• Health Policy and Management
• /
• v.3 no.1
• /
• pp.25-52
• /
• 1993

Variation in the utilization of medical services is a very important issue in cost containment and quality assurance of health care. Practice variation directly affects health care expenditure especially in fee-for-service system, which is the payment system of health insurance in Korea. In addition to cost issue it is generally accepted that variations in medical practice and the cost of inpatient care suggest the possibility of inappropriate quality of care. This study is to closely examine the patterne and degrees of variation in cost structure of inpatient care among types of hospital and individual hospitals in some tracer diseases, and also to inquire into the service items which contribute much to the variation of total medical care cost. Foru common diseases, i.e. Cesarean Section, appendectomy, cataract extraction and pediatric pneumonia, were selected as tracer diseases. In most tracer diseases there were statistically significant differences in total medical care cost among hospitals in same type of hospital as well as among types of hospital(p<0.01). When total medical care cost were subdivided into the types of service, cost of medication and diagnostic examination varied the most prominenly. When the cost of medication were subdivided again, cost of parenteral antibiotics showed the most prominent variation. Of total medical care cost, medication was most contributory to the variation of total medical care cost(58.1~82.3%), and cost of antibiotics was most contributory to the variation of medication cost(63.9~92.2%). The results of study implicated that reducing the variation of medication may plays a significant role in containing the cost of inpatient care. In order to sort out the factors affecting practice variations including drug prescription pattes further researches are required.

• Korea Journal of Hospital Management
• /
• v.24 no.2
• /
• pp.67-83
• /
• 2019

The aim of this study is to analyze the differences in the publicness indices depending on the environmental factors of regional public hospitals to derive the policy implications for improving management for regional public hospitals. The data of the 34 regional public hospitals from 2016 was used for the analysis. Major results of this study are as follows. First, the analysis of the differences in the scores of the medical safety net function showed significantly higher scores for regional public hospitals with a larger location, a larger number of hospitals in a unit area, a larger number of nurses per 100 beds, and the lower management fee ratio. Second, the analysis of the differences in the scores of the unmet healthcare needs showed significantly higher scores for regional public hospitals with a larger number of hospitals in a unit area, and a larger number of beds. Third, the analysis of the differences in the scores of the hospital-specialized services showed significantly higher scores for regional public hospitals with a larger location, a higher financial independence of the local government, a larger number of hospitals in a unit area, a larger number of beds, and a larger number of nurses per 100 beds. Major conclusions of this study are as follows. Consideration should be given to the appropriate number of nurses for each regional public hospital to maximize publicness by providing the appropriate amount of medical services, but not to incur unnecessary labor costs. In addition, efforts should be made to enhance profitability, which can be a means of strengthening publicness, by identifying the minimum administrative expenses required for efficient operation and reducing unnecessary administrative expenses. Finally, it is necessary to identify the appropriate number of beds to meet the needs of the customers and to create maximum profits.

• Korea Journal of Hospital Management
• /
• v.10 no.1
• /
• pp.48-70
• /
• 2005

The purpose of this study was to make an analysis of the impact of the DRG payment system on medical care pattern and cost of cataract surgery in a general hospital. The subjects were 173 patients whose DRG severity grade was zero, selected from among the hospitalized who underwent cataract surgery before and after the joining to the demonstrational operation of the third year DRG payment system. Their medical records and the details of their medical bills were examined to find out the length of hospital stay, medical care pattern provided to them, the cost of medical care, and the quality of medical care. The length of stay and the amount of medical care supplied during being in hospital dropped significantly for both single-eye and double-eyes cataract surgery groups. The amount of antibiotic use went down during the hospitalization and upon discharge from the hospital, but decreased after discharge. The total medical bills and the rate of basic examination implementation increased in the OPD before hospitalization but after discharge dropped. For double-eyes cataract patients, the rate of double-eyes cataract surgery went down. The total medical bills of DRG payment system converted into the fee-for-service system was greater by 113.3% for the single-eye cataract surgery group and by 102.9% for the doble-eyes cataract surgery group, compared to that by the fee-for-service. The contribution shared by the insurance corporation increased for both single-eye and double-eyes cataract surgery groups, but the copayment by the insured went down. Regarding the treatment outcome, no difference was found in complication rate, resurgery rate and mortality rate before and after the joining to the DRG payment system was implemented. The use of special lens lessened significantly. The amount of medical care supplied during hospitalization decreased but the complication rate didn't increase. But the increased use of low-price artificial cataract and the avoidance of double-eyes cataract surgery was observed. The phenomenon decreased number of OPD visit and the decreased total medical bills of OPD care after discharge in this hospital required further evaluation.

