• Title/Summary/Keyword: medical expense

Search Result 207, Processing Time 0.023 seconds

Study on Big Data Utilization Plans of Medical Institutions (의료기관의 빅데이터 활용방안에 대한 연구)

  • Kim, Sung-Soo
    • Journal of Digital Convergence
    • /
    • v.12 no.2
    • /
    • pp.397-407
    • /
    • 2014
  • Due to rapid development of medical information, a huge amount of information is being accumulated. Desires to conduct clinical researches by using this information are increasing, and medical institutions are encountering problems of aging society and drastic increase of medical expenses. Utilization of Big Data as an alternative is now being emphasized. The purpose of this study is to examine informatization of medical institutions and suggest political implications for Big Data utilization plans. Data was collected through literature searches and interviews with medical information professionals of medical institutions, from September to November, 2013, for four months. As a result of the study, it could be found that the hospital information system is improving from patient management and administration to researches and information strategies. Thus, national supports for medical expense reduction as well as fostering professional manpower should be provided, considering establishment of the system for utilization of Big Data and efficient application of unstructured data.

Effect of the Long-term Care Insurance Policy on Medical Expenditures for the Elderly (노인장기요양보험제도가 노인진료비에 미치는 영향)

  • Han, Nam-Kyung;Chung, Woojin;Kim, Roeul;Lim, Seungji;Park, Chong-Yon
    • Health Policy and Management
    • /
    • v.23 no.2
    • /
    • pp.132-144
    • /
    • 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.

A Study on the introduction of the outpatient and inpatient conversion factors in the 2020 Physician Fee Contract (외래⦁입원 환산지수에 기초한 2020년도 환산지수 산출 연구)

  • O, Dongil
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.22 no.4
    • /
    • pp.183-194
    • /
    • 2021
  • In this study, the conversion factor for 2020 is estimated based on an outpatient and inpatient conversion factor separation model developed from SGR and AR by using actual medical expense data. In addition, a policy plan is proposed to calculate the values of single and multiple conversion factors for each type of medical expense, and to effectively use the conversion factor separation model as one of the means to establish a medical delivery system. The major results are as follows. First, at r=0.1, the rate of adjustment in the hospital single conversion index in 2020 was 2.0%, and the outpatient and hospitalization conversion rates for hospitals were 2.2% and 2.3%, respectively. In addition, a combination of outpatient and inpatient conversion factors can be used for the adjustment. Second, as a measure to establish a medical delivery system, instead of adjusting the addition rate, a method of interlocking the addition rate and the conversion factor is proposed. Third, it is necessary to develop a model that enables target management of volumes, in addition to the outpatient conversion factor, the inpatient conversion factor, and the adjustment coefficient.

A Study on the cost allocation method of the operating room in the hospital (수술실의 원가배부기준 설정연구)

