• 한국실내디자인학회논문집
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• 제25권6호
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• pp.139-148
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• 2016

Chronic patients and staffs in healthcare facilities cannot avoid long-term stays indoors. Therefore, they need to get adequate amounts of sunlight to prevent diseases caused by vitamin D deficiency. This is a case study on the advanced daylighting systems installed to healthcare facilities for therapeutic environments as serving natural light therapy and a pleasant atmosphere. This paper shows daylighting devices that overcome the structural limits of architectural design solutions for inducing natural light. This study presents appropriate daylighting technologies to the purpose and types of healthcare facilities by analyzing therapeutic environmental factors. Natural light delivered through daylighting devices help directly patients recover. In addition, it can improve healthcare providers' performance and productivity, and reduce their errors, thereby creating therapeutic environments for patients, indirectly. Excellent color rendering of solar illumination is also a powerful tool for navigation and wayfinding in the buildings, and for aesthetic treatment in dental office. Furthermore, daylighting systems are streamlined and require the least material and space to attract sunlight up to the deeper inside. But because of expensive cost, they have not yet been widespread. Though daylighting devices are typically more expensive than artificial illuminations to install, the running cost savings can compensate for the initial installation cost. With the development of technology in the future, the market price of them is expected to be formed properly.

• 한국병원경영학회지
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• 제17권2호
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• pp.73-92
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• 2012

This study aims to develop strategic plan for enactment of national license of hospital administrators. To effectively control healthcare cost and mange healthcare organizations, the enactment is an inevitable process. Based on literature reviews, cases of similar licences in advanced foreign countries, and a survey of 200 experts in healthcare fields, this study provide a strategic map how to proceed the enactment.

• 보건행정학회지
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• 제25권2호
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• pp.67-70
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• 2015

To establish an appropriate policy for robotic surgery in Korea, the National Evidence-based Collaborating Agency (NECA) and the Korean Society of Health Policy and Administration held a round-table conference (RTC) to gather opinions through a comprehensive discussion of scientific information in gastric cancer. The NECA RTC is a public discussion forum wherein experts from diverse fields and members of the lay public conduct in-depth discussions on a selected social issue in the health and medical field. For this study, representatives from the medical field, patient groups, industry, the press, and policy makers participated in a discussion focused on the medical and scientific evidence for the use of robotic surgery in gastric cancer. According to the RTC results, robotic surgery showed more favorable results in safety and efficacy than open surgery and it is similar to laparoscopy. When the cost-effectiveness of robotic surgery and laparoscopy is compared, robotic surgery costs are higher but there was no difference between the two of them in terms of effectiveness (pain, quality of life, complications, etc.). In order to resolve the high cost issue of the robotic surgery, a proper policy should be implemented to facilitate the development of a cost-effective model of the robotic surgery equipment. The higher cost of robotic surgery require more evidence of its safety and efficacy as well as the cost-effectiveness issues of this method. Discussions on the national insurance coverage of robotic surgery seems to be necessary in the near future.

• 보건의료기술평가
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• 제6권2호
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• pp.123-132
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• 2018

Objectives: Maternal morbidity and mortality are important healthcare issues. However there have been few studies on cost of illness (COI) from maternal disorders. This study aimed to estimate the COI due to maternal disorders in Korea. Methods: By reviewing previous studies and consulting expert we determined the scope of maternal disorders. We operationally defined maternal disorders as maternal hemorrhage, maternal sepsis, hypertensive disorders of pregnancy, obstructed labor, and abortion for maternal disorders. The reference period of this study is the year 2015. Main source of data were the National Health Insurance Service claims data, cause of death statistics from the Korea National Statistical Office, and the Korea Health Panel study. We classified the total costs into direct and indirect costs. The direct costs cover healthcare costs and non-healthcare costs. The indirect costs consist of productivity losses due to morbidity and premature death. Results: The cost of maternal disorders in 2015 was 229.7 billion won. The direct and indirect costs of maternal disorders were 165.2 billion won and 64.5 billion won respectively. The largest cost item for maternal disorders was healthcare cost (138.3 billion won, 60.2%). By age groups, the COI in 30-39 years old women were the highest (165.1 billion won, 71.9%). Abortion was the disorder with the highest COI among maternal disorders (71.9 billion won, 31.3%). Conclusion: The COI due to maternal disorders in Korea is quite substantial. Economic burden of maternal disorder increased when being compared with the year 2012 data despite the continued low birth rate in Korea. Therefore, it is necessary to continuously monitor the social costs of the maternal disorders in Korea.

