• Journal of the Korea Convergence Society
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• v.8 no.12
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• pp.149-157
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• 2017

Unnecessary readmissions could be the result of the inadequate and unnecessary treatments. Adequate quality indicators for readmission are important because they can identify inadequate spending by inpatients as well as quality screening. This study attempted to estimate the cost incurred by unnecessary readmissions. The Health Insurance Claims Data of 18 years or older who were admitted in the tertiary hospitals in 2014 were analyzed. Admissions and readmissions were sorted and readmissions were classified into planned and unplanned readmissions. We adopted 28 days as a criteria for the classification of the readmission. Proportion of the patients were higher in readmissions among cancer, accompanied diseases, and special rehabilitation patients. Cost of the readmissions were 50% of the total cost of the admission among the patients of same diseases, same departments, and same hospitals. Almost 1,000billion Won were used by the unnecessary readmissions. We need to reduce the readmissions in regions, departments, and diseases studying the pattern of the readmissions. National level efforts are required to improve quality of care and reduce cost by the unnecessary readmissions.

• Proceedings of the Korean System Dynamics Society
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• 2008.05a
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• pp.11-24
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• 2008

의료의 산업화는 의료비의 상승을 가져올것인가. 이것은 전세계적으로 중요한 문제이다. 국민의료비가 지속적으로 상승할 경우 국가의 발전에 적지 않은 부담이 되기 때문이다. 이에의료산업화의 한 큰 조류인 병원영리화와 의료비의 상승의 관계를 연구하였다. 찬성과 반대의 논의가 한 시스템에서 어떻게 조화를 이루고 상생을 할 수 있을지에 대해서 연구를 하였다. 찬성과 반대가 별도의 주장이 아닌 한 시스템내에서 조화롭게 선순환에 참여 될 수 있는 연구결과를 제시한다. 본 연구를 통해서 다음과 같은 사항을 알 수 있다. 의료와 민간의료를 분리시키고, 영리병원이 아닌 연구중심의 민간영리병원이 더욱 효과적이며, 전국민의료의 실시는 상승하는 의료비를 완화시키고 동시에 서비스의 다양화와 고급화를 이룰 수 있으며 국부창출에도 도움이 될 것이다.

• Health Policy and Management
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• v.27 no.4
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• pp.359-365
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• 2017

Background: Computed tomography (CT) is one of the most efficient diagnostic methods for stroke patients. The number of CT scanners in South Korea, however, is higher than in other countries, and may cause the overuse of this tool in healthcare. We aim to study the relationship between using CT and various patient and hospital characteristics among patients with cerebral infarction. Methods: We analyzed nationwide health insurance claims data for patients due to cerebral infarction during the second half of 2013 for up to 3 months. We performed multilevel analysis, including both inpatient and hospital-level variables, to determine how factors affect CT spending and utilization. Results: The data used in our study consisted of 17,046 hospitalizations at 583 hospitals. Inpatients who visited more than one hospital had higher CT utilization numbers and cost (number: ${\geq}3$: ${\beta}$ hospitals, 2.27; p < 0.05; 2 hospitals: ${\beta}$, 0.70; p < 0.05; cost: ${\geq}3$ hospitals: ${\beta}$, 251,108; p < 0.05; 2 hospitals: ${\beta}$, 77,299; p < 0.05). People who visited a general hospital had higher numbers and cost of CT utilization than people who visited a smaller hospital. Conclusion: Increased sharing of records and improved continuity of care between hospitals are needed to help curb the overuse of CT.

• The Journal of the Korea Contents Association
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• v.16 no.10
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• pp.411-419
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• 2016

This study tried to find the relationship between household income level and medical expense to household income ratio. For data analysis, it used 2010 and 2011 yearly data beta version of Korea Health Panel, co-managed by Korea Institute for Health and Social Affairs and National Health Insurance Corporation. To find out how the effect of independent variable changes in 2010 and 2011, the interaction effect between year and independent variable was examined, and separating the factors that showed interaction effect into each year, linear regression analysis was conducted using generalized estimating equations method. As a result of reviewing the factors that were related to medical expense to household income ratio among the people who used medical services, it was found that the higher the household income level, the lower the medical expense. It indicates that policy measures are needed to lessen the medical burden of low-income families.

