• The Journal of Korean Physical Therapy
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• 제2권1호
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• pp.85-93
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• 1990

Effects of various factors related to the process of social action of hospital services on the selecting a hospital were investigated by using of questonnaires answered by 19 patients in Zeon buk Do certain hospital in rehabilitation.

• Journal of Preventive Medicine and Public Health
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• 제27권3호
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• pp.609-626
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• 1994

This study was conducted to investigate whether variations in hospital services utilization across small geographic areas in Korea existed, and if so, what factors are responsible for the variation. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main findings of the research can be summarized as follows: 1 Extremal Quotients (EQ) of hospital expenditure per capita and hospital days per capita were 2.69 and 2.73, and Coefficient of Variation (CV) were 0.14, both, respectively. The EQ and the CV of admission rate were also 2.71, 0.15. The EQ and the CV of expenditure per admission were 1.73, 0.10 and those of hospital days per admission were 1.29, 0.06. All these statistics were statistically significant and this result provides strong evidence for the existence of small area variations. 2. Comparing patterns of variation among areas, the area which showed higher utilization amounts is Chansungp'o. Koje area, whereas the areas which showed lower utilization amounts are Yongju, Changhung, Miryang, Mokp'o, Koch'ang area. 3. Multivariate analytic methods were used to examine factors related to the variation across areas. In terms of the health resource availability variables, beds per capita or physicians per capita were positively associated with all utilization indices. As for the health service market structure variables, the proportion of health care institutions operating for less than f years was positively related to the expenditure per capita, hospital days per capita and expenditure per admission. In addition the proportion of the private health care institutions also had a negative relationship with total utilization amount and admission rate and the proportion of physicians under age 40 was negatively associated with expenditure per capita and expenditure per admission. With regard to the socio-demographic characteristics, proportion of medicaid population was positively related to hospital days per capita, and percentage of paved road was positively related to hospital days per admission. As a conclusion, wide variations existed across small areas in Korea and supply factors were found to be important in explaining the variation.

• 대한한방내과학회지
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• 제42권6호
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• pp.1255-1268
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• 2021

Objectives: This study aimed to analyze the healthcare utilization behavior of patients visiting the department of Korean internal medicine in the Korean medicine hospital of Wonkwang University in Jeon-ju from July 2018 to June 2021. Methods: We retrospectively analyzed the medical records of 26,108 patients and sorted the data by period, month, visiting types, new or returning types, sex, and age group. IBM SPSS 26.0 and the R 4.05 'changepoint' package were used with various statistical methods, such as Independent t-test, Mann-Whitney test, Chi-square test, Simple regression analysis. The P-value was set at 0.05. Results and Conclusions: Females outnumbered males regardless of period, and the ratio of females fell after COVID-19. Regardless of visiting types, patients in their 50s, 60s, and 70s outrated any other age group. The average number of females among the returning patients decreased significantly after COVID-19, but did not in males. Outpatients under 10 and in their 10s decreased significantly after COVID-19, as did inpatients in their 40s and 60s. The average duration of hospitalization was extended significantly after COVID-19. The number of outpatients and inpatients decreased as time passed after COVID-19. We expect that the results of this study will be used as reference materials in analyzing the effects of COVID-19 on healthcare utilization.

• 한방재활의학과학회지
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• 제30권2호
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• pp.139-152
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• 2020

Objectives To explore the traffic injury patients' experience on health care utilization of Korean Medicine (KM) practice and perception of health care system for developing a Korean medicine clinical practice guideline (CPG) of traffic injuries by survey method. Methods Two hundred ten patients in suffering from traffic injuries were surveyed from September 1st, 2019 to January 31th, 2020 at 2 University Hospitals (Pusan National Korean Medicine Hospital and Kyung Hee Korean Medicine Hospital at Gangdong) and 1 Spine Specialty Hospital (Jaseng Hospital of Korean Medicine). A structured questionnaire of experience on health care utilization of KM practice and perception of health care system of was distributed to responders by visits and all data were statistically analysed. Results Survey results showed high satisfaction of patients with the experience of KM treatments in order of daoyin exercise (7.8±2.3), chuna manual therapy (7.7±4.0), pharmacoacupuncture (7.4±3.0) etc. Safety concerns were reported in 9.1% subjects and 205 (97.6%) patients answered that collaboration with KM and western medicine is necessary for patients with traffic injuries. For the patients' requirement for extending insurance coverage, the most required therapy was chuna manual therapy (57.5%) and pharmacoacupuncture (42.0%). Conclusions This study presented the realistic patient-centered perception of KM practice and health care system in Korea. These results will provide basic data to be reflected in the process of adaptation for the revision of Korean Medicine CPG for traffic injuries.

