• Journal of Society of Preventive Korean Medicine
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• v.19 no.2
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• pp.37-50
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• 2015

Objective : In order to understand the scale of medicinal expenditure in the Korean medicine, an analysis has been made of Korean National Health Account and statistic archives used to estimate the Korean National Health Account and also of such archives as are contributory to learn the scale of total health expenditures in the Korean medicine. Method : From the Korean National Health Account archives, an analysis has been made of National health insurance statistic annual reports, National health insurance non-payment items, Korean Economic Census (The Service Industy Survey), and Korea Health Panel data. Moreover, in order to know the sales of overall Korean medicine clinics, relevant data have been utilized and cited from investigations into National tax statistics, Korean medicine medical institutions and Korean medicines used, and current states of medicinal herbs and Korean medicine industry. Results : It is found that the average scale of each section of the medical expenditures archives in the Korean medicine in 2012 was KRW 3.5638 billion and that the average medical expenditures in the Korean medicine derived from Total Health Expenditure, The Service Industy Survey, National tax statistic, and Korean medicine industry are approximately KRW 3.3901, 3.4796, 3.7218 and 3.9634 billion. And the average expenditures derived from National health insurance patients and Korea Health Panel data are 2.5162 and 2.2292 billion won and those from the users and consumers of Korean medicines and herbs are 5.6,461 billion won. In order to verify the appropriateness of estimated medical expenditures in the Korean medicine included in the archives, an analysis has been made of uninsured costs which come from the aggregate sales amount surveyed minus health insurance treatment expenditures and it is found that the ratio of insured costs against total health expenditures in 2006 was 50.67% and 41.92% in 2012 and that the ratio based on National tax statistics and The Service Industy Survey was 52.19% and 49.28% in 2006 and 50.54% and 50.64% in 2012 and that the ratio of uninsured costs against Korean medicines and herbs and Korean medicine industry was 37.5% and 58.27% in 2013. Conclusion : It calls for the improvement of the accuracy of an investigation into Total Health Expenditure which comprise the actual conditions of health insurance and Korea Health Panel, the development of statistic schemes for understanding and classifying medical expenditures of all the Korean medicine medicinal institutions like medicinal clinics, and enhanced methods for independent panels to comprehensively collect and analyze the number of sampled Korean medicine medical institutions.

• Communications for Statistical Applications and Methods
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• v.16 no.2
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• pp.349-361
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• 2009

In this paper, we derive the approximate maximum likelihood estimators of the shape parameter and the scale parameter in a Weibull distribution under multiply Type-II censoring by the approximate maximum likelihood estimation method. We develop three modified empirical distribution function type tests for the Weibull distribution based on multiply Type-II censored samples. We also propose modified normalized sample Lorenz curve plot and new test statistic.

• Journal of the Korean Data and Information Science Society
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• v.22 no.3
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• pp.467-476
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• 2011

We developed the hybrid model coupled with predictive model and business rule model for administration of injury by utilizing medical data of the National Health Insurance in Korea. We performed decision tree analysis using data mining methodology and used SAS Enterprise Miner 4.1. We also investigated under several business rule for benefits (expense paid by insurer) and claims of injury in National Health Insurance Corporation. We can see that the proposed hybrid model provides a quite efficient plausible results.

• Journal of Preventive Medicine and Public Health
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• v.39 no.5
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• pp.433-437
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• 2006

