• Health Policy and Management
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• v.19 no.1
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• pp.81-96
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• 2009

The expansion of long-term care hospitals (LTCHs) is expected to contribute to meeting the long-term care needs of the elderly with chronic diseases in a rapidly aging society. It is also expected to increase efficiency of health resource use and decrease elderly health expenditures by transferring patients from acute care hospitals (ACHs) to LTCHs. This study aimed to empirically examine how the expansion of LTCHs had influences on the length of hospitalization of the elderly in ACHs. Panel regression analysis was employed as an analytic tool using data of the National Health Insurance and the National Statistical Office from 2002 to 2006. The expansion of LTCHs was measured as location quotient (LQ) of LTCHs, denoting the share of LTCHs in a large city or province relative to the share of LTCHs at the national level. In addition, per capita GRDP (gross regional domestic product) and the proportion of population over 65 were included as control variables. The main findings are as follows. First, it was observed that LQ of LTCHs showed a statistically significant negative association with the length of hospitalization of the elderly in ACHs. Second, the negative correlation was evident among general hospitals with over 100 beds while it was not among hospitals with less than 100 beds. Third, LQ of LTCHs had more influences among the elderly over 85. In conclusion, the expansion of LTCHs seems to contribute to decrease in the inpatient cost of the elderly in ACHs and to increase efficiency in the utilization of health resources.

• Environmental Analysis Health and Toxicology
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• v.30 no.sup
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• pp.6.1-6.4
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• 2015

Objectives This study is conducted to estimate the cost paid by the public suffering from disease possibly caused by chemical and to examine the effect on public health. Methods Cost-benefit analysis is an important factor in analysis and decision-making and is an important policy decision tool in many countries. Cost-of-illness (COI), a kind of scale-based analysis method, estimates the potential value lost as a result of illness as a monetary unit and calculates the cost in terms of direct, indirect and psychological costs. This study estimates direct medical costs, transportation fees for hospitalization and outpatient treatment, and nursing fees through a number of patients suffering from disease caused by chemicals in order to analyze COI, taking into account the cost of productivity loss as an indirect cost. Results The total yearly cost of the diseases studied in 2012 is calculated as 77 million Korean won (KRW) per person. The direct and indirect costs being 52 million KRW and 23 million KRW, respectively. Within the total cost of illness, mental and behavioral disability costs amounted to 16 million KRW, relevant blood immunological parameters costs were 7.4 million KRW, and disease of the nervous system costs were 6.7 million KRW. Conclusions This study reports on a survey conducted by experts regarding diseases possibly caused by chemicals and estimates the cost for the general public. The results can be used to formulate a basic report for a social-economic evaluation of the permitted use of chemicals and limits of usage.

• Journal of Korean Academy of Nursing
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• v.5 no.1
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• pp.93-111
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• 1975

As the hospitalized patients will be facing new stress situation due to change of his environment from home to hospital it will be very important to understand the psychological stress experienced by hospital patients not only for helping patients in the process of recovery from illness but also fulfil1ing the objective of comprehensive nursing care by understanding the needs of the patients. There is no doubt that it would be very helpful for treatment of patients as well as for improvement of nursing care if we know more about psychological needs of patients and give them adequate support to meet these needs. The study to find out the causes and degree of stress events experienced by hospitalized patients, with the objective of instituting improvement of nursing care program based on the needs of patients, was conducted during the month of September 1974 with 60 patients randomly selected from those admitted to medical and surgical wards at Yonsei Medical Center in that period The questionnaire form included 36 questions which are considered to be stress events for hospital patients, and was devide into five areas namely, such events related to 1) disease itself, 2) hospital environment, 3) nursing care and treatment, 4) communication and human relations, and 5) family and economic problems. The results of the study were as follows: 1. It was confirmed that hospitalization considered to be a stress producing factor and most patients perceived the admission to hospital as a stress factor. 2. According to the rating scale, it was found that degree of perceived stress shows a variation according to the source of stress producing event. 3. No significant differences in the mean values were observed statistically with the perceived stress levels according to demographic and other variables of patients related to hospitalization. 4. Among the questions related to disease itself, "Admission for surgery" was perceived most frequently as a stress event (97.14%) by patients. 5. With regard to the questions related to hospital environment, "death of the patient room-mate" was the most serious stress event perceived by patients (90%) and "living with hospital regulations"was considered to be less serious stress event (23.33%). 6. As for the questions related to nursing care and treatment, "limitation of freedom" was perceived as a stress factor most frequently (70.91%) by the patients and "worry for wrong treatment" turned out to be less frequent stress event (50.0%). 7. As for the questions related to communication and human relations, "difficulty to meet doctors when wanted"appeared to be the most frequent stress event by the respondents (75.86%) , followed by "no explanation about treatment or examination"(75.0%) and "no explanation about nursing care procedures"(71.66%). 8. With regard 111 tile questions related to family and economic problems, "inadequate finances for family living due to hospitalization"and "high cost of hospitalization" were the most frequent cause of stress mentioned by the patients. (80.0%). 9. As a result of application of the stepwise regression analysis, it was found that about 89% was explained by those events associated with disease itself, hospital environment and family and economic problems. By adding those events related to "nursing care and treatment" and "communication and human relation", 100% of stress associated with hospitalization was explained.