  • Kim, Hwi-Jung;Jung, Key-Sun;Choi, Sung-Woo
    • Korea Journal of Hospital Management
    • /
    • v.8 no.1
    • /
    • pp.135-164
    • /
    • 2003
  • The operating room is the major facility that costs the highest investment per unit area in a hospital. It requires commitment of hospital resources such as manpower, equipments and material. The quantity of these resources committed actually differs from one type of operation to another. Because of this, it is not an easy task to allocate the operating cost to individual clinical departments that share the operating room. A practical way to do so may be to collect and add the operating costs incurred by each clinical department and charge the net cost to the account of the corresponding clinical department. It has been customary to allocate the cost of the operating room to the account of each individual department on the basis of the ratio of the number of operations of the department or the total revenue by each operating room. In an attempt to set up more rational cost allocation method than the customary method, this study proposes a new cost allocation method that calls for itemizing the operation cost into its constituent expenses in detail and adding them up for the operating cost incurred by each individual department. For comparison of the new method with the conventional method, the operating room in the main building of hospital A near Seoul is chosen as a study object. It is selected because it is the biggest operating room in hospital A and most of operations in this hospital are conducted in this room. For this study the one-month operation record performed in January 2001 in this operating room is analyzed to allocate the per-month operation cost to six clinical departments that used this operating room; the departments of general surgery, orthopedic surgery, neuro-surgery, dental surgery, urology, and obstetrics & gynecology. In the new method(or method 1), each operation cost is categorized into three major expenses; personnel expense, material expense, and overhead expense and is allocated into the account of the clinical department that used the operating room. The method 1 shows that, among the total one-month operating cost of 814,054 thousand wons in this hospital, 163,714 thousand won is allocated to GS, 335,084 thousand won to as, 202,772 thousand won to NS, 42,265 thousand won to uno, 33,423 thousand won to OB/GY, and 36.796 thousand won to DS. The allocation of the operating cost to six departments by the new method is quite different from that by the conventional method. According to one conventional allocation method based on the ratio of the number of operations of a department to the total number of operations in the operating room(method 2 hereafter), 329,692 thousand won are allocated to GS, 262,125 thousand won to as, 87,104 thousand won to NS, 59,426 thousand won to URO, 51.285 thousand won to OB/GY, and 24,422 thousand won to DS. According to the other conventional allocation method based on the ratio of the revenue of a department(method 3 hereafter), 148,158 thousand won are allocated to GS, 272,708 thousand won to as, 268.638 thousand won to NS, 45,587 thousand won to uno, 51.285 thousand won to OB/GY, and 27.678 thousand won to DS. As can be noted from these results, the cost allocation to six departments by method 1 is strikingly different from those by method 2 and method 3. The operating cost allocated to GS by method 2 is about twice by method 1. Method 3 makes allocations of the operating cost to individual departments very similarly as method 1. However, there are still discrepancies between the two methods. In particular the cost allocations to OB/GY by the two methods have roughly 53.4% discrepancy. The conventional methods 2 and 3 fail to take into account properly the fact that the average time spent for the operation is different and dependent on the clinical department, whether or not to use expensive clinical material dictate the operating cost, and there is difference between the official operating cost and the actual operating cost. This is why the conventional methods turn out to be inappropriate as the operating cost allocation methods. In conclusion, the new method here may be laborious and cause a complexity in bookkeeping because it requires detailed bookkeeping of the operation cost by its constituent expenses and also by individual clinical department, treating each department as an independent accounting unit. But the method is worth adopting because it will allow the concerned hospital to estimate the operating cost as accurately as practicable. The cost data used in this study such as personnel expense, material cost, overhead cost may not be correct ones. Therefore, the operating cost estimated in the main text may not be the same as the actual cost. Also, the study is focused on the case of only hospital A, which is hardly claimed to represent the hospitals across the nation. In spite of these deficiencies, this study is noteworthy from the standpoint that it proposes a practical allocation method of the operating cost to each individual clinical department.

  • PDF

A Study on Self Care and the Problems in Patient with Ostomy (장루보유자의 자가 간호정도 및 문제점에 관한 연구)

  • Go, Yun-Hee;Choi, Mi-La;Lee, Mung-Sun;Han, Seung-Min;Han, Geum-Yung;Ym, Eun-Sun;An, Hae-Jein;Kim, Kwuy-Bun
    • Journal of East-West Nursing Research
    • /
    • v.10 no.1
    • /
    • pp.95-105
    • /
    • 2004
  • This study was conducted to confirm the degree of self care and problems in patients with ostomy. The subjects were 80 patients with ostomy who were visiting to OPD in K University Medical Center and were members in the Ostomy Association of Korea. Data were collected from August, 2004 to September. The research tools were a self care measure for ostomy patient developed by Park (1996) and a problem measure for ostomy patient developed by Lee (1996). Data were analyzed by t-test, ANOVA, and Pearson's correlation. The results were as following: 1. Male (65.8%) and female (34.2%) had the ostomy in the most. Age was the most 61 years old and over. 68.5% of the subjects had managed the ostomy by themselves. 2. The mean score of self care in ostomy was 3.57 score. Hygiene of skin care around ostomy in the behavior of self care was the highest as mean 4.47 score. 3. The problems were as following: 1) expense 2) a decline on Activity of Daily Living 3) discomfort in travel 4) worry about ostomy 5) trouble of workplace 4. In the relationship between self care and religion there was significant difference in religion(t= 2.727, P=.008). 5. The relationship between self care and problem with ostomy was found to have statistically significant negative correlation(r= -.237, P=.041).

