• Title/Summary/Keyword: Pain of Payment

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Decision-Making of Consumers with Higher Pain of Payment: Moderating Role of Pain of Payment When Payment Conditions Differ

  • Koh, Geumjoung;Sohn, Young Woo;Rim, Hye Bin
    • Science of Emotion and Sensibility
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    • v.21 no.4
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    • pp.3-10
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    • 2018
  • The present study explores two relationships: first, between number of payment and payment option preference, and second, total sum and payment option preference, with pain of payment as a mediator variable. The analyses revealed that consumers who feel higher pain of payment preferred the pennies-a-day pricing to the aggregate pricing when the per-payment price is low. Consumers who experience higher pain of payment prefer to pay in small frequent installments because they feel the small per-payment price can be comparable to daily expense. Consumers who experienced higher pain of payment preferred aggregate pricing to pennies-a-day pricing when the per-payment price was high. When the per-payment price is high, it is no longer comparable to daily expense, thus leading to greater pain of payment among consumers. The study discusses the implications for mechanism of pain of payment on payment option preference.

Increase in Potential Low-value Magnetic Resonance Imaging Utilization Due to Out-of-pocket Payment Reduction Across Income Groups in Korea: An Experimental Vignette Study

  • Shin, Yukyung;Lee, Ji-Su;Do, Young Kyung
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.4
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    • pp.389-397
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    • 2022
  • Objectives: This study examined the effect of out-of-pocket (OOP) payment reduction on the potential utilization of low-value magnetic resonance imaging (MRI) across income groups. Methods: We conducted an experimental vignette survey using a proportional quota-based sample of individuals in Korea (n=1229). In two hypothetical vignettes, participants were asked whether they would be willing to use MRI if they had uncomplicated headache and non-specific low back pain, each before and after OOP payment reduction. To account for the possible role of physician inducement, half of the participants were initially presented with vignettes that included a physician recommendation for low-value care. The predicted probability, slope index of inequality (SII), and relative index of inequality (RII) were calculated using logistic regression. Results: Before OOP payment reduction, the lowest income quintile was least likely to use low-value MRI regardless of physician inducement (36.7-49.6% for low back pain; 30.5-39.3% for headache). After OOP payment reduction, almost all individuals in each income quintile were willing to use low-value MRI (89.8-98.0% for low back pain; 78.1-90.3% for headache). Absolute and relative inequalities concerning potential low-value MRI utilization decreased after OOP payments were reduced, even without physician inducement (SII: from 8.15 to 5.37%, RII: from 1.20 to 1.06 for low back pain; SII: from 6.99 to 0.83%, RII: from 1.20 to 1.01 for headache). Conclusions: OOP payment reduction for MRI has the potential to increase low-value care utilization among all income groups while decreasing inequality in low-value care utilization.

Factors Affecting the Compensated Low Back Pain Disability (산업재해 요통 근로자의 기능장애에 영향을 미치는 요인)

  • Kjm, Ji-Yun
    • Korean Journal of Occupational Health Nursing
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    • v.13 no.1
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    • pp.48-58
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    • 2004
  • Purpose: To identify the factors which are related to compensated low back pain disability. These include individual. workplace. economic and injury factors. Method: Data collection was performed at 13 office of Korea Labor Welfare Corporation and 29 hospitals from 23th June to 4th August 2003. This study used 212 workers with compensated low back pain. Result: From the bivariate analysis, industry kind, type of employment, rest schedule, Job control, compensation, payment of company, diagnosis, cause of occupational injury, duration of compensated low back pain, pattern of pain, operation, other injury is related to low back pain disability. From the multiple regression analysis, rest schedule, compensation, diagnosis, pattern of pain, other injury have statistically significant effect on the low back pain disability. Conclusion: In order to reduce low back pain disability, occupational rehabilitation nursing intervention is necessary to workers with compensated low back pain.

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Therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain: cost utility analysis based on a randomized controlled trial

  • Manchikanti, Laxmaiah;Pampati, Vidyasagar;Kaye, Alan D.;Hirsch, Joshua A.
    • The Korean Journal of Pain
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    • v.31 no.1
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    • pp.27-38
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    • 2018
  • Background: Related to escalating health care costs and the questionable effectiveness of multiple interventions including lumbar facet joint interventions, cost effectiveness or cost utility analysis has become the cornerstone of evidence-based medicine influencing coverage decisions. Methods: Cost utility of therapeutic lumbar facet joint nerve blocks in managing chronic low back pain was performed utilizing data from a randomized, double-blind, controlled trial with a 2-year follow-up, with direct payment data from 2016. Based on the data from surgical interventions, utilizing the lowest proportion of direct procedural costs of 60%, total cost utility per quality adjusted life year (QALY) was determined by multiplying the derived direct cost at 1.67. Results: Patients in this trial on average received $5.6{\pm}2.6$ procedures over a period of 2 years, with average relief over a period of 2 years of $82.8{\pm}29.6$ weeks with $19{\pm}18.77$ weeks of improvement per procedure. Procedural cost for one-year improvement in quality of life showed USD $2,654.08. Estimated total costs, including indirect costs and drugs with multiplication of direct costs at 1.67, showed a cost of USD $4,432 per QALY. Conclusions: The analysis of therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain shows clinical effectiveness and cost utility at USD $2,654.08 for the direct costs of the procedures, and USD $4,432 for the estimated overall cost per one year of QALY, in chronic persistent low back pain non-responsive to conservative management.

