• The Journal of Korean Medicine
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• 제29권1호
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• pp.15-24
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• 2008

Objectives : The purpose of this study is to reexamine current oriental medical treatment fees based on valuation of input resources which are the treating time, the treatment's difficulty, and the material cost. Methods : This study obtained the following results by reviewing the answers given by 172 oriental medical doctors from March 1 to April 15, 2006. To investigate material cost, we took inventory of treatment materials used by 2 oriental hospitals. Results : The current system does not reflect well enough the treating time and treatment's difficulty. Considering current oriental treatment fees, material costs are too much of doctors' fees. Especially, Wang-ssuk-dduem, which is another form of moxibustion treatment, was spent as much as 74.6% on materials cost. Conclusions : The findings suggest the current oriental treatment fees should be revised to reflect the actual input resources into oriental medical doctor activities and to avoid a distortion of physicians' behavior.

• The Korean Journal of Nuclear Medicine Technology
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• 제15권2호
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• pp.111-115
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• 2011

Purpose: In vitro uses dose response curve with 6 to 7 standard concentrations in every examination to analyze examination results and this use of dose response curve comprises a large portion of the consumption of medicine material. At this present, some ones of in-hospital examination items have shown mostly low result of distribution in the analyzed features and these examinations have been judged that it would be unnecessary to use the last standard concentration. Hence, this study selects those examination items showing low result of distribution and reviews the cases contributed to less consumption of medicine material and revenue growth of hospital by reduction of medicine material used in the place of the last standard concentration. Materials and Methods: The study was made targeting 11 examination items out of total 43 items of the in-hospital examination and since these examination items were mostly low in the features as the examination results of patients or the examination results were distributed to show lower concentration than the previous last standard concentration, it carried out the examination without using the last standard concentration, which could generate the effect to reduce medicine material (examination tube) used in the last standard concentration as many as the number of examination carried out. For this, it examined the number of medicine material reduction by month during the period from July, 2009 to February, 2011 and estimated the reduction amount of medicine material calculated the number of reduction by the unit cost of medicine material as well as the profit generated by the reduced medicine material to use for the medicine material of patient examination. Results: The total number of medicine material reduced during the period from July, 2009 to February, 2011 was 3,131 pieces, which had the effect to reduce the medicine material equivalent to about 31 kits of reagent. To calculate this by the unit cost of the medicine material, it analyzed to reduce about 6.4 million won of medicine material cost. Also the reduced medicine materials were used for medicine materials of patient examination and this was analyzed to generate about 13.75 million won of profit based on the ABC cost accounting. Conclusion: It showed no problem in the analysis of examination result even without using the last standard concentration regarding those examination items with low distribution of the patient examination result. For these examination items, it was able to reduce medicine material used for the last standard as many as the number of examination carried out. Also, the adjustment of concentration range was found to have no problem in the reliability of examination result. Therefore, this case will be applicable in those occasions of when the analysis of patient examination result is mostly distributed at the lower level or when an examination with the distribution of patient results in the range of lower concentration than the previous last standard concentration is carried out and this is considered to increase the efficiency in the use of medicine material in vitro as well as contribute to the profit of hospitals.

• Journal of Preventive Medicine and Public Health
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• 제14권1호
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• pp.3-12
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• 1981

To identify the changes in professional care patterns after the introduction of medical insurance in Korea, professional care in hospitals and clinics of two succeeding years were compared. The hospitals and clinics selected for this study were those which located in Seoul city. Hospitals were classified into 3 categories: university hospital, general hospital and hospital. The diseases selected for this study were acute appendicitis and normal delivery. They were selected because their disease courses are considered to be fairly stable. The variables used for this study were length of stay, total hospital costs, costs of each components of cares. The information used for this study was obtained from the official forms requested by the medical facilities to the Korea Medical Insurance Corporation. The two periods studied were 3 months of each year from March 1st to May 31st in 1979 and 1980, The total number of normal delivery studied was 289 in 1979, 301 in 1980 respectively and the acute appendicitis was 92 and 111 respectively. In order to compare the quantity of medical care between 2 study periods the insurance price scores of 1979 were converted to prices of 1980. For statistical test of difference between 2 periods T-test and Welch's test were used. The result of the study were briefly summarized in below. 1. No significant difference was observed in the average length of stay of both disease between two study periods in all types of hospitals. 2. No significant difference was observed in the average total hospital costs of both diseases in all types of hospital, but in the private clinic the average clinic costs was rather decreased significantly in 1980. 3. More cost decrease were seen than cost increase in 1980 in all types of facilities, More cost changes by items were seen in acute appendicitis than in normal delivery between two study periods. The total hospital costs can be devided into 2 portions: charges for drug and material and for physician. In normal delivery, costs for physician's charges was significantly decreased in almost all the hospitals and costs for drug and material were not changed significantly in all the hospitals in 1980. In the university hospitals, however, the costs for drug and material were increased significantly in 1980. The cost decrease for physician's charge were mainly due to the decrease in the costs of laboratory test, treatment and physical therapy. The increase in the costs for the drug and material in the university hospitals was mainly due to the increase in the cost for drugs for oral administration and injection. 4. The proportion of components of medical care in the hospital has not been changed significantly, however, the cost for injection in normal delivery was characteristically increased in 1980 in all hospitals studied. In general the proportion of the costs for drug and material was tended to increase and the costs for physician was tended to decrease in 1980. The increase in the costs for drug and material were considered to be due to increase in the cost for drugs for oral administration and injection. The decrease in the costs for physician were due to decrease in the costs of laboratory test, treatment and physical therapy. Above mentioned changes in hospital and clinic care patterns are considered to be mostly influenced by the review criteria set by the K.I.C. for the assessment of the fee request made by clinics and hospitals.

