• Title/Summary/Keyword: Total payment

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Prediction of Health Care Cost Using the Hierarchical Condition Category Risk Adjustment Model (위계적 질환군 위험조정모델 기반 의료비용 예측)

  • Han, Ki Myoung;Ryu, Mi Kyung;Chun, Ki Hong
    • Health Policy and Management
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    • v.27 no.2
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    • pp.149-156
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    • 2017
  • Background: This study was conducted to evaluate the performance of the Hierarchical Condition Category (HCC) model, identify potentially high-cost patients, and examine the effects of adding prior utilization to the risk model using Korean claims data. Methods: We incorporated 2 years of data from the National Health Insurance Services-National Sample Cohort. Five risk models were used to predict health expenditures: model 1 (age/sex groups), model 2 (the Center for Medicare and Medicaid Services-HCC with age/sex groups), model 3 (selected 54 HCCs with age/sex groups), model 4 (bed-days of care plus model 3), and model 5 (medication-days plus model 3). We evaluated model performance using $R^2$ at individual level, predictive positive value (PPV) of the top 5% of high-cost patients, and predictive ratio (PR) within subgroups. Results: The suitability of the model, including prior use, bed-days, and medication-days, was better than other models. $R^2$ values were 8%, 39%, 37%, 43%, and 57% with model 1, 2, 3, 4, and 5, respectively. After being removed the extreme values, the corresponding $R^2$ values were slightly improved in all models. PPVs were 16.4%, 25.2%, 25.1%, 33.8%, and 53.8%. Total expenditure was underpredicted for the highest expenditure group and overpredicted for the four other groups. PR had a tendency to decrease from younger group to older group in both female and male. Conclusion: The risk adjustment models are important in plan payment, reimbursement, profiling, and research. Combined prior use and diagnostic data are more powerful to predict health costs and to identify high-cost patients.

An Analysis of Economic Value of Children's Library (어린이도서관의 경제적 가치 분석)

  • Kang, Mi-Hee
    • Journal of Korean Library and Information Science Society
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    • v.47 no.2
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    • pp.305-328
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    • 2016
  • This study is intended to check economic value of and factors influencing children's library. To this end, data on a total of 614 questionnaires to which parents among users of 6 children's libraries responded were collected. The results of analysis by contingent valuation method after selecting library fee per person as payment vehicle were as follows. First, willingness to pay was estimated to be a monthly average of KRW 9,243 per person. Second, it was shown that factors influencing willingness to pay included the frequency of utilization, satisfaction, the number of children per family, gender, age, and income and so on. Third, with regard to influence according to each factor, an additional unit in all the rest of factors except gender increased probability of willingness to pay such as the frequency of utilization(1.140), satisfaction(1.335), the number of children per family(1.417), age(1.124), income(2.426). On the other hand, in terms of gender, probability of willingness to pay was lower in female by 0.364 than in male. The implication of this study is that an interview is held with actual user and specific amount of money is presented regarding the economic value of children's library, which has been little known until now.

A Study on the Fisheries Marketing Channels (수산물 마아케팅 경로(FMC)에 관한 연구)

  • 강연실
    • The Journal of Fisheries Business Administration
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    • v.23 no.2
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    • pp.101-128
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    • 1992
  • How to distribute fisheries catches from producer to consumer is very important for everybody joined fisheries marketing channels (FMC), because most people are influenced their revenue and expenditure through marketing channels. Many institutions in Korea after 1960's have tried to develop the rationalization of FMC, but they have not gotten the satisfactory results in general in spite of a lot fruits. Comparing with general manufacturing industry, the fisheries industry has some specializations in the marketing channels. It makes them unique structure included wholesale market system similiar to fresh (perishable) food market with expertised technology. Wholesale market collects, distributes the fisheries catches and evaluates in by auction or bidding without consideration of producer's opinion. It is very necessary institution to make a decision to equatible price for fresh food and to play an important role for marketing effectiveness with minimum total transation and with massed reserve among institutions. But it has two weak points to increase the marketing cost and to make products bad fresh (perishable). Therefore, both Producer and consumer want to find the direct channels not to pass through wholesale market and to get more profit. I wanted to explain what problems of traditional FMC are and why the direct channel is necessary as follows in this paper. Chapter II : The types and specialization of FMC Chapter III : The structure and problem of fisheries wholesale market channel Chapter IV Marketing cost of FMC and direct channel I suggested when the direct channel in FMC is designed, new planner must carry out marketing functions which are performanced by wholesaler, middle man and the joined members of auction at wholesale market. In view of consumption area, these functions are : (1) the finding of production partner to make a business ; (2) communication of information ; (3) collecting ; (4) distribution ; (5) selecting and grading ; (6) evaluating ; (7) financing and payment ; (8) organization, in view of consumption area. The government must support also the group or individual of new direct channels to succeed it with (1) furnishing of market information (2) supplying of land and facility (3) financing (4) feed-back of dierct channels totally (5) making an opportunity of communication between producer and consumer. I want to emphasize again wholesale market is necessary and important institution for equatible price of fresh food in spite of the its weak points. At the same time. the direct channels are necessary to reduce the marketing cost and to keep better fresh food.