The Development of Classification System of Dental Services for Temporomandibular Joint Disorders (측두하악장애 의료행위분류에 관한 연구)

  • Song, Yun-Heon;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.30 no.2
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    • pp.257-268
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    • 2005
  • It is recently suggested in Korea that Resource-Based Relative Value Scale (RBRVS) is an alternative plan of Korean Dental Fee Schedule which has been operated on a fee-for-service basis since the introduction of the national health insurance program in 1977. RBRVS applicable to diagnosis and treatment for temporomandibular disorders (TMD), a common cause of orofacial pain, is needed to be estimated in Korea and the establishment of the standard terminology of dental procedures for TMD should be preceded. The purposes of this study were to develop a new classification system of health care service items for TMD and to investigate time needed for each item, which enables RBRVS to be estimated prior to establishment the payment system of health care services for TMD. The dental service items for TMD in this study were categorized through Delphi process which 10 TMD specialists were participated in and the time needed for each service item was investigated by work sampling and time study method with a stopwatch. The results of this study demonstrated the new classification system of dental services for TMD comprising 151 service items and exhibited the average time for each items ranging from 7.22 min for cold laser therapy to 171.71 min for direct fabrication of anterior repositioning splint. Conclusively, it is suggested that the classification system for TMD developed in this study, considering specific characteristics on basis of resources for health care service of dental procedures, should be helpful to estimate payment level for each service item.

Economic Evaluation of Eastern, Western and Collaborative Treatments for Patients with Frozen Shoulder Pain (견비통의 한${\cdot}$양방 진료 및 협진의 경제성 평가)

  • Jang, Hye-Jung;Hong, Sang-Min;Park, You-Seon;Nam, Dong-Woo;Lim, Doo-Ik;Lee, Jae-Dong;Lee, Yun-Ho;Lim, Sabina
    • The Journal of Korean Medicine
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    • v.28 no.1 s.69
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    • pp.72-86
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    • 2007
  • Objectives : The purpose of this study was to evaluate and compare the cost-effectiveness of Eastern, Western, and collaborative treatments and suggest a cost-effective approach for patients with frozen shoulder pain. Methods : Using the data of fifty-two patients, treatment effectiveness was measured by CSA, SPABI, and ROM scales and changes from the baseline score were evaluated. Data source for cost estimation was based on the national health insurance (NHI) payment system. Because the price in NHI was differentiated by health care institutions, five collaborative types were considered in assessing costs. Cost-effective ratios were computed for economic evaluation. Results : Compared with Eastern treatment, collaborative and Western treatments showed better effects on CSA scale after 4 weeks' treatment. The collaborative approach was also the most effective treatment on SPADI and ROM scales. The direct cost per patient receiving Eastern treatment was less than other treatments. In general, collaborative treatment dominated Eastern and Western treatments in cost-effectiveness an analysis. However, the cost-effectiveness ratio of Eastern treatment resulted in \9,000 compared to \29,000 of collaborative treatment on SPADI. Four different indicators of ROM scales resulted in different approaches as the cost-effective treatment. Conclusions : Considering cost-effectiveness ratios, collaborative treatment was the best treatment on CSh and SPADI scales after 4 weeks' treatment. As for ROM scales, the recommended alternatives were Eastern treatment for patients with abduction and adduction disabilities, Western treatment for those with flexion disability, and collaborative approach fir those with extension disabiliry.

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Relationship between Fatigue and Depression in Patients with Hemato-Malignancy receiving Chemotherapy (항암 화학요법을 받는 혈액종양 환자의 피로와 우울의 관계)

  • Son, Hye-Gyeong;Kim, Sang-Hee;Sohn, Sue-Kyung
    • Asian Oncology Nursing
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    • v.7 no.1
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    • pp.14-25
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    • 2007
  • Purpose: The purpose of this study was to identify the relationship of fatigue and depression in patients with hemato-malignancy receiving chemotherapy. Methods: The data were collected from December 2005 to November 2006. Study objects were recruited from 4 university hospital in B and U city. Fatigue and depression were measured using the Cancer Fatigue Scale and the Revised Zung's Self-rating Depression Scale, respectively. Results: 1) The mean score of fatigue was $64.64{\pm}21.58$. The mean score of depression was $41.28{\pm}7.62$. 2) The fatigue score was significantly different with age, employment status, and present pain. 3) The depression score was signigicant different by the payment, diet, and present pain. 4) There was a moderate positive correlation between depression and fatigue. Conclusions: Patients with hemato-malignancy receiving chemotherapy experience in fatigue. Decrease in fatigue are associated with decreases in depression. Therefore, nurses must provide planned nursing intervention to reduce fatigue and depression in patients with hemato-malignancy.

