• Journal of Preventive Medicine and Public Health
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• 제36권4호
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• pp.325-331
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• 2003

Objectives : To analyze medical service utilization and trends among the elderly in the last year of life. Method : The subjects of this study were People that had died at the age sixty-five and above between January $1^{st}$ and June $30^{th}$ 2000 The names of the deceased and their dates of death were collected from the data of the funeral-expenses-receivers of the National Health Insurance Corporation (NHIC). This data was merged with that of the individual medical expenses of the NHIC. Results : In the first half of 2000, 84.2% of the funeral-expenses-receivers (53,063) utilized medical services during the year prior to their death; 51.0% (27,042) were female and 49.0% (26,021) male. In the last twelve months of life, the medical fees, the number of days receiving medical services and the number of days receiving medicine were 3,107,935 Won, 47.88 and 153.21, respectively, for each person. As the age of the groups increased, the level of medical service utilization decreased; the change was more obvious in female group. The level of medical service utilization during the twelve months prior to death drastically increased around the time of death. Conclusions : This study, from an analysis of the level of medical service utilization prior to death, shows a concentrated volume of medical services during a certain time period prior to death.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.178-187
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• 2012

Purpose: In Korea, the nation's medical expenses were 12 billion won in 2010. The medical costs for individuals can also be overwhelming. If a patient has sustained severe trauma, his/her insurance company responsible may pay only part of the medical bills. In Korean, there are diverse types of medical insurance, such as health insurance, automobile insurance, and industrial accident compensation insurance. And each insurance system has a different type of payment system. Our study will be essential for establishing the optimal medical expense payment system. Methods: From January to December 2011, we retrospectively reviewed the medical charts of 161 patients who were admitted to our hospital's emergency room after having undergone severe trauma. Of those 161 patients, 125 were retrospectively reviewed. Written permission was obtained from all of the patients. We analysed the demographic characteristics, clinical outcomes, data of the trauma, type of the patient's insurance, and the entire bill when the patient was discharged. Results: Seventy-one patients had health insurance, 48 automobile insurance, and six industrial accident compensation insurance. High-deductible insurance included health insurance and industrial accident compensation insurance, with the deductibles up to 20.6% and 19.1%, respectively. We attempted to analyze the cause of the high deductible rate. In patients with health insurance, medicines, primarily sedatives, pain killers, antibiotics, and fluids. comprised a large proportion. On the other hand, industrial accident compensation insurance deducted for a high-grade hospital room charge. Conclusion: We found that medical expenses were diverse according to the type of insurance. In particular, health insurance forced patients to pay too much of the medical expenses. Therefore, in Korea we should try to identify the insurance problems and improve the wage system.

• 대한한방소아과학회지
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• 제30권4호
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• pp.60-65
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• 2016

Objectives The purpose of this study is to emphasize the importance of preventing precocious puberty. This study assessed current number of the patients with early puberty and their medical expenses from 2010 to 2015. Methods Using the data from Korean Statistical Information Service and Heathcare Bigdata Hub, number of patients diagnosed with precocious puberty by gender, age, and year from 2010 to 2015 were reviewed. Also, annual medical insurance expenses and the incidence of leuprorelin use were reviewed. Results Number of the patients with precocious puberty has increased from 29,251 in 2010 to 75,945 in 2015. Total medical insurance expenses have increased from 25,716,431 won in 2010 to 56,367,981 won in 2015. The use of lueprorelin also has increased annually from 11,097,590,000 won in 2010 to 21,617,585,000 won in 2015. Conclusions As a result, the patients diagnosed with precocious puberty are increasing in number, and their medical costs have been rising as well. It may be necessary to control the environmental causes of precocious puberty to reduce not only the physical and psychosocial health problems, but also the social costs.

• 문화기술의 융합
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• 제4권4호
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• pp.187-199
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• 2018

본 연구는 2012년 한국의료패널자료의 보건의식행태에 응답한 만 18세 이상만으로 처리하였으며 전체 2,757명, 남자 2,614명(44.6%), 여자 143명(2.3%)으로 선정하였다. 흡연으로 의료이용 및 의료비지출 자료를 통하여 흡연자의 응급. 입원, 외래 의료이용횟수에 따른 의료비를 통하여 사회적 비용을 추계하였다. 사회적비용은 보건경제학자인 Rice(1968)의 의해 정립된 사회적관점을 채택하여 의료이용에 따른 의료비와, 보험자(공단)비용, 본인부담금, 비급여, 생산성 비용을 합산하여 사회적비용을 산출하였다. 흡연상태별 연간 응급의료이용률은 인구 백명당 흡연자 7.5%, 이용횟수 9.8회 사회적비용은 809,003원으로 나타나고 있다. 흡연상태별 인구 백명당 연간 입원의료이용률은 인구 백명당 흡연자 9.6%, 이용횟수 9회, 사회적비용은 706,870원으로 나타나고 있다. 흡연상태별 연간 외래이용률은 흡연 68.6%, 연간의료이용건수는 9건, 사회적비용은 706,870원으로 나타났다.

• Journal of Hospice and Palliative Care
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• 제8권2호
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• pp.234-244
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• 2005

As Korea has just turned into an aging society with the increase of average life expectancy, and the main causes of deaths is cancer and other chronic diseases. And this corresponds to a dramatic increase in medical expenses for the aged. To curve this problem, the hospice care can be an effective alternative, which can provide patients with both quality service and intensive care to help ensure high quality life for the patients. To demonstrate the economical effect of hospice services, a comparative study on the media expenses of geriatric hospitals and general hospitals, which bear similarities in common regarding the characteristics of their patients, is performed. Thus the results of the study can serve as a quantitative indication for the management of hospice services.

