• 간호행정학회지
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• 제23권2호
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• pp.139-150
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• 2017

Purpose: The purpose of this study was to identify nursing service costs associated with all health care costs incurred by the institution. Methods: This study was an empirical case study research in which the nursing cost was separated from total medical cost. The nursing cost index was calculated through a cost allocation method after summarizing costs for personnel, raw materials and administration of each department in one public hospital. The 2014 budget plan, published in 'Public Hospitals Alert', was used as data and the data were analyzed using the Microsoft Office EXCEL 2013 program. Results: When comparing total medical costs and nursing costs, the nursing cost were 27.14% of the total medical cost. The nursing cost per nurse per hour was calculated as \29,128 The nursing cost per inpatient per day was calculated as \157,970, and the administration cost per patient was calculated as \133,710. Conclusion: The results of the research present the process of cost allocation of specific cost elements in the hospital and evidence for administrative costs which in the past have been only vaguely formulated. These are the significant implications of this study.

• 한국임상약학회지
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• 제28권1호
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• pp.57-64
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• 2018

Background: Patients experience significant differences in aspects of mortality, quality of life, and costs between during the year of receiving liver transplant (LT) and the subsequent years (post-LT). This study aimed to estimate the medical utilization and cost of LT for patients compared to post-LT patients by using a recent National Patient Sample (NPS) data provided by the Korean Health Insurance Review and Assessment Service (HIRA). Methods: This study used a subset of the 2015 HIRA-NPS. Patient claims data that included Z944 (Korean Standard Classification of Diseases code for LT status) were selected. Within the selected data, LT patients were identified based on whether the national health insurance number code of Q80 (procedure code for LT surgery) was included, and they were compared to post-LT patients. Results: In the analysis, 330 patients were included. The average cost per patient was $90,066{\pm}36,959$ thousand KRW and $10,557{\pm}9,668$ thousand KRW for LT and post-LT patients, respectively. Especially, LT patients' costs for injection/procedure, surgery/treatment, and examination were higher than other costs, being $35,983{\pm}18,115$ thousand KRW, $28,246{\pm}9,408$ thousand KRW, and $12,131{\pm}6,604$ thousand KRW, respectively. For inpatients, the average number of hospitalized days was $63.5{\pm}66.0$ days for LT patients and $22.3{\pm}35.1$ days for post-LT patients. Conclusion: Compared to post-LT patients, LT patients had higher costs, especially for injection/procedure, surgery/treatment, and examination. Additionally, the LT group had longer hospitalization duration and higher costs for their hospital admission, whereas they did not show a significant difference in number of visits and medical costs for outpatient-care.

• 한국산업정보학회논문지
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• 제20권4호
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• pp.55-65
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• 2015

손상 사고 중독과 관련해 환자의 의료비 증가는 국가건강보장체계의 지속가능성을 제고하기 위한 중대한 과제이며, 제도의 개선이나 건강보험의 관리 운영 효율화를 통한 의료비 증가를 억제할 필요가 있다. 따라서 손상 발생과 사망률이 높은 우리나라에서 손상 문제를 사회적으로 강조하기 위해서는 손상의 사회경제적 비용을 추계하는 것이 필요하다. 본 연구는 2008년도 한국의료패널 조사 중 외래 손상 사고 중독 환자를 대상으로 이용실태와 의료비지출을 전반적으로 파악하여, 손상으로 외래 서비스 이용 시 환자의 직접비용과 생산차질 등으로 인한 생산손실비용을 추계하였고, 궁극적으로 손상의 사회경제적 손상 비용을 추계하였다.

