• 보건교육건강증진학회지
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• 제14권1호
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• pp.97-113
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• 1997

It is very important to estimate the patients satisfaction level with medical services, to classify the objectvies according to the patients characteristics and sub-satisfaction factors. The purpose of this study is to determine the factors affecting satisfaction in oriental hospital. The 549 patients' hospitalized in five oriental hospital in Taegu city and one oriental hospital in Kyungbuk province were selected for this study. The results summarized are as follows. l. The general characteristics of 549 objectvies were included gender, age, education, occupation, income level, length of stay, health status of hospitalized, and expectation for medical care. 2. Patients characteristics affecting patients total satisfaction, as for age(b=0.05), health status of patients(b=-0.052), and expectation for medical care(b=0.117) were significant, while gender, education, job, income level, and length of stay were not. As the factors according to patients satisfaction, accessibility(b=0.09l), doctor's kindness(b=0.357), staff kindness(b=0.137), nurse's skills(b=0.111), hospital facilities(b=0.211), and medical fee(b=-0.160) were significant. In total patients' satisfaction, Doctor's kindness was the most significant of prediction variables. In general the factors affecting In-patient satisfaction of oriental hospital was highly associated with doctor's kindness.

• 보건행정학회지
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• 제27권3호
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• pp.191-198
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• 2017

Moon Jae-in Government announced the Government's 5-Year Plan on July 19, 2017, President Moon directly announced the Government's Plan for Benefit Expansion in National Health Insurance on August 7, 2017. The main contents of the announced expansion include benefit coverage for all medically necessary services with control over non-covered service occurrence, a decrease in the cost-sharing upper limit, and monetary support for catastrophic medical costs. Although past governments have been continuously striving for benefit expansion in the last 15 years, this plan has its breakthrough aspect in that all medical services will be covered by the National Health Insurance. In alignment, there are important tasks to solve: attaining a proper fee schedule, reforming the healthcare delivery system, and improving healthcare quality. This plan is a symptom oriented action in that it is limited in reducing patients' out-of-pocket money, unlike the systematic approach of the National Health Insurance. The sustainability of the National Health Insurance is being threatened due to South Korea's low birth rate, rapidly aging society, and low economic growth, in addition to the unification issue of the Korean Peninsula, medical utilization of the elderly, management of non-communicable diseases, and so on. Therefore, the Government needs to plan the National Health Insurance system reformation including actions addressed toward medical consumers.

• Perspectives in Nursing Science
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• 제6권1호
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• pp.55-65
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• 2009

The Korean government introduced Home Care Services System to cut medical cost and make efficient use of limited medical resources because of increasing chronic diseases and the growing population of the elderly. The Korean government established measures to control the use of insurance services by restricting the number of nurse's visits to patient's home and by asking the patients to shoulder the transportation fee of nurses during the visit. Factors such as oversupply of hospital facilities, low price of home care services, high insurance coverage for hospital services and increased nuclear family set up resulted in the limited use of home care nursing services. The introduction of long-term care insurance in 2007 brought the decrease in the number of home care agencies and these agencies are facing a crisis today. The increase in chronic diseases and growing population of the elderly recently resulted in the need to control the high medical cost. Home care services for early discharge patients and chronic-severe disease patients will contribute in the reduction of medical cost at the same time improves the quality of patient's life. To catch up with the demands of the nation, accessibility to home care services should be improved and policies such as the expansion of home care services insurance coverage and promotion of establishing home care agencies should be considered.

• 한국병원경영학회지
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• 제26권3호
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• pp.13-27
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• 2021

Purpose: We examined the relationship between operating income and volume of medical services provided at general hospitals in 2018 according to characteristics of general hospitals and measured as operating income(net income) and volume(adjusted inpatient days) covered or non-covered by National Health Insurance(NHI). Methodology: Finance data from income statement reports in 212 general hospitals and the national health insurance claim data of these hospitals were used. The characteristics of the general hospital were divided into structural, operational, financial, and patient aspects. Operating income and volume were divided into covered and non-covered by NHI. Findings: The results showed high volume hospitals tended to be more profitable than low volume hospitals, especially in non-covered services. Operating income was more likely to be sensitive to non-covered services volume than to covered services volume. Practical Implications: It is necessary to understand the volume of services in non-covered, in order to obtain reliable cost information to be used for the fee schedule. Researches on small size hospitals(<160 beds) are needed, with a large variation in the volume of services and a strong tendency to compensate for the loss in the covered part in non-covered part.

