• Health Policy and Management
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• v.9 no.1
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• pp.156-177
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• 1999

The current method of rate adjustment for inflation is based on the evaluation of the financial performance of hospitals. The method has the disadvantage such as too complicated, expensive process as well as low reliability. This study, therefore, develops the 'Korean Medical Insurance Economic Index(MIEI)' as a new model for the rate adjustment with the use of the macro economic indices. In addition, we calculate the 1992∼1998 rate adjustment with the MIEI, and examines the validity of the MIEI by comparing with the conventional method. Medical costs are classified into nine categories : physician salaries, nurse·pharmacist·medical technician salaries, assistants & others salaries, material cost(by imports), material cost(by domestics), depreciation & rent paid(by imports), depreciation & rent paid(by domestics), power utilities, other administrative costs. Then the category weight which is the ratio of category in the total cost is calculated. Macro economic indices are selected for each cost category in order to reflect the concept of the each cost category and inflation during the year of 1992∼1998. Finally MIEI which integrate all category according to the category weight and selected macro indices is calculated. The mean of hospital MIEI which weighting by amount paid by insurers was cacluated. The result from the application of empirical data to the MIEI model is very similar to that of the current method. Furthermore, this method is very simple and also easy to get social consensus. This MIEI model can be replaced the current method based on the analysis of the financial performance for the adjustment of medical fees.

• The Journal of Korean Medicine
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• v.30 no.4
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• pp.64-78
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• 2009

Objectives: To research Korean oriental medical doctors' use of uninsured herbal extracts and how to bring about the insurance coverage of such herbal extracts. Methods: We surveyed Korean oriental doctors about the following issues from October 17th to November 15th, 2008: (1) Korean oriental medical doctors' knowledge about herbal extract insurance and the circumstances of oriental medicine in Korea, (2) their opinion on the coverage of currently uninsured herbal extracts and the dispensing of herbal extracts from pharmacies rather than from their clinics, (3) their use of herbal extracts, and (4) how to bring about insurance coverage of uninsured herbal extracts. Results: Over 70% of the respondents said that herbal medicine prescriptions have been reduced recently and that the existence of herbal medicine is in danger. In addition, 63.64% respondents agreed with expanding insurance coverage to include currently uninsured herbal extracts in spite of the fact that patients might have to obtain herbal extracts from pharmacies rather than from Korean oriental medical clinics. The average patient number per month of uninsured herbal extracts was 13.64 people, the average dosage was 5.64g, the average cost per day was 3,859 won, and the average prescription period was 2.65 days. Korean oriental medical doctors asked an average of 12,486 won for the medical examination-prescription fee and 3,292 won in fees for prescriptions obtained outside the hospital. If insurance coverage expands to include these herbal extracts, their usage is expected to increase 2.31 times. Conclusions: This study shows Korean oriental medical doctors' use of herbal extracts and their opinions about execution of herbal extracts' insurance. A periodic study such as this one will hopefully aid in establishing polices for uninsured herbal extracts' insurance.

• Journal of Korean Academy of Nursing Administration
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• v.19 no.4
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• pp.437-448
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• 2013

Purpose: This study was a retrospective survey to examine economic feasibility of home care services for patients with diabetic foot. Methods: The participants were 33 patients in the home care services (HC) group and 27 in the non-home care services (non-HC) group, all of whom were discharged early after inpatient treatment. Data were collected from medical records. Direct medical costs were calculated using medical fee payment data. Cost-effectiveness ratio was calculated using direct medical costs paid by the patient and the insurer until complete cure of the diabetic foot. Effectiveness was the time required for a complete cure. Direct medical costs included fees for hospitalization, emergency care, home care, ambulatory fees, and hospitalization or ambulatory fees at other medical institutions. Results: Mean for direct medical costs was 11,118,773 won per person in the HC group, and 16,005,883 won in the non-HC group. The difference between the groups was statistically significant (p=.042). Analysis of the results for cost-effectiveness ratio showed 91,891 won per day in the HC patients, and 109,629 won per day in the non-HC patients. Conclusion: Result shows that the cost-effectiveness ratio is lower HC patients than non-HC patients, that indicates home care services are economically feasible.

• Journal of Technologic Dentistry
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• v.35 no.4
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• pp.395-403
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• 2013

Purpose: This article examined the affecting factors of a malocclusion status of a patient for orthodontic treatment, orthodontics medical expenses and oral health behavior on orthodontic satisfaction. Methods: This paper conducted a survey from the 15th of July to 30th of September 2012 for the patients who were under orthodontic treatment at three dental clinics where are in Deagu, and distributed a total of 210 questionnaires and analyzed 194 questionnaires, excepting for some questionnaires that were answered unfaithfully. Results: This study classified the related factors into a feeling of satisfaction with treatment and mental satisfaction for finding orthodontic satisfaction. There were the effect of the right tooth-brushing method, a periodic scaling and orthodontics medical expenses on a feeling of satisfaction with treatment, and power of explanation was 16.7%. Conclusion: There were the effect of a malocclusion status, matters that requires attention during orthodontic treatment, a periodic scaling during orthodontic treatment and orthodontics medical expenses on mental satisfaction, and power of explanation was 16.9%. Based on the result above, this paper concluded that preventive treatment and early treatment should be emphasized through developing a program for regular oral examination suited to each medical type, including the method for improving the medical treatment condition and care service for increasing orthodontic satisfaction, which the dental medical-service providers could consider the patients and secure trust.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2006.05a
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• pp.1051-1054
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• 2006

