• Title/Summary/Keyword: Healthcare institution

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Bundled Discounting of Healthcare Services and Restraint of Competition (의료서비스의 결합판매와 경쟁제한성의 판단 - Cascade Health 사건을 중심으로 -)

  • Jeong, Jae Hun
    • The Korean Society of Law and Medicine
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    • v.20 no.3
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    • pp.175-209
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    • 2019
  • The bundled discounting which the dominant undertakings engage in is problematic in terms of competition restraint. Bundled discounts generally benefit not only buyers but also sellers. Specifically, bundled discounts usually costs a firm less to sell multiple products. In addition, Bundled discounts always provide some immediate consumer benefit in the form of lower prices. Therefore, competition authorities and courts should not be too quick to condemn bundled discounts and apply the neutral and objective standard in bundled discounting cases. Cascade Health v. Peacehealth decision starts ruling from this prerequisite. This decision pointed out that the dominant undertaking can exclude rivals through bundled discounting without pricing its products below its cost when rivals do not sell as great a number of product lines. So bundled discounting may have the anticompetitive impact by excluding less diversified but more efficient producers. This decision did not adopt Lepage case's standard which does not require the court to consider whether the competitor was at least as efficient of a producer as the bundled discounter. Instead of that, based on cost based approach, this decision said that the exclusionary element can not be satisfied unless the discounts result in prices that are below an appropriate measures of the defendant's costs. By adopting a discount attribution standard, this decision said that the full amount of the discounts should be allocated to the competitive products. As the seller can easily ascertain its own prices and costs of production and calculate whether its discounting practices exclude competitors, not the competitor's costs but the dominant undertaking's costs should be considered in applying discount attribution standard. This case deals with bundled discounting practice of multiple healthcare services by the dominant undertaking in healthcare market. Under the Korean healthcare system and public health insurance system, the price competition primarily exists in non-medical care benefits because public healthcare insurance in Korea is in combination with the compulsory medical care institution system. The cases that Monopoly Regulation and Fair Trade Law deals with, such as cartel and the abuse of monopoly power, also mainly exist in non-medical care benefits. The dominant undertaking's exclusionary bundled discounting in Korean healthcare markets may be practiced in the contracts between the dominant undertaking and private insurance companies with regards to non-medical care benefits.

Changes in the Behavior of Healthcare Organizations Following the Introduction of Drug Utilization Review Evaluation Indicators in the Healthcare Quality Evaluation Grant Initiative (의료질평가지원금 제도의 의약품안전사용서비스 평가지표 도입에 따른 의료기관의 행태 변화)

  • Hyeon-Jeong Kim;Ki-Bong Yoo;Young-Joo Won;Han-Sol Jang;Kwang-Soo Lee
    • Health Policy and Management
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    • v.34 no.2
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    • pp.178-184
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    • 2024
  • Background: This study aimed to determine the effectiveness of drug utilization review (DUR) evaluation indicators on safe drug use by comparing the changes in DUR inspection rates and drug duplication prescription prevention rates between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative. Methods: This study used DUR data from the Health Insurance Review and Assessment Service in 2018 (pre-implementation) and the evaluation results of the Healthcare Quality Evaluation Grant Initiative in 2023 (post-implementation). The dependent variables were the DUR evaluation indicators, including DUR inspection rate and drug duplicate prescription prevention rate. The independent variable was the implementation of the DUR evaluation indicators, and the control variables included medical institution characteristics such as type, establishment classification, location, DUR billing software company, and number of beds. Results: The results of the analysis of the difference in the prevention rate of drug duplicate prescriptions between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative showed that the prevention rate of drug duplicate prescriptions increased statistically significantly after the implementation of the DUR evaluation indicators. Conclusion: The policy implications of this study are as follows: First, ongoing evaluation of DUR systems is needed. Second, it is necessary to establish a collaborative partnership between healthcare organizations that utilize DUR system information and the organizations that manage it.

Measuring Quality of Life in Cerebral Palsy Children According to the Severity Using the Visual Analogue Scale, Time Trade-Off, and EQ-5D-Y Proxy (뇌성마비 환아 중증도별 시각화척도, 시간교환법, EQ-5D-Y Proxy를 이용한 삶의 질 측정)