  • PDF

An analysis of contributing factors to financial status of regional health insurance (지역의료보험조합의 재정 상태에 영향을 미치는 요인분석)

  • Moon, Jong-Kook;Park, Myeong-Ho;Kim, Yong-Joon
    • Journal of Preventive Medicine and Public Health
    • /
    • v.24 no.2 s.34
    • /
    • pp.211-220
    • /
    • 1991
  • Finances of health insurance can be explained by factors determining benefit expense and premium collection. This study was conducted to analyze factors contributing to the financial status of rural health Insurance. Nationwide 134 health insurance associations except the six pilot project counties were analyzed and obtained the followings. 1. In univariate analysis, statistically significant variables that explain 1) outpatient benefit expenditures include public health center utilization, proportion of pregnant women. premium and collection rate of premium 2) inpatient benefit expenditures include public health center utilization, Proportion of old age, proportion of pregnant women, premium and collection rate of premium 3) profits include public health center utilization, proportion of old age, proportion of pregnant women and collection rate of premium. 2. In multiple regression analysis, statistically significant determinants in 1) outpatient benefit include premium and public health utilization 2) inpatient benefit include premium 3) profit include public health center utilization, premium and collection rate of premium.

  • PDF

The Effects of Fatigue and Distress on Self-efficacy among Breast Cancer Survivors (유방암 생존자의 피로와 디스트레스가 자기효능감에 미치는 영향)

  • Seo, Mi Hye;Lim, Kyung Hee
    • Korean Journal of Adult Nursing
    • /
    • v.28 no.4
    • /
    • pp.378-387
    • /
    • 2016
  • Purpose: The purpose of this study was to describe the impact of fatigue and distress on self-efficacy among breast cancer survivors and to provide a base for development of nursing intervention strategy to improve self-efficacy. Methods: A descriptive research design was used. The subjects were 158 patients who were either being treated or were receiving follow-up care at a university breast center in D City from May 30 to August 30, 2014. Structured questionnaires, Revised Piper Fatigue Scale, Distress Thermometer, and Self-Efficacy Scale for Self-Management of Breast Cancer were used to measure fatigue, distress, and self-efficacy. Data were analyzed using t-test, ANOVA, Pearson's correlation coefficients, and multiple regressions. Results: The mean scores of fatigue, distress, and self-efficacy were 3.83, 4.31, and 3.77, respectively. There were significant differences among participants in terms of educational background, current treatment methods, perceived health status, economic burden for fatigue and perceived health status for distress. Self-efficacy was impacted by age, educational background, marital status, average monthly income, perceived health status, and medical expenses. Fatigue, age, and the burden on medical expense had the most impact on self-efficacy, accounting for 17% of the variance. Conclusion: Fatigue should be managed to improve self-efficacy of breast cancer survivors. Therefore, nursing programs designed to decrease fatigue may be helpful.

Impact of the Private Insurance Benefits and the medical Care Expenditure on Household Income Inequality (가구소득불평등에 민간보험수입과 의료비본인부담지출이 미친 영향)

  • Lee, Yong-Jae;Kim, Hyung-Eick
    • Journal of Digital Convergence
    • /
    • v.15 no.12
    • /
    • pp.625-633
    • /
    • 2017
  • The purpose of this study is to investigate the effect of private insurance revenues and household spending on household income inequality. To this end, we conducted a concentration index and concentration curve analysis for the income level of medical panel survey data in 2015. The main results are as follows. First, the household income concentration ratio is 0.3580, which means that income is concentrated in the high income group, and the degree of inequality is considerably large. Second, although the portion of the private insurance benefits was small on the high-income household, it helped to strengthen the benefits concentration on this group. Third, the low income group has a large self-pay medical expense. Finally, the index of the income excluding the burden of the total medical expenses in the household income was 0.3676, so that even accounting for medical expenses, the income was concentrated in the high income class. Therefore, private insurance benefits and medical expenses were all contributing factors to the inequality of household income, and this study provides the essential materials for research and policy planning which could lead to the convergence of different fields.

