• 보건행정학회지
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• 제31권4호
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• pp.508-517
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• 2021

Background: After the first case of coronavirus disease 2019 (COVID-19) in January 2020, Korea has experienced three waves in 2020. This study aimed to analyze changes in health care utilization according to the period of the 1st to 3rd waves of the COVID-19 pandemic. Methods: We analyzed 3,354,469,401 national health insurance claims from 59,104 medical facilities between 2017 and 2020. Observed-to-expected ratios (O:E ratio) with data from 2017 to 2019 as expected values and data from 2020 as observed values were obtained to analyze changes in medical utilization. T-test was used to test whether the difference of observed and expected values was statistically significant. Results: In 2020, the O:E ratio was 0.894, indicating a decrease in health care utilization overall during the pandemic. The O:E ratio of the 1st wave was 0.832, which was lower than those of the second (0.886) and third (0.873) waves. Health care utilization decreased relatively more among outpatient, women, children and adolescents, and health insurance patients. And health care utilization decreased more in small medical facilities and in Daegu and Gyeongbuk during the first wave. During the pandemic, the O:E ratios of respiratory diseases were 0.486-0.694, while chronic diseases and mental diseases were more than 1.0. Conclusion: Health care utilization decreased during the COVID-19 pandemic overall, and there were differences by COVID-19 waves, and by the characteristics of patients and medical facilities. It is necessary to understand the cause of changes in health care utilization in order to cope with the prolonged COVID-19 pandemic.

• 한국엔터테인먼트산업학회논문지
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• 제14권6호
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• pp.201-208
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• 2020

본 연구는 건강보험심사평가원의 청구 자료를 바탕으로 만65세 이상의 주진단이 무릎 관절증으로 슬관절 전치환술을 시행한 환자를 대상으로 의료기관 종별에 따라 재원일수에 영향을 주는 요인을 분석하였다. 연구결과 의료기관 종별에 따라 성별, 연령, 의료보장형태, 중증도, 거주지역 및 병상규모가 재원일수에 영향을 미치는 요인으로 분석되었다. 인구의 고령화로 인한 노인 인구의 증가와 이로 인한 노인 진료비 증가는 가계 및 국가 경제의 많은 부담으로 작용하는 시점에서 본 연구결과를 토대로 재원일수 단축효과와 함께 효율적인 병상운영을 도모해야 할 것이다. 뿐만 아니라 환자의 진료비 부담을 경감시키는 위한 체계적인 관리시스템을 도입하여 노인환자의 양질의 라이프케어를 위한 기초자료로 활용하는 데 본 연구의 의의가 있다.

• 보건행정학회지
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• 제12권1호
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• pp.1-20
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• 2002

National health expenditure account describes expenditure flows both public and private within the health sector. It describes the sources and uses and channels for all funds utilized in the health sector and is a basic requirement for optimal management of the allocation of health sector resources. Constructing a national health expenditure account should begin with sound estimates. This paper thoroughly examines the sources and discusses the estimation methods, and provides the national health expenditure account of Korea by function and source of funding category The national health expenditure account produced in this parer has, however, some drawbacks and followings are proposed fur enhancing the comprehensiveness and consistency of the account. First, comparable data un health related expenditures of local government and private sector should be produced because data sets on the sectors are very limited. Second, we need further study un overall scope and boundaries of health expenditure estimates in order to improve compatibility of other main aggregates.

• 보건행정학회지
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• 제2권1호
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• pp.80-114
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• 1992

Current compensation schemes for medical malpractice based on negligence is absolutely malfunctioning in Korea. Focussing on the reform of present tort systems for resolving medical malpractice disputes, this paper discusses the alternative models of the Social Relief Schemes for Medical Malpractice (SRSMM). Alternative models of SRSMM should fundamentally be based on either negligence or nofalult compensation principle. On the foundation of the previous relief principle, the SRSMM should be equupped with three major components-the preventio/reduction of the sharp increasing medical malpractice, the effective and efficient resolving process for malpractice disputes and the proper social financing scheme for compensation. The paper deals with pros and cons of the possible alternative models for reform centering on the three major components of the scheme. As conclusions, administrative arbitration machinaries and a compulsory fund for compensating the injured under the negligence principle are proposed to resolve the current problems Korea has faced.

