• Korea Journal of Hospital Management
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• v.5 no.2
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• pp.78-99
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• 2000

Objectives: The purpose of this study was to evaluate the opinions of hospital managers on DRG pilot study. Methods: Managers of 800 hospitals which had participated in DRG pilot study during the period 1997-1999, were requested to respond to structured self-administerd questionnaire. The questionnaire was composed with six categories: the motivation and satisfaction for the DRG pilot study, the opinions on the level of unit price, the appropriateness of DRG classification, the change of medical service quality during the pilot study, the patient's complains resulted from DRG system. and the opinions on the nation-wide application of DRG system. Results : Of the 800 subjects, 327(clinic, 210: 25 hospitals, 82 general hospitals, and 16 tertiary hospitals) completed the questionnaire, and the overall response rate was 41%, 121 hospitals(27%) answered that they participated in DRG pilot study because of convenience of claims and 118 hospitals(35%) dissatisfied with DRG system. 251 hospitals(85%) thought that the level of unit price under the DRG system was same as or lower than that of fee-for service. 297 hospitals(92%) responded that DRG classification should be modified and 137 hospitals(47%) experienced deterioration of medical service quality during the DRG pilot study. The 116 hospitals(35%) experienced the patient's complains resulted from DRG system. The 85 hospitals(88%) didn't want nation-wide application of DRG system. Conclusion: Most of the responded managers seemed to have negative opinions on DRG pilot study, even though they had been participated voluntarily. Further studies and extensive evaluations of DRG reimbursement system are needed before nation-wide application.

• Journal of Korean Clinical Nursing Research
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• v.19 no.3
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• pp.321-332
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• 2013

Purpose: Korean health insurance extended application of the Diagnosis Related Groups (DRG) payment system to tertiary and general hospitals from July, 2013. This study was done to develop a DRG fee adjustment mechanism applied to levels of nurse staffing to assure quality nursing service. Methods: Nurse stafffing grades among hospitals in Korea were analyzed. Differences and ratio of inpatient costs by nurse staffing grades in DRG fees and differences of DRG fee between tertiary and general hospitals were compared. Results: In 2013, nurse staffing grades in tertiary and general hospitals had improved, but other hospital nurse staffing grades remained at the 2001 level. Gaps of inpatient costs between first and seventh nurse staffing grades were over 10% in 4 out of 7 DRG diagnosis; However differences of DRG fee between tertiary and general hospitals were only 4.51% and 4.72% respectively. A DRG fee adjustment mechanism was developed that included nurse staffing grades and hospitalization days as factors of the formula. Conclusion: Current DRG fees motivate hospitals to decrease nurse staffing grades because cost reduction is bigger than compensation. This DRG fee adjustment mechanism reflects nurse staffing supply to motivate hospitals to hire more nurses as a reasonable compensation system.

• Journal of Korean Academy of Nursing Administration
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• v.10 no.1
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• pp.1-9
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• 2004

Korean health insurance has adopted preliminary DRG payment system through 8 DRGs from 1997. But present DRG payment system gives economic incentives for hospitals to hire less nurse. This study was attempted to develope DRG adjust index to differentiate DRG price by nurse staffing level for nursing care quality. Method: We analyzed inpatient care cost by medical institute and developed DRG adjust index to differentiate DRG price by nurse staffing level. Results: Among same medical institute, inpatient care cost are very different according to hospital's nurse staffing level. In the case of casarean section, inpatient care cost of the 1st grade general hospital are more expensive 85,732won than the 6th grade hospital. The cost difference are 8.24% of total casarean section DRG price and 16.48% of DTG variable price. We developed DRG adjust index-a to apply DRG variable price and index-b to apply DRG total price for compensation cost difference of hospitals. Conclusions: DRG price adjust index will give economic incentive for hospitals to hire more nurse and improve nursing care quality.

• Journal of Preventive Medicine and Public Health
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• v.44 no.1
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• pp.48-55
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• 2011

Objectives: The purpose of this study was to examine the impact of Diagnosis-Related Group (DRG)-based payment on the length of stay and the number of outpatient visits after discharge in for patients who had undergone caesarean section. Methods: This study used the health insurance data of the patients in health care facilities that were paid by the Fee-For-Service (FFS) in 2001-2004, but they participated in the DRG payment system in 2005-2007. In order to examine the net effects of DRG payment, the Difference-In-Differences (DID) method was adopted to observe the difference in health care utilization before and after the participation in the DRG payment system. The dependent variables of the regression model were the length of stay and number of outpatient visits after discharge, and the explanatory variables included the characteristics of the patients and the health care facilities. Results: The length of stay in DRG-paid health care facilities was greater than that in the FFS-paid ones. Yet, DRG payment has no statistically significant effect on the number of outpatient visits after discharge. Conclusions: The results of this study that DRG payment was not effective in reducing the length of stay can be related to the nature of voluntary participation in the DRG system. Only those health care facilities that are already efficient in terms of the length of stay or that can benefit from the DRG payment may decide to participate in the program.

• Journal of Microbiology
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• v.40 no.4
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• pp.295-300
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• 2002

Previously, we reported induced expression of developmentally regulated CTP-binding protein 2 (DRG2) in fish cells at the late stage of rhabdovirus infection. To investigate the biological role of fish DRG2 (fDRG2), we transfected CHSE-214 cells with an expression vector containing complete fDRG2 fused to the N-terminal end of an enhanced green fluorescent protein (EGFP). Low level expression of fDRG2-EGFP did not induce morphological change or cell death. However, a high level expression of fDRG2-EGFP induced cell rounding and caused depletion of the cell population in FACS analysis. Several truncated fragments were fused to EGFP. FACS analysis was conducted to determine the presence of cells expressing high levels of the resulting chimera. While cells expressing a high level of N-terminus were detected, those expressing high levels of the C-terminal fragment 243-290 containing the G4 motif were absent in FACS analysis. Based on these observations, we propose that overexpression of fDRG2 may induce cell rounding, a representative cytopathic effect of virus-infected cells in the late stage of infection and the C-terminus of the fDRG2 is essential for this function.