Factors Affecting Profitability of General Hospitals Focused on Operating Margin (병원의 수익성 관련 요인 분석 - 의료수익의료이익율을 중심으로 -)

  • Park, Byung-Sang;Lee, Yong-Kyoon;Kim, Yoon-Shin
    • The Journal of the Korea Contents Association
    • /
    • v.9 no.6
    • /
    • pp.196-206
    • /
    • 2009
  • The profitability of a hospital refers to business administration results achieved through its medical care and other management activities during applicable fiscal year. This study focused on operating margin as a measurement index of hospital profitability, which is a genuine medical return obtained by subtracting medical expenses from medical profits achieved during business administration of hospital. Based on the index, this study could deduce certain factors on hospital profitability in terms of various indices affecting profitability. And based on those factors, this study sought to provide more useful reference materials which allow us to devise possible ways to improve hospital profitability. As a result, it was found that public hospitals attained lower profitability than private ones. To analyze profitability depending on each index, this study divided hospitals broadly into deficit group and surplus group. As a result, it was found that there were significant differences in hospital profitability between two groups depending upon relevant indices such as labor cost ratio, maintenance expense ratio, number of operations per medical specialist and medical instrument turnover. According to analysis on potential effects of relevant indices upon profitability, it was found that each index had its explanatory power ranging from 25% to 74.5% depending on given model.

Analysis research about awareness of demanders of recuperation allowance for dental clinic health insurance in Daejun and Chunchung area (대전·충청지역 치과건강보험 요양급여비용 청구자의 인식도 분석조사)

  • Kim, Sung-Hee;Kim, Min-Ja;Nam, Yong-Ok
    • Journal of Korean society of Dental Hygiene
    • /
    • v.11 no.2
    • /
    • pp.275-289
    • /
    • 2011
  • Objectives : The recognition rate for issues and improving resolution for the recuperation income expense claim policy was examined. Methods : 1,135 copies of survey have been sent to the group of people who have claimed the dental recuperation income expense to dental recuperation institutions in Daejeon, Chungcheong Do that are registered to the health insurance evaluation and estimation office as of the May 2010 and 207 surveys that were regarded to be sincere for answering were analyzed. Results : Majority of respondence were belonged to the dentist institutions with more than 5 years of claim experiences as well as 10~50% of claim rate. The recognition of medical fee evaluation guideline was normal level, and negative recognition was higher to the health center with daily charge policy compare to the dental hospital and university affiliated dental center with treatment charge policy, Highest opinion for inappropriateness of dentist with significance was found (p<0.05). The openness of evaluation cases are regarded to be discharged through the transparent evaluation and most of the opinions for insurance claim evaluation adjustment are within the both 'Do not understand the evaluation guideline and program error of disease category, code and program' with significance(p<0.05). The reaction after the evaluation adjustment was high in reflection on the claim process after examining the reason for the evaluation adjustment through the evaluation and estimation office and university affiliated dental institution and dental center was regarded to be most active and deputy reclaimment was seemed to be most actively discharge the objection registration task (p<0.05). The claim error improving resolution recognition was highly prioritized to the accurate charting for the disease title and treatment description, improving the setting of claim program, and most highly recognized by the university affiliated dental hospital/dental center and comparably low by health center(p<0.05). and although the most of the responds of treatment description and browsing the medical fee was positive, 50% of dentists disagreed the idea so that this was creating a significant discrepancy with other groups(p<0.05). Conclusions : From this research, the recognition of medical fee evaluation guideline for dental (university) hospital and dentists were negative and high adjustment experience was examined as lacking of evaluation guideline understanding and error of disease name, code and programs and deputy reclaimment, university affiliated dental hospital/dental center were most actively handle the objection registration tasks and dentists have objection on the treatment description and browsing the treatment fee so that if these indexes can be referred to implement into the recuperation income claim process, this can be regarded to be a opportunity to create mutual credibility between recuperation institution, treatment pensioner and the evaluation institutions.