• 임상간호연구
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• 제14권1호
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• pp.161-172
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• 2008

Purpose: This study was to classify patient severity score for hemodialysis patients. Method: The subject of this study was 1,575 patients. To study the severity of the patients, we used t-test and ANOVA. The congruity was measured by Kappa coefficient and the severity in each medical facility was analyzed by ANOVA. Result: The results showed that there was a significant difference according to the levels of medical center (F=171.187, p<.0001). Categorizing the severity of the patients in each medical facility, group II and III of the secondary medical institution had higher ratio than the primary medical institution. There was not a single patient coming under group IV in both of the primary or secondary medical institutions. However, the tertiary medical institutions had more subjects in group II and III than the primary and secondary medical institutions. The group IV with the highest severity had 11 patients(1.5%), demonstrating that the tertiary medical institution had higher severity patients than the primary or secondary medical institutions. Conclusion: The results of this study appropriately reflects the repayment system of medical expenses by the government. Also, it provides the fundamental information to develop nursing fee system taken into account of the systemic differences among the primary, secondary and tertiary medical institutions.

• 한국직업건강간호학회지
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• 제17권1호
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• pp.86-95
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• 2008

Purpose: The objectives for this study are to produce the comprehensive management indexes and find their application strategies for appropriate medical care in primary care clinics under workers' compensation insurance. Method: Data of this study was workers' compensation insurance medical fees claim's data from July 2006 to June 2007. Data were analyzed using SAS 9.1 version by applying descriptive statistics and Pearson's correlation. The indexes such as costliness index(CI), standard medical fee were calculated based on the fourth revision of korean classification of diseases(KCD-4.). Results: The CI, visiting index(VI), outliers index(OI), and medical review adjustment percentage were positively correlated in the both inpatient and outpatient medical fees in primary care clinics under workers' compensation insurance. The major medical specialities were neurological surgery, general medicine, general surgery, rehabitational medicine, and orthopedic surgery. The CIs were slightly high in rehabitational medicine among major medical specialities. The CIs were mostly high in diagnosis, test, anesthesia, and rehabitational assistive device fees among major medical specialities. The CIs were slightly high in Kwangju, Daegu, Daejeon, and Busan districts among district management centers of Korea Workers' Compensation and Welfare Service. Conclusions: We suggest the continuous development of appropriate disease classification system and medical care quality indicators to successfully take root the comprehensive management for appropriate medical care under workers' compensation.

• Journal of Preventive Medicine and Public Health
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• 제18권1호
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• pp.41-50
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• 1985

To find out the differences in medical practice according to the environment of patient care and managerial situation of the medical care institutions, normal spontaneous vaginal delivery and acute appendicitis were selected, which is suitable for comparison because of their high comparability. A total of 473 cases of normal spontaneous vaginal delivery and 408 cases of acute appendicitis was sampled from the claims to Korea Medical Insurance Cooperations during January to June 1984. Complicated cases were excluded from population and sampling was restricted from 40 to 60 percentile for total charges by the type of medical care facility in order to rule out the influence originating from case mix. Important items representing type and quantity of medical care service were compared by type of facility. Major findings are as follows : 1. University hospital shows the highest in charges per case and decrease in order of general hospital, and clinic. 2. In case of normal spontaneous vaginal delivery, average length of stay shows statistically significant difference by type of facility. 3. Charge amount for each service item affected by practice pattern shows statistically significant difference mostly by type of facility. It is suggested that medical practice pattern is different by type of facility for medical services. 4. Difference in total medical expenditure by type of facility is affected more with charges for materials, consumables and drugs than with fee for service activity. 5. In administering drugs to patients, hospital and clinic show higher injection rate than university and general hospital. 6. Clinical Laboratory tests were common in order of uninalysis, hemoglobin, hematocrit, white blood cell count, urine microscopic examination in cases of normal spontaneous vaginal delivery; white blood cell count, urinalysis, hemoglobin, hematocrit, urine microscopic examination, white blood cell differential count, in cases of acute appendicitis. 7. The result for Laboratory test and Radiologic study shows extreme difference by type of facility. Test rate is lowest in clinic and increase hospital, general hospital, and university hospital in order, both in type and frequency.

