• Proceedings of the KAIS Fall Conference
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• 2009.05a
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• pp.405-406
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• 2009

Introduction : 최근 의료기관 내 진료비 정산으로 인한 전산화사업이 적극 추진되면서 각 의료기관은 생성된 자료의 목적과는 무관하게 대량의 자료를 지니고 있으면서도 병원경영과 관련하게 자료를 활용하고 있지 못하다．Objectives : 병원 입원환자의 데이터를 분석하여 입원환자의 이탈요인을 파악하여 이탈을 방지하고 지속적인 의료서비스를 제공할 수 있도록 하고자 한다. Method : 본 연구는 일개병원을 퇴원환자를 대상으로 2006년 1월 1일~2007년 12월 31일 동안의 퇴원환자 데이터를 기반으로 연구되었다. 퇴원환자 38,359명의 병원데이터 베이스를 기반으로 동일 연구기간 외래 누적데이터 375,659건의 외래환자 데이터와 비교하여 퇴원환자 중 재입원 예약 및 외래진료 예약 부도여부를 비교하는 후향적 연구를 수행하였다. 2008년 1월 1일 기준 재입원 예약 및 외래진료 예약부도 발생여부를 기준으로 계속진료환자 그릅과 이탈환자그룹을 생성하였다. 중복을 제거한 총 대상은 3,503명이였다. Discussion :본 연구에서 얻어진 결과를 기초로 퇴원환자의 이탈률이 높은 환자그룹을 집중 관리하여 이탈을 방지하고 관심을 갖고 향후 잠재적 이탈 고객을 다시 유입할 수 있는 많은 방안들이 마련되어야 할 것이다.

• The Korean Journal of Health Service Management
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• v.8 no.2
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• pp.11-22
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• 2014

This study purposed to analyze the regional variation of the local-out rates of inpatient services. Multiple data sources collected from National Health Insurance Corporation and statistics Korea were merged to produce the analysis data set. The unit of analysis in this study was city, Gun, Gu, and all of them were included in analysis. The dependent variable measured the local-out rate of inpatient cost in study regions. Local environments were measured by variables in three dimensions: provider factors, socio-demographic factors, and health status. Along with the traditional ordinary least square (OLS) based regression model, geographically weighted regression (GWR) model were applied to test their effects. SPSS v21 and ArcMap v10.2 were applied for the statistical analysis. Results from OLS regression showed that most variables had significant relationships with the local-out rate of inpatient services. However, some variables had shown diverse directions in regression coefficients depending on regions in GWR. This implied that the study variables might not have consistent effects and they may varied depending the locations.

• Korea Journal of Hospital Management
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• v.15 no.2
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• pp.15-26
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• 2010

Stroke is a high-risk disease. The future of the medical environment is that the proportion of elderly population is increasing, the average life expectancy is being increased, while the fatal rate of stroke will be low. These situation will due to the financial burden on medical insurance. The most important factor that affects on the medical costs of stroke patients is the length of stay. In this study the mean length of hospital for stroke stay was 21.81days(37.97days for intracerebral hemorrhage, 18.89 days for cerebral infarction). The payment per case of stroke was 6.86 million won(12.6 million won for intracerebral hemorrhage, 5.72 million won for cerebral infarction). The payment per case of intracerebral hemorrhage was 2.2 times more than that of cerebral infarction. The payment in the day of hospitalization was the highest and until the second day medical costs was high. After the third day medical costs tended to decline, after that seemed to show an almost constant level. The length of hospital stay was found to be the most important determinant of inpatient charges for stroke. Accordingly rational management of the length of stay will be beneficial to health care consumers, providers, states.

• Korea Journal of Hospital Management
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• v.20 no.2
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• pp.28-38
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• 2015

This study was conducted by extending Ajzen's Theory of Planned Behavior(TPB) model in analyzing physician's observance behavior of National Health Insurance review standards. An extended TPB model was proposed by including 'background knowledge'and 'dorganizational commitment'in original model to predict physician's review standards observance behavior. Surveys for data collection were carried out on the physicians who were working in a general hospital, clinics, specialized hospitals, local medical centers and long term care hospitals located in Daegu and Kyoung-Buk province in Korea. Two hundreds twenty copies of questionnaires were distributed and 166 physicians responded. Data were analyzed using a structural equation model. The results show that an affirmative attitude and subjective norms have significant positive effects on physicians' behavior of observing review standards. However, the effect of perceived behavioral control on intention to behavior is not significant. The organizational commitment and background knowledge have a positive effect on the intention of observance of review standards. In conclusion, because physician's observance behaviors are affected by background knowledge and organizational commitment as well as attitudes, subjective norms, hospital managements should establish a communication system to share information on the review standards among physicians and provide appropriate measures to increase physician's organizational commitment.

