• Health Policy and Management
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• v.24 no.4
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• pp.396-412
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• 2014

Background: As a reform plan of health care system, Accountable Care Organization (ACO) has became an object of attention in the United States after Patient Protection and Affordable Care Act was enacted. ACO is a group of various health care providers and provide coordinated care to its assigned beneficiaries. If ACOs improve the quality level and reduce the cost of care, they can get financial incentives. Under the discussion for a quite long time and demonstration projects, ACO has been established. We aimed to analysis and discuss the history, policy mechanism, contents, status and outcomes of ACO. Also, we intended to suggest political implication Korean health care system with regard to ACO. Methods: We searched the articles related ACO in PubMed and selected several available papers about ACO. Total 56 studies were reviewed and categorized three parts; demonstration projects for formation of ACO, policy mechanism and agenda, empirical results of ACO performance. Results: As a result, establishment of ACO was successful partly in the US. It seems to be due to various project and pilot test for verification in the long time. The empirical effect of ACO was also identified in a few study but it needs more evidences to judge its positive effect. Conclusion: In Korea, there are arguments for the application of ACO. However it is difficult to implement a ACO by different political conditions between Korean and US. Nevertheless ACO proposed us the necessity of paradigm shift in our health policy and could be significant to national policy orientation in the future.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.20 no.8
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• pp.1460-1465
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• 2016

Lots of costs threaten the sustainability of the national health-guarantee system. Despite research by the national center for disease control and prevention on health care dynamics with its auditing systems, there are still restrictions of time limitation, sample limitation, and, target diseases limitation. Against this backdrop, using huge volume of total data, many technologies could be fully adopted to the preliminary forecasting and its target-disease expanding of health. With structured data from the national health insurance and unstructured data from the social network service, we attempted to design a model to predict disease. The model can enhance national health and maximize social benefit by providing a health warning service. Also, the model can reduce the advent increase of national health cost and predict timely disease occurrence based on Big Data analysis. We researched related medical prediction cases and performed an experiment with a pilot project so as to verify the proposed model.

• Health Policy and Management
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• v.27 no.3
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• pp.247-255
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• 2017

Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

• Journal of Korea Association of Health Promotion
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• v.2 no.2
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• pp.187-197
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• 2004

Owing to continuous economic growth, an increased standard of living, and improvements to health care in Korea, the life expectancy of Koreans rose from 69.0 years in 1985 to 71.3years in 1990. It continued to rise throughout the 1990s, and, by 2002, had reached 76.5years for the general population and 80.0 years for Korean females. Similarly, the percentage of the Korean population that is 65 years of age or older increased from 3.1 in 1970 to 7.1in 2000, and is expected to reach approximately 14,0 in 2019. Thus, according to this estimate, Korea will have evolved from an "aging society" to an "aged society" in only 19years. In the case of other countries, this same transformation has generally taken 2 to 5times longer. One of the major issues related to Korea's rapidly aging population relates to the health problems of the elderly. According to the 2002 National Health Survey Report, 87,6 percent of the elderly were reported to Have at least one chronic disease. In other words, almost 9out of every 10 elderly persons in Korea were suffering from a chronic illness, This, clearly, places a significant economic burden on Korean society in the form of increased health care Costs. This paper examines the increasing prevalence of chronic diseases within Korea's rapidlv aging population and offers some possible short- and long-term solutions to cope with the increased burden being placed on Korea's health care system. These include the basic services at local health centers for the elderly and the national life-long health promotion programs that aim to correct unhealthy behavior, such as smoking, the excessive use of alcohol, and poor eating and exercise habits.

• Journal of Korean Academy of Nursing
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• v.37 no.5
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• pp.790-800
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• 2007

Purpose: This study was to identify knowledge, perception and health behavior about metabolic syndrome for an at risk group in a rural community area. Methods: A descriptive cross-sectional survey design was used. A total of 575 adults with hypertension, diabetes mellitus, dyslipidemia, and/or abdominal obesity were recruited from 11 rural community health care centers. A questionnaire was developed for this study. Anthropometric measures were measured and blood data was reviewed from the health record. Results: Knowledge about the metabolic syndrome was low as evidenced by only a 47% correct answer rate. Only 9% of the subjects ever heard about the disease, and 87% answered they do not know the disease at all. 87% of the subjects were not performing regular exercise, 31% drank alcohol more than once a month, 12.5% were current smokers, and 33.6% are did not have a regular health check-up. Conclusion: Development of systematic public health care programs are needed to prevent future increases in cardiovascular complications and to decrease health care costs. These might include educational programs for the primary health care provider and an at risk group, a therapeutic lifestyle modification program, and a health screening program to identify potential groups.

