• Health Policy and Management
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• v.23 no.1
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• pp.35-43
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• 2013

Background: Diagnosis procedure combination (DPC) has recently been introduced in Korea as a demonstration project and it has aimed the improvement of accuracy in bundled payment instead of Diagnosis related group (DRG). The purpose of this study is to investigate that the model of end-stage liver disease (MELD) score as the severity classification of liver diseases is adequate for improving reimbursement of DPC. Methods: The subjects of this study were 329 patients of liver disease (Korean DRG ver. 3.2 H603) who had discharged from National Health Insurance Corporation Ilsan Hospital which is target hospital of DPC demonstration project, between January 1, 2007 and July 31, 2010. We tested the cost differences by severity classifications which were DRG severity classification and clinical severity classification-MELD score. We used a multiple regression model to find the impacts of severity on total medical cost controlling for demographic factor and characteristics of medical services. The within group homogeneity of cost were measured by calculating the coefficient of variation and extremal quotient. Results: This study investigates the relationship between medical costs and other variables especially severity classifications of liver disease. Length of stay has strong effect on medical costs and other characteristics of patients or episode also effect on medical costs. MELD score for severity classification explained the variation of costs more than DRG severity classification. Conclusion: The accuracy of DRG based payment might be improved by using various clinical data collected by clinical situations but it should have objectivity with considering availability. Adequate compensation for severity should be considered mainly in DRG based payment. Disease specific severity classification would be an alternative like MELD score for liver diseases.

• Journal of Preventive Medicine and Public Health
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• v.37 no.3
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• pp.260-266
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• 2004

Objectives : To assess the impacts of implementing case payment system (CPS) to Medical Aid (MA) hemodialysis patients on the frequencies and expenditure of dialysis. Methods : Fifty-eight clinics and 35 tertiary care hospitals were identified as having a minimum of 10 hemodialysis patients for each of the MA and Medical Insurance (MI) programs, who received hemodialysis from the same dialysis facilities for both periods of July 2001 and July 2002. From these facilities, a total of 2,167 MA and 2,928 MI patients were identified as the study subjects. Using electronic claims data, the changes in the total number of monthly treatments and charges for outpatient hemodialysis treatments for each patient after the introduction of the CPS were compared between the MA and MI patients. Multiple regression analyses were performed to examine the independent impact of the CPS on the utilization and expenditure of dialysis treatments among the MA patients. Results : There was a significant decrease in the total charges for the hemodialysis treatments of the MA patients, 3.4% (p<0.05), whereas a significant increase was observed for the MI patients, 2.5% (p<0.05). For both the MA and MI patients, the frequency of the monthly hemodialysis treatments were significantly increased, 5.5 (from 12.1 to 12.7) and 7.8% (from 11.6 to 12.5), for the MA and MI patients, respectively. However, a multivariate regression analysis showed no significant difference in the changes in the total number of monthly hemodialysis treatments between the MA and MI patients after implementation of the CPS. Another regression model, regressing on the changes in the monthly claims of dialysis treatments, showed a significant negative coefficient for the MA ((=-70725, p<0.05). Conclusion : The significant decrease in the total charges for hemodialysis treatments among MA as compared to MI patients suggests that there was a cost reduction in the MA program following the introduction of the CPS.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.43 no.4
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• pp.485-492
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• 2023

Among the methods to improve traffic congestion by providing real-time traffic information and solving problems like traffic congestion and traffic crashes, private enterprise is implementing policies to lower insurance premiums like compensation for drivers' driving safety scores. Despite the emergence of various incentive policies, a study on the level of incentive payment for safe/eco-friendly driving is insufficient. The research analyzed the satisfactory factors that affect the scale of incentives through questionnaires and the applicable scale of incentives that enable safe/eco-friendly driving using a binary logistic regression model. As a result of analyzing the incentive scale of the appropriate payment amount for each driving score increase, 0.4% of the toll fee was derived when the driving score increased by 20 points, and 0.5% of the toll fee was derived when the driving score increased by 30 points. This study on calculating the appropriate incentive payment scale for driver information sharing and driving score increase will help optimize incentives and prepare system implementation plans.

• Health Policy and Management
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• v.14 no.2
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• pp.138-162
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• 2004

This study was performed to investigate small area variation in rates of three common surgeries in general surgery department across 156 small areas. Three surgery rates were analyzed; Anal and/or stomal procedures, inguinal and/or femoral hernia procedures, appendectomy. Methods: We used health insurance claims data and the number of patients were 13,845, 2,154 and 7,151 persons respectively. Surgery rates were directly standardized with age and sex and logistic regression was used to analyze surgery rates. Results: Mapping of the surgery rates, there was small area variation in anal and/or stomal procedures. The clinic which was located in more competitive market and chose DRG payment system tends to do more anal and/or stomal procedures. There was no factor except DRG bed rates had effect on rate of inguinal and/or femoral hernia procedures. Conclusions: Findings of this study will contribute to developing investigation method on small area variation and policy to reduce the variation such as developing evidence based medical practice guideline.