• Journal of Acupuncture Research
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• 제33권3호
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• pp.67-73
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• 2016

Objectives : The objective of this study is to discuss problems and potential improvements of national health insurance fees associated with miniscalpel acupuncture according to Korean medical doctors' workload, material cost and degree of risk. Methods : We researched the change of relative value points, national health insurance fees, the acupuncture process, and Korean medicine doctors' workload related to Miniscalpel acupuncture, as compared to general meridian point acupuncture. We also examined material cost by surveying pharmacies, internet shopping malls and medical appliance shops. Results : Relative value point for Miniscalpel acupuncture decreased from 2010 to 2012, and remained the same from 2012 to 2016. National health insurance fees for Miniscalpel acupuncture increased by a small margin annually for rise of equivalent index. There was no reporting on workload related to Miniscalpel acupuncture. Material cost of Miniscalpel acupuncture was 18.2~20.7 times higher than actual cost of procedure. There were few studies examining medical accidents related to Miniscalpel acupuncture, and thus we could not evaluate degree of risk. Conclusion : We suggest revaluating Korean medical doctors' workload related to including Miniscalpel acupuncture, to consider the material costs of Miniscalpel acupuncture, and investigate its degree of risk by researching medical accidents.

• Journal of Society of Preventive Korean Medicine
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• 제18권1호
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• pp.43-52
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• 2014

This study was conducted to analyze if there is a difference between the head hospital and branch hospital by comparing the profitability and operating expenses to patient revenue of oriental medicine hospitals affiliated with universities in order to find whether opening branch hospitals is an appropriate method to increase profitability. Profit indices used for the comparison of head hospital and branch hospital include ratio of operating profit on medical revenue, net-income on medical revenue, net profit to total assets, and operating profit to total assets; and cost indices included ratio of labor costs, material costs and administrative costs. In comparison of profit indices of head hospitals and branch hospitals, head hospitals displayed negative(-) in all four profit index averages while branch hospitals displayed positive(+), showing that branch hospitals have higher profitability. In particular, in the case of head hospitals, ratio of net profit to total assets was -13.6%, while that of branch hospitals was 12.9%, which was higher than 3.1%, the average of Korean oriental medicine hospitals in 2011. As a result of difference analysis between groups of head hospitals and branch hospitals, profit indices of ratio of operating profit on medical revenue, net-income on medical revenue, and ratio of net profit to total assets were found to vary by hospitals, but there was no statistically significant difference between head hospitals and branch hospitals(p<0.1). Only the ratio of operating profit to total assets of head hospitals and branch hospitals indicated significant difference between the two groups, showing that ratio of operating profit to total assets of branch hospitals is larger than that of head hospitals. Meanwhile, the cost indices of ratio of labor costs, material costs and administrative costs in the difference test results did not show significant difference between the head hospital and branch hospital(p<0.1). Thus, it cannot be said that a certain oriental medicine hospital's profitability is high or low depending on whether it is head hospital or a branch as profitability varies depending on the management environment of the hospital. Therefore, oriental medicine hospitals affiliated with universities would need to make efforts to increase their profitability as an individual hospital rather than focusing on whether they are head hospital or a branch.

• Archives of Reconstructive Microsurgery
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• 제18권2호
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• pp.75-78
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• 2009

Purpose: Microsurgery is an essential technique in plastic and reconstructive surgery. However, microsurgical suturing and handling of the instrument are difficult for beginners, and who requires a steep learning curve. Therefore, methods for improving the technical skill are needed. The authors describe the value of a small stereoscopic microscope as a training tool. Materials and Methods: A small stereoscopic microscope was used to help improve the microsurgical skill. Monofilament 10-0 Nylon and a surgical rubber globe were used as a suture material and education material, respectively Result: Stereoscopic view of the operation field was obtained and basic microsurgical suture was possible. Conclusion: The stereoscopic microscope is an effective training tool for beginners of microsurgery with benefits in cost and usefulness in small place.

• Quality Improvement in Health Care
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• 제6권1_2호
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• pp.150-160
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• 1999

Background : Because hospitals had to faced with financial hardship, we have to have more effective hospital management. In this study, we tried to improve job performance and to reduce cost maintaining safety in fields of patients care. Methods : Central Supply Room(CSR) staffs taught strategy of material cost reduction to middle level managers and staffs 14 times. All staffs and voluntary service workers, working in 33 nursing units, participated in this activity. We developed questionnaire to check the degree of participate in cost reduction activity and job performance in CSR, and quality improvement in the wards. Two hundred questionnaires were distributed and 197 returned. Results : Because CSR staffs developed new items and every item was managed at each department, stocks of each department were reduced. Overall, by comparing before and after cost reduction activity, almost 1.2 billion won reduced for one year. Staffs' loyalty and spirits of cost reduction were improved by changing clothes and duty environment. Furthermore, these activity improved patients' satisfaction. Conclusion : We suggest that CSR activity in a university hospital contributes to improve job performance and to reduce cost without any problem in patient care.

