• Health Policy and Management
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• v.5 no.2
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• pp.35-69
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• 1995

The managerial environment of hospitals in Korea characterized by low levels of medical insurance fees is worsening by increasing government regulations as to the utilization of medical services, rising costs of labor, material, and medical equipments, growing patient expectations concerning the quality of services, and escalating competitions among large hospitals in the market. Hospitals should seek for their survival strategies in this harsh environment and they should have information about costs of their products in doing so. However, it has not been available due to the complexity of the production process of hospital services. The objectives of this study were to develop a service-based cost accounting model and to apply the developed model to a study hospital to obtain cost information of hospital services. A model commonly used for the job-order product cost accounting in the manufacturing industry was modified for the use in hospitals in Korea. Actual costs, instead of standard costs, incurred to produce a unit of services during a given period of time were estimated in the model. Data required to implement the model included financial information, statistics for the allocation of supportive cost center costs to final cost centers, statistics for the allocation of final cost center costs to services, and the volume of each services charged to patients during a study period. The model was executed using data of a university teaching hospital located in Seoul for the fiscal year 1992. Data for financial information, allocation statistics fo supportive service costs, and the volume of services, most of them in electronic form, were available to the study. Data for allocation statistics of final cost center costs were collected in the study. There were 15 types of evaluation and management service, 2, 923 types of technical service, and 2, 608 types of drug and material service charged to patients in the study hospital during the fiscal year 1992. Labor costs of each of seven types of pesonnel, material costs of 611 types of drugs and materials, and depreciation costs of 212 types of medical equipments, miscellaneous costs, and indirect costs incurred in producing a unit of each services were estimated. Medical insurance fees for basic services such as evaluation and management of inpatients and outpatients, injection, and filling prescriptions, and for operating procedures were found to be set lower than costs. Infrequent services which use expensive medical equipments showed negative revenuse as well. On the other hand, fees for services not covered by the insurance such as CT, MRI and Sonogram, and for laboratory tests were higher than costs. This study has a significance in making it possible for a hospital to obtain cost information for all types of services which produced income based on all types of expenses incurred during a given period of time. This information can assist the management of a hospital in finding an effective cost reduction strategy, an efficient service-mix strategy under a given fee structure, and an optimum strategy for within-hospital resource allocations.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.107-116
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• 2005

Objectives : We analyzed the changes from 1996 to 2002 in distributive equity of the contribution burden in the Korean National Health Insurance. Methods : The study subjects were a total of 8,923 employee households and a total of 7,296 self-employed households over the period from 1996 to 2002. Those were the households meeting the two criteria as completing each annual survey and having no change in the job of head of the household during that period from the raw data of the Household Income and Expenditure Survey annually conducted by the Korean National Statistical Office. The unit of analysis was a household, and this was the standard for assessing the contribution that is now applied on a monthly basis. Deciles Distribution Ratio, Contribution Concentration Curve and Contribution Concentration Index were estimated as the index of inequality. Multiple regression analysis was conducted to compare the annual ability-to-pay elasticity of the contribution to the reference year of 1996 for three groups (all households, the employee households, and the self-employed households). Results : For the index of inequality, the distributive equity of contribution was improved in all three groups. In particular, the employee group experienced a substantial improvement. Using multiple regression analysis, the ability-to-pay elasticity of the contribution in the employee group significantly increased ($\beta$=0.232, p<0.0001) in the year 2002 as compared to the reference year of 1996. The elasticity in the self-employed group also significantly increased ($\beta$=0.186, p<0.05), although its change was smaller than that in the employee group. Conclusions : The employee group had a greater improvement for the distributive equity of the contribution burden than the self-employed group. Within the observation period, there were two important integration reforms: one was the integration of 227 self-employed societies in 1998 and the other was the integration of 139 employee societies in 2000. We expected that the equity of the contribution burden would be improved for the self-employed group since the integration reform of 1998. However, it was not improved for the self-employed group until the year 2000. This result suggests that capturing exactly the beneficiaries' ability-to-pay such as income is the precedent for distributive equity of the contribution burden, although a more sophisticated imposition standard of contribution is needed.

