• Health Policy and Management
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• v.32 no.2
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• pp.154-163
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• 2022

Background: 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. Methods: 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. Results: 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. Conclusion: 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.

• Health Policy and Management
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• v.32 no.2
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• pp.125-136
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• 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.

• Archives of Craniofacial Surgery
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• v.23 no.4
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• pp.163-170
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• 2022

Background: Personal mobility devices (PMDs) have become an increasingly popular transport modality globally. With increasing social interest in and demand for PMDs, the number of individuals visiting emergency departments with PMD-related injuries has also increased annually. This study aimed to evaluate injury patterns and treatment costs for patients treated in the department of plastic surgery in a trauma center. Methods: In this retrospective study, data concerning patients with PMD-related injuries from January 2017 to December 2021 were reviewed. The data retrieved included age, sex, alcohol consumption, helmet use, the type of impact, onset of injury, place of first visit, type of injury, admission status, operation status, and treatment cost. Multiple linear regression analysis was performed to determine the effects of various factors on cost. Results: Data were collected from 93 patients. Until 2019, the annual number of PMD-related accidents was less than 10; however, this number increased sharply in 2020. The average cost of hospitalization was USD 7,698 whereas the average cost of non-hospitalization was USD 631. Only fractures had a significant association with total cost in linear regression analysis (p< 0.001). Conclusion: The prevalence of PMD use and related injuries requiring plastic surgery during the study period showed significant health and financial costs both to the patients involved and to society. This cost could be reduced through stricter regulations concerning PMD use, advocating the use of protective gear, and promoting greater awareness of safety measures and of the consequences of PMD-related accidents.

• Korea Journal of Hospital Management
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• v.9 no.2
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• pp.102-127
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• 2004

The objective of this study is to analyze a current trend of and relating factors on profitability of the Korean Public Corporation Medical Centers(KPCMCs, hereinafter, hospitals) in Korea. There are 34 hospitals in Korea as of 2004. Among these hospitals some are red ink hospitals, others are black inks in terms of profitability. Data were collected by Korea Health Industry Development Institute(KHIDI) Statistics for Hospital Management 2000-2002 and Ministry of Health and Welfare(MOHW) financial data of public hospitals which was planned to coordinate public health care services roadmap in the long run. The samples are 32 hospitals. Profitability was measured in the aspect of profit rate with normal profit to total assets, and normal profit to gross revenues as dependent variables in respective. Independent variables were classified by general factors, i.e., location, intern/resident training, period of opening, number of beds, and managerial factors(current ratio, fixed ratio, liability to total assets, total assets turnover, personnel costs, materials cost, administrative cost), and finally factors related to patient treatment(average length of stay, bed occupancy rate, admission ratio of outpatients). The methods of analysis are correlation and multiple regression analysis. This study shows firstly, a lot of hospitals are optimal current ratio. Hospitals in upper 100% current ratio are 81.2%. And the personnel cost in total costs are high. Secondly, the trend of normal profit to gross revenues of hospitals are deteriorating gradually. And lastly, as a result of multiple regression analysis, the factors had on significant effect on normal profit to total assets are fixed ratio(+), liability to total assets(-), bed occupancy rate(+), admissions of outpatients(+), etc. And the factors had on significant effect on normal profit to gross revenues are current ration(+), fixed ratio(+), personnel cost(-), administrative expenses(-), admissions of outpatients(+), etc. In conclusion, to improve the profitability of hospitals, the efforts to reduce personnel cost and average length of stay might be needed. And also beds utilization rate need to be increased.

• Journal of Digital Convergence
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• v.11 no.6
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• pp.289-298
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• 2013

The objective of this study was to predict the changes in the duration of hospital stay, hospital admission fee, costs of drugs, changes in laboratory cost, material cost, total medical cost, adjusted amount of treatment and the efficacy of obstetrics and gynecology DRG system. The cost of drugs showed the greatest change and was followed by materials for medical examinations and the change in methods of medical examinations. In the analysis of the quantity of medical service the profit of medical examinations were influenced mostly by the duration of hospital stay. The results and data in this study could be used as a basis of future DRG system protocols and will be utilized so that hospitals can build a efficient medical system.

• The Korean Journal of Community Living Science
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• v.28 no.3
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• pp.429-446
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• 2017

The current study aims to identify factors associated with private tutoring of college students in Korea. For this purpose, this study used the Korean Education and Employment Panel survey, which contains items regarding whether or not college students receive private tutoring as well as the monthly costs of private lessons. The current study focuses on private English lessons due to the very low response rates of other types of private tutoring. For the analysis, the 5th wave of KEEP collected in 2008 was selected, and a Heckman selection model was employed, including three categories of variables: individual, school, and parent/household factors. The results have revealed that for the selection model (receiving private English tutoring or not), having received private lessons in high school, gender, and level of satisfaction regarding the respondent's current university were significant. In terms of the outcome model (cost for private English tutoring in college), university admission type (rolling vs. regular), living with parents, school type (4-yr university vs. others), being in debt to cover private lesson fees in high school, and monthly household income had significant effects. This article also discusses the results and implications for future research and policy makers.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.15 no.2
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• pp.79-84
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• 2012

