• 한국병원경영학회지
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• 제10권2호
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• pp.45-63
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• 2005

The purposes of this study are to understand the doctors' attitude and satisfaction about the review system of national health insurance claim in Korea and to suggest the way to improve this system This study conducted a survey of the doctors registered in the medical association in Seoul city. The survey was performed as a form of self-administered questionnaire from January 2004 to February 2004. The contents of questionnaire dealt with doctors' attitude and satisfaction about the review system of medical service claim. Totally, 1,037 members replied to our survey and we analysed 981 doctors' data, excluding incomplete responses. As a result, 89.7% of repliers showed a negative attitude about the influences of the review system on improvement of medical service quality, 98.0% of repliers have had experiences that they have given distorted insufficient medical services in order to evade the curtailment of service claim. Also, 91.6% of repliers stated that they have had experiences of intentional modification or alteration of diagnostic code to shun the curtailment. Most of the doctors showed negative attitude to the curtailment procedure and the review system of service claim originally intended to be one of the quality control methods of medical service in Korea also, the development of both scientific and reasonable parameters and criteria for claim is needed. 'Through the improvement of review system for appropriate medical service, there is a need of a way to increase the satisfaction of medical service providers, and to encourage the motivation for quality control. Also, education is strongly needed to provide doctors with sufficient information about review criteria and curtailment cases.

• 대한한의학회지
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• 제42권4호
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• pp.133-149
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• 2021

Objectives: To lay the foundation for future research into Korean Medicine treatment for Rotator Cuff repair surgery patients by analyzing Korean Medical and Western Medical service utilization and treatment duration. Methods: Data sampling was performed on 2015's HIRA patient data (confidence level of 97%) to analyze patients' Korean Medical and Western Medical service usage tendency. Sampled groups were divided into two groups: i) Patients who completed their treatment within five months after the rotator cuff surgery (termination group), ii) Patients who were treated for more than five months after the surgery (continuation group). Then the patients' Korean Medical and Western Medical service usage tendency was investigated and information of these patients are arranged. Results: Out of 1,453,486 patients who were gathered for sampling, 2,461 patients in total had gone through rotator cuff repair surgery. The termination group had 517 patients and the continuation group had 541 patients. The proportion of patients who visited a Korean Medicine clinic was lower in the termination group than the continuation group. Conclusion: The continuation group received more treatments (both in Western Medicine and Korean Medicine) and spent more on medical expenses compared to the termination group. Further research is highly recommended for more efficient Western Medicine and Korean Medicine treatments and reduced medical expenditure.

• 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.

• Journal of Preventive Medicine and Public Health
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• 제36권4호
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• pp.325-331
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• 2003

Objectives : To analyze medical service utilization and trends among the elderly in the last year of life. Method : The subjects of this study were People that had died at the age sixty-five and above between January $1^{st}$ and June $30^{th}$ 2000 The names of the deceased and their dates of death were collected from the data of the funeral-expenses-receivers of the National Health Insurance Corporation (NHIC). This data was merged with that of the individual medical expenses of the NHIC. Results : In the first half of 2000, 84.2% of the funeral-expenses-receivers (53,063) utilized medical services during the year prior to their death; 51.0% (27,042) were female and 49.0% (26,021) male. In the last twelve months of life, the medical fees, the number of days receiving medical services and the number of days receiving medicine were 3,107,935 Won, 47.88 and 153.21, respectively, for each person. As the age of the groups increased, the level of medical service utilization decreased; the change was more obvious in female group. The level of medical service utilization during the twelve months prior to death drastically increased around the time of death. Conclusions : This study, from an analysis of the level of medical service utilization prior to death, shows a concentrated volume of medical services during a certain time period prior to death.

