• Archives of Plastic Surgery
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• v.51 no.3
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• pp.304-310
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• 2024

Background Hidradenitis suppurativa (HS) is associated with a high prevalence of psychiatric disorders. However, no studies examine how psychiatric disorders influence surgical and financial outcomes. This study aimed to assess impact of a psychiatric diagnosis on patients treated for HS. Methods Patients with HS were retrospectively identified at a single institution from 2010 to 2021. Cohorts were stratified by the presence of a psychiatric disorder. Demographics, comorbidities, and disease characteristics were collected. Outcomes assessed included the procedural interventions and emergency department (ED) visits. Financial distress was assessed via the COST-FACIT Version 2 survey. Results Out of 138 patients, 40 (29.0%) completed the survey of which 19 (47.5%) had a preexisting psychiatric diagnosis. No demographic differences were found between cohorts. Mean follow-up was 16.1 ± 11.0 months. The psychiatric cohort had a higher median number of surgeries received (7.0 vs. 1.5, p < 0.001), a higher median number of ED visits (1.0 vs. 0, p = 0.006), and a similar hospital length of stay (p = 0.456). The mean COST-FACIT score of the overall study population was 19.2 ± 10.7 (grade 1 financial toxicity). The psych cohort had a lower mean COST-FACIT score (16.8 vs. 21.3, p = 0.092) and reported greater financial hardship (3.3 vs. 1.7, p < 0.001). On multivariate analysis, a psychiatric diagnosis was predictive of lower credit scores, more ED visits, and a higher number of surgeries. Conclusion Preexisting psychiatric conditions in patients with HS are associated with increased health care utilization and surgical intervention with substantial financial distress. Plastic surgeons should be cognizant of such comorbid disorders to facilitate holistic care addressing all patient needs.

• The Journal of the Korea Contents Association
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• v.19 no.5
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• pp.331-341
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• 2019

The purpose of this analysis is to examine the effects of health expenditure on income inequality on household income after the financial crisis by using the household income survey form 1996 to 2016. The main results are as follows. First, after the financial crisis, the gross income inequality of households has been changing steadily, though there has been a slight change in each year. Second, high-income earners spend more on health care expenditure by income level. Therefore, unequal levels are maintained. Third, the Gini coefficient of income excluding health care expenditure was calculated. The results of the analysis are larger than the Gini coefficient of total income. Income inequality is intensified by the expenditure of health care expenditure of households. The inequality of household income due to health care expenditure has been increasing steadily since the financial crisis. Efforts such as strengthening the protection of health insurance have been continuously carried out for the purpose of reducing the burden of the national medical expenses. However, it does not contribute to resolving income inequality. In the future, it will be necessary to provide a more selective medical support system to reduce the medical expenditure of the low income class.

• Management & Information Systems Review
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• v.38 no.4
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• pp.25-39
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• 2019

The purpose of this study is to analyze the management performance of hospitals by analyzing the ratio of stability, profitability ratio, and growth rate through the financial ratios of medical institutions using accounting information disclosure data of medical institutions, financial status table and profit and loss statement. The main goal is to analyze and analyze financial statements of medical institutions' accounting information in 2016 and 2017, analyze the difference and analyze the general characteristics and financial ratios by type, type and size of medical institutions, The financial characteristics of medical institutions were identified. The ratio of stability, profitability, and growth rate through financial ratios were compared and analyzed. In addition, we analyzed the correlation between the medical profit margin, the total asset profit margin, the medical profit margin rate, and the net profit margin of the medical institutions through the financial ratios of accounting information disclosure data of medical institutions. The main results are as follows: First, the size of the hospital and the size of the debt through the change of assets, liabilities and capital of the financial statement are increasing, the size of own capital is relatively decreased, and the management performance is getting worse It is showing. Second, the increase in average medical revenues in the income statement is small, and the average increase in net profit is small. Thus, medical institutions were able to confirm the difficulty in creating profits through medical activities. In addition, there was a large difference in the debt ratio, the stability ratio, and the profitability ratio of the general hospitals and the general hospitals according to the types of medical institutions, and the difference in the average financial ratios of national and public hospitals, school corporation hospitals, I could confirm. The correlation between independent variables in the correlation was -0.904 between the capital ratio and the total assets turnover ratio, -0.800 between the labor cost ratio and the hospital income ratio, and -0.631 between the labor cost ratio and the foreign profit ratio. In order to improve the management deterioration of hospitals by using accounting information disclosure data of medical institutions, it is necessary to have a large effect on the net profit margin of the medical care and the net profit margin of the total assets.

