• Health Policy and Management
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• v.31 no.4
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• pp.423-436
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• 2021

This article summarizes the structure of China's current social health insurance system and reviews the development status of China's private health insurance (PHI). China's medical security system is mainly composed of two parts: basic medical insurance (BMI) and PHI. Among them, the BMI provides reimbursement of basic medical expenses for the insured persons according to different proportions. PHI is a necessary supplement to the BMI and provides assistance to the insured persons in the event of illness or accident. By having PHI, people can obtain medical protection outside the coverage of BMI. In the development of PHI in China, the total medical cost is high and the insurance market size is large, but the proportion of PHI expenditure is low and the personal burden is high. Through this Chinese case, it will be helpful for mutual development between Korean PHI and national health insurance, for Korean insurance companies to enter the Chinese market, and for removing the medical burden on the people.

• Journal of Korean Academy of Nursing
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• v.34 no.6
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• pp.1117-1128
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• 2004

Purpose: This study was carried out to substantiate the application process of activity-based costing on the current cost of hospital home care (HHC) service. The study materials were documents, 120 client charts, health insurance demand bills, salary of 215 HHC nurses, operating expense, 6 HHC agencies, and 31 HHC nurses. Method: The research was carried out by analyzing the HHC activities and then collecting labor and operating expenses. For resource drivers, HHC activity performance time and workload were studied. For activity drivers, the number of HHC activity performances and the activity number of visits were studied. Result: The HHC activities were classified into 70 activities. In resource, the labor cost was 245￦per minute, operating cost was 9,570￦ per visit and traffic expense was an average of 12,750￦. In resource drivers, education and training had the longest time of 67 minutes. Average length of performance for activities was 13.7 minutes. The workload was applied as a relative value. The average cost of HHC was 62,741￦ and the cost ranged from 55,560￦ to 74,016￦. Conclusion: The fixed base rate for a visit in the current HHC medical fee should be increased. Exclusion from the current fee structure or flexible operation of traveling expenses should be reviewed.

• Korea Journal of Hospital Management
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• v.5 no.1
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• pp.156-175
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• 2000

This study was designed to find out the relations between the major investment decision-making behaviors and profitability of the hospital. A total of 57 hospitals were analyzed on this study. The major findings were as follows; 1. Among the types of the investment decision-making, major factors affecting the profitability were where the top management belongs among the defender, analyzer, prospector, and reactor type. Other factors were whether or not hospital analyzes which is more economical between the purchase by cash and lease of the medical equipment and whether or not hospital changes the decision before the actual investment. 2, Among the types of the investment decision-making, major factors affecting the financial structure and efficient operation of the assets were ranking of the priority and whether or not hospitals can get enough revenue and cash flow when hospitals have to borrow a big amount of fund from outside. 3. Among the financial indices regarding the financial stability, major factor affecting the profitability was fixed assets to long-tenn capital. Other factors affecting the financial structure and efficient operation of the assets were value added to medical equipment, normal profit to medical equipment, liability to total assets, current ratio, value added to payroll expenses. 4. Investment decision-making behaviors are partially influencing on the financial structure and efficient operation of the assets. However it was proved that the profitability was the most influencial factor than other factors related with the operation of the hospital. 5. To improve the irrational investment decision-making behaviors strategic management system should be introduced, and the top mamagement's investment decision-making style should be changed from reactor and analyser styles to prospector and reactor ones.

• Korea Journal of Hospital Management
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• v.6 no.2
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• pp.138-155
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• 2001

This study was designed to find out the factors which influence on the financial performance of the hospital. Out of 32 provincial hospitals which were established by the government, 10 hospitals were selected as sample hospitals. Ten hospitals were divided into two groups(5 hospitals each), one of which was profit-making and the other loss-making. The criteria in selecting profit or loss-making hospitals was net profit to total revenue. The major finding of the study was as follows; 1. Whether or not a hospital had specialized in certain departments was proved to be the major factor influencing on the financial performance. Three out of five profit-making hospitals could harvest following results by operating specific departments. (1) Man powers needed for the operation of specific departments were 14.6 persons per 100 bed, which was only 1/7 of the general hospital. (2) The number of doctors has not increased in proportion to the increase of the number of beds. (3) Ratio of total revenue to MD.'s payroll expenses of the profit-making hospitals was 75.0% higher than the loss-making hospitals. (4) The average length of stay of specific department was very long(388.1 days). However, the specific departments were found to have contributed much to the financial performance because the occupancy rate of such departments was very high(94.5%). 2. The headcount per 100 bed of the profit-making hospitals was 23.9 persons(24.0%) less than the loss-making hospitals and the ratio of payroll expenses to total revenue 15.1% less. 3. Averagel revenue per specialist of the profit-making hospitals was 100 million(25.1%) more than loss-making hospitals and the ratio of total revenue to MD's payroll expenses of profit-making hospital was 75.0% higher. 4. Profit-making hospitals have introduced new systems or renovation in 36 fields, such as incentive payment system, utilization of contracted man powers, change of the payroll structure of the nurses, specialization in certain departments, etc; however, loss-making hospitals introduced only 25 new systems or renovations. These kind of renovation could not be achieved without the cooperation of the labor union and the strong will of the top management. Therefore, it could be said that the labor union of the profit-making hospitals seems to have been very cooperative compared with that of loss-making hospitals.

