• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.3
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• pp.1920-1927
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• 2015

This study examined health insurance costs of occupational therapy in stroke patients. The subjects were stroke patients, who underwent occupational therapy by hospitalization or out-patient centers in 2010. The cost of occupational therapy was analyzed from the insurance claims data of Health Insurance Review and Assessment Service in 2010. The kinds of occupational therapy were divided according to the insurance fee of occupational therapy in 2010. In-patients who received occupational therapy paid the highest rehabilitation treatment fee, whereas outpatients paid the highest nervous system function test fee. The cost of occupational therapy in the special rehabilitation treatment fee was highest by 25.3 billion won. The number of uses of general hospitals was the highest by 180 thousand but the total cost of long-term care hospital was highest by 10.4 billion won. The number of uses and cost by regional groups was highest in Seoul and Gyeonggi-do province. This study is meaningful in that a cost analysis of occupational therapy in stroke patients was performed for the first time using the stroke data from the whole country. The result can be used to provide basic data to improve the insurance fee in the future.

• Journal of Home Health Care Nursing
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• v.3
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• pp.75-85
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• 1996

Nursing Intervention Classification(NIC) includes the 433 intervention lists to standardize the nursing language. Efforts to standardize and classify nursing care are important because they make explicit what has previously been implicit, assumed and unknown. NIC is a standardized language of both nurse-initiated and physician-initiated nursing treatments. Each of the 433 interventions has a label, definition and set of activities that a nurse does to carry it out. It defines the interventions performed by all nurses no matter what their setting or specialty. Principles of label, definition and activity construction were established so there is consistency across the classification. NIC was developed for following reasons; 1. Standandization of the nomen clature of nursing treatments. 2. Expansion of nursing knowledge about the links between diagnoses, treatments and outcomes. 3. Devlopment of nursing and health care information systems. 4. Teaching decision making to nursing students. 5. Determination of the costs of service provided by nurses. 6. Planning for resources needed in nursing practice settings. 7. Language to communicate the unigue function of nursing. 8. Articulation with the classification systems of other health care providers. The process of NIC development ; 1. Develop implement and evaluate an expert review process to evaluate feedback on specific interventions in NIC and to refine the interventions and classification as feedback indicates. 2. Define and validate indirect care interventions. 3. Refine, validate and publish the taxonomic grouping for the interventions. 4. Translate the classification into a coding system that can be used for computerization for articulation with other classifications and for reimbursement. 5. Construct an electronic version of NIC to help agencies in corporate the classifiaction into nursing information systems. 6. Implement and evaluate the use of the classification in a nursing information system in five different agencies. 7. Establish mechanisms to build nursing knowledge through the analysis of electronically retrievable clinical data. 8. Publish a second edition of the nursing interventions classification with taxonomic groupings and results of field testing. It is suggested that the following researches are needed to develp NIC in Korea. 1. To idenilfy the intervention lists in Korea. 2. Nursing resources to perform the nursing interventions. 3. Comparative study between Korea and U.S.A. on NIC. 4. Linkage among nursing diagnosis, nursing interventions and nursing outcomes. 5. Linkage between NIC and other health care information systems. 6. determine nursing costs on NIC.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2533-2540
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• 2013

Background: Although screening is necessary where gastric cancer is particularly common in Asia, the performance outcomes of mass screening programs have remained unclear. This study was conducted to evaluate cost-effectiveness outcomes of the national cancer screening program (NCSP) for gastric cancer in South Korea. Materials and Methods: People aged 40 years or over during 2002-2003 (baseline) were the target population. Screening recipients and patients diagnosed with gastric cancers were identified using the NCSP and Korea Central Cancer Registry databases. Clinical outcomes were measured in terms of mortality and life-years saved (LYS) of gastric cancer patients during 7 years based on merged data from the Korean National Health Insurance Corporation and National Statistical Office. We considered direct, indirect, and productivity-loss costs associated with screening attendance. Incremental cost-effectiveness ratio (ICER) estimates were produced according to screening method, sex, and age group compared to non-screening. Results: The age-adjusted ICER for survival was 260,201,000-371,011,000 Korean Won (KW; 1USD=1,088 KW) for the upper-gastrointestinal (UGI) tract over non-screening. Endoscopy ICERs were lower (119,099,000-178,700,000 KW/survival) than UGI. To increase 1 life-year, additional costs of approximately 14,466,000-15,014,000 KW and 8,817,000-9,755,000 KW were required for UGI and endoscopy, respectively. Endoscopy was the most cost-effective strategy for males and females. With regard to sensitivity analyses varying based on the upper age limit, endoscopy NCSP was dominant for both males and females. For males, an upper limit of age 75 or 80 years could be considered. ICER estimates for LYS indicate that the gastric cancer screening program in Korea is cost-effective. Conclusion: Endoscopy should be recommended as a first-line method in Korea because it is beneficial among the Korean population.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1580-1591
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• 2000

