• Korea Journal of Hospital Management
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• v.12 no.1
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• pp.31-50
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• 2007

This study was carried out to analyze the present condition of high-price medical technologies in South Korea and to compare it with OECD countries. This study included 10 high-price medical equipments and used medical equipment registry data of Health Insurance Review Agency. The major findings of this study are as follows; Firstly, The number and growth of high-price medical equipments in South Korea is much higher than those in other OECD countries. There are many of high-price medical equipments even in clinics. Secondly, the percentage of old poor-quality medical equipments is very high, especially in clinics. This is because of high-price of medical equipments. The results of this study implicated that there is high possibility of inappropriate use of high-price medical technologies. This may result in the increase of health expenditure; therefore, there should be a kind of regulation policy to control amount and quality of medical equipment.

• The Journal of Health Technology Assessment
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• v.6 no.2
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• pp.81-87
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• 2018

With the recent change of healthcare environment including rapid technological development, evidences are more and more important and necessary to support relevant policies in health technology assessment to provide safe and effective health services, utilizing medical resources efficiently. Despite of the emphasis on the importance of real world data and real world evidence in health care research, current infrastructure supporting clinical research is considerably weak due to absence of legal and institutional basis. However, in accordance with the Article 26 of the Health and Medical Technology Promotion Act, there is a limited legal apparatus that can be used only in public data with other dataset for the purpose of healthcare technology assessment at the National Evidence-based Collaborating Agency. Although the use of linked data from various sources was often required in the field of clinical research, it was not yet working well due to insufficient environmental conditions. In order to support the decision-making of medical practice and health care policies, data-linking platform for clinical research is needed. If the legal system that can link up to the data of the private institutions without violating the significant value such as the protection of private informations is established, it will be a decisive foundation reinforcing the researches and policy making processes for the improvement of the national health care system.

• Health Policy and Management
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• v.26 no.1
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• pp.63-70
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• 2016

Background: Selective health benefit was introduced for decreasing economic burden of patients. Medical devices with economic uncertainty have been covered as selective health benefit by National Health Insurance since December 2013. We aimed to analyze impact of selective health benefit to medical expenditure and provider behavior focused on electrosurgery (ultrasonic shears, electrothermal bipolar vessel sealers) for gastric cancer patients covered since December 2014. Methods: We used the National Health Insurance claims data of 2,698 patients underwent gastric cancer surgery between August 2014 and March 2015. Medical cost and patient sharing per inpatient day were analyzed to verify that covering electrosurgery increased medical expenditure and changed provider behavior from open surgery to endoscopic or laparoscopic surgery. Additionally, we analyzed the claim rate of medical device or goods relating gastric endoscopic and laparoscopic surgery. Results: Medical cost and patient sharing per inpatient day were increased after covering electosurgery as selective health benefit (39,724/1,421 won). However, there were no medical expenditure increases after adjusting claim of electosurgery and patient sharing was decreased 1,057 won especially. The coverage of selective health benefit did not increase the claim rate of medical device or goods related endoscopic or laparoscopic surgery, either. Conclusion: Covering electosurgery decreased patient economic burden and did not change of provider behavior. Expanding selective health benefit is needed to decrease economic burden of severe patients. Further study should evaluate the long term effect with accumulated data.

• Health Policy and Management
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• v.12 no.1
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• pp.125-143
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• 2002

The objectives of this study were analysis of patient\`s characteristics and market segmentation in oriental medical care and western medical care. This study focused on medical utilization using Anderson's health utilization model. The source of data was 1998 National Health and Nutrition Survey which Korean Institute For Health and Social Affairs carried out. A stratified multistage probability sampling design was used in this survey. The analysis was conducted using the statistical software package SPSS version 10.0 and Answer Tree 2.1 which is one of data mining methodology. The results were as follows ; 1) 44.9% of respondents reported visiting oriental medical center within recent two weeks. 3.4% of them used oriental medical care. The group of age, kind of disease and medical expenditure are associated with the difference western and oriental medical utilization rate. 2) There were several factors related to utilization of oriental medical care according to decision tree. Especially, important factors that patient chose his medical center were kinds of disease, kinds of common medical use, and expenditure. 3) in the results of CART analysis, market of oriental medical care were classified by seven categories. The major groups who have a preference for oriental medicine were those musculo-skeletal, cerebra-vascular disease, or chronic headache patients, and they had a preference fur oriental medical care in common use. These results show that oriental and western medical market were divided into various areas by market segmentation.

• Journal of Korean Academy of Nursing Administration
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• v.14 no.4
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• pp.396-403
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• 2008

Purpose: The purpose of this study was to identify experiences when Koreans who reside in Thailand visit Thai health facilities. Methods: The data were collected via direct interview from 36 Korean residents of Thailand. Collected data were analyzed by content analysis. Result: 1) 162 content analysis data were collected from the participants' statements. These data were categorized into 70 attributes and 9 higher attributes. 2) Out of the 70 attributes, the 3 attributes which were most commonly mentioned by the participants were the following: medical expense for foreigners were expensive(66.7%), difficulties in communication with health care providers(36.1%), kindness of nurses(33.3%). 3) The 9 higher attributes were 1) high medical expense to foreigner, 2) difficulties in communication, 3) distrust about medical service, 4) excessive prescription in oral medicine, 5) kindness, 6) good service, 7) difference in medical environment according hospital type, 8) irrational process in medical treatment for out patients, 9) cultural difference in postpartum care. Conclusion: When Korean residents in Thailand use Thailand health facilities, they experience high medical expense, difficulties in communication, low quality in medical service and kindness of the medical staff.