• Health Policy and Management
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• v.15 no.2
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• pp.1-15
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• 2005

The aim of this study was to compare medical cost of hospice care and that of conventional care during the last year of life, and identify factors that influenced the cost. From January to August 2003 592 terminal cancer patients receiving care from 5 hospice care units and 2 hospice care teams in general hospitals were enrolled to case group. Two hundreds and seventy two terminal cancer patients receiving conventional care from 7 general hospitals were enrolled to hospital-based control group, and 1,636 terminal cancer patients from 122 general hospitals located in same regions with the 7 hospitals were enrolled to community-based control. We used characteristics and medical cost from data of National Health Insurance Cooperation. Total medical cost per beneficiary in cases was about 10 millions won, 14.5 millions in hospital-based controls and 11.1 millions in community-based controls. The hospice care saved $45\%$ over the last year of life compared with hospital-based controls (p<0.0001). Saving of inpatient cost account for approximately $80\%$ of saving per beneficiary. Hospice care saved $29\%$ of medical cost per hospitalization day compared with hospital­based controls and $17\%$ compared with community-based controls (p<0.0001). Multiple regression analyses showed that hospice care significantly saved the medical cost. This study suggest that hospice care save medical cost compared with hospital-based control and community-based control. Most of saving of inpatient cost account for approximately $80\%$ of saving of medical cost.

• Korean Journal of Social Welfare Studies
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• v.42 no.2
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• pp.303-322
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• 2011

The increased needs for medical cost containment and the quality of life improvement for the low-income elderly with chronic disease require the complementary relationship between hospital care and community health services. This study investigated the current status of the linkage between Korean hospital care and community services using Seoul Welfare Panel Study(SWPS) data. Logistic regression analysis was used to examine the effects of experiences of hospitalization and outpatient health services on use and needs of community health services. The analysis results indicated that the elderly with chronic disease who have not experienced outpatient health services were unlikely to receive health and social services in the community. Even those who have experienced hospitalization were not provided complementary health services in the community despite the increasing demand.

• Journal of Korea Society of Industrial Information Systems
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• v.28 no.6
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• pp.11-20
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• 2023

The cost of medical treatment for motor vehicle accidents is increasing every year. In this study, we created a model to predict long-term hospitalization(more than 18 days) among minor patients, which is the main item of increasing traffic accident medical expenses, using five algorithms such as decision tree, and analyzed the factors affecting long-term hospitalization. As a result, the accuracy of the prediction models ranged from 91.377 to 91.451, and there was no significant difference between each model, but the random forest and XGBoost models had the highest accuracy of 91.451. There were significant differences between models in the importance of explanatory variables, such as hospital location, name of disease, and type of hospital, between the long-stay and non-long-stay groups. Model validation was tested by comparing the average accuracy of each model cross-validated(10 times) on the training data with the accuracy of the validation data. To test of the explanatory variables, the chi-square test was used for categorical variables.

• Research in Community and Public Health Nursing
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• v.21 no.4
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• pp.375-385
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• 2010

Purpose: This study examined the effects of case management (CM) for Medicaid on healthcare utilization considering the Medicaid system. Methods: Data were extracted from survey data on "Healthcare utilization and health status of Medicaid beneficiaries" conducted in 2007 and 2008 by the Ministry for Health, Welfare and Family Affairs. This study was designed to compare the effects on healthcare utilization between the CM group and the non-CM group. The subjects were 535 Type I Medicaid beneficiaries who utilized healthcare more than 365 days during 2006. Results: The outpatient days and medication days of the CM group decreased significantly more than those of the non-CM group with the copayment system. There were no significant differences of healthcare utilization between the CM group and the non-CM group with the designated doctor system. Conclusion: CM worked effectively on Medicaid beneficiaries' outpatient healthcare utilization with the copayment system. However, its effects on hospitalization, which is a major cause increasing the total expense, were not observed. Therefore, future studies are needed to develop strategies to reduce hospitalization and Medicaid beneficiaries outpatient healthcare utilization with the designated doctor system.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.2
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• pp.351-361
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• 1998

