• 제목/요약/키워드: Inpatient service

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Analysis of Medical Use and Treatment Costs of Hepatocellular Carcinoma Patients Using National Patient Sample Data (환자표본자료를 이용한 간세포암종 환자의 의료이용 특성 및 치료별 의료비용 분석)

  • Oh, Byeong-Chan;Cho, Jeong-Yeon;Kwon, Sun-Hong;Lee, Eui-Kyung;Kim, Hye-Lin
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.2
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    • pp.153-159
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    • 2021
  • Background: With increasing economic evaluation studies on the treatment of or screening tools for liver diseases that cause hepatocellular carcinoma (HCC), interest in the analysis of the medical utilization and costs of HCC treatment is increasing. Therefore, we aimed to estimate the medical utilization and costs of HCC patients, and calculate the cost of main procedures for HCC treatment, including liver transplant (LT), hepatic resection (HR), radiofrequency ablation (RFA), and transarterial chemoembolization (TACE). Methods: We analyzed claim data from January to December 2018 from the Health Insurance and Review and Assessment Service-National Patient Sample (HIRA-NPS-2018) dataset, including data of patients diagnosed with HCC (Korean Standard Classification of Diseases code C22.0) who had at least one inpatient claim for HCC. Results: A total of 715 HCC patients were identified. In 2018, the yearly average medical cost per HCC patient was ₩18,460K (thousand), of which ₩14,870K was attributed to HCC. Among the total medical costs of HCC patients, the inpatient cost accounted for the largest portion of both the total medical and HCC-related costs. The major procedures of HCC treatment occurred most frequently in the order of TACE, RFA, HR, and LT. The average medical cost per treatment episode was the highest for LT (₩87,280K), followed by HR (₩10,026K), TACE (₩4,047K), and RFA (₩2,927K). Conclusion: By identifying the medical costs of HCC patients and the costs of the main procedures of HCC treatment, our results provide basic information that could be utilized for cost estimation in liver disease-related economic evaluation studies.

The Effect of inpatients' Experience on Patients' Satisfaction and Willingness to Recommend Hospital (입원경험이 환자의 만족도와 병원추천의향에 미치는 영향)

  • Cho, Myong Sun
    • Journal of Digital Convergence
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    • v.19 no.2
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    • pp.299-305
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    • 2021
  • This study examined to identify the factors influencing on inpatients' satisfaction with hospitalization and willingness to recommend hospital to others. Data from the 2018 National Patient Experience Survey were used for the analysis. Of the 593 patients experiencing inpatient services, multivariate linear regression analysis was conducted to explore the factors such as physician care, nursing care, facility and administrative support, and healthcare system on inpatients' satisfaction after controlling for their socio-demographic and health related factors. The study found that physician care, nursing care, administrative support and healthcare system were related to inpatients' satisfaction and willingness to recommend hospital. To improve inpatients' satisfaction, it is necessary to improve healthcare professionals' overall patient-centerdness attitude, user friendly hospital facilities and administrative support services and efforts to trust and satisfaction on healthcare system from the patients' perspectives.

A Study on the Efficiency Improvement of Information Materials for Diet of Inpatient Hospitalization (입원환자를 위한 효율적 정보전달의 식단안내문 현황분석 및 사용자 인식 조사)

  • Chun, Eunyoung;Paik, Jinkyung
    • Design Convergence Study
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    • v.14 no.4
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    • pp.169-180
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    • 2015
  • This research is to analyze the status of menu guides provided to inpatients in Korean hospitals, analyze the problem of delivering information, and propose improvement plans through information visualization as a part of improving service for inpatients. The nutrition department in hospitals were directly visited, data were collected, and the types and contents of menu guides were analyzed. Then, problems were found by focusing on whether there is an effective delivery of information, in terms of information visualization aspects. The menu provided to inpatients in Korean hospitals are divided into general, optional, and therapeutic menu depending on patients' conditions, and the menu guide is largely divided into a general guide and optional guide. The information covers menu, origin of ingredients, guide, withdrawal time, etc. However, there is no categorization according to the contents or importance of information, thus creating inefficient problems for patients to acquire information. The problem of menu guides is that they do not deliver information properly due to disorganized information. In order to improve this, information should be categorized and visualized according to its contents and importance for enhancing readability, which will then be able to provide menu guides that can deliver information more efficiently to patients.

