small-and Medium-sized Hospitals in Seoul and Daejeon. The data were collected from May 11 to May 22, 2015 using a structured questionnaire. For data analysis, descriptive statistics, Pearson correlation coefficient, t-test, ANOVA and Scheffe test were used with the SPSS 21 package. Results : The mean score for pay satisfaction perceived by the employees at small-and medium-sized Hospitals that adopted an annual salary system was 1.74. The mean score for OCB and QoS was 4.02 and 4.43, respectively. The pay satisfaction perceived by the employees at small-and medium-sized Hospitals that adopted an annual salary system were positively related to the OCB. Pay satisfaction was positively related to the QoS; however, it was not statistically significant. The OCB and QoS showed a significant difference in age, marital status, and education level. Conclusions : Small and Medium sized Hospitals have to develop an efficient pay management system which evaluates the CSFs and KPI of every department or staff member.

• 보건행정학회지
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• 제23권4호
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• pp.343-348
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• 2013

Background: Price control alone may not successfully restrain growth in health expenditures. This study aimed to propose fee adjustment model suitable for Korea reflecting health service volume and to clarify applicability of the model by comparing actual conversion factor with estimated conversion factor from simulation of this model. Methods: Fee adjustment model was developed based on Alberta's fee adjustment formula in Canada and 7 alternatives were assessed according to diversely applied parameters of the model. Results: Estimated conversion factors of the tertiary care hospital and the hospital were lower than actual conversion factors, since the utilization of heath service has been increased. However, there was no big difference between estimated conversion factors and actual conversion factors of the general hospital and the clinic. Eventually this fee adjustment model could estimate proper conversion factor reflecting health service volume. Conclusion: This model may be applicable to the mechanism as determining conversion factor between insurer and provider via negotiation and controling growth in health expenditures.

• 한국병원경영학회지
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• 제6권2호
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• pp.37-69
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• 2001

A new cost management system, called Activity Based Costing (ABC) system, has arisen to solve the limitation of a Traditional Cost Accounting (TCA) system until last two decades and ABC has been applied by many companies. TCA systems have limitation in tracing cost because they arbitrarily allocate overhead cost to the cost objects without standard for direct cost distribution. ABC is an accounting system that assigns costs to products or services based on the resources they consume. The costs of all activities are traced to the products for which they are performed. Therefore ABC is a cost management system that provides a matrix to accurately quantify consumed resources triggered by activities and activities triggered by products and services. There is little implementation of ABC in the health services field, one of service industries, due to complicated and many activities, and volatile cost object. However, the necessity for applying reasonable cost accounting system is largely issuing as strategy responding hostile environment, and financial pressure, and it is imperative to implement the Activity Based Costing (ABC) system. Therefore, this study presents the framework to develop ABC system for total health service organizations. Cost objects in this study base on medical service activities per health insurance claim from one general hospital located in Metropolitan Statistical Areas (MSAs). Medical service activities include all health insurance claims in the hospital. The purpose of the study is presenting useful tools and basic frame to develop Activity Based Costing system for health service organizations which want to use ABC system. The steps to develop ABC system for health service organizations are following: 1. Identifying of activity centers; 2. Definition of cost objects and activity by activity center; 3. Analysis of activity and tracing activity contribution; 4. Allocation of direct cost for specific activity; 5. Allocation of indirect cost for specific activity; 6. Allocation of depreciation for facilities, applicants, and consumption goods; 7. Allocation of administration cost; 8. Allocation of cost among activity centers; and 9. Tracing cost of cost objects by activity center. This study identified necessary information from existing reports which hospitals generally made by each step, and defined outcome which had to be produced in each step using this information. The steps of this study had limitation to apply all different size hospitals because the steps were structured ABC system by one hospital, however, this study used similar basic framework and methods with general cases. When a health service organization want to apply Activity Based Costing (ABC) system on all activities of it in future days, this study is very useful to design system structure in the health service organization.

• 보건의료산업학회지
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• 제10권1호
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• pp.1-11
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• 2016

Objectives : Medical service specialization could have positive effects on their profits and medical service quality. This study was to examine the relationship between medical service specializations and operational performance in hospitals. Methods : We used the National Inpatient Sample data provided by the Health Insurance Review and Assessment Service from 2010 to 2013. The hospital operational performance was determined by measuring the specialization level of the hospital based on DRGs. Results : The information theory index was 2.38 in 2010, 2.38 in 2011, 2.37 in 2012, and 2.37 in 2013. A multiple regression model was constructed which showed that if the specialization level becomes higher, it decreases the length of stay per case with an increase in medical expense. Conclusions : Differentiation and concentrated medical service specialization strategy have had a positive effect on the operational performance of hospitals.