The purpose of this study was to explore whether there is a point within the range of physical impairment after which the cost of home care exceeds the cost of nursing home care among the elderly who require long-term care. The provision of long-term care for the elderly is a major health policy issue, in part due to the aging of the American population and dramatic increase in health care costs. The framework for this study was guided by Pollak's(1973)model of costs of alternative care settings for the elderly. This study used a retrospective, descriptive correlational design. Physical impairment was measured by the modified Index of Activities of Daily Living(Katz et al. 1963). Cost of care was measured by the average cost per patient per day. The sample for this study included 67 patients receiving long-term care at home from the Long-term Home Health Care Programs (LTHHCPs) and 67 patients receiving long-term care in nursing homes. Data were collected on patient characteristics. including activities of daily living and cognitive impairment. and on the number of physician visits. emergency room visits. and hospitalization from the patient records. For each patient. Medicaid cost data for home care services/or nursing home services were collected from the financial department of each home care agency or nursing home. The living costs and informal care costs were estimated for home care patients. The results indicated that the home care sample and the nursing home sample were similar in terms of gender. ethnic background. and marital status. The elderly patients in the home care sample were: however. younger and less physically impaired than those in the nursing home sample. The hypotheses of this study were supported: For elderly persons with physical impairment scores below 12(possible range of 0 to 14), cost of care was lower in home care than in the nursing home care setting. However, for elderly persons with physical impairment scores above 12. the cost of care was higher in home care than in the nursing home care setting. Thus. in this sample for elderly patients with extreme physical impairment, the cost of home care exceeded the cost of nursing home care.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.1
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• pp.123-135
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• 2002

Purpose: In this study, the critical pathway for laparoscopic cholecystectomy patients was developed and applied for clinical study. The effectiveness of the critical pathway was analyzed. Method: The subjects with no critical pathway services of this study were 30 laparoscopic cholecystectomy operation patients, who were hospitalized in B General Hospital in Busan from Nov. 28. 2000 to May 2. 2001. The subjects with critical pathway services of this study were 30 laparoscopic cholecystectomy operation patients, who were hospitalized in B General Hospital in Busan from June. 11. 2001 to Oct. 31. 2001. Results: 1. Development for critical pathway Preliminary critical pathway for the laparoscopic cholecystectomy patients was developed though analysis of the reference and 34 case of medical record. The items on the y-axis were assessment, test, treatment, diet, fluid, consult, medication, activity and education and the items on the x-axis were till 3days after operation. The developed critical pathway was applied in clinical field. 2.　Effectiveness of application on developed critical pathwayPost operational complication was not found in neither the critical pathway using Group nor Non-using Group. Hospitalization period mean was 4.63 days for the using Group and 5.93 days for the Non-using Group(P=.001). The mean cost for medical examination and treatment for the using Group was 786,270 won, 117,454 won(12.9%) less than that of the Non-using Group, 903,724 won(P=.000). The degree of satisfaction for the using group was 3.7 points, for the Non-using Group, 3.15 points. The degree of satisfaction for the used Group was 0.55 points higher than that for the Non-using Group and there was a statistically significant difference(P=.000). Concousion: From results of this study, Using the critical pathway in the laparoscopic cholecystectomy operational patients was effective in decreasing the hospitalization period and cost, and increasing the satisfaction about the medical service.

• The Journal of the Convergence on Culture Technology
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• v.4 no.4
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• pp.187-199
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• 2018

In this study, only 2,877 men, 2,614 men (44.6%), and 143 women (2.3%) were selected as the subjects who were over 18 years old in response to the health consciousness of the Korean medical panel data in 2012. Emergency of smokers through medical use and medical expenditure data by smoking. The social costs were estimated through medical expenses according to the number of hospitalization and outpatient medical use. The social cost was calculated by summing the social expenditure on health care costs, insurer (corporation) costs, copayment, non - salary, and productivity costs by adopting the social perspective established by the health economist Rice (1968). The rate of annual emergency medical use by smoking status is 7.5% for smokers per 100 people, 9.8 times for use, and 809,003 won for social expenses. The annual rate of hospitalization per 100,000 population by smoking status was 9.6% for smokers per 100 population, 9 times for use, The social cost is 706,870 won. Annual smoking rate by smoking status was 68.6% for smoking, 9 cases for annual medical use,