• 치위생과학회지
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• 제9권1호
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• pp.1-8
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• 2009

본 연구는 교정환자를 대상으로 의료서비스에 대한 만족도를 조사하여 교정환자의 다양한 요구와 치과의료기관의 경쟁력 강화를 위한 정보를 제공하고자 2008년 12월 3일부터 20일까지 부산지역 Y치과의원, 대구지역 B치과의원의 교정내원환자 226명을 대상으로 설문조사를 실시하였으며 SPSSWIN 14.0을 이용하여 분석한 결과 다음과 같은 결론을 얻었다. 1. 치과의원을 선택한 이유로는 '주위의 소개'가 50.7%로 가장 많았으며, 전체의 절반정도인 47.8%가 불만사항이 있을 때 '이야기 하는 편이다'라고 응답하였다. 교정치료 후 기대하는 것은 '가지런한 치아배열' 58.3%로 가장 많았으며, 교정치료 후 치아건강에 대한 기대로는 80.9%가 많이 혹은 아주 많이 나아질 것으로 기대하고 있었다. 교정치료 후 가장 하고 싶은 치료로는 미백이 70.6%로 가장 많았다. 2. 진료서비스 만족도에 유의한 영향을 미친 요인으로는 직원(치과위생사) 만족도가 가장 크고, 편의시설 만족도, 진료비 만족도, 치과의사 만족도, 친절성 만족도 순이었다. 3. 다른 사람에 대한 권유의사에 영향을 미친 요인으로는 진료비 만족도가 가장 크고, 치과의사 만족도, 직원(치과위생사) 만족도 순이었다. 교정환자가 원하는 치과의료서비스를 제공하기 위해서는 치과의료진의 지속적인 치과진료서비스 교육과 친절교육이 이루어져 교정환자의 요구도를 만족시켜야 할 것으로 사료된다.

• 한국산학기술학회논문지
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• 제22권4호
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• pp.183-194
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• 2021

본 연구에서는 SGR 모형과 AR 모형으로 부터 개발된 유형별 외래 및 입원 환산지수 분리 모형을 바탕으로 실제 건강보험 진료비 자료를 사용하여 2020년도 환산지수를 추정하였다. 또한 유형별 환산지수 계약 하에서 병원의 단일 환산지수 조정률과 외래 및 입원으로 분리된 복수의 환산지수 조정률을 산출하였다. 마지막으로 환산지수 분리 모형이 의료전달체계를 확립하기 위한 수단의 하나로 효과적으로 사용되기 위한 정책적 방안을 제안하였다. 본 연구의 주요 결론은 다음과 같다. 첫째, r=0.1에서 2020년도 병원의 단일 환산지수 조정률은 2.0%이며 병원의 환산지수를 분리하는 경우 외래 및 입원 환산지수 조정률은 각 각 2.2%, 2.3%로 나타났다. 그리고 조정계수를 활용하여 외래 및 입원 환산지수를 결합하는 방안을 제시하였다. 둘째, 의료전달체계 확립을 위한 조치의 하나로 제안된 가산율 조정 방식 대신에 가산율과 환산지수를 연동하여 운영하는 방안을 제안하였다. 셋째, 병원⦁의원 등 유형별로 외래환산지수, 입원환산지수, 조정계수를 도입하는 것에 추가해 진료량에 대한 목표관리를 가능하게 하는 모형 개발이 필요하다.

• 한국의료질향상학회지
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• 제8권2호
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• pp.232-243
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• 2001

Background : the hospitals in Korea are in a situation of a severe competition than the past. This situation was resulted from the increase in the number of hospitals and also from the government policy controlling the medical insurance fee. Moreover, consumer's desire for the high quality medical service g\has been significantly increased. Many programs to improve the quality of medical services are being performed in hospitals since the middle of 1990's. Studies up to now reported that more than 10 programs are being performed per hospital in Korea. So far studies have been performed to measure only the number of such programs in a hospital. The purposes of this study are to examine a specific area involved in the programs designed to improve the medical service quality and to suggest a future direction of the such programs. In addition, we hope that the results from this study could assist the programs for the medical service quality. Methods : A mailed questionnaire survey of the QI staffs at hospitals with 400 beds or more was conducted between September 15 and October 30, 2000. Of the 108 hospitals eligible for inclusion in our study, 69 participated, yielding a response rate of 63.9%. Excluding 7 hospital which are not responsed about activities of hospital then 62 hospitals were used for the analysis. Result : The total number of programs was 1,081 from the 62 hospitals participated in the survey. The highest number (24.8 programs) was found in the hospital having more than 800 beds and performing the programs more than 5 years. The 1,081 programs were consisted of 445 from the medical examination area, 343 from the medical examination support area, and 296 from the management area. Conclusion : This study showed the present situation of hospitals in Korea regarding to the quality improvement programs. The results from this study suggest that the pattern of the program for the medical service improvement is being changed to service process and result-centered programs from the structural area.