This study was conducted to assess the amount of nursing services for psychiatric inpatients and to estimate psychiatric nursing costs by using the RBRVS. Full details of medical services, including physician and nursing services, for psychiatric inpatients were surveyed and data of general characteristics of hospitals and patients were also collected. The cost of nursing activities was estimated by the multiple conversion factor which was drawn from the Korean RBRVS Development Project to the RBRVS score of each nursing activities, which was drawn from the results of Korean Nurses Association (KNA)'s projects about nursing RBRVS development and cost of nursing activities. The data about 89 inpatients from 3 general hospitals with psychiatric departments were analyzed. The total cost of nursing activities for each patient per admission day was from KRW 22,185 to KRW 27,954 by hospital, and KRW 25,220 in average. The percent of nursing cost to the total cost of medical services was from 36% to 48% by characteristics of patients and 41.4% in average. The cost of nursing activities estimated in this study was between the existing NHI fee schedule and the one suggested by KNA. It is considered as appropriate and acceptable level compared to the total amount of medical services. In the process of KNA's activities to get nursing fee in NHI fee schedule, results of additional studies to estimate the cost of nursing activities balanced with total cost of medical services in every departments should be found and utilized.

• Korean Journal of Agricultural Science
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• v.43 no.5
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• pp.761-768
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• 2016

Recently, swine production costs have increased due to increased feed cost, especially the price of corn and soybean meals. Soybean meal is traditionally an expensive ingredient, but the price of corn has dramatically increased because of increased biofuel production. This change has resulted in the swine industry looking for alternatives in order to reduce feed cost, resulting in decreased production costs. Thus, various alternatives have been used as feed ingredients to replace corn, soybean meal, or other expensive ingredients. One othercandidate may be palm kernel co-products that are a by-product of oil extraction from palm fruits. Palm kernel co-products have not been used in swine diets due to high fiber content and imbalanced amino acids compared with corn and soybean meal. However, recent studies showed that palm kernel co-products did not have any negative effects on growth performance of pigs when they replaced some proportions of corn and soybean meal. In addition, palm kernel co-products may provide some physiological properties to pigs by modifying gut microbiota and/or immunity of pigs, resulting in improvement of growth and health of pigs. Therefore, the value of palm kernel co-products were reviewed as one of the alternatives for corn, soybean meal, or other major ingredients in swine diets.

• Journal of Korean Academy of Nursing
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• v.42 no.3
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• pp.351-360
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• 2012

Purpose: The purpose of this study was to propose optimal hospitalization fees for nurse staffing levels and to improve the current nursing fee policy. Methods: A break-even analysis was used to evaluate the impact of a nursing fee policy on hospital's financial performance. Variables considered included the number of beds, bed occupancy rate, annual total patient days, hospitalization fees for nurse staffing levels, the initial annual nurses' salary, and the ratio of overhead costs to nursing labor costs. Data were collected as secondary data from annual reports of the Hospital Nursing Association and national health insurance. Results: The hospitalization fees according to nurse staffing levels in general hospitals are required to sustain or decrease in grades 1, 2, 3, 4, and 7, and increase in grades 5 and 6. It is suggested that the range between grade 2 and 3 be sustained at the current level, the range between grade 4 and 5 be widen or merged into one, and the range between grade 6 and 7 be divided into several grades. Conclusion: Readjusting hospitalization fees for nurse staffing level will improve nurse-patient ratio and enhance the quality of nursing care in hospitals. Follow-up studies including tertiary hospitals and small hospitals are recommended.

• The Journal of Korean Medicine
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• v.37 no.1
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• pp.135-150
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• 2016

