• Journal of Preventive Medicine and Public Health
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• v.11 no.1
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• pp.123-127
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• 1978

The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.

• Journal of the Korea Convergence Society
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• v.11 no.11
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• pp.321-335
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• 2020

Given that with the development of the 4th industry, interest and desire for smart cities are gradually increasing and related technologies are developed as a way to strengthen urban competitiveness by utilizing big data, information and communication technology, IoT, M2M, and AI, the purpose of this study is to find out how to achieve this goal on the premise of the idea of smart well fair city. In other words, the purpose is to devise a smart well-fair city in the care area, such as health care, medical care, and welfare, and see if it is feasible. With this recognition, the paper aimed to review the concept and scope of smart city, the discussions that have been made so far and the issues or limitations on its connection to social security and social welfare, and based on it, come up with the concept of welfare city. As a method of realizing the smart welfare city, the paper reviewed characteristics and features of a social security platform as well as the applicability of smart city, especially care services. Furthermore, the paper developed discussions on the standardization of the city in terms of political and institutional improvements, utilization of personal information and public data as well as ways of institutional improvement centering on social security information system. This paper highlights the importance of implementing the digitally based community care and smart welfare city that our society is seeking to achieve. With regard to the social security platform based on behavioral design and the 7 principles(6W1H method), the present paper has the limitation of dealing only with smart cities in the fields of healthcare, medicine, and welfare. Therefore, further studies are needed to investigate the effects of smart cities in other fields and to consider the application and utilization of technologies in various aspects and the corresponding impact on our society. It is expected that this paper will suggest the future course and vision not only for smart cities but also for the social security and welfare system and thereby make some contribution to improving the quality of people's lives through the requisite adjustments made in each relevant field.

• The Korean Society of Law and Medicine
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• v.18 no.1
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• pp.237-264
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• 2017

With the onset of the Human Genome Project, social concerns about 'genetic information discrimination' have been raised, but the problem has not yet been highlighted in Korea. However, non-medical institutions' genetic testing which is related to disease prevention could be partially allowed under the revised "Bioethics and Safety Act" from June 30, 2016. In the case of one domestic insurance company, DTC genetic testing was provided for the new customer of cancer insurance as a complimentary service, which made the social changes related to the recognition of the genetic testing. At a time when precision medicine is becoming a new standard for medical care, discipline on genetic information discrimination has become a problem that can not be delayed anymore. Article 46 and 67 of the Bioethics Act stipulate the prohibition of discrimination on grounds of genetic information and penalties for its violation. However, these broad principles alone can not solve the problems in specific genetic information utilization areas such as insurance and employment. The United States, Canada, the United Kingdom, and Germany have different regulations that prohibit genetic information based discrimination. In the United States, Genetic Information Non-Discrimination Act takes a form that adds to the existing law about the prohibition of genetic information discrimination. In addition, the range of genetic information includes the results of genetic tests of individuals and their families, including "family history". Canada has recently enacted legislation in 2017, expanding coverage to general transactions of goods or services in addition to insurance and employment. The United Kingdom deals only with 'predictive genetic testing results of individuals'. In the case of insurance, the UK government and Association of British Insurers (ABI) agree to abide by a policy framework ('Concordat') for cooperation that provides that insurers' use of genetic information is transparent, fair and subject to regular reviews; and remain committed to the voluntary Moratorium on insurers' use of predictive genetic test results until 1 November 2019, and a review of the Concordat in 2016. In the case of employment, The ICO's 'Employment Practices Code (2011)' is used as a guideline. In Germany, Human Genetic Examination Act(Gesetz ${\ddot{u}}ber$ genetische Untersuchungen bei Menschen) stipulates a principle ban on the demand for genetic testing and the submission of results in employment and insurance. The evaluation of the effectiveness of regulatory framework, as well as the form and scope of the discipline is different from country to country. In light of this, it would be desirable for the issue of genetic information discrimination in Korea to be addressed based on the review of related regulations, the participation of experts, and the cooperation of stakeholders.

• Journal of Internet Computing and Services
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• v.16 no.2
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• pp.109-115
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• 2015

