• Journal of Society of Preventive Korean Medicine
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• v.11 no.2
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• pp.71-86
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• 2007

This study aims at looking into the use of oriental medical services in treating disease and patient's attitude of oriental medicine by social classes. The first to be explored through this study is medical accessibility, classifying them by age, gender and job. Second is to examine kinds of oriental medical services and expenses incurred in treating the disease. Third is to compare satisfaction for the services offered and investigate into relations between disease and oriental medicine through cross-analysis by class, and provide fundamental materials for enhancing accessibility to oriental medical centers for treating chronic diseases. The 1,376 households for the period of time from Apr. to Jun. 2005, were asked to answer to the questionnaires offered. The conclusion from the survey can be summarized as follows. Medical services for the onset of disease were less offered to females, older group, low schooling, and low-income bracket. It is attributable to an economic cause, in both genders. The in- and outpatients' rate were found higher in groups of female, older age, low-income and blue-color workers. Use of oriental medical centers were higher in outpatients than inpatients probably for low-income brackets were less frequently put on regular physical checkups, more exposing to diseases. Each hospitalization was found over six days longer in average; 19.7 days for oriental medical hospitals, 12.5 for hospitals. The hospital charges that patients should pay for one hospitalization showed 909,000 won in oriental medical hospitals, much higher than 518,000 won in hospitals. Outpatients were also found to pay more for oriental medical services; 55,000 won for oriental medical hospitals, 19,000 for hospitals. As to outpatients' satisfaction, oriental medical hospitals were generally found to be a little more satisfactory than general hospitals; 11.2% of respondents answered Very Satisfactory. Satisfaction to services offered to outpatients showed 82.2% of respondents responded to Over Satisfactory for herb clinics, 76% for general hospitals. For future intention to use oriental medical services, females, over 51 years old, lower education and income, and blue color workers showed more intention to use them. To be more competitive in treating chronic diseases, it is necessary that oriental medical services become more accessible through extending its coverage of insurance into more medical herbs and their prepared packs, as well as mapping out extensive publicity strategies to make known to the public about high efficacy of medical herbs and their safety.

• Health Policy and Management
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• v.22 no.1
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• pp.29-48
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• 2012

The purpose of this study is to analyze medical expenses by decedents in their last year of life and compare them with those by survivors during the year 2008. This study is conducted firstly in Korea, except some studies focusing on medical cost of decedents from specific diseases. To study this, national health insurance(NHI) claims data was used with medicaid claims data. The study group(decedents) was selected from the insurance entitlement file who were dropped out from January to December of 2008. The control group(survivors) was selected from the entitlement file by stratified sampling with keeping age-sex composition of the study group. The medical expenses of decedents during one year before death were measured and compared with those of survivors by sex and age. And the medical expenses were analyzed by causes of death, and also the expenses were examined by each item of medical services. On average, the medical expense amounted to 11 million Korean Won per decedent during their last year of life in 2008. The medical expense per decedent was 9.3 higher than that of survivor. The death-related expense of under the age 35 was about 16 million Won, compared with 4 million Won in the case of over the age 95, in average. The death-related expense is higher in younger ages. This means that more medical resources are put in to save life in younger ages. Total death-related expenditure took 8.3 percent in total NHI expenditures. Of the death-related medical expenses, the largest one was injection-related cost which shares twenty five percent, and the second largest one was hospitalization charges, and then the third one was surgery cost. The results of this study suggested that we should pay attention to the medical expenses in the last of year of life when we study health care expenditure in Korea. In addition, we have to deliberate health care policy to cope with medical expenditures before death in more efficient way.

• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.1
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• pp.1-7
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• 2021

Purpose: The purpose of this study was to conduct a systematic review to investigate the socio-economic benefits of the poison control center (PCC) and to assess whether telephone counseling at the poison control center affects the frequency of emergency room visits, hospitalization, and length of stay of patients with acute poisoning. Methods: The authors conducted a medical literature search of the PubMed, EMBASE, and Cochrane Library databases. Two reviewers evaluated the abstracts for eligibility, extracted the data, and assessed the study quality using a standardized tool. Key results such as the cost-benefit ratio, hospital stay days, unnecessary emergency room visits or hospitalizations, and reduced hospital charges were extracted from the studies. When meta-analysis was possible, it was performed using RevMan software (RevMan version 5.4). Results: Among 299 non-duplicated studies, 19 were relevant to the study questions. The cost-benefit ratios of PCC showed a wide range from 0.76 to 36 (average 6.8) according to the level of the medical expense of each country and whether the study included intentional poisoning. PCC reduced unnecessary visits to healthcare facilities. PCC consultation shortened the length of hospital stay by 1.82 (95% CI, 1.07-2.57) days. Conclusion: The systematic review and meta-analysis support the hypothesis that the PCC operation is cost-beneficial. However, when implementing the PCC concept in Korea in the future, it is necessary to prepare an institutional framework to ensure a costeffective model.

• The Korean Journal of Health Service Management
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• v.4 no.1
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• pp.145-156
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• 2010

The purpose of this study is one of high price medical equipment wished to grasp propriety factor about the MRI introduction, analyzing payability through cost accounting into compensation. It was investigated from January 1 to December 31, 2007 about the MRI of a General Hospital. Expectation availability was 23.2 cases, but actual availability did achievement more than 196.1% with 45.5 items. It is estimated that there are a lot of occurrence cases because great reasons that actual availability increases more than expectation availability is excellent resolving power than a CT, and is device that prefer to reason back that radiation damage is less in person body. The followings show the main results of this study. 1. The MRI was construed in order of cost accounting, wave and personnel expenses 45.4%, administrative expenses 53.0%, and material costs 1.6%. 2. According to CVP (Cost-volume-profit) analysis, BEP (Break Even Point) profit is 173,931,428 won for 11 months, and break even usage number of items are 37.5 cases, and separation usage number of items were confirmed by 1.4 cases. Therefore, was construed that can achieve BEP within 11 months though usage number of items keeps 1.4 items day to create the MRI's hospital operation profit. 3. Estimated limit profitability appears high by 96.7%, exceed fixed charges even if when is non-benefit and when it is benefit consider variable, is judged that the MRI's addition induction helps in hospital management enhancing earning rates.

• Journal of Preventive Medicine and Public Health
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• v.28 no.2 s.50
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• pp.325-333
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• 1995

Laparoscopic cholecystectomy was introduced into Korea in 1990 and has been rapidly replacing open cholecystectomy when the indications were met. In this study a medical utilization and technology was assessed on the selected hospitalized patients with cholelithiasis who underwent open or laparoscopic cholecystectomy from April 1, 1991 to March 31, 1994. The results are as follows. Despite the low reimbursement rate by the health insurance, the number of laparoscopic cases have been steadily increased. The post-operative days before health insurance coverage were significantly shortened from 8.4 days to 4.6 days. The preoperative days before health insurance coverage were significantly shorted from 8.4 days to 4.0 days. The total length-of-stays in the hospital were also significantly shortened from 15.2 days to 10.7 and 9.8 days in laparoscopic cholecystectomy. The laparoscopic cholecystectomy showed low expenses in all aspects expect the average hospital charges per day. For the hospital to have cost containment, it is more effective if length-of-stay is shorter because of high daily inpatient hospital charge. The laparoscopic cholecystectomy also showed shortened anesthesia time and operation time compared with open cholecystectomy that were statistically significant. The mean anesthesia and operation time for open cholecystectomy were 113.2 and 90.2 minutes but those of laparoscopic cholecystectomy were 105.7 and 68.6 minutes. According to this study the laparoscopic cholecystectomy has reduced the medical expenditure and we recommend this procedure over open cholecystectomy. The further discussion on the different morbidity rate between two types of procedure is essential in providing quality medical care, and to educate specialist.