• 한국콘텐츠학회논문지
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• 제11권8호
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• pp.23-32
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• 2011

만성질환자가 증가함에 따라서 유헬스 서비스는 특정 질병의 치료 및 관리에서 서비스 대상자에 대한 행동수정기반의 예방서비스로 진화하고 있다. 기존의 유헬스 서비스는 원격진료나 상담을 통한 서비스나 생체정보의 모니터링만을 제공하여 대사증후군 등 만성질환자를 예방하거나 관리하는 것에는 한계가 있다. 이에 본 논문에서는 만성질환자의 건강관리를 위한 멀티플랫폼 기반의 유헬스 서비스 모델를 제안한다. 멀티플랫폼 기반의 유헬스 서비스는 PC와 스마트폰을 통하여 사용자의 위치와 제한없이 지속적으로 건강 정보 및 식이, 운동에 대한 서비스가 가능하다. 또한 임상정보를 바탕으로 CDS(Clinical Decision Support) 모듈을 활용한 처방 서비스를 의사와 간호사에게 제공한다. 의사는 행동수정 프로그램을 통해 서비스 대상자의 생활패턴을 파악하고 맞춤화된 서비스의 제공이 가능하다. 본 유헬스 서비스 모델은 서비스 대상자에게 멀티플랫폼 환경에서 효과적인 서비스를 제공하여 만성질환자의 건강증진에 기여할 것으로 기대된다.

• 대한간호학회지
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• 제39권3호
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• pp.366-375
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• 2009

Purpose: To evaluate the effects of case management using Resident Assessment Instrument-Home Care(RAI-HC) in home health service for older people. Methods: All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living(ADL), Instrumental Activities of Daily Living(IADL), Cognitive Performance Scale(CPS), Depression Rating Scale(DRS), Pain and the number of Clinical Assessment Protocols(CAP). Results: Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression(odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL(OR: 4.423, CI: 1.151-16.999) and the number of CAP(OR: 11.443, CI: 3.805-34.410). Conclusion: Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.

• 보건의료산업학회지
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• 제10권2호
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• pp.71-82
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• 2016

Objectives : This study purposed to analyze the productivity trends of regional health care resource uses in South Korea. Methods : Data was provided from the regional health care statistics by the National Health Insurance Service(NHIS) and collected from 2011 to 2014 at the 226 administrative regions such as Si(city in Korean), Gun(county in Korean), Gu(district in Korean). Productivity trend was analyzed with Malmquist Productivity Index(MPI). Input variables were the number of medical personnels, facilities, and major medical equipments. Output variables were the number of inpatient and outpatients in model A, and the amount of inpatient and outpatient reimbursements in model B. Results : In model A, the productivity of 62 regions were increased but it was decreased in 164 regions. In model B, the productivity of 123 regions were increased but it was decreased in 123 regions. Conclusions : If these trends were continued, there will be problems with the efficiency of national regional healthcare resource utilization. Health policy makers will require to focus in solving this phenomenon.

• 보건의료산업학회지
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• 제7권3호
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• pp.83-93
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• 2013

This study was conducted on 350 students of health and medical department of universities in Busan from June 3, 2013 to June 21, 2013, and a total of 350 questionnaires were researched. Among them 337 responses were used after 13 unfaithful responses were excluded. The effects of oral health belief on use of dental service of students of health and medical department of universities were examined and analyzed to provide basic data which can be used to expand understanding about oral health belief, to promote changes in behaviors regarding oral health and to improve oral health of the public. Collected data was analyzed through SPSS (Statistical Packages for Social Science 15.0. SPSS Inc. USA). For verification of differences of oral health belief depending on general matters and oral health behavior, t-test and ANOVA analysis were conducted, and for examination of the effects of oral health belief on use of medical service, logistic regression and regression analysis were conducted. The study results suggest that those who had higher sensitivity among oral health belief variables had higher probability of needing dental treatment and seeing the dentist immediately. And those who showed higher sensitivity and importance had higher frequency of seeing the dentist for six months. Future studies need to be conducted on the methods to change oral health belief for sustainable and systematic oral health enhancement in consideration of the factors affecting oral health belief and oral health behavior of the students of dental hygiene department.