Research Methods: This research analyzed the data on those aged 20 and older from the Report on Korean Medicine Usage Research, which was conducted in 2011. The definitions of toxicity were defined by the presence of toxicity listed in the survey. The questions used in analysis were sex, age, household income, health insurance, medical fees, satisfaction rates on treatments, as well as the types of diseases and the presence of toxicity from treatments. The analysis was done through frequency analysis using SAS 9.2 and Fisher's Exact Test. Results: Toxicity occurred in 2.1% patients out of the 3518 studied. The types of toxicity were skin problems, such as hives and pruritus (34.7%), gastrointestinal problems (20.8%), neurological diseases (4.2%), liver(1.4%), kidney toxicity(1.4%), and others (22.2%). There were no differences in toxicity by sex, age, household income and the types of health insurances. However, toxicity were positively correlated with the increase in standard of education (p=0.0124). In addition, as treatment costs increased (p<0.0001) and satisfaction rates decreased, toxicity increased (p<0.0001). Toxicity increased in patients with low back pain (p=0.0429), hwabyung (p=0.0392), lumbar sprain (p=0.0004), correction body type (p=0.0118), growth (p=0.0045), and from motor accidents (p=0.0448). In logistic regression analysis, Toxicity were positively correlated with medical fees, and cancer treatment and negatively correlated with satisfaction rate on treatments. Conclusion: The toxicity that occurred in outpatients who used Korean medical clinics mostly happened in skin, digestive organs, nerves, livers, and kidneys toxicity. The occurrences differed by the Educational lengths, expensive costs of treatments, low satisfaction rates of the treatments, and cancer.

• Health Policy and Management
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• v.9 no.1
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• pp.156-177
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• 1999

The current method of rate adjustment for inflation is based on the evaluation of the financial performance of hospitals. The method has the disadvantage such as too complicated, expensive process as well as low reliability. This study, therefore, develops the 'Korean Medical Insurance Economic Index(MIEI)' as a new model for the rate adjustment with the use of the macro economic indices. In addition, we calculate the 1992∼1998 rate adjustment with the MIEI, and examines the validity of the MIEI by comparing with the conventional method. Medical costs are classified into nine categories : physician salaries, nurse·pharmacist·medical technician salaries, assistants & others salaries, material cost(by imports), material cost(by domestics), depreciation & rent paid(by imports), depreciation & rent paid(by domestics), power utilities, other administrative costs. Then the category weight which is the ratio of category in the total cost is calculated. Macro economic indices are selected for each cost category in order to reflect the concept of the each cost category and inflation during the year of 1992∼1998. Finally MIEI which integrate all category according to the category weight and selected macro indices is calculated. The mean of hospital MIEI which weighting by amount paid by insurers was cacluated. The result from the application of empirical data to the MIEI model is very similar to that of the current method. Furthermore, this method is very simple and also easy to get social consensus. This MIEI model can be replaced the current method based on the analysis of the financial performance for the adjustment of medical fees.

• Journal of Korean Physical Therapy Science
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• v.20 no.1
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• pp.27-35
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• 2013

Background : This study aims to examine the awareness as to the terminological comprehension about the home and visiting physical therapy and the school physical therapy and the need for development as to the associated insurance costs. And the purpose of the study is to provide the basic data in terms of the preparation process for implementation of the related system. Methods : The study conducted the research that targeted the physical therapists, who were working at the rehabilitation hospital located in Seoul and Gyeonggi-do as for the survey questionnaires as to the need and awareness of development of the adequate insurance fee of home physical therapy, visiting physical therapy and school physical therapy. Result : Even though the level of understanding for the terminologies was low, the need for development of insurance fee for home physical therapy, visiting physical therapy and school physical therapy was shown to be high regardless of age and work experience. However, there was not a statistical difference in accordance with age and work experience (p>.05). Conclusion : It directly reflects the result, which hopes home physical therapy, visiting physical therapy and school physical therapy to enter immediately into the frame of system.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2721-2728
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• 2012

Background: There are limited data evaluating the cost-effectiveness of gastric cancer screening using endoscopy or upper gastrointestinal x-ray in the general population. Objective: To evaluate the cost-effectiveness of population-based screening for gastric cancer in South Korea by decision analysis. Methods: A time-dependent Markov model for gastric cancer was constructed for healthy adults 30 years of age and older, and a deterministic sensitivity analysis was performed. Cost-utility analysis with multiple strategies was conducted to compare the costs and effects of 13 different screening alternatives with respect to the following eligibility criteria: age at the beginning of screening, screening interval, and screening method. The main outcome measurement was the incremental cost-effectiveness ratio. Results: The results revealed that annual endoscopic screening from ages 50-80 was the most cost-effective for the male population. In the females, biennial endoscopy screening from ages 50-80 was calculated as the most cost-effective strategy among the 12 screening alternatives. The most cost-effective screening strategy may be adjustable according to the screening costs and the distribution of cancer stage at screening. The limitation was that effectiveness data were obtained from published sources. Conclusions: Using the threshold of $19,162 per quality-adjusted life year on the basis of the Korean gross domestic product (2008), as suggested by the World Health Organization, endoscopic gastric cancer screening starting at the age of 50 years was highly cost-effective in the Korean population. The national recommendation for gastric cancer screening should consider the starting age of screening, the screening interval, and the screening modality.