The new medical device technologies for bio-signal information and medical information which developed in various forms have been increasing. Information gathering techniques and the increasing of the bio-signal information device are being used as the main information of the medical service in everyday life. Hence, there is increasing in utilization of the various bio-signals, but it has a problem that does not account for security reasons. Furthermore, the medical image information and bio-signal of the patient in medical field is generated by the individual device, that make the situation cannot be managed and integrated. In order to solve that problem, in this paper we integrated the QR code signal associated with the medial image information including the finding of the doctor and the bio-signal information. bio-signal. System implementation environment for medical imaging devices and bio-signal acquisition was configured through bio-signal measurement, smart device and PC. For the ROI extraction of bio-signal and the receiving of image information that transfer from the medical equipment or bio-signal measurement, .NET Framework was used to operate the QR server module on Window Server 2008 operating system. The main function of the QR server module is to parse the DICOM file generated from the medical imaging device and extract the identified ROI information to store and manage in the database. Additionally, EMR, patient health information such as OCS, extracted ROI information needed for basic information and emergency situation is managed by QR code. QR code and ROI management and the bio-signal information file also store and manage depending on the size of receiving the bio-singnal information case with a PID (patient identification) to be used by the bio-signal device. If the receiving of information is not less than the maximum size to be converted into a QR code, the QR code and the URL information can access the bio-signal information through the server. Likewise, .Net Framework is installed to provide the information in the form of the QR code, so the client can check and find the relevant information through PC and android-based smart device. Finally, the existing medical imaging information, bio-signal information and the health information of the patient are integrated over the result of executing the application service in order to provide a medical information service which is suitable in medical field.

• Journal of Korea Entertainment Industry Association
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• v.13 no.8
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• pp.411-424
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• 2019

The purpose of this study is to explore the feasible policy directions for sports welfare that can not only improve the standard of living through health but also ensure a happy and enjoyable life for the people of Gangwon Province. For this purpose, I have conducted studies such as the analysis on the sports class voucher project being implemented by the South Korean government and the case analysis in sports welfare, and present policy directions as follows. First of all, it is about upgrading the sports class voucher project. And as its implementation plans, I suggest ① increased publicity, ② the earmarking of the province's own budget for the sports class voucher project, ③ the establishment of a system for cooperation for work implementation between the related organizations and their staff in charge with a view to activating the sports class voucher project, and ④ the upgraded services for the sports class voucher project and the upgraded access to the life cycle-based universal welfare. Second, it is about using public sports facilities and developing various programs. I suggest the active utilization of the public sports facilities that enable people to learn the skills for such sports disciplines as baseball, badminton, ice sports, and golf and the development and distribution of distinctive educational programs for dance for media entertainment shows for female youths, climbing, cheer leading, fencing, surfing and horseback riding. Third, it is about nurturing the human resources and networking. For this, I suggest the creation of 'Sports Welfare Specialist Training Program' and the training of the college students majoring in sports science with the aim of creating a number of jobs. Fourth, it is about refurbishing the system and establishing the support system. I suggest the dismantling of the partitions in the welfare policy related to sports activities and the formation of (tentatively named) 'Gangwon Province Sports Welfare Implementation Committee', and the creation of (tentatively named) 'Sports Welfare Project Support Team' in Health, Welfare & Women's Affairs Bureau or Culture, Tourism and Sports Bureau in the short term and then its long-term expansion into (tentatively named) 'Gangwon Province Sports Welfare Support Center' in responding to the needs that reflect the provincial demographics, with a view to establishing a single lineup for the administrative support system. Furthermore, as budget and manpower are needed to realize customized sports welfare that suits the characteristics of the province and in which all the provincial residents can collect benefits, I suggest that the province provide the legal basis through creating 'Ordinance Promoting Sports Welfare in Gangwon Province' and pushing forward with (tentatively named) 'Gangwon Province Sports Welfare Competition' as what revises the sports class voucher project for the purpose of broadening the basis for sports welfare promotion.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.13 no.4
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• pp.59-72
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• 2018

The purpose of this study is to investigate the factors affecting the intention to use healing farming by setting aged readiness, rural healing supply condition, and rural healing service as independent variables. This study has been started based on the idea that it is necessary to provide healing service through healing agriculture to the rapidly increasing elderly people and urban people who need mental rest. Therefore, the purpose of this study is to find out the various factors influencing intention to use healing agriculture through empirical analysis. Second, we want to examine whether the variables influenced the intention to use more. Third, based on the results of these tests, we suggest the policy for activation of healing agriculture by examining the factors necessary for the promotion of physical and mental health of the elderly in the aging society and the revitalization of healing agriculture for the mental healing of the urban people. For this study, a questionnaire survey was conducted for men and women over 30 years old, and the final 356 copies were analyzed. The validity of the research hypothesis was verified by linear regression analysis. The results of the analysis are as follows. First, the physical preparation, emotional preparation, and economic preparation of aged care preparations were found to have a significant effect on intention to use. Second, natural landscape, accessibility, and stability of rural healing supply conditions were found to have a significant effect on intention to use. But economics and expertise were dismissed. Third, crop cultivation, animal medication and healing facilities of rural healing service were proved to have significant influence on intention to use. In order to increase the utilization of healing agriculture, it is necessary for the consumer to be well prepared for aging. In rural healing supply conditions, accessibility and safety should be provided for healing facilities in rural healing services.And to increase the intention to use it.