Lots of information such as prescription transmitted to the drug store by the result of separation of medical activity from medicine one, EDI for billing medical charge to Health Care Public Cooperation and the returned opinion letter sent to doctor etc is scattered in the Web document made from XML. Especially information containing medical treatment charge is one of the materials that are revised frequently. It is the current situation that document is transmitted or form is made for distribution whenever this kinds of revision is occurred. In this thesis, DTD design and implementation for the information system regarding the rate of medical charge is studied based on XML which is used to calculate charges for the several activities including consulting and prescribing. Patient or patron as well as doctor, pharmacist and nurse are all interested in the information regarding the rate of medical charge. It aims everybody to easily obtain information about the rate of medical charge by querying it anytime, anywhere.

• Health Policy and Management
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• v.3 no.1
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• pp.25-52
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• 1993

Variation in the utilization of medical services is a very important issue in cost containment and quality assurance of health care. Practice variation directly affects health care expenditure especially in fee-for-service system, which is the payment system of health insurance in Korea. In addition to cost issue it is generally accepted that variations in medical practice and the cost of inpatient care suggest the possibility of inappropriate quality of care. This study is to closely examine the patterne and degrees of variation in cost structure of inpatient care among types of hospital and individual hospitals in some tracer diseases, and also to inquire into the service items which contribute much to the variation of total medical care cost. Foru common diseases, i.e. Cesarean Section, appendectomy, cataract extraction and pediatric pneumonia, were selected as tracer diseases. In most tracer diseases there were statistically significant differences in total medical care cost among hospitals in same type of hospital as well as among types of hospital(p<0.01). When total medical care cost were subdivided into the types of service, cost of medication and diagnostic examination varied the most prominenly. When the cost of medication were subdivided again, cost of parenteral antibiotics showed the most prominent variation. Of total medical care cost, medication was most contributory to the variation of total medical care cost(58.1~82.3%), and cost of antibiotics was most contributory to the variation of medication cost(63.9~92.2%). The results of study implicated that reducing the variation of medication may plays a significant role in containing the cost of inpatient care. In order to sort out the factors affecting practice variations including drug prescription pattes further researches are required.

• Korea Journal of Hospital Management
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• v.28 no.2
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• pp.44-65
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• 2023

Purposes: As super-aging population and low fertility rates are threatening the sustainability of the National Health Insurance funds, enhancing the efficiency of hospital management is paramount. In the past, studies analyzing the efficiencies of hospitals primarily made inter-hospital comparisons, but it is important to assess hospitals' internal efficiency and develop improvement measures in order to attain practical improvements in hospital efficiencies. The purpose of this study is to analyze the efficiencies of specialists by medical specialty in a hospital in order to provide foundational data for efficient hospital management. Methodology/Approach: We used the activity-based costing (ABC) data and hospital statistical data from one tertiary hospital in Seoul to analyze the efficiency of specialists by medical specialty. Efficiency was analyzed and compared among specialists using the data envelopment analysis developed by Charnes, Cooper, and Rhodes (DEA-CCR) model and the slacks-based measure (SBM) models. The input variables were labor cost, material cost, and operational expenses, and the output variables were the number of outpatients, number of inpatients, outpatient revenue, and inpatient revenue. Findings: First, there was a marked deviation in efficiency across specialists. Second, there was a marked deviation in efficiency across medical specialties. Third, there was little difference in efficiency according to the specialist's sex, age, and job position. Fourth, the SBM model produced more conservative results and better explained efficiency parameters than the CCR model. Practical Implications: The efficiency of a specialist was more influenced by their medical specialty than their personal characteristics, namely sex, age, and job position. Therefore, Further research is needed to analyze the efficiencies of each subspecialty and identify factors that contribute to the variations in efficiencies across medical specialties, such as clinical practices and fee structures.