• Journal of Nutrition and Health
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• v.36 no.10
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• pp.1083-1093
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• 2003

Efficient financial management is a critical factor in achieving school foodservice goals. The objective of this study was to suggest efficient financial management practices in secondary school foodservices. In pursuit of this objective, we first identified performance indexes for measuring the success of financial management. Second, we suggested financial management standards, financial data classification methods and a report system. Last, we analyzed operating ratios with the financial data of self-operated and contract-managed school food services. The data were collected through an open-ended questionnaire from 10 middle/high school foodservices in Seoul and Kyeonggi Provincial during on-sites visits and interviews with dieticians and managers. Student participation, sales goals, re-contract frequency and number and cost of disaster loss were identified as the performance indexes for financial management. Income statements were compiled by identifying and classifying financial data. Total revenues consisted of subsidies, meal sales, other revenue and interest. Expenditures consisted of purchased food, salaries and wages, utility costs, office supplies, kitchen supplies, purchased services, company overhead indirect costs, facility investment and maintenance, facility usage expenses, employee benefits and miscellaneous. Mean price of a meal was 2,326 won at self-operated foodservices when the subsidies were included as revenues and 2,360 won at contract-managed foodservices. When including the subsidies as revenues, the operating ratios of self-operated foodservice showed that the food cost percentage was 66.9％, labor cost 23.2％, operation cost 9.9％ and profit 0％. The correspond figures at contract-managed foodservices were 57.6％, 21.5％, 15.3％, and 5.5％, respectively. Food costs in self-operated foodservices was significantly higher than that for contract-managed foodservices, however, facility investment and maintenance and facility usage expenses at self-operated foodservices was significantly lower than those for contract-managed foodservices. Based on this study, the methodology and classification system of financial data was found to be applicable to assess the financial structure of school foodservices.

• The Journal of the Convergence on Culture Technology
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• v.5 no.4
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• pp.137-145
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• 2019

Among the participants of the 2012 Korea Medical Panel survey, 308 people who have used emergency, hospitalization and outpatient services for cancer have been selected. The average annual direct cost per cancer patient was analyzed by adding up the patient's medical expenses, industrial copayments, and non-salary costs. The average annual direct direct cost of cancer spent by cancer patients is about 129,093,792 per male, 158,100,612 won for men and 110,482,075 for women.For those with health insurance, the total direct cost per person from cancer was 183,095,125 won and the beneficiaries were 46,241,705 won. By household income, the average annual direct direct costs per person were 112,459,971 won per patient in the household income quartile, 137,910,890 won for patients in the second quartile, 149,556,570 won in the third quartile and 112,730,461 won, quartile 5, respectively.Was 142,926,331 won.

• Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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• v.6 no.2
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• pp.35-44
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• 2016

MICE industry is emerging as a new growth engine recently. Most of the domestic MICE events are carried out at low cost on a small scale. The event organizers want to cut down on costs of prints such as brochures and other promotional printed materials, as well as the personnel costs for the simple guide job needed on site, which are generated repeatedly and wastefully. The existing mobile web has a defect that the participants can't easily earn the information in the fixed menu, but have to search by themselves wasting lots of time. Therefore, it is necessary to develop the solution enables providing information efficiently at low cost for short-term use during the events. In this study, we implemented specific total management system for exhibitions and convention using beacon. The information system for exhibitions and events using beacon can raise the management efficiency, and the digital brochure function based on CMS heightens the information retrieval ability and also reduces costs. Organizers can manage their event efficiently in a small exhibition and convention event by running an online website and operate a site management system by them selves.

• Journal of Microbiology and Biotechnology
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• v.33 no.11
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• pp.1531-1541
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• 2023

Lipase is a well-known and highly in-demand enzyme. During the last decade, several lipase optimization studies have been reported. However, production costs have always been a bottleneck for commercial-scale microbial enzyme production. This research aimed to optimize the conditions for lipase production by Limtongozyma siamensis DMKU-WBL1-3 via a One-Factor-At-a-Time (OFAT) approach combined with statistical methods while using a low-cost substrate. Results suggest that low-cost substrates can be substituted for all media components. An optimal medium was found, using response surface methodology (RSM) and central composite design (CCD), to consist of 0.50% (w/v) sweet whey, 0.40% (w/v) yeast extract (food grade), and 2.50% (v/v) palm oil with the medium pH adjusted to 4 under shaking flask cultivation. From an economic point of view, this work was successful in reducing production costs while increasing lipase productivity. The medium costs were reduced by 87.5% of the original cost while lipase activity was increased by nearly 6-fold. Moreover, lipase production was further studied in a 2-L stirred-tank fermentor. Its activity was 1,055.6 ± 0.0 U/ml when aeration and agitation rates were adjusted to 1 vvm and 170 rpm, respectively. Interestingly, under this optimal lipase production, the yeast showed accumulated lipids inside the cells. The primary fatty acid is a monounsaturated fatty acid (MUFA) that is typically linked to health benefits. This study hence reveals promising lipase production and lipid accumulation by L. siamensis DMKU-WBL1-3 that are worthy of further study.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.6
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• pp.119-128
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• 2017

This study estimated the optimal nursing workforce and financial costs of providing comprehensive nursing services at hospitals under the national health insurance system. Data on registered nurses, nursing aids, medical institutions, and number of patients were obtained from the Health Insurance Review and Assessment Service. The optimal size of the nursing workforce was calculated using the workload model. A bottom-up approach was used to estimate the annual total financial cost of comprehensive nursing services. The number of registered nurses and nursing aids would need to be increased by 81.75% and 83.23%, respectively, in order to fully apply comprehensive nursing care on a national scale. The additional financial costs for comprehensive nursing services at all hospitals was estimated to be as much as 110.39% of the current cost. For the comprehensive nursing service, nurses with a career and newcomers need to be retained at their hospitals, and the validity of the nurse-patient ratio should be continuously checked. The financial shock to the national health insurance system could be minimized by gradually extending the system to all hospitals.