• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.6
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• pp.3534-3547
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• 2014

Although there are many positive sides of the current fee-for-service payment schedule, there is a strong necessity to control the rapidly increasing national healthcare expenditure. The global budget is often mentioned as one prominent alternative for solutions. In this article, both microscopic and macroscopic approaches are considered to set the hospital medical expenditure budget. In a macroscopic aspect, the SGR model, which considers the financial limit of the healthcare system, is used to set the next year target budget. In addition, the DEA model is used to measure the inefficiency and cost recognition. In this article, the national medical target expenditure is distributed to an individual hospital based on the level of efficiency. By combining the SGR and DEA, it will be possible to set a real world applicable target medical expenditure budget model.

• Journal of Society of Preventive Korean Medicine
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• v.1 no.1
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• pp.27-41
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• 1997

The degree of KAP study on oriental traditional medicine was examined with some korean from July 1st to August 30th in 1996. The result of the study for predicting health and ill patterns runs as fellows. 1) It is too weak to understand and adertise oriental traditional medicine doctors and the curable disease; moreover cured diseases rather preponderate. 2) Although most patients go to oriental traditional medical clinic for the purpose of medical herbs in package and acupuncture, they think the medical fee a high expensive. 3) The 77.9% of respondents recognize oriental traditional medical doctors as a profession and others think them only abundant workers; therefore it is rather low to think oriental traditional doctors a profession. 4) Most respondents ink that oriental traditional medicine should improved in the inside; such as the expensive fee, scientific reinforcement of theory, lack of univerality, improvement and enlargement of insurance, unkindness, shortage of publicity, dropped equipment, system of medical specialist, lack of integration with western medicine, exact diagnosis and confidence of remedy and low efficacy, etc. 5) The struggle against the government (1995-1996 about herbal prescription right by western pharmacy) has taken the change of affirmative recognition. 6) The degree that acknowleges of oriental traditional medicine through these basic contents is average 61.65 mark. To be brief, although the step of recognition and attitude of oriental me야cine is very affirmative aspect, actually considerable difficult factors is in the last chosen step.

• Journal of Korean Clinical Nursing Research
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• v.28 no.2
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• pp.122-136
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• 2022

Purpose: This study attempted to recommend a revision of inpatient nursing fees based on analyzing current and appropriate staffing levels. Methods: Staffing grades and their inpatient nursing fees as of the first quarter of 2022 were analyzed. Nurse managers and staff nurses answered surveys about the current and appropriate staffing levels, working days, and monthly salary. A total of 101 nurse managers and 588 staff nurses working in general wards at tertiary hospitals and general hospitals participated in the study. Results: The results showed that grade 1 staffing was found in 73.3% of tertiary hospitals and 63.7% of general hospitals. The current staffing ratios of tertiary hospitals and general hospitals were 1:9.3 and 1:10.4, respectively. The appropriate staffing ratios according to nurse managers and staff nurses at tertiary hospitals were 1:7.6 and 1:7.0, respectively, and 1:8.7 and 1:8.8 in general hospitals, respectively. The average estimated annual working days of staff nurses were 235.2 days in tertiary hospitals and 240.0 days in general hospitals. The median monthly salary for staff nurses was 4.957 million won in tertiary hospitals and 4.140 million won in general hospitals. The new staffing grade system was suggested from 1:6 (Grade 1) to 1:12 (Grade 5). The new inpatient nursing fee schedules were recommended to be paid based on nursing hours per patient day of each grade. Conclusion: The new staffing grade and inpatient nursing fee schedules are expected to increase staffing levels, improve the quality of nursing care, and provide a better work environment for nurses.

• The Journal of Pediatrics of Korean Medicine
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• v.25 no.1
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• pp.90-110
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• 2011

Objectives: The purpose of this study is to examine the parental recognition and utilizing patterns of oriental medical care in children who live in Seong-Dong district. Methods 802 day-care center children's parents participated in the survey on recognition and utilizing patterns of oriental medical care, and 702 of the surveys were analyzed. Results: 1. 38.33% has received previous oriental medical treatments and most were received at the children's age under 12-24 months. Majority of the treatments took place in the clinical settings. By recommendation, some also received their treatment at the medical centers. One of the reasons why they receive oriental medical treatments was that they prefer to balance their treatment with the orental medical treatments along with the western's. 2. 53.85% of those who received oriental medical treatments were satisfied with their treatments. The effective treatment results were the major reason for the satisfaction. 3. 49.56% of those who had oriental medical treatments chose specific oriental medical facilities for the children's ailment. Most specific oriental medical facilities were local oriental medical clinics. Reputation fame were the main reason in choosing the clinics. 4. In 2009, 55.26% had received care in the specific oriental medical clinics for the diseases, such as respiratory symptoms, systemic symptoms, gastrointestinal symptoms, skin problems, neurological and psychiatric disease for infants, and respiratory symptoms, gastrointestinal symptoms, systemic symptoms, skin problems, neurological and psychiatric symptoms, urinary symptoms and musculoskeletal symptoms for toddlers. 5. The average duration of herbal treatment were 7-14 days, preferably 4-6 days, and preferred number of medical visits were once a week on Saturdays and preferred day for night cares were on Friday nights. Average treatment fee per treatment was less than 10,000 won which coincided with the preferred treatment fee per visit. 6. The very first medical institutions chosen by parents once their children are ill are the following; Western medical institutions, western medical clinics, pharmacies, oriental medical clinics, health centers, and lastly, oriental medical institutions. The major concerns in receiving oriental medical cares include pesticides in herbs and hazardous substances in heavy metals. Preferred form of oriental medicine was decoction, the negative feedback of oriental medicine was mostly due to the bitter taste of the oriental herbal decoctions. Preferred frequency of intake was twice a day with less than 10cc~20cc per single intake. Conclusions: Taken all together, we conclude that the growing recognition of Oriental Pediatric medicine is needed among parents.

