• 한국병원경영학회지
• /
• 제25권1호
• /
• pp.13-20
• /
• 2020

Purposes: This study has the purpose to the improvement of health promotion for local residents through delivery of high-quality medical service by improving imbalance of medical use and seeking an improvement plan for accessibility of effective medical service by understanding the pattern of medical use by region. Methodology: As for the method, this study derived results at the significance level of p<0.05 through chi square test(χ² test) and Generalized Estimating Equation(GEE) SAS 9.4 version by using the data of the 7th Korean Longitudinal Study of Ageing 2018. Findings: Study results show that local residents use medical service such as hospitalization care and outpatient visit more as compared to the residents in Gyeonggi-do/large or medium-sized cities. The more the number of chronic disease, the more they select hospitalization care rather than outpatient visit. Results also show that patients engaged in labour tend to select outpatient treatment rather than hospitalization treatment. Meanwhile, severity of disease turned out to be higher amongst medical care beneficiaries than that of national health insurance patients when comparing the types of medical security. Practical Implications: In stead of solving the problem of the difference in medical use by region from the aspect of income and economic level, an integrative solution shall be provided putting viewpoint on the social phenomenon suited to the changes of the times. This study suggests a plan for using a health and medical community care center that acts as a gate keeper of regional medical service.

• 보건행정학회지
• /
• 제32권2호
• /
• pp.125-136
• /
• 2022

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. 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. 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. 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.

• 보건의료산업학회지
• /
• 제11권3호
• /
• pp.37-49
• /
• 2017

Objectives : This study analyzes the characteristics of prescription drugs for acute upper respiratory tract infection in outpatient clinics and provides basis for establishing the correct evaluation project on appropriate prescribing indicators. Methods : Research data were collected from two for each family medicine, internal medicine, pediatric, otorhinolaryngology and general practitioner clinics with a total of 10 clinics with diseases classifications codes J00-J06, J20 on patients receiving treatment between January 1, 2013 and December 31, 2013 every Monday in Busan City. Results : The antibiotic prescription rate in evaluating the project on appropriate prescribing indicators of Health Insurance Review & Assessment Service was 44.3%, whereas this study was approximately 30% higher because analysis to target the entire cold-related diagnosis. Conclusions : The correct antibiotic prescription by expanding the current assessment standard should be identified as a minor diagnosis because the evaluation project on appropriate prescribing indicators targets the major diagnosis only.

• 한국병원경영학회지
• /
• 제8권1호
• /
• pp.81-94
• /
• 2003

This paper aims at developing a prediction model and analyzing a sensitivity for the outpatient's overall satisfaction on utilizing hospital services by using data mining techniques within the context of customer satisfaction. From a total of 900 outpatient cases, 80 percent were randomly selected as the training group and the other 20 percent as the validation group. Cases in the training group were used in the development of the CHAID and Neural Networks. The validation group was used to test the performance of these models. The major findings may be summarized as follows: the CHAID provided six useful predictors - satisfaction with treatment level, satisfaction with healthcare facilities and equipments, satisfaction with registration service, awareness of hospital reputation, satisfaction with staffs courtesy and responsiveness, and satisfaction with nurses kindness. The prediction accuracy rates based on MLP (77.90%) is superior to RBF (76.80%).

• Industrial Engineering and Management Systems
• /
• 제13권2호
• /
• pp.193-202
• /
• 2014

Patients' satisfaction while receiving medical service is affected by whether or not their preferences can be met, including time and physician preference. Due to scarcity of medical resource in China, efficient use of available resources is urgently required. To guarantee the utilization ratio, the scheduling decisions are made after all booking information is received. Two integer models with different objectives are formulated separately, maximizing the degree of satisfaction and revenue. The optimal value of the two models can be considered as the bound of corresponding objectives. However, it is improper to implement any of the extreme policies. Because revenue is a key element to keep the hospital running and satisfaction degree is related to the hospital's reputation, neither the revenue nor the satisfaction can be missed. Therefore, hospitals should make a balance. An integrated model is developed to find out the tradeoff between the two objectives. The whole degree of mismatching that is related to patient satisfaction and other separate mismatching degree are considered. Through a computational study, it is concluded that based on the proposed model hospitals can make their decisions according to service requirement.

• 보건행정학회지
• /
• 제22권4호
• /
• pp.579-596
• /
• 2012

The purpose of the study is to examine the use of medication among adults by comparing the pattern of outpatient prescription drug use with the pattern of long term taking lifestyle drug use. Furthermore, the study investigates factors associated with the use of medication, particularity focusing on socioeconomic factors. Korea Health Panel data of 2008 was used to conduct the study analysis. By performing four different logistic regression models, the study noticed different patterns of the medication use between prescription drugs and lifestyle drugs. More specifically, the study showed that adults with lower education level tend to more frequently receive prescriptions while adults with higher education as well as income level tend to more use lifestyle drugs than their counterparts. Furthermore, other control factors such as age and gender were statistically significant for the use of both prescription and lifestyle drugs in different patterns. The study findings expect that reimbursement structure of drugs may be significantly associated with the different patterns and accordingly the accessability of medicine in particularly vulnerable population. Therefore, these policy factors should be considered in future study to more comprehensively understand about the diverse patterns in the medication use.