• The Korean Journal of Pain
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• v.30 no.4
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• pp.272-280
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• 2017

Background: The high cost of intrathecal morphine pump (ITMP) implantation may be the main obstacle to its use. Since July 2014, the Korean national health insurance (NHI) program began paying 50% of the ITMP implantation cost in select refractory chronic pain patients. The aims of this study were to investigate the financial break-even point and patients' satisfaction in patients with ITMP treatment after the initiation of the NHI reimbursement. Methods: We collected data retrospectively or via direct phone calls to patients who underwent ITMP implantation at a single university-based tertiary hospital between July 2014 and May 2016. Pain severity, changes in the morphine equivalent daily dosage (MEDD), any adverse events, and patients' satisfaction were determined. We calculated the financial break-even point of ITMP implantation via investigating the patient's actual medical costs and insurance information. Results: During the studied period, 23 patients received ITMP implantation, and 20 patients were included in our study. Scores on an 11-point numeric rating scale (NRS) for pain were significantly reduced compared to the baseline value (P < 0.001). The MEDD before ITMP implantation was 0.59 [IQR: 0.55-0.82]. The total MEDD increased steadily to 0.77 [IQR: 0.53-1.08] at 1 year, which was 126% of the baseline (P < 0.001). More than a half (60%) responded that the ITMP therapy was somewhat satisfying. The financial break-even point was 28 months for ITMP treatment after the NHI reimbursement policy. Conclusions: ITMP provided effective chronic pain management with improved satisfaction and reasonable financial break-even point of 28 months with 50% financial coverage by NHI program.

• Korean Journal of Clinical Pharmacy
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• v.22 no.3
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• pp.239-250
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• 2012

In recent years, national health insurance(NHI) coverage had been expanded gradually for cancer as a severe disease requiring high level of medical expenditure, to reduce patient's financial burden. But, subjective burdens level for out-of-pocket(OOP) money expense are still considerable owing to high medical cost and decent numbers of services not covered by benefit plan. This study aimed to investigate OOP medical expenditures and identify factors influencing subjective financial burden in cancer patients. A 28-items questionnaire for self-reporting by responders was designed to satisfy study goal and finalized following by one pilot study and experts' verification process. Subjects were enrolled during July to October 2010 through regular meetings organized by five patient or patient-advocacy groups had acknowledged the study purpose. Subjects who aged 20 or more, have histories of cancer diagnosis and anticancer drug use, and voluntarily agreed to participate in this study were recruited. Total 107 subjects included in the analysis have cancer lesions in breast, colon, kidney, liver or stomach at the stages from I to IV. Approximately 73% of them has passed less than 5 years since cancer diagnosis. For the OOP medical expenditure regarding cancer, less 6 million won was in 31%, 6-15 million won in 35% and more than 15 million won in 28% of responders, and more than half responders(58%) felt financial burden subjectively. 63% of responders had subscribed commercial insurances, resulting in money receipts of more than 10 million won since cancer diagnoses in 76% of responders. Logistic regression results showed significant differences in subjective OOP financial burden level depending on gender, household income level, benefit type, commercial insurance money receipt degree, year cancer diagnosed, cancer lesion, therapy type, duration of anticancer drug use, drug listing in national formulary, total OOP medical expenditure and total OOP anticancer drug expense. They had mixed feelings both wishes to expand NHI coverage to reduce financial burden(70%) and no willingness to increase premium(59%). This result suggested that NHI might direct future strategies to reduce absolute total OOP medical cost and expand benefit plan coverage in higher burden groups in particular.

• Journal of Digital Convergence
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• v.12 no.10
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• pp.455-466
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• 2014

This study has been implemented to improve the quality in geriatric hospital through the Hospital Accreditation. So research a change in the perception and attitude of the Patient Safety, Organizational Culture, Job Satisfaction, Financial Performance of hospital staff after the Hospital Accreditation. For this, a survay was conducted from April 1 to July 20, 2014 to targeting staffs of eight geriatric hospital in the Busan city. Thus, a total of 283 questionnaires were used in the study. Firstly, It was found that change in the perception and attitude of the Patient Safety, Organizational Culture, Job Satisfaction, Financial Performance of hospital staff after the the Hospital Accreditation. Secondly, It was found that a statistical correlation among variables such as Patient Safety, Organizational Culture, Job Satisfaction, Financial Performance. Thirdly, Organizational Culture, Job Satisfaction, Financial Performance had a positive effect on Patient Safety. Therefore, we should develop the Hospital Accreditation program with the internal assessment to implement health care quality and patient safety to ensure a complete job satisfaction of hospital staffs in the Hospital Accreditation program further improve the evaluation process of hospital care.

