• Title/Summary/Keyword: Healthcare costs

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A Study on the Fitness Recommendation System Utilizing Mobile Sensor Control Mechanism (모바일 센서 제어 메커니즘을 활용한 휘트니스 추천 시스템에 관한 연구)

  • Lee, Jong-Won;Kim, Dong-hyun;Park, Sang-no;Jung, Hoe-kyung
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2015.05a
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    • pp.600-602
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    • 2015
  • WHO(World Health Organization) as specified due to the global epidemic of obesity in the nation and the social costs associated with health increase. If treating diseases of the existing research targets the medical field with increasing interest in the welfare and well-being sector due to the improvement in earnings, and gradually change to advance the prevention and management. In this paper, we consider these social changes, we propose a personalized recommendation system fitness. This makes it possible that the recommendation is effective to the movement by the movement mechanism by which user. Mobile sensor is overcome by software and having hardware limitations for this purpose, proposes an optimized sensor control mechanism.

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An Evaluation of Accountable Care Organization in USA and Policy Implications for Korean Health Care System (미국의 책임의료조직(Accountable Care Organization) 운영현황 분석과 국내 의료정책에서 정책적 함의 평가)

  • Seo, Kyung Hwa;Jung, Yu Min;Kim, Min Ji;Lee, Sun Hee
    • Health Policy and Management
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    • v.24 no.4
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    • pp.396-412
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    • 2014
  • Background: As a reform plan of health care system, Accountable Care Organization (ACO) has became an object of attention in the United States after Patient Protection and Affordable Care Act was enacted. ACO is a group of various health care providers and provide coordinated care to its assigned beneficiaries. If ACOs improve the quality level and reduce the cost of care, they can get financial incentives. Under the discussion for a quite long time and demonstration projects, ACO has been established. We aimed to analysis and discuss the history, policy mechanism, contents, status and outcomes of ACO. Also, we intended to suggest political implication Korean health care system with regard to ACO. Methods: We searched the articles related ACO in PubMed and selected several available papers about ACO. Total 56 studies were reviewed and categorized three parts; demonstration projects for formation of ACO, policy mechanism and agenda, empirical results of ACO performance. Results: As a result, establishment of ACO was successful partly in the US. It seems to be due to various project and pilot test for verification in the long time. The empirical effect of ACO was also identified in a few study but it needs more evidences to judge its positive effect. Conclusion: In Korea, there are arguments for the application of ACO. However it is difficult to implement a ACO by different political conditions between Korean and US. Nevertheless ACO proposed us the necessity of paradigm shift in our health policy and could be significant to national policy orientation in the future.

Reviews on the Current Status and Appropriate Management of Polypharmacy in South Korea (우리나라의 다제약제 현황과 적정관리 방안에 대한 고찰)

  • Park, Hae-Young;Sohn, Hyun Soon;Kwon, Jin-Won
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.1
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    • pp.1-9
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    • 2018
  • Polypharmacy is increasing owing to an increase in the elderly population and multimorbidities associated with the increased risk of administration of potentially inappropriate medications (PIMs). The negative effects of polypharmacy on various health conditions and aspects, such as fall, fracture, mortality, cognitive function, and dementia, have been reported. The management of excess and inappropriate polypharmacy through proper interventions and local or national guidelines has been highlighted. The purpose of polypharmacy management is to appropriately prescribe medicines that are essential to treat diseases in patients and to avoid inappropriate polypharmacy, such as interactive or duplicate medicines under prescription and PIMs for specific diseases. Community pharmacists in Australia, the EU, USA, and Japan are collaborating with prescribers to review medications to ensure that the patients can be prescribed appropriate medications. The service cost is reimbursed by public or private insurers. A study in the United States has shown that even with medication review costs, the overall medication cost has reduced. In Korea, various projects such as Drug Utilization Review service and safe use of medicines have been conducted; however, no national guidelines or management measures have been established. It is necessary to implement a national long-term plan on polypharmacy management. Furthermore, a phased implementation plan is required. Shortly, active medication review services and education programs for healthcare professionals with the support of the government should be considered in Korea with reference to other countries in order to raise awareness of seriousness and risks of inappropriate polypharmacy.