  • Lee, Go-Eun;Kim, Nam Kwen;Yun, Young Ju;Wang, Hye Min;Kim, Jeong Hun;Lee, Dong Hyo
    • Journal of Oriental Neuropsychiatry
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    • v.28 no.2
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    • pp.49-59
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    • 2017
  • Objectives: To measure the quality of life in patients according to virtual cerebral palsy severity by using the Korean version of EQ-5D-Y proxy, Visual Analogue Scale (VAS), and Time Trade-Off method (TTO). Methods: The study was conducted in parents of children and adolescents aged 4 to 15 years in Seoul. We analyzed the difference in the utility value according to five levels of cerebral palsy severity in the Gross Motor Function Classification System (GMFCS) and test-retest reliability. Results: 1. There were significant differences in VAS, TTO, and EQ-5D-Y proxy according to the cerebral palsy severity (p<.001). 2. VAS was significantly different according to the respondent's visit to the medical institution, the presence of disease in the respondent, a visit to the child's medical institution, the age of the child, and the sex of the child. The value of TTO was significantly different according to the respondent's visit to the medical institution, respondent's sex, and the age of the child. Also, EQ-5D-Y proxy was significantly different according to the age of the child. 3. Intraclass correlation coefficient values were more than 0.6 for both VAS and TTO at all stages. But for the EQ-5D-Y proxy, the value was less than 0.6 at all stages. Conclusions: The quality of life assessment using EQ-5D-Y proxy showed significant differences in the severity of cerebral palsy. However, large-scale studies using EQ-5D-Y proxy are needed because of low test-retest reliability.

System Software Design of Computed Tomography Radiation Dose Management (컴퓨터 단층촬영(CT) 방사선 노출 관리 시스템 소프트웨어 설계)

  • Yang, Yu-mi;Lee, Kil-hung;Cho, Sang-wook
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2014.05a
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    • pp.489-492
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    • 2014
  • This thesis provides the design of system software for the management of radiation dose that is generated using computer tomography(CT). Because radiation exposure is different depending on the difference in sensitivity to each part for each of the patient's body, if we will be able to manage an appropriate amount of radiation, it is possible to estimate the radiation exposure of the patient as a result. Recently, radiation leakage incident of Japanese nuclear power plant was in the news internationally and there is a growing interest not only a nuclear power plant, to medical radiation exposure. In spite of the fact that currently safety management of radiation is under control only the workers of the radiation involved, exposure management of patients until now have been required. Surgery and inspection using the radiation in Korea will increase, due to this medical exposure has increased, but it is a reality that medical institution don't know the level of radiation exposure applied to the patient. Therefore a system for managing the radiation exposure of the patient from the medical institution is required. This paper proposes a design of a software program to manage the radiation exposure of CT is an typical imaging tool to use the radiation in the medical institution. By check the amount of radiation dose and set the limit of dose, we would help to optimize the medical exposure of the patient.

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Development of an Electronic Document for DNR Informed Consent based on the Electronic Medical Record System (전자의무기록 기반의 심폐소생술금지 동의서의 전자서식 개발)

  • Park, Ji-Kyeong
    • The Korean Journal of Health Service Management
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    • v.10 no.3
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    • pp.99-111
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    • 2016
  • Objectives : This study developed an iPad-based animation for an electronic informed consent to directly help patients prepare an informed consent. The goal was to raise patients' understanding about the contents contained in a DNR informed consent in the current medical situation in which DNR informed consents are mostly written by a guardian. Methods : The development of a DNR electronic informed consent was done in 3 stages: analysis, design and development. The analysis stage was done with a survey on the real status of preparing a DNR informed consent in a medical institution. The design stage was done with the contents in the DNR electronic informed consent through a primary and secondary Delphi survey. The development stage created a DNR electronic informed consent and evaluated it through a tertiary Delphi survey. Results : After evaluating the appropriateness of the composition of the contents, the understanding of the contents, the convenience of use, the reflection of an expert opinion, and the suitability of the application, all had scores higher than 4 points. Conclusions : The results of this study show that our proposed DNR electronic informed consent can help patients better understanding the contents of a DNR informed consent.

Development of Evaluation Indicators for Integrated Home Care (통합가정방문급여 평가지표 개발)

  • Park, Jong Duk;Jung, Dukyoo
    • Korean Journal of Adult Nursing
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    • v.26 no.5
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    • pp.543-552
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    • 2014
  • Purpose: The purpose of this study was to develop integrated evaluation indicators of home care services in the hope that the increasing group of long-term home care patients could receive quality care services. Methods: The development involves a methodological study on a development phase and a verification phase. The main survey at a verification stage was conducted by the staffs at 146 institutions who agreed to participate on this study. Results: The evaluation index for the integrated home visit care consisted of five categories and 57 indicators including Managing Institution (12), Environment and Safety (3), Right and Responsibility (7), Process of Care (31) and Results of Care (4). The criterion-related validity was verified in regard to the participation in the 2010 evaluation of long-term home-care institutions by the National Health Insurance Corporation. Conclusion: The evaluation index of the integrated home visiting care developed in this study is considered suitable to utilize as evaluating indicators in managing and evaluating the way of how institutions integrate and provide home visit care services as well as home nursing care services.

