• Title/Summary/Keyword: 의료비

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The Effect of Public Medical Support for Children on Single Mother's Labor Supply (저소득층 자녀를 위한 의료비지원이 여성노동공급에 미치는 영향: 미국의 저소득층 자녀를 위한 의료보험프로그램 사례)

  • Lee, Kyoungwoo
    • Journal of Labour Economics
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    • v.32 no.1
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    • pp.57-75
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    • 2009
  • This paper provides empirical evidence on the impact of SCHIP (The State Children's Health Insurance Program) on single mothers' working decisions using recent CPS (Current Population Survey) data during 1999-2005. SCHIP are found to have a significant positive impact on hours-worked decision.

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Effects of Usual Source of Care by Patients with Diabetes on Use of Medical Service and Medical Expenses (당뇨병 환자의 상용치료원 보유가 의료이용 및 의료비에 미치는 영향)

  • Lee, So Dam;Shin, Euichul;Lim, Jae-Young;Lee, Sang Gyu;Kim, Ji Man
    • Korea Journal of Hospital Management
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    • v.22 no.3
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    • pp.1-17
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    • 2017
  • Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.

Health Economic Approach to End-of-Life Care in the US: Based on Medicare (말기의료의 경제적 요소에 관한 논의: 미국 메디케어 상황을 중심으로)

  • Suk, Ryan
    • The Korean Society of Law and Medicine
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    • v.15 no.1
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    • pp.335-373
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    • 2014
  • According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

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Deidentification Method Proposal for EHR Data on Remote Healthcare Service (원격 의료 서비스를 위한 EHR 데이터 비식별화 기법 제안)

  • Yoon, Junho;Kim, Hyunsung
    • Proceedings of the Korea Information Processing Society Conference
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    • 2019.10a
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    • pp.268-271
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    • 2019
  • 최근 인공지능과 빅데이터 등 최첨단 기술이 빠른 속도로 의료 정보시스템에 도입됨에 따라 환자정보를 포함한 민감한 개인정보에 대한 사이버 공격이 급증하고 있다. 다양한 개인정보 비식별화에 대한 표준이 제안되었지만, 데이터의 범주에 따른 기법 적용에 대한 연구가 미비하다. 본 논문에서는 EHR 데이터를 위한 심근경색을 대상으로 하는 원격 의료 시스템을 위한 개인정보들에 대한 민감도를 4단계로 분류하고 이에 따른 비식별화 기법에 대해 제안한다. 본 논문에서 제안한 EHR 데이터에 대한 분류 및 비식별화 기법은 다양한 의료 정보 서비스를 위한 프라이버시 보호에 활용될 수 있다.

고발코너: 환자가 만드는 의료 서비스

  • 사단법인 한국당뇨협회
    • The Monthly Diabetes
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    • s.255
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    • pp.62-63
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    • 2011
  • 환자도 소비자이다. 또한 의료행위도 서비스 중의 하나이다. 하지만 다른 서비스업에 비하면 소비자인 환자가 중심이 되지 못하고 있는 실정이다. 물론 요즈음 많은 병원들이 더 나은 의료서비스를 제공하고자 노력하고 있지만, 아직 환자의 목소리가 반영됨을 실감하지 못한다. 앞으로 보다 나은 양질의 의료서비스가 정착되길 기대하며 불합리한 의료서비스를 개선하고자 환자의 의견을 들어보기 위해 <고발코너>를 마련했다.

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고발코너: 환자가 만드는 의료서비스 불합리한 치료를 받았다면

  • 사단법인 한국당뇨협회
    • The Monthly Diabetes
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    • s.257
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    • pp.60-61
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    • 2011
  • 환자도 소비자이다. 또한 의료행위도 서비스 중의 하나이다. 하지만 다른 서비스업에 비하면 소비자인 환자가 중심이 되지 못하고 있는 실정이다. 물론 요즈음 많은 병원들이 더 나은 의료서비스를 제공하고자 노력하고 있지만, 아직 환자의 목소리가 반영됨을 실감하지 못한다. 앞으로 보다 나은 양질의 의료서비스가 정착되길 기대하며 불합리한 의료서비스를 개선하고자 환자의 의견을 들어보기 위해 <고발코너>를 마련했다.