• Korea Journal of Hospital Management
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• v.25 no.2
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• pp.45-56
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• 2020

Purpose: The purpose of this study is to investigate medical care behaviors influencing accuracy of the payment based New diagnosis-related groups (DRG) compared to fee for service (FFS) in hospitalized patients with medical illness. Methodology: In order to estimate the difference in medical costs between New DRG and FFS depending on medical care behaviors, medical records and hospital claims data (n=4,232) were utilized, which were collected from a single public hospital during the first-half of 2018. Data were analyzed by descriptive statistics, t-test, chi-square test, and multivariate binary logistic regression. Findings: The average difference in medical costs between New DRG and FFS were KRW 506,711±13,945 with incentives and KRW -51,506±12,979 without incentives, respectively. Forty-four point two percent (44.2%, n=1,872) of total subjects were shown to have negative compensation in overall medical costs with New DRG compared to the costs with FFS. Medical care behaviors that affected on the negative compensation were the presence of severe bed sores on admission, medical consultations, death, operations, medications and laboratory or imaging tests with unit price over KRW 100,000, hospital-acquired complications or underlying comorbidities, elderly patients (≧65 years), and hospitalized for more than average inpatient days defined by New DRG (p<0.001). The difference in average medical cost between New DRG and FFS for a group with mild illness was KRW -11,900±10,544, whereas it was KRW -196,800±46,364 for a group with severe illness (p<0.0001). Practical Implications: These findings suggest that New DRG payment model without incentives may incompletely cover the variation of medical costs in real clinical practice. Therefore, policy makers need to consider that the current New DRG reimbursement should be focused and refined to improve accuracy of payment on medical care resources utilized in severe and complex medical conditions.

• The Korean Nurse
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• v.29 no.2
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• pp.48-65
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• 1990

The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

• 대한예방의학회:학술대회논문집
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• 1998.10b
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• pp.256-257
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• 1998

• Journal of Korean Academy of Nursing Administration
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• v.7 no.2
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• pp.361-375
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• 2001

This research aims to produce and implement web-based continuing nurse education programs in response to nurses' educational needs, and to verify them, thus preparing for the times that the program will be offered via web. This research designed, produced and implemented 'emergency nursing' and 'medical fee schedule management' subjects based on Jung, In-seong's(1997) web-based instructional system design, and then compared the learning achievements of web-based learning group of 38 people with those of face-to-face learning group of 39 people. The questionnaire have been developed by these researchers to measure pre-learning knowledge on 'emergency nursing' and 'medical fee schedule management.' Data collected for this research have been given statistical analysis, using SPSS 10.0 for Windows Program. As a result of giving Mann-Whitney test, with respect to pre-learning prior knowledge level, there was no significant difference between the web-based learning group and the face-to-face learning group(Z=-.092, p=.926), while after completing learning, there was a significant difference in the learning achievements between the web-based learning group and the face-to-face learning group(Z=-2.406, p=.008). That is, this research revealed this: the web-based learning group and the face-to face learning group with both having no significant difference in the pre-learning level, after receiving the continuing education each with different methods(face-to-face education and web-based education), showed that the web-based learning groups attained higher learning achievements than the face-to-face learning groups. This result proves the effect of the web-based education to be no worse or even better than that of the face-to-face education, provided that choices of appropriate themes and quality courses composition, as well as systematic design development effective implementation are guaranteed.

• Journal of Preventive Medicine and Public Health
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• v.5 no.1
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• pp.125-132
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• 1972

The status of health administration and medicare insurance program of 58 universities and colleges of 4-year course was studyed in 1971 and the following results were obtained; 1. The average number of students of 30 universities was $4,800{\pm}2,600$ and that of 36 colleges was $780{\pm}620$. 2. The types of health service facilities for the students varied widely according to the institutions, from an elaborate one, university health center, to a poor one, first aid room. 3. Thirty-six out of 58 institutions had some sort of health service facilities, either health center or health service room. And 14 out of 36 institutions had elaborate health service facilities such as university health center or student health center 4. The number of full time staff of the health center and that of the health service room were 2 to more than 10 and 0 to 3 respectively. 5. The range of student health service fee varied widely according to the institutions from \50 to \550 per student, per semester. The average cost of student health service fee at the institutions with health centers was $\300{\pm}150$ and that with health service rooms was $\200{\pm}150$ per student, per semester. 6. Utility rate of the student health service facilities at the institutions with health centers and with health service rooms were 1,200 to 1,400 and 3,900 to 4,100 per 1,000 students per year. 7. There was an obvious increasing tendency of tuberculosis prevalence rate in the students. 8. The institutions which had appointed hospitals for student medicare were 24; where the reduction rate of medical expenses for students varied from 10 to 50 per cent. 9. Students medicare insurance program was adopted by six universities which accomodated more than 2,000 students. 10. The range of student medicare insurance fee varied widely according to the institutions from \140 to \800 per student per year. Each of the six universities which had adopted the insurance program had each own's special regulations to apply for pay claims.

• Journal of The Korea Institute of Healthcare Architecture
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• v.4 no.7
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• pp.67-74
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• 1998

Although Medical Care System pays medical fee for each patients with the establishment of National Medicare System, patients cannot be equally benefited from hospitals. At present, the Korean government provides minimum requirements on medical facilities in enforcement of medical law, but it is not enough to guarantee the rights of patients. The purpose of this study is in search for the way to improve the minimum requirements of ward which will be needed to examine the present situation of general hospitals, to find out their problems, and to compare the law of medical facilities in korea.