• Korea Journal of Hospital Management
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• v.22 no.2
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• pp.44-57
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• 2017

The objective of this study is to investigate financial integrity strategies for sustainable development of local public medical centers, and particularly focus on seeking ways to enhance its financial efficiency and publicness. The data which was collected from 33 local public medical centers was analyzed by Data Envelopment Analysis to measure its financial efficiency. Then, Matrix Analysis was used to examine the association of financial efficiency and publicness of local public medical centers with related factors. In the aspects of facilities and location, according to the results, the local public medical centers which have larger number of available hospital beds or located in bigger cities were examined to have higher degree of publicness. In the aspect of human resources, greater number of doctors made both financial efficiency and the degree of publicness decreased, whereas higher participation rate of educational program for doctors affects increasing its financial efficiency and publicness. Lastly, in the aspect of costs, higher labor, material, and administrative cost diminished financial efficiency, but enhanced the degree of publicness. Based on these results, this study concluded that enhancing the publicness of local public medical centers should be pursued by increasing the accessibility with better facilities and location, and also concurrently organizing rational expenditure structure with appropriate cost investment to the resources of local public medical centers. Also, it is necessary to enhance both financial efficiency and publicness simultaneously by improving the quality of health care services through the educational programs for medical staffs.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2021.05a
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• pp.12-14
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• 2021

For the past couple of years, the medical data has been stored in centralized systems which is not the ideal storage technique since all data can be altered, stolen, or even used for evil purposes and, furthermore, the data cannot be safely shared with other doctors and hospitals in case of patient's transfer, change of state or country, in addition, patient's health status cannot be tracked and the patient's medical history is unknown. Therefore, powerful decentralized technologies and expertise can help provide better health information and help doctors and patients to better understand the situations before and after treatment, and do more research based on immutable and trusted data. One of the proposed solutions is storing and securing data on the blockchain which is less scalable, slow and expensive. Introducing a scalable, robust medical data storage and sharing system based on AI/ML, IoT, IPFS, and blockchain.

• Health Policy and Management
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• v.22 no.4
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• pp.497-521
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• 2012

Objectives This study aimed to investigate the effect of social capital, health risk behavior and health status on medical care utilization by the elderly. The data and Research method Data were obtained from the 4th wave survey of the Korea Welfare Panel Study. 4,087 household members aged 65 years and over were subject to analysis. Descriptive statistics are used to describe the basic features of the data in a study. we performed a structural equation modeling(SEM) analysis to evaluate the effect of social capital and mediating effect of health risk behavior and health status. Results Results showed that factors related to medical care utilization of the elderly were different depending on types of service (inpatient and outpatient service) except health status. Age, higher social capital, more health-risk behavior and poorer health status were associated with increased use of inpatient service. Social capital was found to have a positive direct effect on it. Also, social capital had an indirect effect on reducing use of inpatient services by improving health status. On the other hand, lower age and higher household income tended to increase use of outpatient service, while higher social capital and higher health status were inversely related. Social capital had a direct effect and an indirect effect on reducing use of outpatient service and, at that time, health status played a mediating role. Conclusions Social capital may contribute to improve health status and indirectly reduce medical care utilization of the elderly by enhancing their health status. These results provide evidence that more policy and strategy considerations should be needed for the elderly to strengthen their social capital in order to enhance their levels of health and more efficient utilization of medical care.

• Journal of Korean Academy of Nursing
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• v.42 no.7
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• pp.928-935
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• 2012

Purpose: The current study was done to identify individual- and group-level factors associated with health care service utilization among Korean medical aid beneficiaries by applying multilevel modeling. Methods: Secondary data analysis was performed using data on health care service reimbursement and medical aid case management progress from 15,948 beneficiaries, and data from 229 regions were included in the analysis. Results: Results of multilevel analysis showed an estimated intraclass correlation coefficient (ICC) of 18.1%, indicating that the group level accounted for 18.1% of the total variance in health care service utilization, and that beneficiaries within the region are more likely to share common features with regard to health care service utilization. At the individual level, existence of disability and types of medical aid beneficiaries showed a significant association, while, at the group level, social deprivation index, and the number of beneficiaries and case managers within the region showed a significant association with health care service utilization. Conclusion: The significant influence of group level variables in health care service utilization found in this study indicate a need for group level approaches, such as policy change and/or promotion of community awareness.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.2107-2111
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• 2013

Objectives: To investigate data agreement of cancer registries and medical records as well as the quality of care and assess their relationship in a 5-year period from 2006 to 2011. Methods: The present cross-sectional, descriptive-analytical study was conducted on 443 cases summarized through census and using a checklist. Data agreement of Nemazi hospital-based cancer registry and the breast cancer prevention center was analyzed according to their corresponding medical records through adjusted and unadjusted Kappa. The process of care quality was also computed and the relationship with data agreement was investigated through chi-square test. Results: Agreement of surgery, radiotherapy, and chemotherapy data between Nemazi hospital-based cancer registry and medical records was 62.9%, 78.5%, and 81%, respectively, while the figures were 93.2%, 87.9%, and 90.8%, respectively, between breast cancer prevention center and medical records. Moreover, quality of mastectomy, lumpectomy, radiotherapy, and chemotherapy services assessed in Nemazi hospital-based cancer registry was 12.6%, 21.2%, 35.2%, and 15.1% different from the corresponding medical records. On the other hand, 7.4%, 1.4%, 22.5%, and 9.6% differences were observed between the quality of the above-mentioned services assessed in the breast cancer prevention center and the corresponding medical records. A significant relationship was found between data agreement and quality assessment. Conclusion: Although the results showed good data agreement, more agreement regarding the cancer stage data elements and the type of the received treatment is required to better assess cancer care quality. Therefore, more structured medical records and stronger cancer registry systems are recommended.