• Journal of Preventive Medicine and Public Health
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• v.14 no.1
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• pp.65-74
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• 1981

This survey was made to determine the overall health situation on (1) the status of sickness; (2) the medical care utilization; (3) the medical cost in Mi-Kum Myun, Nam Yang Ju Gun, Kyung-Gi Do. The survey with questionnaire was carried out with 2,840 peoples in 560 households from August 9th to 16th, 1979. The findings from the survey were as follows; 1. Annual morbidity rate of the prolonged ill cases was 97.2 per 1,000 population (male 94.7, female 99.6), The highest age specific morbidity rate was 274.5 of the 45-to 64-year group and the lowest was 21.9 of the 5-to 14-year group. 2. Annual morbidity rate of the new patients was 777.5 per 1,000 population(male 644.5, female 909.5). 3. The chief complaints distribution of the prolonged ill cases was: local pain 36.6%, indigestion 22.4%, and coughing 7.3%, respectively, In terms of age and sex distribution, a large number of female of the 45-to 64-year group complained of local pain or general pain and a large number of both sexes of the 25-to 44-year group complaned of indigestion. 4. The major diseases of the new patients which classified with International Classfication of Diseases (I.C.D.) were disease of the respiratory system, disease of the digestive system, and disease of the musculo-skeletal system and connective tissue for male, disease of the respiratory system, disease of the digestive system, and accident, poisoning, violence for female. 5. Total ill days of the 92 new patients were 536 days and average ill days per case were $6{\pm}38.3$ days. 6. The rate of receiving treatment in the prolonged ill cases was 82.2%(medical facilities 46.4%, drug stores 27.5%, herb medicine 8.3%). 7. The rate of receiving treatment by first choice of the new patients was 88.0% (drug stores 57.%, medical facilities 28.2%, and herb medicine 2.2%), and the rate of receiving treatment by second choice was 30.9% of first treatment cases (medical facilities 44.0%, drug store 44.0% and herb meicine 12.0%). 8. Annual hospitalization rate per 1,000 population was 12.0 (male 12.0, female 11.9). 9. The locations of medical facilities utilized by out-patients were: in the prolonged ill cases Seoul or other places 66.4%, Nam Yang Ju Gun 33.6%, in cases of the new patients Seoul or other places 35.1% and Nam Yang Ju Gun 64.9% respectively. 10. The satisfaction rate of the new patients by mode of receiving treatment was: in cases of primary utilization by first choice herb medicine 100.0%, medical facilities 88.5%, and drug stores 69.8%, in cases of secondary utilization medical facilities 100.0%, herb medicine 100.0%, and drug stores 72.7% respectively. 11. The medical cost per utilized facilities was as follows; in average medical fee per case out-patient 8.947 won, in-patient 266,000 won, drug stores 1,532 won, and herb medicine 15,607 won, in average medical fee per day out-patient 4,829 won, in patient 14,178 won, drug stores 891 won, and herb medicine 4,906 won respectively. 12. The sources of the hospital charges paid out were: there own expense 50.0%, debt 35.3%, and security of medical care 14.7% respectively.

• Korea Journal of Hospital Management
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• v.1 no.1
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• pp.154-169
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• 1996

Some of the large sized companies have taken parts in a hospital business with a view or justification to improve medical care regadless of the disadvantageous fee-for-service medical insurance reimbursement system controlled by authorities related. This gradually brought about the financial difficulties to university hospitals as well as general hospitals that were less competitive. In this circumstance the hospital administrators are called for preparing and implementing proper financial strategies by analyzing external circumstances and internal abilities of their hospitals. In this aspect, an effective cost-analysis system in the hospital has been needed for years. K-University hospital developed the practical cost-analysis system and applied it to the hospital management. The effects of cost analysis system are as belows: first, the trend of the monthly revenue per medical specialist from March to July in 1996 showed increasing pattern which is different from that in past years. second, it turned out that the department of functional laboratory in relation to medical treatment enlarged the medical revenue very sharply. third, the intensive care units were being operated at the state of deficit, while other general wards were lucrative.

• Korea Journal of Hospital Management
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• v.5 no.2
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• pp.78-99
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• 2000

Objectives: The purpose of this study was to evaluate the opinions of hospital managers on DRG pilot study. Methods: Managers of 800 hospitals which had participated in DRG pilot study during the period 1997-1999, were requested to respond to structured self-administerd questionnaire. The questionnaire was composed with six categories: the motivation and satisfaction for the DRG pilot study, the opinions on the level of unit price, the appropriateness of DRG classification, the change of medical service quality during the pilot study, the patient's complains resulted from DRG system. and the opinions on the nation-wide application of DRG system. Results : Of the 800 subjects, 327(clinic, 210: 25 hospitals, 82 general hospitals, and 16 tertiary hospitals) completed the questionnaire, and the overall response rate was 41%, 121 hospitals(27%) answered that they participated in DRG pilot study because of convenience of claims and 118 hospitals(35%) dissatisfied with DRG system. 251 hospitals(85%) thought that the level of unit price under the DRG system was same as or lower than that of fee-for service. 297 hospitals(92%) responded that DRG classification should be modified and 137 hospitals(47%) experienced deterioration of medical service quality during the DRG pilot study. The 116 hospitals(35%) experienced the patient's complains resulted from DRG system. The 85 hospitals(88%) didn't want nation-wide application of DRG system. Conclusion: Most of the responded managers seemed to have negative opinions on DRG pilot study, even though they had been participated voluntarily. Further studies and extensive evaluations of DRG reimbursement system are needed before nation-wide application.