• Title/Summary/Keyword: Hospital utilization

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Relationship between Resource Utilization and Long-term Care Classification Level for Residents in Nursing Homes (노인요양시설 거주자의 장기요양등급에 따른 요양서비스 및 자원이용량 분석)

  • Lee, Min-Kyung;Kim, Eun-Kyung
    • Journal of Korean Academy of Nursing
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    • v.40 no.6
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    • pp.903-912
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    • 2010
  • Purpose: This study was conducted to examine whether the level of classification for long-term care service under longterm care insurance reflects resource utilization level for residents in nursing homes. Methods: From 2 long-term care facilities, the researchers selected 95 participants and identified description and time of care services provided by nurses, certified caregivers, physical therapists and social workers during a 24-hr-period. Results: Resource utilization level was: 281.04 for level 1, 301.05 for level 2 and 270.87 for level 3. Resource utilization was not correlated with level. Differences in resource utilization within the same level were similar with the coefficient of variance, 22.7-27.1%. Physical function was the most influential factor on long-term care scores (r=.88, p<.001). The level for long-term care service did not reflect differences in resource utilization level of residents on long-term care insurance. Conclusion: The results of this study indicate that present grading for long-term care service needs to be reconsidered. Further study is needed to adjust the long-term care classification system to reflect the level of resource utilization for care recipients on the long-term care insurance.

Stochastic Programming Approach to Scheduling Elective Surgeries and the Effects of Newsvendor Ratio on Operating Room Utilization (추계적 계획법을 이용한 수술실 예약 모델과 Newsvendor 비율의 자원 효율성에 대한 영향 분석)

  • Min, Dai-Ki
    • Korean Management Science Review
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    • v.28 no.2
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    • pp.17-29
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    • 2011
  • The purpose of this paper is to schedule elective surgery patients using a stochastic programming approach and to illustrate how operating room utilization behaves when a decision-maker varies costs associated with utilization. Because of the uncertainty in surgery durations, the underage and overage costs that a decision-maker considers plays an important role in allocating surgery cases into available operating room capacity. We formulate the problem as a stochastic mixed integer programming and propose a sampling-based approximation method for a computational purpose. Newsvendor model is employed to explain the results from numerical experiments that are conducted with the actual data from a hospital. The results show that the operating room utilization is more sensitive when the unit overtime cost is relatively larger than the unit cost for underutilized time.

Effects of Private Health Insurance on Health Care Utilization and Expenditures in Korean Cancer Patients: Focused on 5 Major Cancers in One Cancer Center (민간의료보험이 암 환자의 의료이용과 의료비에 미치는 영향: 일개 암전문의료기관의 우리나라 주요 암종을 중심으로)

  • Lim, Jin-Hwa;Choi, Kui-Son;Kim, Sung-Gyeong;Park, Eun-Cheol;Park, Jae-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.4
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    • pp.329-335
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    • 2007
  • Objectives : To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer were included as study subjects. Data were gathered using a structured questionnaire from face-to-face interviews, the hospital Order Communication System (OCS) and medical records. Clinical, socio-demographic and private health insurance related factors were also gathered. The differences of health care utilization and expenditure were compared between those who have private health insurance and those who do not using t-test and multivariable regression analysis. Results : Individuals with private health insurance spent larger inpatient costs than those without, but no differences were found in utilization in other service such as hospital admissions, hospital days and physician visits. Conclusions : We found that private health insurance exerts a significant effect on the health care expenditure in inpatient service. These study results can provide a rational basis to plan a national health policy regarding private health insurance. Further studies are needed to investigate the impacts of private health insurance on cancer patients' outcomes and survival rates.

The Impacts of Private Health Insurance on Medical Institution Selection: Evidence from Outpatient Service Utilization among Arthritis Patients (민간의료보험이 의료기관 종별 선택에 미치는 영향: 관절염 환자의 외래 이용을 중심으로)

  • You, Chang Hoon;Kang, Sungwook;Choi, Ji Heon;Kwon, Young Dae
    • Korea Journal of Hospital Management
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    • v.22 no.2
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    • pp.58-69
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    • 2017
  • Recently, with the increase in the number of private health insurance subscribers, interest in overuse of the medical service is increasing. This study analyzed the impacts of private health insurance (PHI) on medical institution selection in outpatient service utilization among persons with arthritis. In order to control patients' health status, we extracted outpatient episodes with the same disease (KCD6, M13) from Korea Health Panel. The unit of analysis was an outpatient visit with arthritis in 2014 (n=23,363). In the light of insurance coverage, we redefined three type of private health insurance (ex, indemnity, fixed benefit, and non-insured) as a test variable and two type of medical institution (ex, hospital and physician visit) as a dependent variable. We conducted a probit regression analysis to identify the impacts of PHI on medical institution selection controlling for heteroscedasticity. The results of this study showed that the insured with indemnity were more likely to choose hospital departments than clinics (marginal effect=0.0475, p=0.000). The impact of participation of fixed benefit PHI was not as clear as that of indemnity type (marginal effect=0.0162, p=0.047). In conclusion, this study confirmed that PHI, particularly indemnity type has a significant impact on the selection of medical institutions. Healthcare policy makers should consider that PHI not only affects the overall quantitative increase in healthcare utilization, but also influences the selection of medical institutions.