• The Journal of Pediatrics of Korean Medicine
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• v.22 no.2
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• pp.171-186
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• 2008

Objectives : The purpose of this study is to investigate necessity of overtime hospital business hours and patient's visiting time preferences. Methods : The study was composed of 117 children's protectors who visited the pediatrics department in Kyunghee university oriental medicine hospital between on April 14th and on July 4th in 2008. Results and Conclusions : 1. Question for asking the preference of weekdays regular consultation hours 27% of preschool children preferred time around 11 am to 12 pm, each 32% of school aged children preferred time around 3:30 to 4:30 pm, 4:30 to 5:30 pm. 2. Question for 'Have you ever experienced inconvenience for regular consultation hours' 41% of them said 'Yes', and 59% said 'No'. 3. School aged children more experienced inconvenience for regular consultation hours than preschool children, and more likely to come at overtime hospital business hours. 4. Question for 'If the hospital extends the business hours for holidays and weekdays and Saturdays, would you prefer to come at that time?' 88% of them answered 'Yes'. 5. Question for asking the preference time on weekdays, 35% of them preferred 6:30 to 7:00 p.m. 6. Question for asking the preference time on Saturdays, 44% of them preferred 1:30 to 2:30 p.m. 7. Question for 'Do you willing to pay extra charges if you visit in non office hours?' 66% were willing to pay, 24% of them said "no", 'the other opinion' is 10%.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.396-399
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• 2002

Intense quasi-monochromatic x-ray irradiation from the linear plasma target is described. The plasma x-ray generator employs a high-voltage power supply, a low-impedance coaxial transmission line, a high-voltage condenser with a capacity of about 200 nF, a turbo-molecular pump, a thyristor pulse generator as a trigger device, and a flash x-ray tube. The high-voltage main condenser is charged up to 55 kV by the power supply, and the electric charges in the condenser are discharged to the tube after triggering the cathode electrode. The x-ray tube is of a demountable triode that is connected to the turbo molecular pump with a pressure of approximately 1 mPa. As electron flows from the cathode electrode are roughly converged to the molybdenum target by the electric field in the tube, the weakly ionized plasma, which consists of metal ions and electrons, forms by the target evaporating. In the present work, the peak tube voltage was almost equal to the initial charging voltage of the main condenser, and the peak current was about 20 kA with a charging voltage of 55 kV. When the charging voltage was increased, the linear plasma x-ray source grew, and the characteristic x-ray intensities of K-series lines increased. The quite sharp lines such as hard x-ray lasers were clearly observed. The quasi-monochromatic radiography was performed by a new film-less computed radiography system.

• Korea Journal of Hospital Management
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• v.14 no.3
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• pp.23-48
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• 2009

The purpose of this study was to provide criteria which help executives to make decisions through the analysis of profitability of ultrasonography conducted in each medical department. In order to achieve such purpose, the study conducted break-even analyses on three medical departments of a university hospital in which has used ultrasonography was largely conducted in diagnosing diseases and performing surgeries. The research was carried out from January to June 2008. The data necessary for calculating cost, were collected using by computerized data. The results of the study were summarized as follows. 1. The Cost structure of each medical department: The Cost of ultrasonography was divided into direct cost and indirect cost through the categorization by cost object. Labor cost accounted for the largest portion of the direct cost with 69.3% in the department of obstetrics and gynecology, 67.4% in the department of radiology and 58.2% in the cardiac ultrasonography center, which followed by the depreciation cost of ultrasonography equipment. The calculation of the average material cost of each ultrasonographic test by medical test found that the cardiac ultrasonography center took first place with 2,355 won, followed by the department of obstetrics and gynecology with 266 won and the department of radiology with 233 won. As for the power cost of ultrasonography equipment, the department of radiology took fist place with 442,000 won. The power cost, however, did not affect much the cost price, because it accounted for only a small portion of the cost. As for indirect cost, the cardiac ultrasonography center ranked first with 7,156,000 won. Building depreciation cost accounted for the largest portion of the indirect cost. 2. Break-even analysis: Under the supposition that cost price can be divided into fixed cost and variable cost, a break-even analysis was conducted using the cost price confirmed through the cost structure of each medical department. As for the average customary charge of ultrasonography test conducted in each medical department, the department of obstetrics and gynecology charged 24,627 won, the department of radiology 53,179 won and the cardiac ultrasonography center 65,174 won. According to these results, the charges of ultrasonography test imposed by the department of radiology and the cardiac ultrasonography center wre enough to surpass break-even levels, but the charge imposed by the department of obstetrics and gynecology was not enough to offset the cost price. In conclusion, labor cost accounted for the largest proportion of cost price of ultrasonography test conducted in diagnosing diseases and performing surgeries in medical departments, followed by the fixed cost of ultrasonographic equipment depreciation cost. In medical department where the current charge of ultrasonography test turned out not to offset cost price through the break-even analysis of ultrasonographic equipment, ways to reduce fixed cost which accounts for the largest proportion of the cost price should be sought. Even medical departments whose current charge of ultrasonography test is enough to surpass break-even level are required to work for efficient management and cost reduction to continuously generate profits.