• Health Communication
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• v.13 no.2
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• pp.159-166
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• 2018

Background: It is important to investigate patient satisfaction to improve the quality of healthcare. Among the many factors that affect patient satisfaction, perceived health status has been considered as one of the major factors. Therefore, we investigated patient satisfaction through patient experience in outpatient settings according to perceived health status. Methods: This cross-sectional study using questionnaires of patient experience and perceived health status from the Korean National Health and Nutrition Examination Survey 2015 included 4267 people aged over 19 years who met the inclusion criteria. Perceived health status was classified into three: good, fair, and poor. Questions about patient experience consisted of four items: doctor spending enough time with patients, doctor providing easy-to-understand explanation, doctor giving opportunity to ask questions or raise concerns, and doctor involving patient in decisions about care or treatment. Patient experience was classified into two: satisfied and non-satisfied. A multivariate regression model was used to analyze the data. Results: In the good perceived health status group, level of satisfaction was 79.2%, 88.5%, 83.3% and 87.2%, respectively for the four items targeting patient experience. In the poor group, level of satisfaction was 76%, 84.9%, 79.5%, and 83.1%, respectively for the four items. In multivariate logistic regression analyses, the odds ratios of good perceived health status group were 1.775 (1.347-2.338), 1.946 (1.356-2.793), 1.652 (1.218-2.240), and 1.665 (1.193-2.323) compared with the poor group. Conclusion: Perceived health status is associated with patient satisfaction. In particular, the better the perceived health status, the better the patient satisfaction through patient experience.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.14 no.1
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• pp.167-185
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• 2019

As most G-20 countries expect medical spending to grow rapidly over the next few decades, the burden of healthcare costs continues to grow globally due to an increase in the elderly population and chronic illnesses, and the ongoing quality improvement of health care services. However, under the rapidly changing technological environment of healthcare and IT convergence, the problem may become even bigger if not properly recognized and not properly prepared. In the context of the paradigm shift and the increasing problem of the medical field, complex responses in technical, institutional and business aspects are urgently needed. The key is to derive a business model that is appropriate for businesses that integrate IT in the medical field. With the arrival of the era of the 4th industrial revolution, new technologies such as Internet of Things have been applied to eHealthcare, and the need for new business models has emerged.In the e-healthcare of the Internet era, it became a traditional firm-based business model. However, due to the characteristics of dynamics and complexity of things Internet in the Internet of things, A business ecosystem-based approach is needed. In this paper, we present and analyze the major success factors of the ecosystem based on the 3 - layer structure of the e - healthcare business ecosystem as a result of research on e - healthcare business ecosystem based on emerging technology such as Internet of things. The three-layer business ecosystem was defined as (1) Infrastructure Layer, (2) Character Layer, and (3) Stakeholder Layer. As the key success factors for the eHealthCare business ecosystem, the following four factors are suggested: (1) introduction of the iHealthcare concept, (2) expansion of the business ecosystem, (3) business ecosystem change process innovation, and (4) business ecosystem leadership innovation.

• Journal of the Korea Fashion and Costume Design Association
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• v.14 no.2
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• pp.199-214
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• 2012

$21^{st}$ century customer is voluntary actor, who has hegemony of communication based on digital surrounding. They are co-creator dismantling boundary between production and spending, and digital homonarrance of digital storyteller acting on the emotion. What is more, they prove the utility of 5 sense, value, experience, and story in market. 20th century Me generation is changing into We generation, who overcomes a sense of alienation and aim at smart life style for harmonious symbiosis with earth environments. Customer cultural trends are as follow as that 1) personalization of taste and experience, 2) spreading and sharing about personal use and experience, 3) consumption centered the value, 4) retreat and healthcare, 5) counter trend comes into the reaction about the forceful major trend. Contemporary customer changes essence of the life on the ground of emotion, symbol, image, and value not a commodity, function, and logos, and demands into change about direction of business to mostly enterprises. Customer's need and desire are on the increase as various emotion and value. Therefore, change of customer cultural trend is barometers for the growth and development of new fashion industry in $21^{st}$ century.