• Health Policy and Management
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• v.3 no.2
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• pp.27-80
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• 1993

It is widely known that patients' utilization pattern for medical care facilities and the patientflow are influenced by multi-factors, such as demographic characteristics, structural characteristics of society, socio-psychological characteristics(value, attitude, norms, culture, health behavior, etc.), economic characteristics(income, medical price, relative price, physician induced demand, etc.), geographical accessibility, systematic characteristics(health care delivery system, payment methods for physician fees, form of health care security, etc.), and characteristics of medical facilities(reliability, quality of medical care, convenience, kindness, tec.). This study was conducted to research the mechanism of patient-flow according to changes of health care system(implementation of national health insurance, health care referral system and regionalization of health care utilization, etc.) and characteristics of medical facilities(ownership of hospital, characteristics of medical services, non-medical characteristics, etc.). In this study, the fact could be ascertained that the patient-flow had been influenced by changes of health care system and characteristics of medical facilities.

• Journal of Korean Physical Therapy Science
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• v.8 no.1
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• pp.735-744
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• 2001

After providing the purpose, scope and methods of present study in the first chapter. the second chapter discusses a theoretical overview on the social implication of medical expenditure and the medical insurance program for the aged population. In conclusion, to realize the reduction of aged population's medical expenditures, some possible plans are conceivable. Firstly, the payment level of medical insurance should be upgraded and the insurance coverage in oriental medicine treatment and the drug-store protection program need to be implemented. Secondly, the medical facilities and man-power have be expanded for the sake of reducing the social and geographical distances the aged population has to overcome to receive the medical benefits. Thirdly, the expansions of medical services for the home-stay aged are all the more required. Finally, a wide range of programs needs to be augmented to promote health for the aged population.

• Communications for Statistical Applications and Methods
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• v.20 no.4
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• pp.311-319
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• 2013

Cooray and Ananda (2005) proposed a composite lognormal-Pareto model to analyze loss payment data in the actuarial and insurance industries. Their model is based on a lognormal density up to an unknown threshold value and a two-parameter Pareto density. In this paper, we implement the minimum density power divergence estimation for the composite lognormal-Pareto density. We compare the performances of the minimum density power divergence estimator (MDPDE) and the maximum likelihood estimator (MLE) by simulations and an example. The minimum density power divergence estimator performs reasonably well against various violations in the distribution. The minimum density power divergence estimator better fits small observations and better resists against extraordinary large observations than the maximum likelihood estimator.

• The Korean Journal of Emergency Medical Services
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• v.19 no.3
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• pp.33-49
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• 2015

Purpose: This study aimed to investigate the work and job satisfaction of military emergency medical technicians (EMTs). Methods: We selected 122 military EMTs who participated in the refresher education in 2012. This study was conducted from November 12 to December 21, 2012. Results: The most frequent duties of military EMTs were scene assessment, cardiopulmonary resuscitation, surgical treatment, prehospital first-aid, transfer to the hospital, education, and call response. The air force and navy EMTs had better performance than the army EMTs. As for job satisfaction, the work itself ranked highest, whereas payment ranked lowest. Conclusion: The scope of the work of the military EMTs varied in the 14 fields of work but should be considered for further evaluation. In order to increase the job satisfaction of EMTs, their work conditions should be improved such as through salary increase and extra pay for those with professional certificates.

• Journal of Multimedia Information System
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• v.9 no.3
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• pp.191-200
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• 2022

These days, businesses, in both online and offline, have started accepting cryptocurrencies as payment methods. Even in countries like El Salvador, cryptocurrencies are recognized as fiat currencies. Meanwhile, publicly known, but not patched software vulnerabilities are security threats to not only software users but also to our society in general. As the status of cryptocurrencies has gradually increased, the impact of security vulnerabilities related to cryptocurrencies on our society has increased as well. In this paper, we first analyze vulnerabilities from the two major cryptocurrency vendors of Bitcoin and Ethereum in a quantitative manner with the respect to the CVSS, to see how the vulnerabilities are roughly structured in those systems. Then we introduce a modified AML vulnerability discovery model for the vulnerability datasets from the two vendors, after showing the original AML dose not accurately represent the vulnerability discovery trends on the datasets. The analysis shows that the modified model performs better than the original AML model for the vulnerability datasets from the major cryptocurrencies.

• Asian Journal of Business Environment
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• v.12 no.4
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• pp.25-34
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• 2022

Purpose This research develops the expanded Technology Acceptance Model (TAM) to investigate the relationship between perceived usefulness and perceived ease of use with satisfaction and loyalty by considering the role of sharia compliance, commitment, and trust. Research design, data and methodology: A data source is 300 respondents from a self-administered survey. The target population is Muslims who are customers of Islamic banks, with age at least 18 years, and used e-banking to make payment transactions. The analysis methods are MANOVA and Multiple Linear Regression. Results: The results suggest that intention to use and actual behavior variables are replaced with satisfaction and loyalty. Commitment is not recommended, while trust is an explanatory variable that can be used as an external variable. Conclusions: It is important to increase satisfaction and commitment also concentrate to various aspects of sharia compliance to increase customer's loyalty to use e-banking. The fulfillment of sharia compliance by Islamic banks will increase the Islamic bank customers loyalty.