Traditional Korean Medicine Doctors' Awareness and Utilization of the Case Report (한의사의 증례연구에 대한 인식 및 활용)

  • Baek, Seung-Min;Park, Jeong-Hwan;Lee, Sang-Hun;Kim, Sul-Gi;Lee, Jeong-Hwa;Kim, Bo-Young;Choi, Sun-Mi
    • Korean Journal of Acupuncture
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    • v.29 no.1
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    • pp.57-70
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    • 2012
  • Objectives : The purpose of this study is to assess Traditional Korean Medicine (TKM) doctors' awareness and utilization of the case report, based on the opinion that careful observation on the case sometimes provides us with the important information as clinical trial especially in the traditional medicine research field. Methods : A questionnaire study was conducted among TKM doctors who participated in the annual continuous maintenance education (CME) held at 5 regions of the Republic of Korea. Results : Almost 60% of the respondents had read case reports published in medical journals and 67% had openly shared their clinical cases with their colleagues. Of the respondents, 18.6% had been educated on reporting cases, and only 16% had the experience of reporting cases on one's own. However, 32.6% of the respondents had the intention to report cases in the future. These results show significant differences between general physicians who holds a license but no hospital training experience and board certified TKM doctors who have training experience. Conclusions : A majority of TKM doctors have read case reports but holds little experience of having been properly trained. Through this research, it has been found that awareness of case reports is rising in hospital training. Thus, the objective of case report education for TKM doctors who have hospital training experience should be set on encouraging them to do more whereas for doctors without hospital training experience, the objective should be set on making them more exposed to case reports to heighten one's awareness.

An Analysis of Effects of Differential Coinsurance Policy and Utilization of Outpatients Care by Types of Medical Institutions (종별 의료기관 외래 경증질환 약제비 본인부담 차등정책 효과분석)

  • Park, Yoon-Sung;Kim, Jin Suk
    • Health Policy and Management
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    • v.27 no.2
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    • pp.128-138
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    • 2017
  • Background: The purpose of this study is to analyze the effects of differential coinsurance policy on prescription drug coverage of outpatients by types of medical institutions. Methods: In this study, we used a sample cohort database of the National Health Insurance Service and frequency analysis and marginal logistic regression model using generalized estimating equation were used for statistical analysis. Results: The summary on the major research is followed. First, about 16% of patients who used only tertiary or general hospital due to 52 ambulatory care sensitive conditions before policy implementation moved to hospitals and clinics. However, about 57% of them still use tertiary or general hospital. Second, the factors influencing the utilization of hospitals and clinics after the implementation of the policy were gender, age, and income level. As a result, the policy is effective to reduce the medical use of outpatient mental patients in tertiary or general hospital, but the effect is not significant. Conclusion: Therefore, in order to achieve the purpose of the policy for establishing the health care delivery system, it is necessary to adjust the co-payment so as to feel the burden on the co-payment when the outpatient for 52 ambulatory care sensitive conditions is used at the tertiary or general hospital.

The Effect of Hospital Mobile App Quality Factors on Users ' Continuous Use Intention: An Integrated Approach of Information Systems Success and Expectation-Confirmation Models (병원모바일앱 품질요인이 이용자의 지속이용의도에 미치는 영향: 정보시스템성공모형과 기대일치모형의 통합적 접근)

  • Min Soo Kim;Sang-Hyeak Yoon;Sae Bom Lee;Sung-Byung Yang
    • Journal of Service Research and Studies
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    • v.13 no.1
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    • pp.76-95
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    • 2023
  • As information and communications technology-based "smart hospitals" and "digital healthcare" have become a hot topic in the healthcare field, hospital mobile apps are gaining attention; but, the utilization rate is low due to lack of publicity, unstable systems, and late updates. In this situation, systematic research is needed to increase the utilization rate of hospital mobile apps, but related research has been rare. Therefore, this study integrates the information systems success model (ISSM) from the technical perspective and the expectation-confirmation model (ECM) from the cognitive perspective to demonstrate the influence mechanism on the continuous use intention of hospital mobile apps. For this purpose, an online survey was conducted among 181 Korean adults who have used hospital mobile apps. The results of the structual equation modeling showed that most of the quality factors have significant effects on expectation confirmation, perceived usefulness, and satisfaction. Additionally, expectation confirmation significantly affects perceived usefulness and satisfaction, and both perceived usefulness and satisfaction significantly affect the continuous use intention of hospital mobile apps. This study is of importance in that it integrates the ISSM and ECM and applies them to the context of using hospital mobile apps, which are underutilized in the healthcare field, and provides practical implications for increasing the utilization rate of hospital mobile apps and operating effective and efficient services through the findings.

A study on utilization behavior for hospital injury inpatient in Gyeongsangnam-do (경남지역 입원손상환자의 의료이용에 관한 연구)

  • Nam, Mun-Hee;Kun, Yeong-Chae
    • Journal of Digital Convergence
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    • v.10 no.5
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    • pp.289-299
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    • 2012
  • The study was carried out to provide basic data of improving the accessibility of medical service through identifying the factors that make hospital injury inpatient in non-residential area not in their residential area in Gyeongsangnam-do. This study analyzed not only 8,225 cases of discharged patients with damages from 2008, provided by the Korea Centers for Disease Control and Prevention, but also using a census and a research data on the actual condition from health care system. This study conducted a frequency test, a chi-square test and a logistic regression In result, first, the centralization of medical utilization of patients with damages is apparent centrally the city area. Second, medical utilization of injury patients in non-residential areas were significantly higher local area compared to City area. To improve this, a policy that can not only provide medical centers and sickbed, but also improve the quality of local medical treatments for the localization of medical treatments, for the accessibility of medical services, government is demanded policy for patients with damages in local area.