Pediatric patients in hospital are at risk of malnutrition at admission and even during their hospitalization. Although the concept of nutritional support team (NST) was introduced to hospitals for optimal nutritional care since 1960s and the benefits of pediatric NST have been proven by many studies and reports in terms of patient clinical outcome and cost saving, the pediatric NST is not widespread yet. The pediatric NST composed of pediatricians, dieticians, pharmacist, and nutrition support nurses as core members dedicated to nutritional care in children should be independent of central NST or other disciplines, but closely cooperate with other teams in hospitals. There is no doubt that a multidisciplinary NST is an effective way to provide appropriate nutritional support to an individual patient. Therefore, the implementation of the pediatric NST in hospitals should be recommended to provide optimum nutritional support including enteral tube feeding and parenteral nutrition and to assess pediatric patients at risk of malnutrition.

• Korean Journal of Artificial Intelligence
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• v.6 no.1
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• pp.16-20
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• 2018

The development of modern information technology has increased the amount of big data about patients' information and diseases. In this study, we developed a prediction model of diabetes using the health examination data provided by the public data portal in 2016. In addition, we graphically visualized diabetes incidence by sex, age, residence area, and income level. As a result, the incidence of diabetes was different in each residence area and income level, and the probability of accurately predicting male and female was about 65%. In addition, it can be confirmed that the influence of X on male and Y on female is highly to affect diabetes. This predictive model can be used to predict the high-risk patients and low-risk patients of diabetes and to alarm the serious patients, thereby dramatically improving the re-admission rate. Ultimately it will be possible to contribute to improve public health and reduce chronic disease management cost by continuous target selection and management.

• Proceedings of the Korean Information Science Society Conference
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• 2006.10d
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• pp.671-676
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• 2006

차세대 이동 네트워크에서는 다양한 무선 접속 기술이 공존하게 된다. 이에 따라, 다양한 무선망을 지원하기 위한 분산방식의 호 수락 제어 구조인 SmartCAC를 제안한다. 우리는 네트워크간 정보 수집이 필요없는 분산방식을 위하여 모바일노드와 네트워크간의 상호동작을 이용한다. SmartCAC는 기본적으로 VHO call과 new call의 구분을 가능하도록 함으로써 VHO call에 handoff를 위해 예약된 채널을 사용할 수 있도록 한다. 또한, 이종망에서 네트워크 필터링을 할 수 있도록 모바일노드의 스피드를 이용한다. 이 때 효율적인 호 수락 제어 방식을 위하여 QoS 요구와 네트워크 사용에 대한 cost를 다룬다. 특히 우리는 이종망의 상태정보를 알 수 없는 모바일 노드가 네트워크의 상태정보를 받아 비교할 수 있도록 확장된 프로토콜을 제시하고, 시뮬레이션 연구에서 복잡도와 프로토콜 효율성에 따른 SmartCAC 평가를 수행하여 복잡도는 낮추고 효율성은 높이는 결과를 얻는다.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.2
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• pp.389-400
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• 1999

The purpose of this study is to examine a possibility of applying the ABC system to analyze the cost of nursing service on one obstetrics and gynecology (OB/GYN) unit in a major medical center. The activities of nurses on an OB/GYN unit were analyzed for 4 days for 96 hours. 2 week days and 2 days on weekend. Total cases included in the study were activities of 12 charge nurses and 12 staff nurses. Activities were categorized into direct and indirect activities in order to calculate the cost of activities. Nursing activities were defined multidimesionally in order to utilize the ABC system. The 60 nursing activities were classified into the direct nursing activities and the indirect nursing activities based on a literature review, interview, and survey results. The direct activities were further categorized into the single nursing activities and the multiple nursing activities. The indirect activities were classified into the indirect nursing service activities and the general management activities. The major findings of this study were as follows : 1. There were differences in activities according to the positions and duties of the nurses. The charge nurses mostly performed the indirect nursing service activities and the general management activities. Almost all of their indirect nursing activities spent on each patient were similar. The staff nurses performed the single nursing activities and the multiple nursing activities. 2. The activities of staff nurses included medication, patient assessment, rounding and organizing the unit. patient education, nursing treatment, admission and discharging of patients. There was no differences in types and amount of time spent between the nurses on day-time duty and evening-time duty, but the patient assessment activity increased during the night-time. 3. The cost of post partum nursing services for women who had a normal vaginal delivery using the ABC system included the cost incurred by direct nursing activities provided by the staff nurses (85.9%), indirect nursing activities incurred by the staff nurses(19.0%) and the nursing activities by the charge nurses and the head nurse(14.1%). The ABC system is a relatively new method of cost analysis. The results of this study can provide the nursing and hospital managers with useful information on cost control. It is suggested that more studies should be done using the ABC system and extend the scope of studies to include value analysis to aid the Activity-Based Management(ABM) and/or the reengineering of hospital process.