• 대한한방내과학회지
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• 제38권3호
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• pp.336-352
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• 2017

Objective: This study investigated the perception, utilization, and satisfaction (in the general population), of the common cold treatment at the Korean Medical Clinic, to provide basic information for the development of Korean medicine clinical practice guidelines for the common cold. Method: A questionnaire was developed that consisted of questions about the general perception, utilization status, degree of satisfaction, willingness to use, and the improvement of the common cold treatment at the Korean Medical Clinic. An online survey was conducted using this questionnaire. Results: Three-hundred subjects responded to the survey. The results of the analysis were as follows. 1. 73.7% of the subjects recognized the common cold treatment at the Korean Medical Clinic. 2. 72% of the subjects had a positive perception of Korean medicine for common cold treatment. The major reason for the positive perception was the expectation about improving immunity and preventing recurrence. 3. Only 20% of the subjects had visited the Korean Medical Clinic for common cold treatment. The expensive cost was the major reason for not visiting the Korean Medical Clinic for common cold treatment. 4. The ratio of subjects who were willing to visit the Korean Medical Clinic for common cold treatment was 70%. 5. The expansion of health insurance coverage (67.7%), the activation of public relations (54.7%), and the development of a new herb medicine preparation that was easy to take (43.3%) were found to be necessary for improving the Korean medical service for common cold treatment. Conclusion: In spite of high recognition and positive perception, actual utilization of common cold treatment at the Korean Medical Clinic was relatively low. Multifaceted efforts are necessary to enhance the competitiveness of Korean medical service for treatment of the common cold.

• Journal of Preventive Medicine and Public Health
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• 제21권2호
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• pp.442-450
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• 1988

충남지역에 소재한 모 대학 병원에 1986년 11월부터 1987년 11월까지의 기간중에 입원한 환자 1,400명중 본 조사에 응한 1,319명을 조사대상으로 병원써비스의 사회적 작용 과정 측면에서의 의료기술외적 제조건들이 병원 선택 태도에 미치는 영향을 설문지 조사방법으로 실시한 바 아래와 같은 결과를 얻어 요약한다. 1. 창구직원의 친절, 환자의 병실 방문 요청에 대한 의사 또는 간호사의 반응, 의사의 병세 설명에 대한 성실성, 주치의의 진료성실성, 의사에 대한 환자의 신뢰감, 간호사의 친절, 간호사에 대한 환자의 신뢰감, 병원의 청결, 환의의 청결, 침구의 청결, 병원식, 배선원의 친절, 병원의 휴식분위기 등 모든 조건이 비록 결정적인 병원선택의 조건은 아니나 복합적으로 작용하여 병원선택의 기준이 되고 있다. 2.사회적 작용 과정 측면에서의 병원써비스 조건들은 의료시설 또는 의료기술을 동기로 병원에 입원한 경우보다 단순히 교통조건을 동기로 병원에 입원한 경우가 차후 병원선택의 태도에 더욱 더 영향을 미치는 것으로 추정된다.

• 한국병원경영학회지
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• 제2권1호
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• pp.1-21
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• 1997