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The Solutions of Problems in E-Commerce in China (중국 전자상거래의 문제점과 해결방안)

  • Choi, Seok-Beom;Lee, Young-Chan
    • International Commerce and Information Review
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    • v.8 no.2
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    • pp.187-210
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    • 2006
  • China continues to experience an expansion of its e-Commerce industry. This is true both for B2C and for B2B sectors. B2C websites are created by various players. B2C E-commerce is divided into three categories in China: online direct sale, online retail, and online booking services. Online retail remains the major form of B2C business, and online booking services and online direct sale also maintained rapid growth. The rapid growth of B2C E-commerce in China was due to three factors. Firstly, the number of Internet users is increasing, which expands E-commerce user base. Secondly, users' acceptance and recognition of E-commerce are gradually increasing. Lastly, improvement on payment, logistics and credit also provides a better and better industrial environment for B2C e-commerce. The B2C sector has seen a low transaction volume in spite of its large number of websites. The B2B sectors has seen a higher transaction volume and more stable growth than the B2C sector. There is a wide range of the total market size estimated by different sources. China's C2C market witnessed rapid growth in 2005, the market growth may slow down in 2006 and 2007, due to heavy market competition, challenges to the business model and slow corporate user growth. But there is the bottlenecks in E-commerce in China. The purpose of this paper is contribute to development E-commerce in China by finding the solutions of the bottlenecks in E-commerce in China.

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Cost Analysis of Fall Accidents in Domestic Construction Industry (국내 건설산업의 추락재해 비용 분석)

  • Sa, Young Bae;Choi, Sung Uk;Cho, Won Cheol;Lee, Tae Shik
    • Journal of Korean Society of Disaster and Security
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    • v.5 no.1
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    • pp.1-6
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    • 2012
  • This study analyzed the direct costs of fall accidents, which have the highest accident rate, for domestic construction industry workers. Firstly, the average insurance payment per person due to fall accidents in the construction industry is around 19 million won (18,971,000 won). Given that the average number of workers suffering fall accidents over ten years is 5,863, the total cost of losses from fall accidents is about 1.1 trillion won (111,360,000,000 won). Secondly, a cost-based economic feasibility analysis was done to develop nonstructural preventive measures for fall accidents. Since there was no data expressing the costs and effects of preventive measures in terms of monetary value, the economic feasibility analysis was attempted with a focus on how much the newly introduced preventive measures can reduce the accident loss costs due to fall accidents. Thirdly, if the accident loss size is grasped and the preventive measures for the causes of fall accidents are developed and strictly implemented, the insurance fee that can reduce the accident loss costs can be determined. Further study is needed to estimate the benefit of the accident loss cost reduction seen from the cost-based approach method.

The Health Insurance system and the Quality Improvement Policies for Chinese Medicine in Taiwan (대만 중의 건강보험의 체계와 서비스 질 향상 정책)

  • Kim, Dongsu;Kwon, Soo Hyun;Chung, Seol Hee;Ahn, Bo Ryung;Lim, Byungmook
    • Journal of Society of Preventive Korean Medicine
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    • v.20 no.2
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    • pp.27-38
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    • 2016
  • Backgrounds : Taiwan has similar national health insurance (NHI) system for traditional medicine with South Korea. Recently, new quality improvement policies for traditional medicine is being attempted in Taiwan. Objectives : This study aimed to review the Taiwanese NHI system for Chinese Medicine (CM) and introduce quality improvement policies. Methods : Research articles, reports, government publications and year books which handled traditional medicine system and NHI system in Taiwan were searched and collected. The authors analyzed and summarized the contents in a qualitative manner. Results : In Taiwanese NHI system, CM procedures and medication for outpatients are reimbursed through a mix of fee-for-service and global budget payment system. CM shares 4% of total expenditure of NHI in Taiwan. Mostly, the expenses for procedures are reimbursed regardless of disease type, however, in the specialized program for quality improvement, CM doctors have to comply with standard operating procedures (SOPs). Conclusions : Taiwanese NHI system implemented SOP-based new reimbursement system for CM. Yet, the scientific evidences for SOPs are not sufficient, it can be useful references when we develope disease related reimbursement system for Korean Medicine in South Korea.