• Research in Community and Public Health Nursing
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• v.32 no.1
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• pp.116-129
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• 2021

Purpose: This study aimed to investigate the maternal health effects of internet-based education interventions on parturients during the postpartum period through a systematic review of randomized controlled trials. Methods: An electronic literature search of the Cochrane Library, CINAHL, EMBASE, Eric, PsycINFO, PubMed, RISS, and KISS databases was performed, using the combination of keywords such as 'parenthood education', '*natal education', '*birth intervention', 'internet-based intervention', 'randomized controlled trial'. The inclusion criteria were peer-reviewed papers in English regarding randomized controlled trials of internet-based postnatal education interventions. Educational interventions were delivered through any web, mobile, eHealth, mHealth, virtual reality, short message service, or social networking service platform. Quality appraisal was performed using the Risk of Bias 2 (RoB 2) for randomized controlled trials. Nine articles were yielded, and the intervention effects were analyzed. Results: Internet-based education interventions during the postpartum period affect maternal self-efficacy, postpartum depression, and successive breastfeeding; however, they do not affect maternal satisfaction and parenting confidence. Conclusion: This study demonstrated that internet-based education interventions affect maternal health status in terms of psychological, emotional, and physical wellness. Therefore, maternal health care professionals can utilize remote education using the internet or mobile-based interventions during the postpartum period.

• 대한예방의학회:학술대회논문집
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• 2002.10a
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• pp.420-421
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• 2002

• Journal of Korean Academy of Nursing
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• v.10 no.1
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• pp.41-55
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• 1980

The medical care insurance system, being put into practice nearly for three years, seem to have brought about some considerable problems as serious for the government as to consider a revision of that system. As one of the most serious problems of present system, the treatment cost of insurance patients is so remarkably low in comparison with than of non-insurance cases that normal operation of hospitals is threatened and care services of low quality are induced. The researcher carried out this survey to analyze and bring to light several aspects of treatment cost of non-insurance patients as a material for a re-assessment of the cost of insurance cases which shows a a considerable difference in amount at the standpoint of hospitals with than of non-insurance cases and further, hoping the significant blind spot of present insurance system(that is, the absence of regulations' for cost assessment by patterns or types of health care treatment) will be mended in near future. The survey was carried out with the treatment invoice sheets of total 902 in-hospital Patients of a general hospital in Seoul during the period of the 2 nd quarter of the year(1979). Among total 902 patients, 694 cases were used for analysis, because those disease or syndromes shared by less than 10% of the patients were put aside before procession. The data were analyzed by kinds or types of diseases, demographic characteristics of patients, hospitalization patterns, types of nursing treatment, etc. The result of analysis was as follows 1. Among all the non-insurance cases, those who received one or more kinds of nursing treatment mounted up to 96. 7 ％. The invoice issue frequency per person was 7.2 times, while that frequency per day for a person was 0.8, : the treatment cosr per person was ￦22,650 while its daily average was ￦2,430, due to the average 9.3 in-hospital days per person. 2. As to the nursing treatment types by the demographic characteristics of patients and hospitalization patterns. a. The unit cost female patients was generally more expensive them that of males, and independent nursing service was more given than other types of treatment. As to age, higher age groups received independent nursing service most, while the youngest group received instrumental and integrated nursing services. b. As to room grade, the unit cost of I.C.U. cases was the highest : and the cast of private room patients was higher than that of public room patients. By in-hospital days, the curve of function showed L. type : that is, the longer stay, the lower function. 3. State of treatment types by kinds of disease were ; a. Dependent nursing service showed comparatively high availability in surgical and neurologic disease and independent nursing service was most received by medical, obstetrical and urological patients, while instrumental and integrated services were most available for respiratory disease and obstetrical and neurologic diseases next. b. The invoice issue frequency per day for a patient was highest in obstetrical disease 3.8 times, and the unit cost(per one invoice sheet) was also highest in obstertrical disease(￦10,880) and next in neurologic cases(￦ 4,690 ). 4. As to the pertained departments. a. Cost amount per person was highest in department of Psychiatries daily cost was highest in obstetrical cases : while the invoice issue frequency was highest in obstetrics and next in pediatrics. b. In departments in need of surgical operation, dependent nursing care was highly availabl : while in internal medicine and obstetrics, independent service was higher. Psychiatrics showed the highest the of integrate nursing while pediatrics and obstetrics higher of instrumental services. The variation co-efficien of treatment cost came out to be relatively in high in special surgery, opthalmology and internal medicine. 5. State of treatment cost by types of nursing behavior was. a. The average frequency of invoice issue was 3.5 (times). Among the type four types of treatment, instrumetal service (4.3) and independent nursing behavior(3.9) showed higher frequency than average respectively. But as to unit cost (per invoice). dependent (￦5,200) and integrated (￦5,340) nursing care services were higher than average and considerably higher than the other two types. b. In repect patient distribution. independent nursing behavior(80.3% ) was the highest and depend ent nursing (31.7% ) the lowest. The variation co-efficient of treatment cost appeared highest in dependent nursing be havior as a whole, and among that, doctor's diagnosis showed the highest coefficient value (100.7). In conclusion, the variaty of treatment cost(treatment itself ) by various characteristics and treatment types pro- that treatment various sort of patients and treatment cost of various types of nursing behavior cannot be uniform. Therefore, to attain the equalization of health care service and its cost both for insurant and non-insurant patients, a more specific provision for assessment of cost should be added to the present medical care insurance system and, in addition, the cost of nursing treatment is desired to be inserted into the treatment invoice.