• Korean Journal of Health Education and Promotion
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• v.15 no.2
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• pp.217-233
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• 1998

This paper analyzed four different perspectives on health care reform in Korea in terms of the basic values, formulated problems and reform plans, implementation methods, and supporting groups. The medical security plan was insisted by social security specialists and social activists focusing on the integration of medical insurance coops in order to enhancing equity and right of the people. However, its perspective was limited to promoting security instead of reforming health care system. The government proposed the health care reform plans in 1994 and in 1997, focusing on promoting efficiency by remedying many problems in health care delivery system. However, its implementation was not successful due to the lack of organizational and financial supporters. Recently, two opposite proposals were issued. The market reform plan paid attention to revitalizing the market function to promoting efficiency by allowing hospitals to treat private patients instead of applying the medical insurance regulation. The government reform plan focused on intensifying governmental planning and intervention in the health care sector in order to removing inefficiency and promoting equity with the supports of social activists and labor unions. Finally, this paper proposed an alternative plan to promote harmonious social relationship between actors in the health care system.

• Industrial Engineering and Management Systems
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• v.14 no.1
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• pp.104-110
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• 2015

Every year governments spend their national budget on public health in order to reduce financial burden of individuals on health. Although it has been widely believed that the increase of public expenditure on health decreases private health expenditure, it has not been proved by analysis with real data. For better understanding, we conducted an empirical study on the real data of 17 OECD countries-Australia, Austria, Canada, Denmark, Finland, Germany, Iceland, Ireland, Japan, Korea, New Zealand, Norway, Portugal, Spain, Sweden, the United Kingdom, and the United States. The panel Granger-causality test is used to verify the cause-and-effect relationship between the two expenditures. As a result, public expenditure on health has a 3 to 4 year-lagged negative effect on private health expenditure in the cases of the 16 countries except for the United States.

• Journal of Korean Academy of Nursing Administration
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• v.17 no.2
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• pp.180-188
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• 2011

Purpose: This study was done to evaluate the operating status of community-based home health center for revitalization of the centers. Method: In this study performance data including organization plan and service utilization plan were evaluated according process theory. Target of evaluation was the community-based home health care center. Results: The vulnerable part of the organization was the information system and financial resources. The home health center introduced PDA (Personal Digital Assistants) in 2005, however home health care nurses did not make full use of it. This service received full support from Seoul city and local government and there were no other sources of income. The vulnerable part of service utilization was service expansion and standardization due to vulnerability of organizational aspects. Conclusions: The home health care center provides high quality services to underprivileged people. In the future, these services should be provided with equity for continuous health care for this population.

• Health Policy and Management
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• v.15 no.1
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• pp.78-96
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• 2005

The purpose of this empirical study is to investigate whether costs are 'sticky' -that is, whether costs increase more when revenues rises than they decrease when revenues falls by an equivalent amount by using the financial data fromf korean general hospital Financial data used in this study were obtained from the Database of Korean Health Industry Development Institute and analyzed using multiple regression model in dummy variables. The main results of this study are as follows: First, we found, for 69 Korean general hospitals for 3 years(2000~2002), that total hospital costs, hospital labor costs, hospital administrative costs were sticky, these costs provided strong support for the sticky costs hypothesis 1, but hospital material costs were shown to be proportional to sales revenues. Second, this results provided strong support for the hypotheses that the' degree of stickiness was lower in sales revenues declining that were preceded by revenue-declining periods (hypothesis 2-1), and that stickiness was less pronounced in a second successive year of revenue decline(hypothesis 2-2). Third, this results provided strong support for the hypothesis(hypothesis 3) that stickiness was greater hospitals that employ relatively more people to support their sales revenues(hypothesis 4) that stickiness was greater for hospital that used relatively more assets to support their sales revenues. After all, a managerial implication of this study was that sticky cost, for the general hospital, could be recognized and controlled.