• 보건행정학회지
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• 제13권3호
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• pp.91-103
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• 2003

The purpose of this study was to provide basic reference data for stabilization scheme of health expenditure through forecasting of health expenditure. The authors analyzed the health expenditure from 1985 to 2000 that had been calculated by Korean institute for health and social affair using transfer function model as ARIMA model with input series. They used GDP as the input series for more precise forecasting. The model of error term was identified ARIMA(2,2,0) and Portmanteau statics of residuals was not significant. Forecasting health expenditure as percent of GDP at 2010 was 6.8%, under assumption of 5% GDP increase rate. Moreover that was 7.4%, under assumption of 3% GDP increase rate and that was 6.4%, under assumption of 7% GDP increase rate.

• 보건행정학회지
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• 제13권2호
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• pp.101-124
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• 2003

Performance of public hospitals is difficult to define and measure because not only their managerial or financial performance but also their role as a public entity is important. The purpose of this paper is to examine the internal and external factors that influence the performance of local government hospitals. A multiple regression was performed to analyze the effects of the environmental, organizational, operational, and cost-related factors on the return on total assets(ROA), operating margin(OM), and the ratio of Medicaid patients. Empirical results show that financial performance (ROA and OM) are more influenced by operational or cost-related factors, while the ratio of Medicaid patients is more affected by environmental or organizational characteristics. It is noteworthy that competition and the contract with private sector management have negative effects on the ratio of Medicaid patients that local government hospitals treat.

• 보건행정학회지
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• 제25권4호
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• pp.333-342
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• 2015

Background: The purposes of this study is to analysis the differences of the job satisfaction between regular and non-regular workers in hospitals. Methods: The samples used for data analysis are 632 workers of 6 hospitals using a standardized questionnaires in B, C, D, and G provinces. In research methodology, all the data were analyzed with descriptive statistics, t-test, Pearson's correlation, and multiple linear regression analysis. Results: In case of regular workers, communication, working conditions and employee benefit, and education were found to have a significant positive (+) effect on job satisfaction. In case of non-regular workers, empowerment, reward systems, communication, working conditions, and employee benefit had a significant positive (+) effect on job satisfaction. Conclusion: These results showed that hospitals needed to reinforce communication, working conditions and employee benefit to regular and non-regular workers in order to improve job satisfaction. Especially, more empowerment, working conditions, and employee benefit should be given to non-regular workers.

• 보건행정학회지
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• 제27권1호
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• pp.30-38
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• 2017

Background: This study aims to analyze the behavioral changes of healthcare providers and influencing factors after the reviewer unification of auto insurance medical benefit claims by an independent review agency. Methods: The comparison data were collected from the second half of 2013 and the same period of 2014. The key indicators are the number of admission days, the number of outpatient visits, inpatient ratio, inpatient medical expenses, and outpatient medical expenses. Results: Four indicators (number of admission days, number of outpatient visits, inpatient ratio, and outpatient medical expenses) showed statistically significant drops, while one indicator (inpatient medical expenses) showed no significant change. Conclusion: The reviewer unification of auto insurance medical benefit claims by an independent review agency showed significant reduction in cost and patient days.

• 보건행정학회지
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• 제1권1호
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• pp.42-53
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• 1991

Analysis of health care utilization is very important for health care policy development. Traditional studies of health care utilization were focused on measuring the level of health care utilization and on analyzing the determinants of health care utilization in the defined areas and populations. But there were some limitations in comparing the health care utilizations rates in traditional studies because so many factors were to be considered. Small area analysis is a method used to demonstrate substantial variations in health care utilization with popualtion-base use rates among similar geographic areas. This review discusses the methods, magnitude and trend of geographic variations, factors influencing small area variations, and makes suggestions for further study. Finally, the article discusses the necessity and feasibility of small area analysis in Korea.

• 보건행정학회지
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• 제1권1호
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• pp.72-94
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• 1991

The number of disputes between physicians and patients caused by medical malpractice are showing a sharp increasing over the past several years. The disputes on medical malpractice may be resolved either in court or by direct negotiation between both sides concerned. There are no special acts relating to the civil or penal liability of the physicians in Korea. The medical disputes are decided merely through legal technicalities and without reference to actual medical practice. The current system which does not compensate injured patients adequately or equitably leads to taking a long time consuming for dispute resolution processes. The things make worsed, the problem is due to not being of insurance system or a proper funds for compensation. This research proposes a outline of new and comprehensive alternative for these problems and failure of conventional resolution of medical disputes. So far, we have learned lessons from the excperiencies of resolving medical malpractice disputes of Japan and the United States. The proposal first calls for an administrative arbitration and pretrial screening panels as a condition precedent to trial. The proposal also includes to facilitate with the funds for compensating the injured.