General Radiography Imaging Usage and Effective Dose of Inpatients: Based on Data from Inpatients in 2018 (입원환자 일반촬영 이용량 및 피폭선량: 2018년 입원환자데이터)

  • Jong-Won Gil
    • Journal of radiological science and technology
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    • v.47 no.2
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    • pp.107-116
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    • 2024
  • In this study, we analyzed the use of general radiography imaging and effective dose in inpatients. Our aim is to help reduce national medical radiation exposure doses and develop rational health-care financial policies. The effective dose for each general radiography was calculated using the ALARA-GR program for 53 types (total: 260 codes) general radiography codes selected from 'National Health Insurance Care Benefit Cost'. The usage of general radiography was analyzed in the 2018 inpatient patient data of the Health Insurance Review and Assessment Service, and the effective dose for each general radiography was analyzed. 89.00% of inpatients undergo general radiography imaging at least once, with an average of 12.63 scans per person and an effective dose of 1.00 mSv. Those who received support from Medical Aid showed a higher value compared to those who were insured by National Health Insurance, with 17.39 cases and 1.43 mSv (p<.001). Chest had the highest usage rate at 23.12% for general radiography imaging, while L-spine had the highest effective dose at 24.53%. It is estimated that 420 inpatients patients undergo 121 to 820 general radiography imaging procedures per year, and 233 inpatients are estimated to have an annual effective dose of >20.00~58.25 mSv. Rational use of health-care finances and the practice of medical radiation safety management are essential for the well-being of individuals, the enhancement of quality of life, and the improvement of health-care quality.

Analyses of the Efficiency in Hospital Management (병원 단위비용 결정요인에 관한 연구)

  • Ro, Kong-Kyun;Lee, Seon
    • Korea Journal of Hospital Management
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    • v.9 no.1
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    • pp.66-94
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    • 2004
  • The objective of this study is to examine how to maximize the efficiency of hospital management by minimizing the unit cost of hospital operation. For this purpose, this paper proposes to develop a model of the profit maximization based on the cost minimization dictum using the statistical tools of arriving at the maximum likelihood values. The preliminary survey data are collected from the annual statistics and their analyses published by Korea Health Industry Development Institute and Korean Hospital Association. The maximum likelihood value statistical analyses are conducted from the information on the cost (function) of each of 36 hospitals selected by the random stratified sampling method according to the size and location (urban or rural) of hospitals. We believe that, although the size of sample is relatively small, because of the sampling method used and the high response rate, the power of estimation of the results of the statistical analyses of the sample hospitals is acceptable. The conceptual framework of analyses is adopted from the various models of the determinants of hospital costs used by the previous studies. According to this framework, the study postulates that the unit cost of hospital operation is determined by the size, scope of service, technology (production function) as measured by capacity utilization, labor capital ratio and labor input-mix variables, and by exogeneous variables. The variables to represent the above cost determinants are selected by using the step-wise regression so that only the statistically significant variables may be utilized in analyzing how these variables impact on the hospital unit cost. The results of the analyses show that the models of hospital cost determinants adopted are well chosen. The various models analyzed have the (goodness of fit) overall determination (R2) which all turned out to be significant, regardless of the variables put in to represent the cost determinants. Specifically, the size and scope of service, no matter how it is measured, i. e., number of admissions per bed, number of ambulatory visits per bed, adjusted inpatient days and adjusted outpatients, have overall effects of reducing the hospital unit costs as measured by the cost per admission, per inpatient day, or office visit implying the existence of the economy of scale in the hospital operation. Thirdly, the technology used in operating a hospital has turned out to have its ramifications on the hospital unit cost similar to those postulated in the static theory of the firm. For example, the capacity utilization as represented by the inpatient days per employee tuned out to have statistically significant negative impacts on the unit cost of hospital operation, while payroll expenses per inpatient cost has a positive effect. The input-mix of hospital operation, as represented by the ratio of the number of doctor, nurse or medical staff per general employee, supports the known thesis that the specialized manpower costs more than the general employees. The labor/capital ratio as represented by the employees per 100 beds is shown to have a positive effect on the cost as expected. As for the exogeneous variable's impacts on the cost, when this variable is represented by the percent of urban 100 population at the location where the hospital is located, the regression analysis shows that the hospitals located in the urban area have a higher cost than those in the rural area. Finally, the case study of the sample hospitals offers a specific information to hospital administrators about how they share in terms of the cost they are incurring in comparison to other hospitals. For example, if his/her hospital is of small size and located in a city, he/she can compare the various costs of his/her hospital operation with those of other similar hospitals. Therefore, he/she may be able to find the reasons why the cost of his/her hospital operation has a higher or lower cost than other similar hospitals in what factors of the hospital cost determinants.