• The Journal of Asian Finance, Economics and Business
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• v.9 no.7
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• pp.53-62
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• 2022

Commercial banks have a significant impact on the economy of Vietnam because they provide the majority of transactional capital. Therefore, the operational efficiency of commercial banks is a viral topic for the study of the Vietnamese banking system. The research aims to examine the efficiency and inefficiency of joint-stock commercial banks in Vietnam from 2016 to 2020 and then classify them into the efficient group and inefficient group. The study employs the time series data of 29 joint-stock commercial banks during the period 2016-2020. Based on the data collected from the annual audited financial statements of 29 Vietnamese joint-stock commercial banks, the authors select input and output variables for the standard DEA models and anti-efficient DEA models. This research uses two stages, first, by applying the standard DEA model, we investigate the efficient banks; second, by employing the anti-efficient DEA model, we find out the inefficient banks. The results reveal that the average efficiency score of 29 joint-stock commercial banks tends to increase in the period 2016-2018 and decrease gradually in the period 2019-2020. The findings of this study suggest that several small and medium-sized banks in the Vietnamese banking sector have both promising and risky performances and the efficiency of state-owned commercial banks has also improved significantly during the study period.

• Journal of The Korean Ophthalmological Society
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• v.59 no.11
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• pp.1039-1048
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• 2018

Purpose: To evaluate the effects of anti-vascular endothelial growth factor (VEGF) treatment on the healthcare-related finances of patients with age-related macular degeneration. Methods: Changes in health care financing due to newly introduced benefit standards were predicted over the coming 5-year period (2018-2022). We also analyzed the financial impact of scenarios in which agents similar to anti-VEGF, such as the over-licensed drug bevacizumab, were introduced. For this purpose, the future number of patients receiving anti-VEGF treatments was estimated for various scenarios based on National Health Insurance Corporation claims data followed by an estimate of the financial burden. Results: In the case of age-related macular degeneration, the current standard of care (14 times in a lifetime) was maintained in scenario 1. In 2018, the insurance budget for the coming 5-year period was estimated at approximately 440.3 billion won. The insurance cost for that period was estimated at approximately 560.1 billion won under the revised standard of December 2017 (scenario 2). For scenarios wherein, after 2020, similar treatments (scenario 3) and bevacizumab (scenario 4) were introduced, the estimated health insurance costs were 521 billion won and 419.7 billion won, respectively. Conclusions: Health insurance costs are projected to increase substantially due to the elimination of the 14 time pay standard; however, the actual budget will only moderately increase, due to new limitations of visual acuity ${\leq}0.1$ or in case of scarring/atrophic lesions. Clinically similar agents and bevacizumab could be considered as alternatives to anti-VEGF treatment for age-related macular degeneration.