• Journal of Oriental Neuropsychiatry
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• v.25 no.4
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• pp.389-400
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• 2014

Objectives: Though there are many studies about sleep disorder, no research has been performed on the utilization of oriental medicine as a treatment. Therefore, the oriental medical treatment pattern of Korean patients with sleep disorders was examined herein using the Health Insurance Review and Assessment Service (HIRAS). Methods: The medical records of patients with sleep disorders (G47) or nonorganic sleep disorders (F51) as a main diagnosis were adopted from the HIRAS database from 2011 to 2013. Analysis was performed on the number of patients and cost per patient, with comparison between oriental and western medicine in terms of gender, age, patient care service type, and hospital type. Results: 1) Regarding sleep disorders, the medical visits and insurance charges have been increasing. Western medicine was utilized 8 times more often than oriental medicine during 3 years. 2) There were 2.5 times more women than men. 3) Among all ages, the 50~59 year group had the highest representation. 4) In comparison of average portions of patient care type over 3 years, outpatients were the majority, while the number of visits of outpatients and hospitalization has been increasing. 5) Comparison of average portion of oriental hospital type over 3 years revealed oriental clinics to be used most. The use of general hospitals was higher in western medicine treatment, while public health centers used oriental medicine more. 6) Regarding average oriental medical cost per patient over 3 years, the total was 88,000 won, with 353,000 won for hospitalization and 85,000 won for outpatients. The outpatient cost has been increasing. 7) In line with 6, oriental medical hospitals cost 126,000 won, local clinics were 85,000 won, and etc. was 95,000 won. Average costs of all types have increased during 3 years, except oriental medical hospitals in 2013. Conclusions: This study provided objective information about the epidemiologic characteristic of oriental medicine used for treatment of sleep disorder. For expansion of oriental medical demand for sleep disorder, this study would be helpful in understanding the recent status.

• Health Policy and Management
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• v.24 no.1
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• pp.92-99
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• 2014

Background: Korea's primary care clinics are seeking increase in consultation fees by expanding supply within the frame of the health insurance system, but inequality of physician income between regions and individuals is exacerbating. The purpose of this study lies in analyzing the distribution of patients of primary care clinics, their specialized field, and the degree of inequality between medical fee income according to region. Data was acquired from the Health Insurance Review and Assessment Service on charged bills made by clinic-size medical institutions from 2008 to 2011. Methods: By comparing the outpatient number per clinic according to the clinic's specialized field, results showed that ophthalmology, otolaryngology, dermatology, orthopedics, and internal medicine showed high numbers whereas plastic surgery, neuropsychiatry, cardiothoracic surgery had fewer outpatients. The number of outpatients for clinic according to region showed Chuncheonnam-do, Jeju-do, Gangwon-do, Chungcheongbuk-do, Ulsan to have higher numbers of outpatients. For those four years, clinics in the Seoul area had a rather lower number. Results: As a result of comparing the decile hierarchy distribution ratio between specialized fields according to primary care clinics income from National Health Insurance, the inequality degree showed that obstetrics and gynecology and general medicine were each 0.130, 0.280 for the decile distribution ratio, which was the highest degree of inequality within the specialized field. Their Gini coefficient were also relatively high at 0.691, 0.528 respectively. On the other hand, the decile distribution ratio for otolaryngology and orthopedics were 0.510, 0.468, respectively, while their Gini coefficient each at 0.318, 0.314 makes their inequality degree relatively lower than other fields. Conclusion: This study is limited in that the data used was the health insurance charges submitted by clinics, which does not provide total information of the doctors' income. However, because most clinics are largely dependant on their income to come from health insurance reimbursements. Therefore, the results of this study can be used effectively. In the future, research that includes data on non-covered service income should be conducted to closely examine policy plans with a new medical fee policy which can resolve the medical fee income inequality issue between clinics as well as revitalize primary medical care.