• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.5
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• pp.274-280
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• 2020

The purpose of this study was to identify the average cost and present status of non-benefit medical expenses by using the data of tertiary hospitals released by the Health Insurance Review and Assessment Service(HIRA), and to compare the data to find cost variations. The target of analysis was the present status of the non-benefit medical expenses reported by 41 tertiary hospitals among the 44 previously designated hospitals (three were excluded due to revocation or new designation) for 2015, 2016, 2017, and 2018 (until April). This study was conducted after approval of using the released data of the HIRA's data opening system. This study was analyzed by its general characteristics, annual non-benefit medical expenses by frequency analysis, and annual understanding of variation by designating Coefficient of Variation (C.V.). The research found out that the number of details of non-benefit medical expense was gradually increased: the numbers of categories were 51 in 2015, 53 in 2016, and 98 in 2017, but there was a rapid increase in 2018 by 193. As a result, to standardize non-benefit medical expense items across tertiary hospitals due to their variations in the expenses, the government should expand standardized non-benefit medical expenses and make it mandatory for medical institutions to use the standardized items or names of such expenses.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.12
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• pp.384-389
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• 2017

This study was conducted to investigate the patient and hospital characteristics that affect receiving and non-receiving blood transfusion for hepatoma embolization. We analyzed data describing 757 patients of the Health Insurance Review and Assessment Service's 2011 claims sample data. Chi-squared and logistic regression analysis was performed using STATA 12.0. Logistic regression analysis revealed that anemia (Odds ratio (OR)=9.544, 95% confidence interval (CI)=3.362-27.097), female (OR=2.186, Cl=l.240-3.854), age 65-74 (OR=0.506, CI=0.269-0.952), 1000 over bed (OR=0.053, CI=0.018-0.151), out-department (OR=0.211, CI=0.081-0.551), and 700-999 bed (OR=0.105, CI=0.036-0.304) were significant predictors of blood transfusion in tertiary hospitals. Additionally, anemia (OR=69.681, CI=8.545-568.246) and aged 75 or over (OR=0.112, CI=0.025-0.506) were significant predictors of blood transfusion in general hospitals. This research would expected to cost effective and preliminary data of blood transfusion quality.

• The Journal of the Korea Contents Association
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• v.15 no.6
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• pp.290-296
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• 2015

The purpose of this study was to derive the proposals and to suggest the exposure dose reduction scheme on pediatric head CT scan by analyzing and comparing CT dose index (CTDI) and the national diagnostic reference levels. From January 2014 to December, 231 children under 10years who were requested a pediatric head CT scan with head injury were examined. Research methods were to research and analyze the general characteristics kVp, mA test coverage $CTDI_{vol}$ and DLP referring to dose reports and electronic medical record (EMR). As a result, 7.4%(17 patients) of the total subjects in $CTDI_{vol}$ showed a national diagnostic reference levels exceeding. For DLP 41.6%(96 patients) in excess was relatively higher than $CTDI_{vol}$. DLP was exceeded more than about 60% that is higher than the CT dose index presented by Korea Food & Drug Administration. it is cause of high DLP that scan range increased more than about 30% wider than the standard test coverage presented in Health Insurance Review & Assessment Service. In conclusion, it is able to significantly lower the dose if it is complied with checking the baseline scan range of pediatric head CT scan and appropriately adjusting the protocol.

• Health Policy and Management
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• v.34 no.1
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• pp.26-37
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• 2024

Background: The purpose of this study was to compare and analyze the differences in charges and length of stay per case between spine specialty hospitals and non-specialty hospitals, and to identify the factors that influenced them. Methods: This study used claims data from the Health Insurance Review and Assessment Service, including inpatient visits from January 2021 to December 2022. The healthcare facility status data was used to identify the characteristics of study hospitals. Multilevel analysis was conducted to identify factors associated with the charges and Poisson regression analysis was conducted to analyze the length of stay between spine specialty hospitals and non-specialty hospitals. There were 32,015 cases of spine specialty hospitals and 17,555 cases of non-specialty hospitals. Results: For four of five common spinal surgeries, specialty hospitals shaped longer length of stay than those of non-specialty hospitals. Multilevel and Poisson regression analysis revealed that regardless of the type of surgery, higher age and higher Charlson comorbidity index scores were significantly associated with an increase in both the charges per case and length of stay (p<0.05). However, when hospitals were located in metropolitan areas, there was a significant decrease (p<0.05). Conclusion: This study found that specialty hospital had higher inpatient charges and loner length of stay contrary to the previous study results. Further studies will be needed to find which contribute to the differences.