• Health Policy and Management
• /
• v.27 no.1
• /
• pp.39-46
• /
• 2017

Background: We evaluated new patient's satisfactory consultation time (SCT) and their willingness to pay additional costs (WPAC) for their SCT. Methods: We surveyed medical service satisfaction, SCT, WPAC for their SCT, and payable amount to 612 new patients of single general hospital and measured their real consultation time (RCT). To compare WPAC and payable amount, we divided RCT into 4 groups (${\leq}3$ minutes, 3-5 minutes, 5-10 minutes, and > 10 minutes), and SCT into 3 groups (${\leq}5$ minutes, 5-10 minutes, and > 10 minutes). On the basis of WPAC, we estimated new patient's SCT. Results: RCT was 6.2 minutes, SCT was 8.9 minutes, and medical service satisfaction score was 4.3 (out of 5). The number of patients having WPAC (payable group) was 381 (62.3%) and the amount was 5,853 Korean won. Their RCT and SCT were longer than non-payable group (6.4 minutes vs. 5.7 minutes, 9.3 minutes vs. 8.2 minutes). From multiple logistic regression analysis, WPAC of RCT 5-10 minutes was higher than that RCT ${\leq}3$ minutes (odds ratio= 1.78). Payable amount was highest in RCT > 10 minutes (6,950 Korea won) and SCT > 10 minutes (7,458 Korean won). Intuitively we suggest 10 minutes as SCT, based on payable group's SCT (9.3 minutes) and cut-off time differentiating payable group with non-payable group (10 minutes). Conclusion: We found that new patient had WPAC for their SCT and the longer the SCT, the greater the amount. From this, we hope that current simplified new patient consultation fee calculating system should be modified combining the consultation time factor.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.11 no.4
• /
• pp.1504-1510
• /
• 2010

According to a research analysis of the factors which affect the medical utilization fee after an increase of health insurance benefits for patients with serious illnesses based on 225 patients over 6 months, both before and after the increase of benefits, from January, 1st, 2005 to June 30th, and also from January, 1st, 2006 to June 30th. In terms of genders, 67.8% of males were affected, whereas only 32.2% of females were effected, a much higher rate of men than women. Men also had higher rates before and after the increase of benefits. Out of 5 categories related to medication and treatment, radiation testing was the most expensive at about 5,300,000, operation fees were 590,000, and costs of other testing approximately 200,000 with the least expensive category being 120,000 for medication. By looking at the relationship between the fees and increase of benefits, medication was a hospital charge (p<0.01), injection fees were hospital charges (p<0.01), operation fees were hospital charges (p<0.01). Medication fees (p<0.01) and injection fees (p<0.01) were found to be related.

• Journal of the Korean association of regional geographers
• /
• v.8 no.4
• /
• pp.430-450
• /
• 2002

This study empirically analyses the spatial features of land use and transportation, and residential characteristics of the cases of the Sangin and Siji newly developed districts in Taegu. Before the development, the areas consisted mainly of rice paddies and fields; these areas are now filled with high-density residential complexes, with a proliferation of commerce and service functions. In Sangin, restaurants, retail services, bars and bakeries are the main developments, but Siji developed retail services, restaurants, private institutions for students, and facilities for convenience goods. While the public transportation system is oriented to CBD, the inter-districts transportation network is lacking. The residents are mainly in their 40s to 50s, with white collar jobs. They have a relatively high level of education with high income. They have migrated a relatively short distance to the district. The locational(pull) factors influencing the decision to migrate, for Sangin are transportation, the physical environment and access to the working place, but for Siji it has been the physical environment, the school group, and access to the working place. The main dissatisfaction factors for Sangin are the management fee, the school group and for Siji they are commuting, the management fee and transportation.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.22 no.4
• /
• pp.183-194
• /
• 2021