Objectives: The aim of this study is to develop a methodology for estimating a nationwide statistic for hernia operations with using the claim database of the Korea Health Insurance Cooperation (KHIC). Methods: According to the insurance claim procedures, the claim database was divided into the electronic data interchange database (EDI_DB) and the sheet database (Paper_DB). Although the EDI_DB has operation and management codes showing the facts and kinds of operations, the Paper_DB doesn't. Using the hernia matched management code in the EDI_DB, the cases of hernia surgery were extracted. For drawing the potential cases from the Paper_DB, which doesn't have the code, the predictive model was developed using the data mining technique called SEMMA. The claim sheets of the cases that showed a predictive probability of an operation over the threshold, as was decided by the ROC curve, were identified in order to get the positive predictive value as an index of usefulness for the predictive model. Results: Of the claim databases in 2004, 14,386 cases had hernia related management codes with using the EDI system. For fitting the models with applying the data mining technique, logistic regression was chosen rather than the neural network method or the decision tree method. From the Paper_DB, 1,019 cases were extracted as potential cases. Direct review of the sheets of the extracted cases showed that the positive predictive value was 95.3%. Conclusions: The results suggested that applying the data mining technique to the claim database in the KHIC for estimating the nationwide surgical statistics would be useful from the aspect of execution and cost-effectiveness.

• Journal of Preventive Medicine and Public Health
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• v.42 no.4
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• pp.267-273
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• 2009

Objectives : To compare the performance of three comorbidity measurements (Charlson comorbidity index, Elixhauser s comorbidity and comorbidity selection) with the effect of different comorbidity lookback periods when predicting in-hospital mortality for patients who underwent percutaneous coronary intervention. Methods : This was a retrospective study on patients aged 40 years and older who underwent percutaneous coronary intervention. To distinguish comorbidity from complications, the records of diagnosis were drawn from the National Health Insurance Database excluding diagnosis that admitted to the hospital. C-statistic values were used as measures for in comparing the predictability of comorbidity measures with lookback period, and a bootstrapping procedure with 1,000 replications was done to determine approximate 95% confidence interval. Results : Of the 61,815 patients included in this study, the mean age was 63.3 years (standard deviation: ${\pm}$10.2) and 64.8% of the population was male. Among them, 1,598 2.6%) had died in hospital. While the predictive ability of the Elixhauser's comorbidity and comorbidity selection was better than that of the Charlson comorbidity index, there was no significant difference among the three comorbidity measurements. Although the prevalence of comorbidity increased in 3 years of lookback periods, there was no significant improvement compared to 1 year of a lookback period. Conclusions : In a health outcome study for patients who underwent percutaneous coronary intervention using National Health Insurance Database, the Charlson comorbidity index was easy to apply without significant difference in predictability compared to the other methods. The one year of observation period was adequate to adjust the comorbidity. Further work to select adequate comorbidity measurements and lookback periods on other diseases and procedures are needed.

• Journal of the Korea Convergence Society
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• v.4 no.2
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• pp.1-8
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• 2013

The purpose of this study was carried out to evaluate the satisfaction relate to health examination of National health insurance service in Busan. This paper provide basic information of conducted by the National Health Insurance service, and the perception of health examination to provide satisfaction. The sampling group was selected in Busan's health examinations tests can be conducted targeting. Distributed 300 questionnaires were used in the final paper, call 221 and survey was accomplished between March and th June in 2013. The analyzed results was as followed; 1) There was significant of have used medical examinations; have medical institutions use 1 month ago; cigarette smoking day; the number of drinking by demographic characteristics, the statistic difference was existed on.(p<0.05, p<0.01) 2) The satisfaction of health examination institutions were recorded to average $3.22{\pm}0.52$ points on 5-points scale; Opinion the health examination services average was $3.31{\pm}0.55$ points on 5-points scale; attitude to health examination average was $3.73{\pm}0.54$ points on 5-points scale.