• Journal of Korean Academy of Nursing Administration
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• v.18 no.2
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• pp.176-188
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• 2012

Purpose: The purpose of this study was to examine nurses' cognition of the diagnosis related group (DRG) in long-term care hospitals and changes in nursing care after application of the DRG system. Method: This study was a descriptive survey involving 161 nurses working in 12 long-term care hospitals located in Gwangju city and Chonnam area. Data were analyzed using the SPSS 18.0 version program. Data analyses utilized descriptive test, chi-square test, Fisher's exact probability test, t-test, and one-way ANOVA. Result: There was no change in cognition of DRG in 55.3% of the nurses, and 26.1% takes to 'change positively'. More than half of the respondents (57.8%) agreed to the application of DRG. After application of DRG, the nurses responded 'there were changes in nursing care' in 23 of the 25 care items. Two items had an increase in nursing care. Conclusions: No distinct changes in nursing care were evident after DRG application. Therefore, there is need to provide education programs related to DRG for nurse in long-term care hospitals.

• The Korean Journal of Health Service Management
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• v.7 no.4
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• pp.243-257
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• 2013

This study was conducted in order to survey in healthcare worker's recognition of diagnosis related group(below; DRG) effect from July 1, 2012, to examine their recognition, expectation of the DRG system, and to provide the basic data necessary for the enforcement of the settlement. The subjects of this study were workers at clinics and hospitals sampled from hospital with DRG applying 7 diseases in Busan and Kyung-nam. A questionnaire of survey was conducted with the subjects working at clinics and hospitals from July, 25, 2012 to September 7, 2012, and the subjects were limited to doctors, officers, nurses, medical technicians and nurse assistants, and a total of 618 subjects were enrolled in this study. In the result of this study, generally, the healthcare workers recognized the DRG system. But their knowledge about that was not clear. Expanding enforcement DRG system at the present time, to provide accurate information to the healthcare consumer, workers need to know about DRG system clearly. To this end, for national health policy and medical institutions, workers should be educated constantly about providing medical service as well as the duty of enough explanation about the healthcare consumer's right to know.

• Korea Journal of Hospital Management
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• v.23 no.2
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• pp.18-27
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• 2018

Purposes: This study aims to investigate the policy effect of mandatory application of DRG for 7 disease groups in general and tertiary hospitals. Methodology: As DRG was fully implemented in July 2013, this study compares two periods before and after the change(from July 2012 to June 2013, and from July 2013 to June 2014). The benefit claim data of the National Health Insurance Service was used for the comparison. Target patients were those who visited general or tertiary hospitals between July 2012 to June 2014. For pharmaceutical consumption, Interrupted Time Series (ITS) analysis was used to see the effect of DRG mandatory application. Findings: The number of drugs prescribed per patient and pharmaceutical expenditure both showed significant reduction compared to before the DRG implementation. Practical Implications: This study used 2 sets of 1 year period data from before and after the full implementation of DRG to analyze pharmaceutical consumption. When the comparison data accumulates further, it would be possible to conduct more diverse analysis to assess policy effect and to provide way forward for the future.

• Molecules and Cells
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• v.39 no.9
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• pp.699-704
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• 2016

Developmentally regulated GTP-binding protein 2 (DRG2) plays an important role in cell growth. Here we explored the linkage between DRG2 and G2/M phase checkpoint function in cell cycle progression. We observed that knockdown of DRG2 in HeLa cells affected growth in a wound-healing assay, and tumorigenicity in nude mice xenografts. Flow cytometry assays and [$^3H$] incorporation assays indicated that G2/M phase arrest was responsible for the decreased proliferation of these cells. Knockdown of DRG2 elicited down-regulation of the major mitotic promoting factor, the cyclin B1/Cdk1 complex, but upregulation of the cell cycle arresting proteins, Wee1, Myt1, and p21. These findings identify a novel role of DRG2 in G2/M progression.

• Health Policy and Management
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• v.20 no.2
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• pp.17-39
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• 2010

This study explored the impact on the DRG(Diagnosis-Related Groups)-based prospective payment system(PPS) operated by voluntarily participation providers. We analyzed whether the provides in the DRG-based PPS and in traditional fee-for-service(FFS) systems showed different the degree of variation in length of stay(LOS), and the providers' behaviors depending on the differences according to the varied participation periods. The study sample included all data 2,061 institutions participated in DRG-PPS in 2007 and all cases 473 FFS institutions which reported fee-for-service claims were reviewed same diagnosized diseases at least 10cases claims during three months We compared the differences of the LOS among health care institutions according to their type, region, and size. For DRGs showing significant differences in LOS, multiple regression analyses were performed to find out factors associated with LOS and interaction effect participation and hospital types or participation periods. The result provide the evidence that the DRG payment system operated by volunteering health care institutions had impact on resources use, which can reduce the institutions' the length of stay. While some DRGs had no correlation between participation periods and LOS, other DRGs, DRG participation period reversely linear relationship with LOS. That is to say, the longer participation year, the less reducing the LOS. These results support the future expansion of the DRG-based PPS plan to all health care services in Korea.