• Archives of Plastic Surgery
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• 제49권2호
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• pp.266-274
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• 2022

Background Many authors have researched ways to optimize fat grafting by looking for a technique that offers safe and long-term fat survival rate. To date, there is no standardized protocol. We designed a "hydraulic system technique" optimizing the relationship among the quantity of injected fat, operative time, and material cost to establish fat volume cutoffs for a single procedure. Methods Thirty-six patients underwent fat grafting surgery and were organized into three groups according to material used: standard, "1-track," and "2-tracks" systems. The amount of harvested and grafted fat as well as material used for each procedure was collected. Operating times were recorded and statistical analysis was performed to establish the relationship with the amount of treated fat. Results In 15 cases the standard system was used (mean treated fat 72 [30-100] mL, mean cost 4.23 ± 0.27 euros), in 11 cases the "1-track" system (mean treated fat 183.3 [120-280] mL, mean cost 7.63 ± 0.6 euros), and in 10 cases the "2-tracks" one (mean treated fat 311[220-550] mL, mean cost 12.47 ± 1 euros). The mean time difference between the standard system and the "1-track" system is statistically significant starting from three fat syringes (90 mL) in 17.66 versus 6.87 minutes. The difference between the "1-track" system and "2-tracks" system becomes statistically significant from 240 mL of fat in 15 minutes ("1-track") versus 9.3 minutes for the "2-tracks" system. Conclusion Data analysis would indicate the use of the standard system, "1-track," and "2-tracks" to treat an amount of fat < 90 mL of fat, 90 ÷ 240 mL of fat, and ≥ 240 mL of fat, respectively.

• Journal of Rhinology
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• 제25권2호
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• pp.86-90
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• 2018

Background and Objectives: Although polyvinyl acetate ($Merocel^{(R)}$) has been widely used as a packing material after septoplasty, removable nasal packing can increase patient discomfort, local pain, and pressure. Furthermore, the removal of nasal packing has been described as the most uncomfortable and distressing feature associated with septoplasty. The purpose of this study was to investigate the efficacy of polyvinyl acetate with carboxymethyl cellulose sheet ($Rhinocel^{(R)}$) nasal packing on patient subjective symptoms, degree of bleeding, hemostasis, and wound healing following septoplasty. Subjects and Method: Forty patients with nasal septum deviation requiring septoplasty were included. Following surgery, one nasal cavity was packed with $Rhinocel^{(R)}$ and the other one with $Merocel^{(R)}$. Patient subjective symptoms while the packing was in situ, hemostatic properties, pain on removal, degree of bleeding on removal, duration of hemostasis after removal, postoperative wound healing, and the cost of the pack were evaluated. Results: Although the two types of packing materials were equally effective in controlling postoperative bleeding after septoplasty, $Rhinocel^{(R)}$ was significantly more comfortable while in situ and less painful on removal than $Merocel^{(R)}$, which was associated with significantly more bleeding on removal and so more time was needed to control hemorrhage. There was no significant difference in postoperative wound healing or pack cost. Conclusion: The use of $Rhinocel^{(R)}$ after septoplasty has less discomfort, greater patient satisfaction, and less bleeding on removal with no adverse reactions compared to $Merocel^{(R)}$ packing. Therefore, $Rhinocel^{(R)}$ may be a useful packing material after septoplasty.

• Archives of Craniofacial Surgery
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• 제16권3호
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• pp.125-130
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• 2015

Background: Poly-L-lactide materials combined with hydroxyapatite (u-HA /PLLA) have been developed to overcome the drawbacks of absorbable materials, such as radiolucency and comparably less implant strength. This study was designed to evaluate the usefulness of u-HA/PLLA material in the repair of orbital medial wall defects. Methods: This study included 10 patients with pure medial wall blow-out fractures. The plain radiographs were taken preoperatively, immediately after, and 2 months after surgery. The computed tomography scans were performed preoperatively and 2 months after surgery. Patients were evaluated for ease of manipulation, implant immobility, rigidity and complications with radiologic studies. Results: None of the patients had postoperative complications, such as infection or enophthalmos. The u-HA/PLLA implants had adequate rigidity, durability, and stable position on follow-up radiographic studies. On average, implants were thawed 3.4 times and required 14 minutes of handling time. Conclusion: The u-HA/PLLA implants are safe and reliable for reconstruction of orbital medial wall in terms of rigidity, immobility, radiopacity, and cost-effectiveness. These thin yet rigid implants can be useful where wide periosteal dissection is difficult due to defect location or size. Since the u-HA/PLLA material is difficult to manipulate, these implants are not suitable for use in complex 3-dimensional defects.