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The Development of Satisfaction Tool to Health Care Services - focused on Patients and their families - (의료 서비스에 대한 만족도 측정 도구의 개발)

  • Kang, So-Young;Lee, Sun-Mi
    • Quality Improvement in Health Care
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    • v.3 no.1
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    • pp.104-124
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    • 1996
  • Background : In these days, the health care organizations have concerned about customer-centered care in order to empower the competitiveness on the health care markets. The departments working for quality management of the hospitals have used health care quality indicators in terms of medical areas as well as service areas of the hospitals. However, there were insufficient efforts to develop the credible measurement to seek the customers' needs, their expectations and their satisfaction levels related to health care services because various kinds of challenges were in the process of scale development to measure customers' satisfaction in health care. The purpose of this study was to develop the satisfaction scale to health care services in a Korea health care organization and to test its tool with validity and reliability. Method : The concept of this tool was acceptability that one of the components of health care quality defined by Donabedian. Acceptability has the five dimensions of concept: Accessibility; Patient-Practitioner Relations; Amenities; Patient Preferences as to the effects of care; and Patient Preferences as to the costs of care. The Satisfaction Tool to Health Care Services was reviewed by expert panel with five researchers, including hospital managers and a professor related to quality management of the hospitals. As a result, the content validity index was .84 in the outpatient satisfaction tool. The inpatient satisfaction tool had .87 of the content validity index. The Satisfaction Tools to Health Care Services finally consisted of 44 items for outpatients/their families and of 60 items for inpatients/their families. Study subjects of the construct validity test were 479 outpatients/their families and 561 inpatients/their families who visited or admitted at a University hospital from July 1, 1996 through August 10, 1996. The data were examined by Factor Analysis with SPSS. Result : The items of Satisfaction tools for outpatients/their families were categorized by eleven factors with eigenvalue greater than 1.0 accounting for 64.2 percent of the variation in item scores. Also, the items of inpatient tool had eleven factors with eigenvalue greater than 1.0 accounting for 60.3 percent of the variation in item scores. The reliability of overall scale were .95 and .96 for the outpatients/their families satisfaction scores and inpatient/their families satisfaction scores. The internal consistency reliability with eleven factors was ranged from .30 to .94 for inpatients/their families. The Satisfaction Tool with eleven factors for inpatients/their families had internal consistency reliability ranged from .53 to .89. Conclusion : The Satisfaction Tools to Health Care Services focused on outpatients/their families and inpatients/their families developed in this study had a high reliability and the strong evidence of content validity and construct validity based on quality concept. Therefore, this tool would be utilized as a credible quality indicator of health care services to assess the quality problems and to monitor the quality improvement activities in Korean Health Care Organizations.

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The Effect of Reform of New Diagnosis-Related Groups on Coverage of National Health Insurance (신포괄수가 시범사업 모형개선이 건강보험 보장률에 미친 영향)

  • Choi, Jung-Kyu;Kim, Seon-Hee;Chang, Cheong-Ha;Yoon, Jong-Min;Kang, Jung-Gu
    • Health Policy and Management
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    • v.30 no.2
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    • pp.178-184
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    • 2020
  • Background: Korea set up a new diagnosis-related group as a demonstration project in 2009. The new diagnosis-related group was reformed in 2016. The main purpose of the study is to identify the effect of reform on coverage of national health insurance. Methods: This study collected inpatient data from a hospital that contains medical information and cost from 2015 July to 2016 June. The dependent variable was the coverage of national health insurance. The dependent variable was divided by total, internal medicine partition, surgical partition, and psychiatric partition. To analyze the effect of the reform, this study conducted an interrupted time series analysis. The final sample included 23,695. Results: The health insurance coverage of internal medicine has the highest, followed by surgery and psychiatry. The health insurance coverage of bundle payment is higher than that of unbundled payment. The proportion of bundled payment and non-benefit decreased and the proportion of unbundled payment increased. The coverage of national health insurance significantly increased after policy reform in internal medicine partition (p-value=0.0356). Conclusion: The results of the study imply that policy reform enhanced the coverage of national health insurance in internal medicine. The government needs to monitor side effects such as an increase of unbundled payment.