The Effects and Variances of the Critical Pathway of Laparoscopic Colon Resection in Colon Cancer Patients (일 병원의 대장절제술 환자를 위한 표준진료지침의 임상적용 효과와 변이분석)

  • Jung, Hye-Jeong;Choi, Mo-Na;Kim, So-Sun;Kim, Nam-Kyu;Lee, Kang-Young
    • Asian Oncology Nursing
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    • v.12 no.3
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    • pp.204-212
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    • 2012
  • Purpose: To investigate the effectiveness and variance of a critical pathway (CP) for laparoscopic colon resection in colon cancer patients, and nurses'satisfaction with the CP. Methods: A CP for laparoscopic colon resection was applied to the CP-group that included 50 patients, who underwent elective colon resection between March and May, 2011. The non-CP group included 51 patients who had the same operation without the CP applied from March to May, 2010. Results: The means of length of hospital stay were 11.7 and 7.3 days (p<.001) and the lengths of postoperative hospital stay were 8.6 and 5.1 days (p<.001) in the non-CP group and CP group, respectively. There was no significant difference between two groups for total healthcare costs, pain score, complications, or emergency room visits within 30 days after discharge. By examining variances of the CP, there were 162 variances and the most frequent cause was patient's condition. Nurses'satisfaction with the use of CP was favorable and the mean score of satisfaction was 3.76 on the 5 point Likert scale. Conclusion: There are clear benefits to use of CP, resulting in standardized and effective patient care. In conclusion, analysis of variance data can assist in evaluating and revising CP for optimal care and reducing variances.

Global O2O Matching Platform research based on Clinics (글로벌 클리닉 기반의 O2O 매칭 플랫폼 연구)

  • Park, Jong-Youel;Park, Dea-woo
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.20 no.8
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    • pp.1517-1523
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    • 2016
  • The global medical tourism industry including Asian market has been activating recently. That is as medical tourists are motivated to seek the higher quality of healthcare with lower costs, as well as of travel. The consumers in this field tend to need customized services of medical tourism. It is needed that the consumers get customized information on medical services and traveling, the clinics and hospitals resolve the issues of offering translation and luring medical tourists from overseas, and the guides, who offer tour and translation service, provide the consumers and the clinics with customized services so that they get the services needed for one another. This research studies the Offline to Online, called O2O, matching platform based on global clinics, which connects medical facilities, patients, and guides for traveling and language services. It presents the customized marketing plans by utilizing customers' experiences from medical services and traveling they use.

Problems in the Medical Dispute Medication System and Improvement Plan (의료분쟁조정제도 운영상의 문제점 및 개선방안)

  • Choi, Jang Seop
    • The Korean Society of Law and Medicine
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    • v.15 no.2
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    • pp.91-122
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    • 2014
  • For a variety of reasons, the number of medical disputes is continuously rising. Due to the intrinsic qualities of medical treatments, one would find it more apt to subject medical disputes to general conflict resolution procedures rather than to once-for-all decisions under legal suits. To address the increasing medical disputes with greater professionalism and efficiency, the Medical Disputes Mediation Act was enacted and a medical dispute mediation system put in place, while drawbacks have been blamed to both. The current mediation procedures require the respondent's agreement as a disclosure requirement. A reasonable improvement to this would be to amend the regulation of agreement supposition, or to enforce procedural participation only to public health facilities managed by the national or regional government. Furthermore, small claims cases of 20 million KRW or less in claim may be considered for conciliation-prepositive principle. The concentration on small claim medical disputes is a phenomenon that can be addressed by carrying out maximum authentication commissions or similar measures, one of the solutions by enhancing the public trust in the Korea Medical Dispute Mediation and Arbitration Agency. The proper management of medical authentication teams is one way to address the existing problems in the authentication system. For this, the number of team members shall be increased under more flexible authentication procedures. All indemnity resources for medical accidents of force majeure must be borne by the Government, for it is the body principally responsible for social compensation. Placing this cost on the establisher of the subject medical facility holds the possibility of violating fundamental rights. While the costs for subrogation payment system for damages may be borne by the healthcare facility establisher, a deposit-based system must be created for cases in which the facility shuts down, without holding the responsibility for accident cause. Such change to a deposit-based system will evade the controversies of unconstitutionality, etc.