• Journal of Digital Convergence
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• v.20 no.4
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• pp.469-482
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• 2022

The purpose of this study is to analyze regional variation factors of hypertension treatment rate in COVID-19 based on the analysis results based on ecological methodology. To this end, data suitable for ecological analysis were collected from the Korea Centers for Disease Control and Prevention's regional health statistics, local government COVID-19 confirmed cases, National Health Insurance Corporation, Health Insurance Review and Assessment Service's welfare statistics, and Korea Transport Institute's traffic access index. Descriptive statistics and correlation analysis were conducted using SPSS Statistics 23 for regional variation and related factors in hypertension treatment rate, and geographical weighted regression analysis was conducted using Arc GIS for regional variation factors. As a result of the study, the overall explanatory power of the calculated geo-weighted regression model was 27.6%, distributed from 23.1% to 33.4% by region. As factors affecting the treatment rate of hypertension, the higher the rate of basic living security medical benefits, diabetes treatment rate, and health institutions per 100,000 population, the higher the rate of hypertension treatment, the lower the number of COVID-19 confirmed patients, the lower the rate of physical activity, and the alcohol consumption. Percentage of alcohol consumption decreased due to COVID-19 pandemic. It was analyzed that the lower the ratio, the higher the treatment rate for hypertension. Based on these results, the analysis of regional variables in the treatment rate of hypertension in COVID-19 can be expected to be effective in managing the treatment rate of hypertension, and furthermore, it is expected to be used to establish community-centered health promotion policies.

• Health Policy and Management
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• v.30 no.4
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• pp.505-512
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• 2020

Background: In monitoring exposure to environmental smoke (ETS), biomarkers can overcome the subjectivity and inaccuracy of self-reporting measurements, and have the advantage of reflecting ETS exposure in all places. This study aims to evaluate the effectiveness of ETS exposure measurement using biomarkers such as urine cotinine. Methods: This study used the Korea National Health and Nutrition Survey data from 2009 to 2018. A total of 28,574 non-smokers with urine cotinine data were selected for the study. The cotinine concentration and ETS exposure rate using urine cotinine was estimated and then compared with the self-reporting measurements. The degree of agreement among measurements of ETS exposure was confirmed. Results: As a result of measuring ETS exposure with urine cotinine, 23,594 (83.8%) out of 28,574 subjects were classified as to exposure groups. This estimate differs significantly from measurements made by self-reporting. In addition, the average concentration of cotinine in non-smokers has decreased to a 10th level over the past 10 years. Based on the biomarker, the sensitivity of the self-reporting was 8.5%-29.0%, the specificity was 16.4%-19.5%, and the kappa value was 2.0%-5.8%. Conclusion: The findings of our study show that self-reporting measurement does not well reflect the extent to which non-smoker's exposure to smoking materials. Whereas cotinine concentration has decreased significantly over the past 10 years, the ETS exposure rate has not reduced. It strongly suggests the need for intervention in the group of non-smokers exposed to low concentrations of smoke. Therefore, an assessment using biomarkers such as cotinine-based measurement should be made in the Health Plan 2030.

• 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.

• Health Policy and Management
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• v.34 no.2
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• pp.178-184
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• 2024

Background: This study aimed to determine the effectiveness of drug utilization review (DUR) evaluation indicators on safe drug use by comparing the changes in DUR inspection rates and drug duplication prescription prevention rates between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative. Methods: This study used DUR data from the Health Insurance Review and Assessment Service in 2018 (pre-implementation) and the evaluation results of the Healthcare Quality Evaluation Grant Initiative in 2023 (post-implementation). The dependent variables were the DUR evaluation indicators, including DUR inspection rate and drug duplicate prescription prevention rate. The independent variable was the implementation of the DUR evaluation indicators, and the control variables included medical institution characteristics such as type, establishment classification, location, DUR billing software company, and number of beds. Results: The results of the analysis of the difference in the prevention rate of drug duplicate prescriptions between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative showed that the prevention rate of drug duplicate prescriptions increased statistically significantly after the implementation of the DUR evaluation indicators. Conclusion: The policy implications of this study are as follows: First, ongoing evaluation of DUR systems is needed. Second, it is necessary to establish a collaborative partnership between healthcare organizations that utilize DUR system information and the organizations that manage it.

• Health Policy and Management
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• v.34 no.1
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• pp.78-86
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• 2024

Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

• Food Science and Industry
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• v.55 no.2
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• pp.154-165
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• 2022

Humans have been breeding the mulberry silkworm for the long period of time to obtain silk fabric and nutrient-rich pupae. Currently, silkworm larvae, pupae, and silk-Fibroin hydrolysates are registered as food raw materials, while silkworm feces and Bombyx batryticatus are registered as Korean traditional medicines. Among sericulture products, individually recognized health functional food ingredients include silk-protein acid-hydrolysates for immunity enhancement, Fibroin-hydrolysates for memory improvement, and freeze-dried 5^th instar and 3^rd-day-silkworm powder for lowering-blood sugar. Recently, HongJam produced by steaming and freeze-drying mature silkworms were reported to have various health-promoting effects such as preventing the onset of Alzheimer's disease and Parkinson's disease, enhancing gastro-intestinal functions, improving skin-whitening and hair growth, and extending healthspan. By consuming silkworm products with various health-promoting effects, it is possible to increase the healthspan of human beings, thereby reducing personal and national medical expenses, resulting in increasing the individual's happiness.