Reliability Model for u-Health SW's BMT (u-Health SW의 BMT를 위한 신뢰성 모델)

  • Chung, Sam-Sool;Yang, Hae-Sool
    • The Journal of the Korea Contents Association
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    • v.10 no.5
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    • pp.80-89
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    • 2010
  • u-Health refers to "Always, ubiquitously" prevention against disease, diagnosis, medical treatment service that can receive treatment even if patient does not visit hospital as abbreviated word of ubiquitous and health. U-Health transmits in individual's living body sign and measuring of health information and health information system that is consisted of process of analysis and feedback transmiting and measure individual's living body signal and health information and health proprietary company or medical institution operates. If analyze pattern to information that health information system is transmited, health care officer or chief physician means that offer healthcare and medical treatment service to remote about target customer. Wish to present authoritativeness model for u-Health's inside and outside of the country same native place and u-Health's BMT in this research.

Quantitative Evaluation of Appointment System for Outpatients in Dental Clinic (치과의원 외래환자 예약관리체계의 계량적 평가)

  • Lee, Hyung-Ju;Chang, Hye-Jung
    • Korea Journal of Hospital Management
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    • v.8 no.2
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    • pp.49-69
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    • 2003
  • This study purported to evaluate the performance of the appointment system for outpatients in primary care dental clinic. The data of patients' time flow for 1,245 patients in Y Dental Clinic were collected for one month in 2002 and then analyzed. Specifically, the time periods of treatment and patients' waiting as well as rates of appointment and it's failure are estimated. The accuracy of expected treatment time period was also evaluated. The results showed that 72% of patients visited the clinic with appointments, and only 56% kept their appointments. The patient's waiting time period turned out to be 11 minutes in Y clinic. The expected treatment time period is turned out to be very important because they influence significantly on patient's waiting time period. Practically, the expected treatment time period should be overestimated about 9 minutes in general, and the characteristics of dentist, each patient's diagnosis and age need to be especially considered. Hospitals and clinics also need to make the systematic and detailed critical pathways for a variety of patient cases by analyzing the patients' treatment pattern. With the improved appointment systems, healthcare institutions will approach the goal of effective and efficient management of the institution and also satisfy their customers.

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Organizational Effectiveness of Hospital Workers (병원종사자들의 조직유효성)

  • Lim, Jung-Do
    • The Korean Journal of Health Service Management
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    • v.5 no.2
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    • pp.63-76
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    • 2011
  • It is necessary to access managing human resources of hospitals with diversity in order to operate hospital organization successfully and efficiently. The research tries to analyze affecting factors of organizational effectiveness of hospital workers according to their positions. The research has been performed on the 836 hospital workers of 8 different positions in the Busan & Gyeong-nam area, utilizing SPSS version 19.0 for processing and analyzing the data. The major results of the research are as following. First, among such factors of organizational effectiveness as sense of belonging to work, pride, work settlement, wage satisfaction, job satisfaction, colleague perception, and unstable consciousness of their job, there is a meaningful difference according to the kinds of working institution and positions. Second, there was higher organizational effectiveness(a sense of belonging and pride) as to higher work settlement and wage satisfaction within all kinds of positions. In addition, there was higher organizational effectiveness(a sense of belonging and pride) as to higher job satisfaction and colleague perception within all kinds of positions except for physical therapist, general adminstration, facilities, nutrition, and etc. There was higher organizational effectiveness(a sense of belonging and pride) within all kinds of positions except for general adminstration, facilities, nutrition, and etc, as to lower job or work complaint.

Tree-based Approach to Predict Hospital Acquired Pressure Injury

  • Hyun, Sookyung;Moffatt-Bruce, Susan;Newton, Cheryl;Hixon, Brenda;Kaewprag, Pacharmon
    • International Journal of Advanced Culture Technology
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    • v.7 no.1
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    • pp.8-13
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    • 2019
  • Despite technical advances in healthcare, the rates of hospital-acquired pressure injury (HAPI) are still high although many are potentially preventable. The purpose of this study was to determine whether tree-based prediction modeling is suitable for assessing the risk of HAPI in ICU patients. Retrospective cohort study has been carried out. A decision tree model was constructed with Age, Weight, eTube, diabetes, Braden score, Isolation, and Number of comorbid conditions as decision nodes. We used RStudio for model training and testing. Correct prediction rate of the final prediction model was 92.4 and the Area Under the ROC curve (AUC) was 0.699, which means there is about 70% chance that the model is able to distinguish between HAPI and non-HAPI. The results of this study has limited generalizability as the data were from a single academic institution. Our research finding shows that the data-driven tree-based prediction modeling may potentially support ICU sensitive risk assessment for HAPI prevention.