Convergence outpatient medical service patient experience research using data mining (데이터마이닝 기법을 이용한 융복합 외래 의료서비스 환자경험조사 연구)

  • Yoo, Jin-Yeong
    • Journal of Digital Convergence
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    • v.18 no.7
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    • pp.299-306
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    • 2020
  • The purpose of this study is to find out specific measures that can help the management strategy of patient-centered medical institutions by conducting research on patient experience surveys of convergence outpatient medical services using data mining techniques according to changes in patient-centered medical culture. Using the raw data of the 2018 Medical Service Experience Survey, 8,843 people over the age of 15 who had patient experience in outpatient medical services were analyzed. Decision tree analysis was performed. The determinants of satisfaction with outpatient medical services patient experience were the doctor's area and patient's rights protection area, and the determinants of intention to recommend outpatient medical services were the doctor's area and facilities comfort. Women evaluated the experience positively in overall satisfaction as compared to men, and those over the age of 60 positively evaluated the overall satisfaction and intention to recommend. It is significant that the outpatient experience decision-making model is presented, and that the doctor's area, patient's rights protection area, and facility comfort are important factors. Long-term research on the 'Medical Service Experience Survey' is needed, and research on the inpatient medical service experience is needed.

Challenges in Patient Counseling and Medication Reconciliation for Foreign Inpatients in Korea (외국인 입원환자의 복약상담과 입원약력관리 현황에 관한 탐색적 연구)

  • Jin, Hye Kyung;Rhie, Sandy
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.1
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    • pp.34-41
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    • 2015
  • Objective: This study is to evaluate the awareness, needs, and barriers in patient counseling for hospitalized foreign patients. As the number of foreign population increases in Korea, demands on quality of Korean health services are rapidly increasing. Previously most of the studies have focused on the availability and utilization of healthcare service, and prevalence of disease for foreigners, however, no study has been conducted on quality of direct-patient care such as patient counseling. Method: In the present study, a survey was conducted on a total of 161 participants between March 7 and May 7 in 2014. The study subjects were consisted with 103 foreign patients who had experienced inpatient care within 1 year and 58 hospital pharmacists who work in the hospital with foreign inpatients. Results: Firstly, the hospital pharmacists were highly aware of the necessity of counseling for foreign inpatients. Secondly, the largest portion of barrier to patient counseling service was accounted a lack of foreign language skills. Lastly, the monitoring of efficacy, potential adverse reactions and discharge follow-up were emphasized. Conclusion: Effective communication skills would be essential to improve pharmaceutical care services to foreign inpatients.

An Analysis of the Diseases Specific Medical Service Organization Selection Factors of Patients (주요 상병 별 환자의 의료기관 선택성향 분석)

  • Youn, Kyung-Il;Doh, Sei-Rok
    • Korea Journal of Hospital Management
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    • v.12 no.4
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    • pp.1-21
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    • 2007
  • The relaxation of the regulation in selection of medical institution allows patients to use their own judgement in choosing proper institution for their diseases. Since the change of the regulation, there should have been many changes in medical institution selection behavior. The analysis of the change in disease specific selection pattern is critical because there be an optimal selection criteria that ensure the efficient and effective utilization of medical resources. This study analysis the institution selection factors by comparing the choice among the cases of acute diseases, the cases of chronic diseases, inpatient services, outpatient services, and emergency medical service. The comparisons performed in terms of size, class and other characteristics of medical institutions. For the study the nationally surveyed database was used and the data were analyzed using logistic regression procedure. The results indicates that the primary care facilities were not properly utilized. This study speculates that the reason for the undesirable pattern of utilization is that the roles of primary care facilities in the healthcare delivery system was not clearly defined. Based on the results, the medical policy implications are discussed.

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