• 보건행정학회지
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• 제5권2호
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• pp.35-69
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• 1995

The managerial environment of hospitals in Korea characterized by low levels of medical insurance fees is worsening by increasing government regulations as to the utilization of medical services, rising costs of labor, material, and medical equipments, growing patient expectations concerning the quality of services, and escalating competitions among large hospitals in the market. Hospitals should seek for their survival strategies in this harsh environment and they should have information about costs of their products in doing so. However, it has not been available due to the complexity of the production process of hospital services. The objectives of this study were to develop a service-based cost accounting model and to apply the developed model to a study hospital to obtain cost information of hospital services. A model commonly used for the job-order product cost accounting in the manufacturing industry was modified for the use in hospitals in Korea. Actual costs, instead of standard costs, incurred to produce a unit of services during a given period of time were estimated in the model. Data required to implement the model included financial information, statistics for the allocation of supportive cost center costs to final cost centers, statistics for the allocation of final cost center costs to services, and the volume of each services charged to patients during a study period. The model was executed using data of a university teaching hospital located in Seoul for the fiscal year 1992. Data for financial information, allocation statistics fo supportive service costs, and the volume of services, most of them in electronic form, were available to the study. Data for allocation statistics of final cost center costs were collected in the study. There were 15 types of evaluation and management service, 2, 923 types of technical service, and 2, 608 types of drug and material service charged to patients in the study hospital during the fiscal year 1992. Labor costs of each of seven types of pesonnel, material costs of 611 types of drugs and materials, and depreciation costs of 212 types of medical equipments, miscellaneous costs, and indirect costs incurred in producing a unit of each services were estimated. Medical insurance fees for basic services such as evaluation and management of inpatients and outpatients, injection, and filling prescriptions, and for operating procedures were found to be set lower than costs. Infrequent services which use expensive medical equipments showed negative revenuse as well. On the other hand, fees for services not covered by the insurance such as CT, MRI and Sonogram, and for laboratory tests were higher than costs. This study has a significance in making it possible for a hospital to obtain cost information for all types of services which produced income based on all types of expenses incurred during a given period of time. This information can assist the management of a hospital in finding an effective cost reduction strategy, an efficient service-mix strategy under a given fee structure, and an optimum strategy for within-hospital resource allocations.

• 보건의료산업학회지
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• 제11권3호
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• pp.65-78
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• 2017

Objectives : Obesity is a worldwide health concern due to an increasing obese population. This study proposed to analyze the differences in medical costs and care utilization between obese and normal group using propensity score matching. Methods : Data were collected from the sample cohort database by the Korea National Health Insurance Corporation. Propensity score matching(PSM) was applied to control selection bias, and factors affecting obesity were used as covariates in PSM. Results : The results showed higher medical costs and care utilization in the obese group than the normal group. According to gender and medical type, there were differences in the relationships between obesity and medical charges and utilization. In particular, the differences in the female population were larger in both outpatients and inpatients than the male population. Conclusions : It is important to manage obesity, because obesity has a negative effect on national health insurance costs. These findings suggest directions for future research.

• Asian Journal of Business Environment
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• 제7권3호
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• pp.17-22
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• 2017

Purpose - Clarifying one of the biggest public Hospital Costs and incomes according to patients' case mix. It leads to prepare financial information about pubic medical tariffs and hospital operational costs. Research design, data, and methodology - This study calculates the costs both, with and without taking into account capital costs. This holds for comparison of hoteling based on case mix in all medical procedures. The checklists were reviewed and filled by reviewing accounting documents of the hospital, warehouse exclusion list, and daily books of laundry and CSR. Data was analyzed descriptively by using Excel. Results - In both cases, the hospital is losing in terms of hoteling. Because the buildings and equipment are new, this loss is not tangible. However, this will be revealed when costs of reconstruction and replacement of equipment. The loss rate per day of hospitalization was 569318 Rials for Coronary Care Unit (CCU), 528171 Rials for Post Intensive Care Unit (Post ICU), 474570 Rials for ICU, 233183 Rials for Post CCU and 204803 for Surgical ward. Conclusions - Income of hoteling was lower than its costs. ANOVA showed a strong relationship between case mix and hospital costs as well as case mix and its income. This suggests that optimal case mix can minimize the costs and maximize income.