In this study, the conversion factor for 2020 is estimated based on an outpatient and inpatient conversion factor separation model developed from SGR and AR by using actual medical expense data. In addition, a policy plan is proposed to calculate the values of single and multiple conversion factors for each type of medical expense, and to effectively use the conversion factor separation model as one of the means to establish a medical delivery system. The major results are as follows. First, at r=0.1, the rate of adjustment in the hospital single conversion index in 2020 was 2.0%, and the outpatient and hospitalization conversion rates for hospitals were 2.2% and 2.3%, respectively. In addition, a combination of outpatient and inpatient conversion factors can be used for the adjustment. Second, as a measure to establish a medical delivery system, instead of adjusting the addition rate, a method of interlocking the addition rate and the conversion factor is proposed. Third, it is necessary to develop a model that enables target management of volumes, in addition to the outpatient conversion factor, the inpatient conversion factor, and the adjustment coefficient.

• Korean Journal of Construction Engineering and Management
• /
• v.20 no.3
• /
• pp.22-30
• /
• 2019

The purpose of this study is to derive basic data of the Guaranteed Maximum Price(GMP) process and to present specimens that can be used at the time of execution of CM at Risk project in South Korea. CM at Risk project is issued in South Korea, but the actual data is lack. On the other hand, CM at Risk project is universalized and the market of the CM at Risk is steadily growing. Because of that, in this study, The United States cases was selected as a sample. GMP consists of CM's fee, CM contingency, project direct cost, project indirect cost, allowance. GMP negotiations are performed before the end of design completion, and after 3 rounds of estimation comparison, preliminary GMP is confirmed. GMP can be multiple contract and it is useful for Procurement of long lead materials and early construction. If the actual cost is lower than expected GMP, sharing of the saving is an option since the conflict of interests between the client and the contractor can occur.

• Journal of Korea Port Economic Association
• /
• v.38 no.2
• /
• pp.11-30
• /
• 2022

Korean ports have some problems in the aspect of quality & quantity in the bunkering process. Quality of bunker is assessed as more higher than competing ports. However, quality of bunkering procedure is assessed as lower. Especially, supply chain from loading of bunker to the bunker barge at oil terminal, transport it, and supply it to the ship has not been secured. Furthermore, aspect of quantity of bunker is more serious rather than that of quality of bunkering process. Disputes on the quantity of bunker between seller and buyer occur frequently, and residue & theft of bunker is also popularized issue and serious problem. Low bunkering fee is recognized as major reason of that problem, however, though low fee can be solved, it can not be necessary secured that problem could be solved, Therefore, this paper investigates and suggests the scheme to solve the quality problems of bunker supplying procedure, and develop solution toward advanced bunkering ports through removal of the quantity disputes. Concretely, this paper suggests introduction of quality system of bunker supply chain in the aspect of bunker supply procedure, and diversion from conventional sounding method to innovative Mass Flow Metering System in the aspect of bunker measuring. These two innovative solutions contribute to the removal and improvement of current structural problems in bunkering procedure.

• The Korean Journal of Franchise Management
• /
• v.2 no.2
• /
• pp.1-23
• /
• 2011

The Freedom of Information System has been introduced into the society based on the Fair Trade Transactions Act, which was established by Fair Trade Commission (FTC) on May, 2002. However, the system itself has showed limitations in guaranteeing a reliability and transparency of the disclosure document. Thus, since February, 2008, FTC not only made franchisors to register disclosure documents but also adopted the Disclosure Document Registration System, which forced them to provide registered disclosure documents to franchise applicants and franchisee. Franchisors consider the newly adopted Disclosure Document Registration System a restrictive system. However, considering the recent trend of fast growing franchising industry and the importance of being competitive, franchisors need to utilize the disclosure documents to promote their business and to gain trusts from franchise applicants by providing truthful information. In that way, franchisors will be able to establish a foundation that franchising industry might be successful and reduce the agency fee by cutting out conflicts with franchisees. Thus, this study aims to study the ways of effective preparation of disclosure document and its utilization from a franchisor viewpoint.