• Journal of Preventive Medicine and Public Health
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• v.34 no.3
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• pp.219-227
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• 2001

Objectives : To understand the current status of the opening, closing and relocation of primary medical institutes in Korea and identify the underlying decision factors. Methods : Sources of analyzed data included the medical institutional master file at the National Health Insurance Corporation(1998, 2000) and Regional Statistic Annual Bulletins. To investigate changes including the opening, closing and relocation, a total of primary medicalinstitutions(16,757 in 1998, 19,267 in 2000) were analysed. Results : Between 1998 and 2000, there was a 15.0%(2,510) increase in the number of primary medical institutions and the rate of increase in the rural area was higher than the urban area, and higher for specialty clinics than primary practice. However, these findings did not suggestany improvement in the maldistribution of primary medical institutions. During the time period studied, newly opened and closed primary medical institutions numbered 4,085 and 1,573, respectively. Additionally, institutions thatrelocated numbered 2,729, or 16.3% of all primary medical institutions in operation in 1998. These openings and closings were more frequent among young doctors. As a result of our analysis on the underlying regional factors forrelocation, the factors that were statistically significant were local per capita tax burden and the number of schools per ten thousand persons. !n, the case of institutional factors, movements were significantly associated with gender and the location of primary medical institutions. Conclusions : In order to establish effective long-term intervention for primary medical institutions, further study and monitoring of primary medical institutions and the identification of factors influencing opening location and relocation is necessary.

• Health Policy and Management
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• v.28 no.3
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• pp.257-262
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• 2018

This study reviews the advent of long-term care (LTC) hospitals and its key issues in Korea. For analysis, enforcement ordinances and enforcement rules related to LTC hospitals were reviewed. Official statistic data were used for quantitative analysis and Organization for Economic Cooperation and Development data were utilized for comparative analysis. Various references and expert interviews were conducted for status analysis. As of 2016, the number of LTC hospitals was 1,386 and the number of beds were 246,373. It showed the trend of increasing medical care costs and the cost of care at LTC hospitals increasing from 998.8 billion Korean won in 2008 to 4,745.6 billion Korean won in 2016, accounting for 7.3% of the total National Health Insurance expenditure. From the societal perspective, several issues were pointed out within the current health care system related to LTC hospitals: establishment of roles, concerns about the increase in medical expenses, and the quality of medical personnel.

• Journal of agricultural medicine and community health
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• v.31 no.1
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• pp.9-20
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• 2006

Objectives: This study was aimed at investigating the ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis and related factors. And we want to compare the ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis and related factors among the provinces. Methods: In order to compare, the data was referred to National health insurance center for affirming the insurance type of the dead. And age adjusted mortality rate of tuberculosis of each insurance type was analyzed by whole country and the provinces. Related factors of the provinces were gathered from public statistic books. We analysed correlation study between the ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis and related factors among the provinces. Results: Major findings were as follows 1. The ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis was 5.6. And the ratio was relatively high at 40-60 ages. 2. The ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis by the province was varying. And the factors that were financial independence, crowdedness, percent of people on medical aid, population size served by each public health center, number of hospital by a million peoples have correlated with increment of the ratio. Conclusions: As a consequence of tuberculosis control, the ratio was high. Thus this finding suggests that medical utilization and preventive behavior, environment of tuberculosis patient are under handicapped condition. Especially large cities like metropolitan area who have high financial independence, high population density, high percentage of medical aid peoples have high ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis. There is need for additional and systematic research on the attitude or tendency toward medical services(inc1uding preventive services) utilization of medical aid tuberculosis patients.

• Korea Journal of Hospital Management
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• v.14 no.1
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• pp.23-35
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• 2009

The objectives of the present study is to examine the validity of Charlson Comorbidity Index(CCI) based on medical record data; to utilize the index to determine outcome indexes such as mortality, length of stay and cost for the domestic patients whose have received total hip arthroplasty. Based on medical record date, 1-year Mortality was analyzed to be 0.664 of C statistic. The $R^2$ for the predictability for length of stay and the cost was about 0.0181, 0.1842. Fee of national health insurance and total cost including the cost not covered by insurance, also had statistically significance above 3 points of Charlson point score(p=0.0290, 0.0472; $p.{\le}0.05$). The 1-year mortality index, length of stay and cost of the total hip arthroplasty patients which was obtained utilizing CCI have a limitative prediction power and therefore should be carefully analyzed for use.