• Health Policy and Management
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• v.23 no.2
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• pp.132-144
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• 2013

Background: The purpose of this study was to analyze the medical expense change and influencing factors after introducing longterm care insurance system. The study period was 2 years before and after introduction of the system. Methods: We analyzed data collected from two divided group lived in Incheon. Four hundred and eighty-five elderly who received long-term care wage for one year were selected for experimental group. For control group, 1,940 elderly were selected by gender and age stratified random sampling. Difference-In-difference analyses was used for evaluating policy effectiveness. Also multiple regression analyses were conducted to identify the factors associated with total medical expenditures. The control variables were demographic variables, economic status, diseases, and medical examination variables. Results: Difference-in-difference analyses showed that total average medical expenses among long-term patients has decreased by 61.85%. Of these, the hospitalization expenses have decreased by 91.63% and the drug expenses have increased by 31.85%. Multiple regression analyses results showed that total average medical expenses among long-term patients have significantly decreased by 46.5% after introducing the long-term care insurance. The hospitalization expenses have significantly decreased by 148.5%, whereas the drug expenses have increased by 53.6%. And outpatient expenses have increased by 10.4%, but the differences were not statistically significant. Conclusion: The results showed that total medical expenses and hospitalization expenses have decreased after introducing the long-term care insurance. These results could support the opinion that the health insurance spending among long-term patients will be reduced gradually by long-term care insurance through changing medical demand.

• Korean Journal of Clinical Pharmacy
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• v.27 no.4
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• pp.228-237
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• 2017

Objective: We conducted a survey to understand the current state of pharmacy services and pharmacists' thoughts in the future of the community pharmacy setting. Methods: A questionnaire was distributed to 229 pharmacists and gathered from 95 respondents. Results: We asked to pharmacists about what the ideal pharmacy duty should be in the next 10 years at the community pharmacy setting in Korea. For this question, the respondents said drug counselling (19.4%), dispensing (13.8%), long-term care of chronic disease and healthcare education (12.8%), and OTC counselling (11.5%). When asked about how much time they were spending doing certain tasks in the pharmacy, the main tasks were dispensing (23.5%), counselling (17.1%), prescription review (10.1%), and OTC counselling (5.5%). When asked about what the most important duty of a pharmacist was, medication counselling (45.4%) was the most important task that they identified and the reasons for not being able to fulfill this role properly was time shortage (78.9%) followed by the lack of counselling spaces, up-to-date knowledges, and focus on financial gains over patient counselling. Conclusion: Korean pharmacists are mainly focusing on dispensing in their daily work. Their basic responsibilities can be easily mechanized over the next few years, but the social expectations of disease-prevention and public health promotion both in current and future can not be replaced by such mechanical measures. Therefore, pharmaceutical services in Korea should be developed in more diverse and professional ways.

• Health Policy and Management
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• v.16 no.1
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• pp.17-40
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• 2006

With the prospect of rapidly growing health insurance expenditures, particularly spending for ambulatory care, the introduction of a case-based payment method is discussed as an alternative to the current fee-for-service based method. A system to measure case mixes of providers is a core component of such payment systems. The objective of this study were to develop a classification system for ambulatory care, Korean Ambulatory Patient Group (KAPG) based on the U.S. APG version 2.0 and to evaluate the classification accuracy of the system. A database of 64,258,386 records was constructed from insurance claims submitted to the Health Insurance Review Agency (HIRA) during three months from August 2002. A total of 41,347,307 records with a single visit was used for the development and 7% random sample of the database was used for the evaluation. Additional groups were defined to include both physician and hospital fees in the classification, age splits were added to classify the entire population as well as the population older than 65, and the definition of medical groups used by the HIRA was adopted. The variance reduction in charges achieved by KAPGs was computed to evaluate the accuracy of classification. A total of 474 KAPGs was defined compare to 290 groups in the U.S. APG. The variance reduction for charges of all visits ranged from 20% to 37% depending on the type of provider, and ranged from 22% to 42% for non-outliers, that were better than those achieved by the system currently used by the .HIRA for its internal review purpose. Although further study is required to improve the classification for complicated care in larger hospitals, the results indicated that KAPGs could be used for better management of costs for ambulatory care.