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Medical Expenses for Trauma According to the Type of Medical Insurance (외상환자의 보험체계에 따른 진료비 분석)

  • Park, Heeseung;Jung, Yooun Joong;Kim, Young-Hwan;Kim, Tae-Hyun;Km, Min Ae;Kyoung, Kyu Hyouck;Kim, Jung Jae;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.178-187
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    • 2012
  • Purpose: In Korea, the nation's medical expenses were 12 billion won in 2010. The medical costs for individuals can also be overwhelming. If a patient has sustained severe trauma, his/her insurance company responsible may pay only part of the medical bills. In Korean, there are diverse types of medical insurance, such as health insurance, automobile insurance, and industrial accident compensation insurance. And each insurance system has a different type of payment system. Our study will be essential for establishing the optimal medical expense payment system. Methods: From January to December 2011, we retrospectively reviewed the medical charts of 161 patients who were admitted to our hospital's emergency room after having undergone severe trauma. Of those 161 patients, 125 were retrospectively reviewed. Written permission was obtained from all of the patients. We analysed the demographic characteristics, clinical outcomes, data of the trauma, type of the patient's insurance, and the entire bill when the patient was discharged. Results: Seventy-one patients had health insurance, 48 automobile insurance, and six industrial accident compensation insurance. High-deductible insurance included health insurance and industrial accident compensation insurance, with the deductibles up to 20.6% and 19.1%, respectively. We attempted to analyze the cause of the high deductible rate. In patients with health insurance, medicines, primarily sedatives, pain killers, antibiotics, and fluids. comprised a large proportion. On the other hand, industrial accident compensation insurance deducted for a high-grade hospital room charge. Conclusion: We found that medical expenses were diverse according to the type of insurance. In particular, health insurance forced patients to pay too much of the medical expenses. Therefore, in Korea we should try to identify the insurance problems and improve the wage system.

A Research of Trend on Japanese Medical Tourism in Oriental Hospital of Daejeon University (대전대학교 한방병원에 내원한 일본인 관광객의 의료관광 현황)

  • Kim, Min Jung;Sung, In Su;Song, In;Ko, Min Kyung;Hong, Kwon Eui
    • Journal of Acupuncture Research
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    • v.29 no.6
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    • pp.85-89
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    • 2012
  • Objectives : This study is to evaluate the current situation of Japanese tourists for medical tour of Daejeon University hospital and to draw up a plan for better policies. Methods : 59 Japanese tourists visiting oriental medicines hospital of Daejeon University from January 2012 to September 2012, were analysed in the statistics. And 8 of them answer a questionnaire about reasons for selection of Daejeon University hospital, satisfaction for thread embedding therapy and side effects of thread embedding therapy. Results : A total of 59 foreigners visited oriental medicines hospital of Daejeon University for medical service, consisting of 54 females(92 %), the thirties to fifties 71 % by age. The 87.5 % of patients answered that the reason for choosing this hospital was the subsidization of the medical expenses, and 50 % for appropriate payment, 37.5 % for safety, 12.5 % for recommendation of the people who had good experience at this hospital. The 71% of patients selected thread-embedding therapy for treating wrinkles. The degree of satisfaction was evaluated as quite satisfaction of 87.5 %, full satisfaction of 12.5 % showing that a whole number of the patients treated with thread-embedding therapy showed relative satisfaction. This evaluation is, however, a short term survey which should lead to a further term study. For the evaluation of side effects of thread-embedding therapy, 75 % of patients answered as pain occurred during the therapy, 62.5 % as edema, 50 % as hypodermal bleeding. Conclusion : First of all, there should be more constructive promotion and support for medical tour of oriental medicines, ultimately leading to promoting better clusters of oriental medicines. Secondly, support in terms of a medical law should be established for medical disputes, and the best follow-up service should be considered.

Process Improvements for Reducing Apartment Defects after Completion (준공후 아파트 하자 저감을 위한 절차개선 방안 연구)

  • Cho, Young-Jun
    • Journal of the Korea Institute of Building Construction
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    • v.18 no.4
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    • pp.355-361
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    • 2018
  • Many defects are occurring in apartments, the main residential area in Korea. This is due to a lack of construction skills and a lack of management. As many apartments are provided to buyers, the dispute over defects after completion is increasing rapidly. The Housing Act was amended so that local governments could order contractors to repair defects. However, even if defects are resolved after a defect is generated, it is not a fundamental solution that can be satisfied because buyers have to endure the pain caused by the defect. So, it is necessary to protect the interests of buyers by fundamentally reducing defects in apartments. Therefore, in this study, it was suggested that the asymmetry of the information about the apartment buyers should be resolved at the time of sale of the apartment, the final drawings should be a contract document, the review period of the apartment house supervision should be secured, the appropriate supervisory fee should be secured at the time of contract change and the payment procedure should be improved.