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The determinants of Emergency Care Utilization and Equity of Access to Care in Elderly Koreans (노인들의 응급의료이용 결정요인과 형평성)

  • Lee, Sukmin;Park, Ju Moon
    • Journal of Urban Science
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    • v.8 no.1
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    • pp.51-58
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    • 2019
  • This study examines the determinants of emergency care utilization and equity of access to care in elderly Koreans. Based on the data from the 2014 Korea Health Panel Survey, descriptive and logistic regression analysis was performed. The sample for this study was 1,313 individuals who participated in interviews. Predisposing factors such as age, sex, and education were significant determinants of emergency care utilization. Differences in need do not fully account for the original differences observed between subgroups of older Koreans. Health status was important determinant of older Koreans using emergency care services. Spending medical expense did not ameliorate the subgroup differences in the use of emergency care services. Nonetheless, spending medical expense remains a particularly important predictor of emergency care utilization. Health care reforms in Korea should continue to concentrate on insuring effective universal emergency care, implying that all older Koreans with need receive effective coverage. Future study is also needed to understand the access barriers that may exist for the selected demographic subgroups, i.e., those over 75, women, less educated persons, and those with higher medical expense.

Analyzing Regional Public Hospitals' Efficiency and Productivity Change (지방의료원의 효율성 및 생산성변화 분석)

  • Jeon, Jin-hwan;Kim, Jong-Ki
    • The Journal of the Korea Contents Association
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    • v.10 no.5
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    • pp.303-313
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    • 2010
  • The purpose of this study is to evaluate the performance efficiency and productivity change of the regional public hospital in Korea. We use DEA(Data Envelopment Analysis) for CCR, BCC model, and MPI(Malmquist Productivity Index). DEA is a useful nonparametric technique for measurement of efficiency of a DMU(Decision Making Unit) and MPI is a evaluation method to measure DMU's productivity change. We utilize 34 regional public hospital's time-series data over 6 years from 2003 to 2008.The results of this study were as follows. First, technical efficiency(TE) shows that approximately 3.6% of inefficiency exists on the regional public hospitals and it reveals that the cause for technical inefficiency is due to scale inefficiency. Second, MPI's results show that regional public hospital made effort to improve total factor productivity change to raise technical efficiency. In order to raise efficiency, the regional public hospitals should deploy internal innovation and the government should support welfare policies.

Considering on De-Identification Method of Personal Information for National Medical Institute by using correlation (상관도를 이용한 국내 의료기관용 개인정보 비식별화 방안에 관한 연구)

  • Yeo, Kwang Soo;Kim, Chul Jung;Lee, Jae Hyun;Kim, Soon Seok
    • Smart Media Journal
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    • v.5 no.4
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    • pp.83-89
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    • 2016
  • Guidelines for protecting personal information are already in progress in USA, UK and other countries and announced many guideline like HIPPA. However In Our national environment, we does not have specialized guideline in national medical industries. This thesis suggest De-indentification method in South Korea by referring 'bigdata De-identification Guideline by Ministry of Science, ICT and Future Planning (2015)', ICO in U. K and IHE, NIST, HIPPA in U. S. A. We suggest also correlation between Guidelines. Corelation means common techniques in three guidelines (IHE, NIST, HIPPA in U. S. A). As Point becomes closer five points, We recommend that technique to national medical institute for De-Identification. We hope this thesis makes the best use of personal information's development in National medical institute.

The Mediating Effect of Depression on the relationship between Emotional Labor and Somatic Symptoms and Insomnia in Non-Medical Hospital Workers (비의료직 병원 종사자들의 감정노동과 신체증상 및 불면증 간의 관계에서 우울의 매개효과)

  • Lee, Jung-Min;Jang, Ki-Won
    • Journal of Convergence for Information Technology
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    • v.11 no.8
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    • pp.185-193
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    • 2021
  • The purpose of this study is to prevent risk of emotional labor and health through verifying the mediating effects of depression on the relationship between emotional labor and somatic symptoms and insomnia in non-medical hospital workers. For this study, a sample of 533 tertiary hospital's non-medical workers completed the questionnaires of the Korean Emotional Labor Scale, PHQ-15, ISI, PHQ-9. The data was analyzed using the SPSS 25.0 program. The results can be summarized as follows. 1. Among the emotional labor sub-factors, emotional dissonance had a significant effect on depression, somatic symptoms and insomnia. Other sub-factors had a relatively small effect or had no effect. 2. The results showed the partial mediating effects of depression on the relationship between emotional labor and somatic symptoms. 3. The results showed the full mediating effects of depression on the relationship between emotional labor and insomnia. On the basis of the results, we suggest the necessity of dealing with emotional dissonance and depression in non-medical hospital workers' emotional labor and health issues.