• 보건행정학회지
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• 제27권1호
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• pp.80-83
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• 2017

The proportion of people who reported unmet healthcare needs is an important indicator to measure the access problem in healthcare service. To examine current status and trends of unmet needs in Korea, we used data from four sources: the Korea National Health and Nutrition Examination Survey (KNHNES, '2007-2015); the Community Health Survey (CHS '2008-2015); the Korea Health Panel Survey (KHP '2011-2013); the Korean Welfare Panel Study (KOWEPS '2006-2015). The proportion of individual reporting unmet healthcare needs as of 2015 was 12.6% (KNHNES), 11.7% (CHS), and 16.3% (KHP, as of 2013). Annual percent change which characterizes trend for follow-up period was -9.4%, -3.4%, and 7.6%, respectively. The proportion of individual reporting unmet healthcare needs due to cost was 2.8% (KNHNES), 1.7% (CHS), and 4.6% (KHP). The proportion of household reporting unmet healthcare needs due to cost was 1.2% (KOWEPS). Annual percent change was -9.0%, -14.9%, 9.4%, and -18.2%, respectively. Low income population reported about 5 times more unmet needs than high income population. Therefore for decreasing the unmet healthcare needs, strategies focusing on low income population were needed.

• Journal of Preventive Medicine and Public Health
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• 제48권6호
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• pp.319-329
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• 2015

Objectives: Parental socioeconomic status (SES) exerts a substantial influence on children's health. The purpose of this study was to examine factors determining children's private health insurance (PHI) enrolment and children's healthcare utilization according to PHI coverage. Methods: Korea Health Panel data from 2011 (n=3085) was used to explore the factors determining PHI enrolment in children younger than 15 years of age. A logit model contained health status and SES variables for both children and parents. A fixed effects model identified factors influencing healthcare utilization in children aged 10 years or younger, using 2008 to 2011 panel data (n=9084). Results: The factors determining children's PHI enrolment included children's age and sex and parents' educational status, employment status, and household income quintile. PHI exerted a significant effect on outpatient cost, inpatient cost, and number of admissions. Number of outpatient visits and total length of stay were not affected by PHI status. The interaction between PHI and age group increased outpatient cost significantly. Conclusions: Children's PHI enrolment was influenced by parents' SES, while healthcare utilization was affected by health and disability status. Therefore, the results of this study suggest disparities in healthcare utilization according to PHI enrollment.

• 보건행정학회지
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• 제29권3호
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• pp.248-261
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• 2019

Establishing a healthcare delivery system is key to building a cost-effective healthcare system that can prevent the waste of healthcare resources and increase efficiency. Recently, the rapid increase in the national medical expenditures due to the aging of the population and the increase in chronic diseases has raised the question about the sustainability of the healthcare system including the health insurance system. This is why we need to reform the medical delivery system, including the function setting of medical institutions. Accordingly, gradual and practical efforts based on the recognition of reality are needed for solving the problems and improving the medical delivery system. The first effort is to secure policy measures to establish functions and roles of medical institutions which are the basis of the healthcare delivery system, and a systematic medical use system for appropriate medical use. This approach can be achieved through a reasonable health insurance schemes. Without reasonable reform efforts, it will be difficult for Korea's health care system to develop into a system that can provide cost-effective and high-quality medical services that the people want.