• 보건의료산업학회지
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• 제11권1호
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• pp.117-130
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• 2017

Objectives : In this study, 3,107 patients were used to evaluate the impact based on raw data of 2014 and the health status and medical expenses income quintile was collected and data was analyzed. Methods : Analysis method was the average comparison, ANOVA, subjected to a multiple logistic regression analysis, the statistical test was the t-test and the scheffe post verification. Results : Gender(p<.000), age(p<.000), marital status(p<.000) educational status (p<.000), easement(p<.000), medication(p<.000), subjective health status(p<.005) were analyzed. First quintile identified that the highest amount was spent in the Chungcheong region, the 2nd quintile showed that the highest output was in the Gyeongsang region. The 3rd and 4th quintiles indicated that the highest expenditure was in the Seoul metropolitan region. The 5th quintile showed that the Chungcheong was the highest once again and the Jeolla region was the lowest in terms of expediture. Conclusions : Future medical research on income will require the government's Big Data collection to create the primary basis for policy making in order to improve the efficiency, effectiveness and equity of medicine spending.

• 보건행정학회지
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• 제29권4호
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• pp.445-453
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• 2019

Background: This study is to investigate the association between the distribution of multimorbidity and length of stay and medical expenses among inpatients in a municipal hospital to achieve an integrated care setting. Methods: We used the exploratory factor analysis and the generalized estimating equation model to analyze the data from patients living in the northeast region of Seoul, who were hospitalized from January 2017 to December 2017 in a municipal hospital. Results: As a result of the factor analysis, seven types of multiple chronic diseases were classified. Among the elderly patients admitted to municipal hospitals, the burden of medical expenses was mainly influenced by the length of stay (B=310,719, p-value <0.0001), not the type of disease (all not significant). Length of stay were mainly due to psychiatric illness (factor 1: B=4.323, p-value <0.0001) related to the brain and metabolic diseases (factor 2: B=2.364, p-value=0.003). Conclusion: This study showed that the medical expenses of the elderly patients were largely due to prolonged hospitalization, not multimorbidity. Therefore, it is necessary to develop an integrated care paradigm strategy cope with the multimorbidity of the elderly in the community and to alleviate the socio-economic burden.

• 한국환경보건학회지
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• 제48권2호
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• pp.123-129
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• 2022

Background: The Environmental Health Action Program was a national project carried out from 2012~2021. It was aimed at developing public technologies to protect people's health from various environmental hazards. Objectives: One of the final goals of the project was "creating health benefits worth more than 179.2 billion won by reducing the environmental burden of disease." This study aims to evaluate whether the program sufficiently achieved the planned benefits. Methods: In order to secure consistency in evaluation, we applied the same equation used in the goal-setting process. It is comprised of six parameters to estimate the benefit: 1. The amount of medical expenses for environmental diseases; 2. The attributable proportion of environmental risk factors' 3. The rate of reduction in medical expenses for environmental diseases; 4. R&D project contribution; 5. The proportion of successful policy reflection; and 6. The contributions of the project. The corresponding variables were estimated at the end of the project, and the health benefits of the project were recalculated using the newly estimated variables. Results: It was estimated that a total of 195 billion won in health benefits occurred or will occur from 2015 to 2026. The main contributors for achieving the target were an increase in medical expenses for environmental diseases, a high score in the R&D project contribution, and the proportion of successful policy reflection. Conclusions: Technically, the equation used in the project is about medical expenses for environmental diseases rather than about the environmental burden of disease. There are several benefits of using the environmental burden of disease in the evaluation of public health policies. In further studies, developing a policy evaluation framework using indicators such as population attributable fraction would be needed.

• 의료법학
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• 제20권2호
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• pp.231-260
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• 2019

지난 호에 이어 2018년도 주요 의료판결을 정리하였는데, 특히 설명의무와 관련된 법원의 설시는 그 한계가 어디까지인지 알 수 없을 정도로 다기(多岐)하여 가급적 많은 판결을 소개하기 위하여 노력하였고, 손해배상의 범위와 관련하여 개호비를 다액 인정한 판결과 각서의 효력이 증가된 치료비에도 미치는 것으로 본 판결도 관심을 가져볼 필요가 있다. 진료비상계 및 공제관련 판결은 서술내용에 비하여 가장 많은 토론이 이루어졌다. 의료기관 다중 운영 사례는 중간적 판결이지만, 워낙 의료계에 관심이 많은 사건이고, 임의비급여 관련 재량권 일탈 남용이 인정된 사건도 과거에 비하여 비중이 많이 줄었지만 여전히 의미가 있다고 보았다.

• International Journal of Advanced Culture Technology
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• 제10권4호
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• pp.19-27
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• 2022

The purpose of this study is to investigate the incidence rate, surgery tendency, and risk factors of cataracts among the elderly in Korea. The subjects were 40-95 years old men and women using the National Health Services' surgical statistics. Among the 33 major surgeries, which increased by 1.1% per year for the last 20years (1.6 million), the most operated surgery in 2020 was cataract surgery (454,000), the number of which was 858.8 per 100,000 people. Among the surgical patients, cataract patients (7.9% increased) was the third largest among the top (2016-2020) constantly with annually 2.2% increasing for 20 years (19.95 million). The medical expenses of major surgeries (excluding non-benefit) increased by an average rate of 9.3% per year over the 20 years (7,204 billion won) out of a total medical expenses of 7.2 trillion won, and the cataract surgery (813.2 billion won) was the second largest among the medical expenses in 2020 (top 3). This study showed that there was a high correlation between cataract and smoking, low income, and low-educated, whereas being no concentration of cataract patient in tertiary hospitals.