• 기본간호학회지
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• 제10권3호
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• pp.300-306
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• 2003

Purpose: This study was done to help provide patients with information on medical insurance cost through medical insurance education for nurses, to increase effective management, check on omissions in treatment and appropriateness and accuracy of fees, and to contribute to the economic growth of hospital by providing nurses with necessary knowledge about medical insurance cost. Method: The participants in this study were clinical nurses in general hospitals. The study instrument was a questionnaire developed by the researcher through reference to data for medical insurance education. The data were analyzed with percentages, means, ANOVA, and Duncan method using SPSS PC+10. Result: The results on knowledge of medical insurance according to general characteristics of the nurses showed that there were significant differences according to age: (p=.0036) highest level of education (p=.0007), position (p=.0010) and place where education on medical insurance was received (p=.0093). Conclusion: Continuous in-service education for clinical nurses is reflected in increased knowledge about medical insurance costs but special attention needs to be given to younger nurses and nurses with less education, as well as staff nurses, and those nurses who only received education on medical insurance during their schooling. Accordingly, in-service education is necessary for nurses at the time of orientation so that they have knowledge on standards for recuperation allowance, guidelines to calculate material costs, and guidelines to calculate drug rates. In addition, as medical insurance cost frequently change, all nurses need continuous in-service education.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1295-1301
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• 2015

Background: Cancer imposes a significant economic burden on individuals, families and society. The purpose of this study was to estimate the economic burden of cancer using the healthcare claims and cancer registry data in Korea in 2009. Materials and Methods: The economic burden of cancer was estimated using the prevalence data where patients were identified in the Korean Central Cancer Registry. We estimated the medical, non-medical, morbidity and mortality cost due to lost productivity. Medical costs were calculated using the healthcare claims data obtained from the Korean National Health Insurance (KNHI) Corporation. Non-medical costs included the cost of transportation to visit health providers, costs associated with caregiving for cancer patients, and costs for complementary and alternative medicine (CAM). Data acquired from the Korean National Statistics Office and Ministry of Labor were used to calculate the life expectancy at the time of death, age- and gender-specific wages on average, adjusted for unemployment and labor force participation rate. Sensitivity analysis was performed to derive the current value of foregone future earnings due to premature death, discounted at 3% and 5%. Results: In 2009, estimated total economic cost of cancer amounted to $17.3 billion at a 3% discount rate. Medical care accounted for 28.3% of total costs, followed by non-medical (17.2%), morbidity (24.2%) and mortality (30.3%) costs. Conclusions: Given that the direct medical cost sharply increased over the last decade, we must strive to construct a sustainable health care system that provides better care while lowering the cost. In addition, a comprehensive cancer survivorship policy aimed at lower caregiving cost and higher rate of return to work has become more important than previously considered.

• Asian Pacific Journal of Cancer Prevention
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• 제17권10호
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• pp.4729-4733
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• 2016

Objectives: Lung cancer is a major public health problem and one of the most costly illnesses. The study aimed to estimate the economic burden of lung cancer in Iran in 2014. Methods: A cross-sectional study was conducted to estimate the direct and indirect costs for patients with lung cancer using a prevalence-based approach. A human capital approach was employed to estimate the indirect costs. Data were obtained from several sources such as through patient interview using structured questionnaire, medical records, the GLOBOCAN databases, the Iranian Statistical Center, the Iranian Ministry of Cooperation, Labor and Social Welfare, and the Institute for Health Metrics and Evaluation (IHME). Results: The economic burden of lung cancer in Iran in the year 2014 was 3,225,998,555,090 IR. The main components of the cost were associated with mortality (81.9 %) and hospitalization (7.6 %). The costs of direct medical care, non-medical aspects, patient time, and mortality accounted for 10.8%, 2.7%, 4.5%, and 81.5% of the total cost, respectively. Conclusion: Findings from this study indicated that the economic burden of lung cancer is substantial both to Iran's health system and to society as a whole. Early diagnosis, strengthening cancer prevention, implementing new cancer therapy and medical technology, and effective smoking-cessation interventions could offset some of the costs associated with lung cancer in Iran.

• 보건행정학회지
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• 제32권2호
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• pp.154-163
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• 2022

Background: The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. Methods: We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. Results: In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. Conclusion: High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.