A Study on Estimating the Benefits by Pedestrian Environment Improvement Using CVM (조건부가치측정법(CVM)을 이용한 보행환경개선사업에 대한 편익 추정)

  • Kim, Jang-Wook;Kang, Soon-Yang;Kim, Kyung-Tae;Kang, Young-Kyun
    • Journal of Korean Society of Transportation
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    • v.30 no.4
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    • pp.7-19
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    • 2012
  • In this study of estimating the benefits of environmental materials, the CVM method used in environmental economics was applied to estimate the value of pedestrian environment improvement. After finding the Willingness To Pay (WTP) level of residents through CVM, this study attempts to calculate quantitative benefits from the pedestrian environment improvement. In this study, a survey targeting the inhabitants in Seongbuk-gu adjacent to a business area was carried out for pedestrian environment improvement considering form of payment, willingness to pay and such by establishing and showing several virtual scenarios depicting a quiet and comfortable pedestrian environment. As a result, the willingness to pay level of the Seongbuk-gu residents was 627 won of surcharge for pedestrian environment improvement per month. Additionally, the annual total benefits by pedestrian environment improvement was estimated within a range from 1,247,516,820 won to 286,305,110 won.

Estimation on Economic Value for Cultivated Wild Ginseng using Choice Experiment (선택실험법을 이용한 산양삼의 경제적 가치평가)

  • Kim, Eui-Gyeong;Kim, Dong-Hyeon
    • Journal of Korean Society of Forest Science
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    • v.102 no.3
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    • pp.338-344
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    • 2013
  • The study was conducted to set up the criteria of judgement that could be utilized for cultivated wild ginseng, easy and well-defined for consumers to understand. For the purpose, the study examined consumers' perception and valuation on each attribute of cultivated wild ginseng that was related to the product quality through a choice experiment. Attributes used in the experiment were based on exterior characteristics of cultivated wild ginseng including ages, planting methods, external dimension, length of fibrous roots, and hue and color. Residents in Seoul and Gyeonggi Province were interviewed and a total of 173 questionnaires were acquired for the analysis. According to the result, respondents valued the highest score on ginseng grown by direct sowing, while they valued rather lower scores on ginseng's external dimension. In general, the hypothetical model was shown to exist within the stable range.

The Undergraduates' Money Income and the Clothes Purchasing Behavior (대학생의 화폐소득과 의복구매행동: 광주.전남지역 대학생을 대상으로)

  • Shin, Hyo-Ryeon;Hong, Eun-Sil
    • Journal of Family Resource Management and Policy Review
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    • v.13 no.4
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    • pp.141-169
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    • 2009
  • This study investigated the effect of the money resource on the resource use behaviors of undergraduate students. The aim of the study was the examination of the relationship between undergraduate income and clothes-purchasing behavior. A total of 415 undergraduates residing in Gwangju City and Chonnam Province were interviewed by means of a questionnaire. SPSS 12.0 software was used for statistical analysis. Cronbach's $\alpha$, t-test, one-way ANOVA, Duncan's multiple range analysis and chi-square analysis were all conducted to acquire the results. The main results of this study are as follows. First, the average undergraduate income average was relatively high. Second, the motive for clothing purchases by undergraduates was to buy clothes similar to those which they already had. The undergraduates acquired their purchasing information from past experiences of buying clothes and considered design, quality and color when choosing their clothing. They purchased their clothes at retail stores and on average bought clothes about once a month. Although theaverage monthly expenditure on clothes was over 100,000 won, in general, the undergraduates spent between 50,000 and 100,000 won a month. They mainly paid cash when they purchased their clothes. Third, by analyzing the income, clothes-purchasing behavior, and clothes purchasing frequency of undergraduates, significant statistical differences in average monthly clothes expenditure and payment methods were detected. The results of the study can be used to understand the patterns of undergraduate money resource usage behaviors and can be utilized as an educational resource at home and within educational institutions.

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A Study on the Risk Examination of the Unit Price of Public Housing Construction Projects (공공주택공사에서의 도급단가 리스크 규명에 관한 연구)

  • Kim, Soon-Young;Han, Choong-Hee;Baek, Tae-Ryong;Kim, Kyoon-Tai;Lee, Jun-Bok
    • Korean Journal of Construction Engineering and Management
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    • v.11 no.2
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    • pp.35-44
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    • 2010
  • Currently, the unit price of public construction projects are not being evaluated appropriately for several reasons. First, the evaluation of the unit price differ per nature of the bidding process and its estimation process. In fact, pricing is determined to meet the total price in turnkey projects and to pass the low bid price deliberation process in unit price projects, and thus, such prices cannot be said to be reasonable prices per public project. After the contract is awarded, however, the prices determined without taking into consideration the characteristic of each bidding process and price estimate process are used for the valuation of progress payment, design changes, and escalation. Furthermore, this is also being applied to other low bid deliberation process as actual public project unit price, thereby affecting other processes as well. In effect, this system increases the risks for both the owner and the bidder who have determined the unit price. This research examines the risk factor and its extent in order to properly manage it in preparation for the future.