• International Journal of Heart Failure
• /
• 제6권1호
• /
• pp.1-10
• /
• 2024

Heart failure (HF) stands as a prevalent chronic ailment, imposing a substantial burden on global healthcare systems due to recurrent hospitalizations, intricate management, persistent symptoms, and polypharmacy challenges. The augmentation of patient safety and treatment efficacy across various care stages, facilitated by a multidisciplinary HF team inclusive of a clinical pharmacist, emerges as paramount. Evidence underscores that the collaborative engagement of a physician and a clinical pharmacist engenders proficient and secure management, forestalling avoidable adversities stemming from drug reactions and prescription inaccuracies. This synergistic approach tailors treatments optimally to individual patients. Post-discharge, the vulnerability of HF patients to re-hospitalization looms large, historically holding sway as the foremost cause of 30-day readmissions. Diverse strategies have been instituted to fortify patient well-being, leading to the formulation of specialized transitional care programs that shepherd patients effectively from hospital to outpatient settings. These initiatives have demonstrably curtailed readmission rates. This review outlines a spectrum of roles assumed by clinical pharmacists within the healthcare cohort, spanning inpatient care, transitional phases, and outpatient services. Moreover, it traverses a compendium of studies spotlighting the affirmative impact instigated by integrating clinical pharmacists into these fields.

• Journal of Preventive Medicine and Public Health
• /
• 제25권1호
• /
• pp.53-63
• /
• 1992

There are increasing interest and need for information on health care consumer with the significance of hospital marketing and strategic planning being increasingly emphasized. This study was conducted to investigate the criteria for selection of medical facilities according to the characteristics of health care consumer by the types of medical services on a sample of 1,500 population aged 20 years and above. Major findings are as follows ; 1. When considering the criteria for selection of medical facilities into two factors, namely, quality or convenience factors, convenience factor was the major contributor for outpatient and dental services whereas it was quality factor for inpatient services. 2. Females and those residing in large cities selected medical facilities based on convenience factor in the outpatient services. In the case of inpatient service, persons who considered their present health status to be good and whose ages were 50 years old and above choose medical facilities based on quality factor. 3. Persons who considered medical facilities to be profit-making tended to choose medical facilities based on convenience factor for outpatient services. There were no differences in the cases of inpatient and dental services. 4. There was no significant difference on the criteria for selection of medical facilities according to the decision maker for selection or trust on medical facilities. On the use of health service information, selection of medical facilities was based on quality factor for those who made more use of the information in the cases of outpatient and dental services. 5. Analysis using the logistic regression model on the criteria for the selection of medical facilities with the characteristics of health care consumer as independent variables was performed. The selection of medical facilities was significantly related with residential area, sex, and use of information on medical facilities for outpatient services and with age, average monthly income, and perception of health status for inpatient services. For dental services significant association with residential area and use of information on medical facilities was seen. The results of this study, despite some limitations, can be used as baseline data for marketing and strategic planning of hospital management.

• 한국산학기술학회논문지
• /
• 제22권4호
• /
• pp.183-194
• /
• 2021

본 연구에서는 SGR 모형과 AR 모형으로 부터 개발된 유형별 외래 및 입원 환산지수 분리 모형을 바탕으로 실제 건강보험 진료비 자료를 사용하여 2020년도 환산지수를 추정하였다. 또한 유형별 환산지수 계약 하에서 병원의 단일 환산지수 조정률과 외래 및 입원으로 분리된 복수의 환산지수 조정률을 산출하였다. 마지막으로 환산지수 분리 모형이 의료전달체계를 확립하기 위한 수단의 하나로 효과적으로 사용되기 위한 정책적 방안을 제안하였다. 본 연구의 주요 결론은 다음과 같다. 첫째, r=0.1에서 2020년도 병원의 단일 환산지수 조정률은 2.0%이며 병원의 환산지수를 분리하는 경우 외래 및 입원 환산지수 조정률은 각 각 2.2%, 2.3%로 나타났다. 그리고 조정계수를 활용하여 외래 및 입원 환산지수를 결합하는 방안을 제시하였다. 둘째, 의료전달체계 확립을 위한 조치의 하나로 제안된 가산율 조정 방식 대신에 가산율과 환산지수를 연동하여 운영하는 방안을 제안하였다. 셋째, 병원⦁의원 등 유형별로 외래환산지수, 입원환산지수, 조정계수를 도입하는 것에 추가해 진료량에 대한 목표관리를 가능하게 하는 모형 개발이 필요하다.

• 한국엔터테인먼트산업학회논문지
• /
• 제14권7호
• /
• pp.609-621
• /
• 2020

본 연구는 의료기관의 환경요인을 매개로 의료기관 종사자들의 라이프 스타일에 따른 조직몰입이 진료비 삭감률에 미치는 영향이 무엇인지 알아보기 위한 연구로 전라도에 있는 의료기관 종사자 300명을 대상으로 설문조사하였다. 본 연구의 결과는 다음과 같다. 첫째, 인구사회학적 특성에 따른 조직 몰입도는 연령, 학력, 성별, 결혼, 직종, 소득과 근무 연수에서 유의한 차이를 보였다. 둘째, 인구사회학적 특성에 따른 환경요인은 결혼, 근무 연수, 병원유형에서 유의한 차이를 보였다. 셋째, 입원삭감률은 직종, 근무 연수 병원유형에서, 외래삭감률은 연령, 결혼, 직종, 근무 연수, 병원유형에서 유의한 차이를 보였다 넷째, 조직몰입, 환경요인, 삭감률의 상관관계를 알아 본 결과 입원 삭감률과 외래 삭감률은 정적 상관이 유의하게 있는 것으로 나타났다. 다섯째, 조직몰입과 환경요인을 동시에 투입하여 입원삭감률에 미치는 영향을 살펴본 결과 조직몰입과 입원삭감률에서 환경요인이 부분매개, 외래삭감률은 조직몰입과 외래삭감률에서 환경요인이 완전매개 하는 것으로 나타났다. 본 연구로 의료기관의 효율적인 운영방안과 효과적인 인력관리를 위한 기초자료를 제공하고자 한다