• 보건의료산업학회지
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• 제10권1호
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• pp.1-11
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• 2016

Objectives : Medical service specialization could have positive effects on their profits and medical service quality. This study was to examine the relationship between medical service specializations and operational performance in hospitals. Methods : We used the National Inpatient Sample data provided by the Health Insurance Review and Assessment Service from 2010 to 2013. The hospital operational performance was determined by measuring the specialization level of the hospital based on DRGs. Results : The information theory index was 2.38 in 2010, 2.38 in 2011, 2.37 in 2012, and 2.37 in 2013. A multiple regression model was constructed which showed that if the specialization level becomes higher, it decreases the length of stay per case with an increase in medical expense. Conclusions : Differentiation and concentrated medical service specialization strategy have had a positive effect on the operational performance of hospitals.

• Journal of Korean Neurosurgical Society
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• 제54권6호
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• pp.528-531
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• 2013

We report a case of infantile fibrosarcoma in an 8-month-old boy manifested as a right-sided lower leg mass. Repeated local recurrence and distant metastasis were noted during the following three-year period. Whole body fluoro-deoxyglucose positron emission tomography scan revealed an asymptomatic metastasis involving the fourth lumbar vertebrae. The patient received chemotherapy (VAC regimen) with Cyberknife$^{(R)}$ stereotactic hypofractionated radiotherapy (26 Gy; 4 fractions). This treatment reduced tumor size by 23% without acute radiation toxicity even after 33 months. This case suggests that combining chemotherapy and this form of radiotherapy may be safe and effective against childhood spinal metastasis.

• Journal of Korean Neurosurgical Society
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• 제55권5호
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• pp.293-295
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• 2014

Post-traumatic cerebral infarction (PTCI) is a secondary insult which causes global cerebral hypoxia or hypoperfusion after traumatic brain injury, and carries a remarkable high mortality rate. PTCI is usually caused by blunt brain injury with gross hematoma and/or brain herniation. Herein, we present the case of a 91-year-old male who had sustained PTCI following a low-energy penetrating craniocerebral injury due to a nail without evidence of hematoma. The patient survived after a decompressive craniectomy, but permanent neurological damage occurred. This is the first case of profound PTCI following a low-energy penetrating craniocerebral nail injury and reminds clinicians of possibility this rare dreadful complication for care of head-injured patients.

• 한국응급구조학회지
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• 제25권1호
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• pp.159-175
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• 2021

Purpose: This study aimed to obtain, categorize, and analyze baseline data regarding the subjective perception of ambulances from the consumers' perspective, which can be utilized for improving emergency medical service systems. Methods: Fifty people aged 20 to 40 years old were selected as P samples. Data from 35 statements of Q-cards and Q-sample distribution plots were gathered using Q-sort and analyzed using the PC-QUANL program for major factor analysis. Results: We found four unique characteristics which accounted for 57.57% of the total variation: "Considerate of emergency situations," "Identifying emergency patients," "Trusting emergency vehicles," and "Sympathizing with emergency patients." Conclusion: Organizations that provide emergency medical services using ambulances should plan and render patient care according to the four types of public perception of ambulances.

• 한국응급구조학회지
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• 제28권1호
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• pp.63-76
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• 2024

Purpose: To analyze trends related to demography and EMS and to provide supporting data for the appropriate deployment of EMS providers. Methods: In this cross-sectional study, data on patients transported by 119 EMS, demographics, and EMS factors were collected using the Korean Statistical Information Service (KOSIS) and the National Fire Agency annual report from 2017 to 2021. Results: During the study period, the total number of patients and those with severe disorders transported via 119 EMS showed an increasing trend. The total fertility rate and population during the same period tended to decrease, and the population density and number of households increased; however, there was a disparity between regions. The main demographic factors affecting the number of patients transported were population density and total fertility rate, while the main EMS factors were the number of ambulances and provision of emergency medical information services(hospital guidance, pharmacy information, and first aid guidance). Conclusion: From the perspective of EMS providers' force deployment, it is necessary to consider population density, population, number of households, total fertility rate, and number of emergency medical institutions and to strengthen the role of diverting the use of 119 EMS by minor patients by providing emergency medical information.

• 대한수의사회지
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• 제36권8호
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• pp.706-713
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• 2000