• Korea Journal of Hospital Management
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• v.6 no.1
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• pp.1-17
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• 2001

According to the increase of the proportion of aged people, the medical demand for a senile chronic disease has been increased; therefore, aged people call for a geriatric hospital for special geriatric medical service. The main purpose of this study was to analyze the general characteristics and financial status of geriatric hospitals. For the study, a questionnaire was designed and sent to the geriatric hospitals to fill out the patient statistics, number of headcount by department, etc. to find out the stability, profitability, activity and so on financial statements of the hospitals were analyzed. The major findings of this study were as belows. 1. The ratio of the medical expenses to the revenue of the geriatric hospitals is much lower than acute care hospitals. But the probability of bankruptcy is higher due to the high ratio of the liabilities therefore it is required to stabilize the financial position by donating more money. 2. Government budget for the elderly people is not enough. To support the geriatric hospitals by going subsides, government should increase the budget. 3. Portion's of the patient of the geriatric hospitals are government support patient. Since the government doesn't pay the medical charges quickly, geriatric hospitals have a serious cash flow problem. Therefore, it is required that government is to prepay the bill. 4. Since geriatric hospitals treat elderly patient and most patients are government support patients, geriatric hospitals can be said to operate under the strict. 5. When we introduce the daily medical charge, the self-liability will be reduced on approximately 50% of current. This affection will bring a huge progressing financial structure to the medical profit of the geriatric hospital, and also patient family will feel less economical burden.

• Health Policy and Management
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• v.32 no.2
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• pp.137-153
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• 2022

In the process of promoting policies to strengthen health insurance coverage, the relationship between public health insurance and private health insurance, along with the management of non-benefit, is also emphasized as a policy issue. First, the concept and scope of non-benefit were comparatively analyzed by country. Second, the interaction between the public and private health insurance was classified as 'large or small,' and the government's regulation and management policy on private health insurance was classified as 'strong or weak.' Korea has relatively smaller benefits covered by public health insurance, higher copayment expenses, and more areas and scope of non-benefits. In countries where the interaction between public and private health insurance is small, private health insurance-related policies are weak. And in countries with large interactions had public-private partnerships and the government's management policies were also strong. On the other hand, Korea has a large interaction, but the actual structure of cooperation between public and private insurance and management policies were weak. Because the non-benefit sector in Korea is relatively wide, it is difficult to manage compared to other countries where the concept of non-benefit is limited. In addition, the health authorities rarely perform the role of supervision over private health insurance, and they have so few linkages and cooperation for public-private insurance. Therefore, practical policy enforcement is necessary to achieve the easing of the burden of national medical expenses through linkage and cooperation of public-private health insurance with reference to relevant other countries' cases.

• Health Policy and Management
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• v.33 no.3
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• pp.243-252
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• 2023

This paper aims to introduce Korea's total current health expenditure (CHE) and National Health Accounts of the year 2021 and their 2022 preliminary figures constructed on the basis of the System of Health Accounts 2011. As CHE includes expenditures for prevention, tracking, and treatment of coronavirus disease 2019 (COVID-19) and compensation for losses to medical institutions from 2020, the details are also introduced. Korea's total CHE in 2021 is 193.3 trillion won, which is 9.3% of gross domestic product (GDP). The preliminary figure in 2022, 209.0 trillion won, exceeded the 200 trillion won line for the first time, and its "ratio to GDP" of 9.7% is expected to exceed the average of Organisation for Economic Co-Operation and Development member countries for the first time. Korea's health expenditures, which were well controlled until the end of the 20th century, have increased at an alarming rate since the beginning of the 21st century, threatening the sustainability of national health insurance. The increase in health expenditure after 2020 is partly due to a temporary increase in response to COVID-19. However, when considering the structure of Korea's health insurance price hike, where the ratchet effect of increased medical expenses works particularly strongly, it is unlikely that the accelerating growth trend that has lasted for more than 20 years will stop easily. More aggressive policies to control medical expenses are required in the national health insurance which not only constitutes the main financing sources of the Korean health system but also has the most powerful policy means in effect for changes in the health care provision.