In order to analyze the shifts in the volume and profits of Computed Tomography(CT) and Magnetic Resonance Imaging(MRI) utilization for a year before and after the implementation of insurance coverage for CT, this study has been undertaken examining CT and MRI cost data from 'Y' University Hospital situated in Seoul, Korea. Following are the results of this study: 1. The medical insurance payment for CT, implemented on January 1, 1996, increased CT utilization from January 1996 to April 1996 due to low insurance premiums: however, from May 1996 the number of CT cases significantly decreased as a result of strengthened medical cost reviews and the new 'Detailed standards for approval of CT' announced near the end of April 1996 by the insurer. 2. Since the implementation of insurance coverage for CT, CT fee reduction rates for reimbursements by the insurer to the hospital were 50% and 40% for January and February, respectively, and 31% and 15% for March and April. A significant point in the lowering of the reduction rate was reached in May at 11%; furthermore, since June the reduction rate fell below the average reduction rate for reimbursements for all procedures. If the 'Detailed standards for approval of CT' had been announced before the implementation of insurance coverage for CT, CT utilization would not have been so high due to the need to meet those 'standards'. In addition, loss of hospital profits resulting from the reduction for reimbursements would not have occurred. 3. The shifts in MRI utilization showed that there was no particular change with the beginning of insurance coverage for CT, and the introduction of the 'Detailed standards for approval of CT' made MRI utilization increase because MRI is free of restrictions imposed by the insurer. 4. The relationship between CT utilization and MRI utilization showed that they were supplementary to each other before insurance coverage for CT, but that CT was substituted for MRI because of strengthened medical cost reviews after t~e beginning of insurance coverage for CT. 5. The shifts in volume by patient characteristics showed that the number of inappropriate case patients, according to the insurer's "Standards for approval", decreased more than the number of appropriate case patients after the introduction of insurance coverage for CT. Therefore, the health insurance fee schemes for CT have influenced patient care. 6. The shifts in profits from CT utilization showed a net profit decrease of 31.6%. In order to match the pre-coverage profit level, 5,471 more cases would need to be seen and productivity would need to be increased by 32.7%. This profit decrease resulted from a decrease of CT utilization and low reimbursements. With insurance coverage, net profits from CT were 24.4%, and a margin of safety ratio was 39.6%. Because of the net profits and margin of safety ratio, CT utilization fees for insured appropriate cases could not be considered inappropriate. 7. The shifts in profits from MRI utilization before and after the introduction of CT coverage showed that in order to match pre-CT coverage profit levels, 2,011 more cases would need to be seen and productivity would need to be increased by 9.2%. The reasons for needing to increase the number of cases and productivity result from cost burdens created by adding new MRI units. But with CT coverage already begun, MRI utilization increased. Combined with a minor increase in the MRI fee schedule, MRI utilization showed a net profit increase of 18.5%. Net profits of 62.8% and a 'margin of safety ratio' of 43.1% for MRI utilization showed that the hospital relied on this non-covered procedure for profits. 8. The shifts in profits from CT and MRI utilization showed the net profits from CT decreased by 2.33billion Won while the net profits from MRI increased by 815.7million Won. Overall, these two together showed a net profit decrease of 1.51billion Won. The shifts in utilization showed a functional substitutionary relationship, but the shifts in profits did not show a substitutionary relationship. From these results, We can conclude that if insurance is to be expanded to include previously uncovered procedures using expensive medical equipment, detailed standards should be prepared in advance. The decrease in profits from the shifts in coverage and changes in fees is a difficult burden that should be shared, not carried by the hospital alone. Also, a new or improved fee schedule system should include revised standards between items listed and the appropriateness of the fee schedule should constantly be ensured. This study focused on one university hospital in Seoul and is therefore limited in general applicability. But it is valuable for considering current issues and problems, such as the influence of CT coverage on hospital management. Future studies will hopefully expand the scope of the issues considered here.

• 대한예방한의학회지
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• 제12권3호
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• pp.9-20
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• 2008

The purpose of this study is to investigate the actual conditions of herbal medicine products for the establishment of drug utilization review system. To accomplish of the purpose, we investigated medical treatment pay of insurance and consumption of herbal medicine products in pharmacy at jeollabuk-do, two oriental hospital etc. To gain valid and reliable the actual conditions of herbal medicine products, it needed close relationship with oriental hospital, society for manufacture of herbal medicines etc and further study classify herbal medicines by Korean Medicine.

• 한방재활의학과학회지
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• 제31권4호
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• pp.105-116
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• 2021

Objectives Lumbar herniated intervertebral disc (L-HIVD) is common disease in which Western-Korean collaborative treatment is performed in Korea. This study aimed to analyze Western-Korean collaborative treatment utilization of Korean patients with L-HIVD using Health Insurance Review & Assessment Service's Patients Sample Data. Methods This study used the Health Insurance Review & Assessment Service-National Patient Sample (HIRA-NPS) in 2018. Claim data of L-HIVD patients were extracted. The claim data were rebuilt with the operational concept of 'episode of care' and divided into Korean medicine episode group (KM), Western medicine episode group (WM) and collaborative treatment episode group (CT). General characteristics, medical expenses and healthcare utilization were analyzed. In addition, the difference of average visit day and average medical expenses between non-collaborative group (KM plus WM) and CT were analyzed by the propensity score matching method. Results A Total of 64,333 patients and 365,745 claims were extracted. The number of episodes of WM, KM and CT was 69,383 (92.97%), 3,903 (5.23%), and 1,341 (1.80%) respectively. The frequency of collaborative treatment episode was higher in women and the age of 50s. The most frequently described treatment in CT was acupuncture therapy. As a result of the propensity score matching, the number of visit days and medical expenses in the collaborative treatment group was higher than in the non-collaborative group. Conclusions The analysis of healthcare utilization of Korean-Western collaborative treatment may be used as basic data for establishing medical policies and systematic collaborative treatment model in the future.

• Korean Journal of Acupuncture
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• 제29권1호
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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.