• Journal of dental hygiene science
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• v.15 no.1
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• pp.1-11
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• 2015

This study analyzed the tooth brushing behavior and oral health status of foreigner immigrant workers and obtained the following results. Statistical significance based on different general characteristics. Gender, educational background, period of stay, health insurance, medical expense coverage, and whether or not one has friends or regular gatherings were significant traits for frequency, while age, marital status, income, and health insurance were traits for part (p<0.05). Statistical significance (p<0.05) was found in marital status and health insurance for time used to brush teeth, period of stay and whether or not one attends a regular gathering for tooth brushing training, and gender, educational background, period of stay, roommate status, medical expense coverage, and whether or not one attends a regular gathering for supplemental oral product usage. The averages of decayed, missing, and filled teeth (DMFT) index and community periodontal index of treatment needs (CPITN) for general characteristics were 6.98 and 3.03 respectively, and gender, roommate status, income, health insurance for DMFT index, and gender, age, marital status, educational background, roommate status, income, health insurance for CPITN were statistically significant (p<0.05). Tooth brushing frequency and part showed statistical significance (p<0.05) for DMFT index based on tooth brushing behavior, while tooth brushing part and time used to brush teeth were significant for CPITN. DMFT index was high at 8.34 for '3 times or more' in tooth brushing frequency, while DMFT index was high at 7.91 and CPITN was low at 2.94 for tooth brushing part. '3 minutes or longer' in time used to brush teeth was the lowest in CPITN at 2.88. As a result of analyzing the correlation between tooth brushing behavior and DMFT index, CPITN, tooth brushing frequency and part in DMFT index, and tooth brushing part and time used to brush teeth in CPITN showed significance (p<0.05). Based on the above results, we must promote the significance of brushing teeth and implement continuous training for correct tooth brushing management to enhance the oral health of foreign immigrant workers.

• Journal of the Korean Data and Information Science Society
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• v.25 no.1
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• pp.245-254
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• 2014

The traditional methods of simulating daily precipitation have paid little attention to the inherent dependence structure between the total precipitation amount and the precipitation frequency for a fixed period of time. To address this issue, we propose a new simulation algorithm using copula in order to incorporate the dependence into the traditional methods. The algorithm consists of two parts: First, while reflecting the observed dependence, we generate the total precipitation amount (S) and the frequency (N) during the period of interest; then we simulate the daily precipitation whose aggregation matches the pair of (N; S) generated in the first part. Our result shows that the proposed method substantially improves the traditional methods.

• Journal of Periodontal and Implant Science
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• v.47 no.5
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• pp.264-272
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• 2017

Purpose: This study evaluated trends in tooth extraction due to acute and chronic periodontal disease (PD) using data from the National Health Insurance Service-National Sample Cohort for 2002-2013. Methods: A random sample of 1,025,340 individuals was selected as a representative sample of the population, and a database (DB) of diagnostic and prescription codes was followed up for 12 years. We used multivariate logistic regression analysis to assess the incidence of total extraction (TE), extraction due to periodontal disease (EPD), and immediate extraction due to periodontal disease (IEPD) according to sociodemographic factors (sex, age, household income, health status, and area of residence). Results: The incidence of tooth extraction was found to be increasing, and at a higher rate for TE in PD patients. In 2002, 50.6% of cases of TE were caused by PD, and this increased to 70.8% in 2013, while the number of cases of IEPD increased from 42.8% to 54.9% over the same period. The incidence rates of extraction due to acute and chronic PD increased monotonically. We found that the incidence rates of TE, EPD, and IEPD were all 2-fold higher among patients with high income levels and those who were not beneficiaries of health insurance. Conclusions: The rates of TE, EPD, and IEPD have been steadily increasing despite dental healthcare policies to expand public health insurance coverage, increasing the accessibility of dental clinics. Moreover, the effects of these policies were found to vary with both income and education levels. Consistent patient follow-up is required to observe changes in trends regarding tooth extraction according to changes in dental healthcare policies, and meticulous studies of such changes will ensure optimal policy reviews and revisions.