• Journal of Preventive Medicine and Public Health
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• 제46권4호
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• pp.201-209
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• 2013

Objectives: The goal of this study was to perform an economic analysis of a primary stenting with drug-eluting stents (DES) compared with bare-metal stents (BMS) in patients with acute myocardial infarction (AMI) admitted through an emergency room (ER) visit in Korea using population-based data. Methods: We employed a cost-minimization method using a decision analytic model with a two-year time period. Model probabilities and costs were obtained from a published systematic review and population-based data from which a retrospective database analysis of the national reimbursement database of Health Insurance Review and Assessment covering 2006 through 2010 was performed. Uncertainty was evaluated using one-way sensitivity analyses and probabilistic sensitivity analyses. Results: Among 513 979 cases with AMI during 2007 and 2008, 24 742 cases underwent stenting procedures and 20 320 patients admitted through an ER visit with primary stenting were identified in the base model. The transition probabilities of DES-to-DES, DES-to-BMS, DES-to-coronary artery bypass graft, and DES-to-balloon were 59.7%, 0.6%, 4.3%, and 35.3%, respectively, among these patients. The average two-year costs of DES and BMS in 2011 Korean won were 11 065 528 won/person and 9 647 647 won/person, respectively. DES resulted in higher costs than BMS by 1 417 882 won/person. The model was highly sensitive to the probability and costs of having no revascularization. Conclusions: Primary stenting with BMS for AMI with an ER visit was shown to be a cost-saving procedure compared with DES in Korea. Caution is needed when applying this finding to patients with a higher level of severity in health status.

• Tuberculosis and Respiratory Diseases
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• 제81권2호
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• pp.116-122
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• 2018

Background: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations. Methods: Toward this end, this study compared the relative effectiveness of six indices in predicting patient healthcare utilization, cost of care, and patient health outcome. The six assessment systems evaluated included the three multidimensional Body mass index, Obstruction, Dyspnea, Exercise capacity index, Dyspnea, Obstruction, Smoking, Exacerbation (DOSE) index, and COPD Assessment Test index, or the unidimensional measures that best predict the future of patient healthcare utilization, cost of care, and patient health outcome among Chinese COPD patients. Results: Multiple linear regression models were created for each healthcare utilization, cost, and outcome including a single COPD index and the same group of demographic variables for each of the outcomes. Conclusion: We conclude that the DOSE index facilitates the prediction of patient healthcare utilization, disease expenditure, and negative clinical outcomes. Our study indicates that the DOSE index has a potential role beyond clinical predictions.

• 보건행정학회지
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• 제33권1호
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• pp.107-113
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• 2023

Unmet healthcare is an important indicator for measuring accessibility of healthcare services. We analyzed the following four data from a nationally representative sample of South Korean population: Korea Health and Nutrition Examination Survey (KNHANES, 2007-2021), Community Health Survey (CHS, 2008-2021), Korea Health Panel Survey (KHP, 2011-2019), and Korean Welfare Panel Study (KOWEPS, 2006-2021). The proportion of individuals reporting unmet healthcare needs were 6.0% (KNHANES), 5.1% (CHS), and 13.1% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.4%, -9.4%, and -5.3%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.2% (KNAHANES), 0.5% (CHS), 2.7% (KHP), and 0.4% (KOWEPS). The APC was -10.4%, -16.1%, -11.5%, and -19.1%, respectively. Compared to the previous year, the rate of unmet healthcare needs decreased slightly, but the rate of unmet health care needs due to cost tended to increase. Overall, higher rates of unmet healthcare needs were reported in the low-income and the elderly population. Although it was confirmed through the APC that the rate of unmet healthcare experience has decreased over the past decade, it can be seen that there is still a disparity by income level and age. These results suggest the need for an appropriate health benefit coverage policy for the low-income and the elderly.