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Development and Evaluation of Korean Ambulatory Patient Groups (한국형 외래환자분류체계의 개발과 평가)

  • Park, Ha-Young;Kang, Gil-Won;Koh, Young
    • Health Policy and Management
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    • v.16 no.1
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    • pp.17-40
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    • 2006
  • With the prospect of rapidly growing health insurance expenditures, particularly spending for ambulatory care, the introduction of a case-based payment method is discussed as an alternative to the current fee-for-service based method. A system to measure case mixes of providers is a core component of such payment systems. The objective of this study were to develop a classification system for ambulatory care, Korean Ambulatory Patient Group (KAPG) based on the U.S. APG version 2.0 and to evaluate the classification accuracy of the system. A database of 64,258,386 records was constructed from insurance claims submitted to the Health Insurance Review Agency (HIRA) during three months from August 2002. A total of 41,347,307 records with a single visit was used for the development and 7% random sample of the database was used for the evaluation. Additional groups were defined to include both physician and hospital fees in the classification, age splits were added to classify the entire population as well as the population older than 65, and the definition of medical groups used by the HIRA was adopted. The variance reduction in charges achieved by KAPGs was computed to evaluate the accuracy of classification. A total of 474 KAPGs was defined compare to 290 groups in the U.S. APG. The variance reduction for charges of all visits ranged from 20% to 37% depending on the type of provider, and ranged from 22% to 42% for non-outliers, that were better than those achieved by the system currently used by the .HIRA for its internal review purpose. Although further study is required to improve the classification for complicated care in larger hospitals, the results indicated that KAPGs could be used for better management of costs for ambulatory care.

Reviewing Efficiency Strategy of Long-term Care System (노인요양보장체계의 효율화에 대한 소고)

  • Shin, Eui-Chul;Im, Geum-Ja;Lee, Eunw-Han;Lee, Yun-Hwan
    • Health Policy and Management
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    • v.21 no.1
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    • pp.115-131
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    • 2011
  • Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.

A Development of Non-Invasive Body Monitoring IOT Sensor for Smart Silver Healthcare (스마트 실버 헬스케어를 위한 비접촉 인체감지 IOT 센서 개발)

  • Kang, Byung Wuk;Kim, Sang Hee
    • Journal of the Institute of Convergence Signal Processing
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    • v.19 no.1
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    • pp.28-34
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    • 2018
  • This paper is composed of a passenger management system using a temperature sensing module, a PIR sensor module for detecting movement inside a room, and a smart breath sensing module for determining a sleeping state. An embedded sensor module and a communication system integrated the sensing part and the algorithm driving part. As the aging society is accelerating and becoming more upgraded, the social cost of Silver Care increases, and in order to protect privacy, it is necessary to reduce costs by developing efficient smart silver care devices. The proposed non - image human body detection IOT sensor system is implemented by hardware and software and has superior performance compared with conventional image monitoring method.

An Analysis on Appropriateness of Health Insurance Fee Using the Activity Based Costing(ABC) Approach (활동기준 원가분석을 통한 건강보험수가의 적정성 분석)

  • Kim, Han-Sung;Shin, Hyun-Woung;Cha, Jae-Young
    • Korea Journal of Hospital Management
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    • v.20 no.3
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    • pp.36-44
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    • 2015
  • The Activity Based Costing(ABC) means the process that makes clear how the actions and input resources have changed into service to calculate medical services costs. These days, the number of hospital which is using the ABC system is increasing to make their policy decision making efficient and run the hospitals more resonable. This study analyzes the unbalance in the level of health insurance service fee and the improvement plans based from 8 hospitals(ABC system) and 95 clinics(ABC survey). The cost recovery ratio has shown different levels according to each service type. A surgery service type recorded 76.8% and an evaluation & management service type is 84.6%, a treatment procedure type(85.8%), a function test type(91.6%) and health insurance fee even did not reach to the original cost. Meanwhile, a laboratory test type and imaging test type show high level of cost recovery ratio. they recorded 188.3% and 158.8%. Resultingly now of unbalance in the level of health insurance service fee accelerates supply of every test. so there is a need to make laboratory test type and imaging test type lower to keep balance with the surgery and medical service. These methods should be performed gradually with monitoring the unbalance fee ratio and for this, a panel medical institution have to be established for generalizations of studying result, fairness of selecting researching sample.