• Health Policy and Management
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• v.15 no.3
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• pp.17-39
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• 2005

Social solidarity, equity in financing, and efficiency in administration have been core issues in the development of Korean health insurance reformation since 1988. This study is to investigate the trend of administrative cost in Korean National Health Insurance from various aspects. For the analysis of administrative cost, the expenditures of each insurance society and the National Health Insurance Corporation are divided into 4 items of (1) insurance benefit, (2) administrative cost, (3) an agency provision accounts, (4) other expenses, and then they are reorganized. The analyses based on 5 types of the health insurance administrative cost showed that efficiency in administration has been improved generally. We, however, should consider qualitative aspects such as customer's satisfaction with health insurance administration, prompt service, control of unjust expenditure (unjust claims), and provision of medical service including health consultation in assessing efficiency of administration. And, in order to connect the administrative costs of health insurance with efficiency, we need to give a fundamentally new definition, which can contain elaborateness of expenditure in details including the structure and evaluation method of administrative costs. It may be necessary to develop new indicators or analyzing methods hereafter.

• Progress in Medical Physics
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• v.21 no.2
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• pp.201-208
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• 2010

Recently, along with technology development of endoscopic equipment, a stent has been developed for the convenience of operation, shortening of recovery times, and reduction of patient's pain. To this end, optimal factors are simulated for the stent structure and mechanical reaction and verified using finite element analysis. In order to compare to present commercialized product such as Zilver (Cook, Bloomington, Indiana, USA) and S.M.A.R.T (Cordis, Bridgewater Towsnhip, New Jersey, USA), mechanical impact factors were determined through Taguchi factor analysis, and flexibility and expandability of all the products including ours were tested using finite element analysis. Also, important factors were sought that fulfill the optimal condition using central composition method of response surface analysis, and optimal design were carried out based on the important factors. From the centra composition method of Response surface analysis, it is found that importat factors for flexibility is stent thickness (T) and unit area (W) and those for expandability is stent thickness (T). In results, important factors for optimum condition are 0.17 mm for stent thickness (T) and $0.09\;mm^2$ for unit area (W). Determined and verified by finite element analysis in out research institute, a stent was manufactured and tested with the results of better flexibility and expandability in optimal condition compared to other products. Recently, As Finite element analysis stent mechanical property assessment for research much proceed. But time and reduce expenses research rarely stent of optimum coditions. In this research, Important factor as mechanical impact factor stent Taguchi factor analysis arrangement to find flexibility with expansibility as Finite element analysis. Also, Using to Center composition method of Response surface method appropriate optimized condition searching for important factor, these considering had design optimized. Production stent time and reduce expenses was able to do the more coincide with optimum conditions. These kind of things as application plan industry of stent development period of time and reduce expenses etc. be of help to many economic development.

• Journal of Home Health Care Nursing
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• v.7 no.1
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• pp.73-82
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• 2000

Twenty-first century coming of health care in our country is in a situation of much conflict because the relationship between nurses and doctors is seen in terms of a traditional and vertical structure. Accordingly. it is very difficult to find collaboration amongst individuals of these two professions. Now nursing is trying to find independence and autonomy by carrying out independent professional skills. This study on collaboration and the obstacles hindering its pursuit. The strategies of collaboration to give better health care quality are as follows; First, a program for professionals should be developed to enhance professional knowledge and technology and train nursing professionals so that nursing can be acknowledged as a profession with a power to carry out on independent job. Second, collaboration reduces expenses and results in satisfactory performances of duty, high productivity, low incidence of medical accident, and higher satisfaction of the patient. Therefore the leader in the higher position should take positive stance for collaboration and help create a cooperative situation through the development of practical orders for collaboration. opening cooperative wards, and meeting for collaboration. Third, a collaboration model should be introduced into the courses of the nursing and medical school curriculum, which would influence job atmosphere after graduation. Fourth, nurses should have pride in their jobs as professionals and have confidence in their professional skill, knowledge and ability. Nurses should make an effort to share responsibility and have independence and autonomy. Fifth, common people as well as doctors know little about professional practice and the role of nurses, so a publicity campaign is also required.