• Health Policy and Management
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• v.11 no.2
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• pp.29-57
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• 2001

Since the inauguration of the medical insurance system in 1977, the increasing medical expenses which can be menace to tile finance of the medical insurance system, have become major concern in the medical insurance field In Korea. This study focuses on the determinants of the medical expenses in the health insurance in Korea and analyzes the impact of these factors on the increase in the medical expenses. The empirical work is done using the pooled cross-section and time-series data of the medical insurance for the self-employeds and the industrial workers from the year 1995 to 1997. The result of this study shows that the main determinants of the medical expenses in the health insurance are the ratio of the population of the aged to the total population, the frequency of the utilization, number of doctors per capita and the regime changes. Although the increasing trend in the medical expenses seems to be unavoidable, we probably need to add some efficiency to the medical expenses by suppressing the supply and the utilization of the unnecessary medical services. The fee-for-service reimbursement system of today can't suppress the supply of the unnecessary medical services effectively. So we need to convert the present fee-for-service system into DRG's which is known to reduce the medical costs. The increase in the medical expenses comes from a lot of factors. Therefore, we should develop more systematic and comprehensive measures to control the soaring medical expenses in consideration of the various factors such as demand, supply, and the organizational side of the medical system.

• Health Policy and Management
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• v.7 no.2
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• pp.1-18
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• 1997

This study was conducted to analyze patient days and medical care benefits of finger-amputated patients due to industrial accident. The 161 personal data on medical care for finger-amputated patients due to industrial accident(88 in 1994, 73 in 1995) of Regional Labor Office and hospital characteristics were analyzed. The major results of this study were as follows : According to stepwise multiple regression analysis of patient days, number of amputated finger, location of hospital, bed capacity of hospital, presence of plastic surgery in hospital, number of orthopedic specialist per 100 beds, sick leave benefits per day were the major significant variables in order. In stepwise multiple regression analysis with medical care benefits as a dependent variable, presence of plastic surgery in hospital, number of orthopedic specialist per 100 beds, number of amputated finger, sick leave benefits per day, age, bed capacity of hospital were the major significant variables in order. The minimum optimal size with the lowest medical care benefits was a hospital with 300 beds. This shows that the economy of scale is also applicable for hospital industry. In summary, presence of plastic surgery in hospital, number of orthopedic specialist per 100 beds, number of amputated finger, sick leave benefits per day, bed capacity of hospital were the major significant variables in both patient days and medical care benefits.

• Journal of the Health Care and Life Science
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• v.9 no.1
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• pp.87-93
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• 2021

Effects on Health Center and Hospital Visit Patient Characteristics and Overall Satisfaction As a result of comparing the characteristics of visiting patients in the public health centers and hospitals, the number of patients at the public health centers was relatively higher than the hospital patients, the number of medical benefits patients was higher, and there were more vaccinations or physiotherapy patients than the purpose of disease treatment.There was a small number of private insurances,The older adults were more. The most influential variable on the overall satisfaction level of the public health center is the facility satisfaction And doctor satisfaction had a weak effect.In the case of hospitals, the facility satisfaction Also, the degree of satisfaction with doctors, satisfaction with medical expenses, and satisfaction with treatment environment were in order.

• Korea Journal of Hospital Management
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• v.27 no.1
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• pp.31-42
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• 2022

Purposes: This study aims to investigate the changes in the length of stay and medical expenses by the impact of the admission decided by patients or their family. Methodology: The analysis was conducted using data from elder patients aged 65 or older who have used admission services more than once from year 6(2012) to year 12(2017) of the Korean Medical Panel Data(KOWEPS). The statistical analysis was performed through the Chi-square test, mean difference analysis, and generalized estimation equation analysis. Findings: Compared to the patients who used admission services decided by doctors, those who used admission services decided by patients or their family had a longer length of stay and a lower daily medical expense. Practical Implications: Inappropriate admission decided by patients or their family can increase the risk of hospital-acquired infections, impairing the health of elderly patients, and has a negative impact on the efficiency of health resources. Therefore, it is necessary to prevent and properly manage inappropriate admission decided by patients or their family

• Health Policy and Management
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• v.33 no.4
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• pp.379-388
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• 2023

This study aims to propose the implementation of innovative payment models in Korea in order to promote the financial sustainability of the national health insurance system by reviewing the current status of the payment system in Korea and examining other countries' experiences with various innovative payment models. Korea primarily uses a fee-for-service payment system and additionally uses various payment systems such as case payment, per diem, and pay-for-performance. However, each payment system has its limitations. Many OECD (Organization for Economic Cooperation and Development) countries have pointed out the limitations of existing payment systems and have been attempting various innovative payment models (e.g., add-on payment, bundled payment, and population-based payment). Therefore, it is essential for Korea to consider innovative payment models, such as a mixed payment model that takes into account the strengths and weaknesses of each payment system, and to design and pilot these models. This process requires stakeholders to work together to build a social consensus on the implementation of innovative payment systems and to refine legal and systematic aspects, develop an integrated health information system, and establish dedicated organizations and committees. These efforts towards innovative payment models will contribute to developing a sustainable health insurance system that ensures the public's health and well-being in Korea.

• Journal of Environmental Health Sciences
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• v.42 no.5
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• pp.324-332
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• 2016

Objectives: The annual average of PM10 in Seoul was $45{\mu}/m^3$, which surpasses the WHO annual guidelines ($20{\mu}/m^3$). Most previous analyses of the effects of PM exposure have been retrospective studies using single hospital data, and fewer studies have attempted to address the relationship of PM10 and hospital costs. This study was conducted to investigate the effects of the concentration of PM10 on hospital visits, admissions and hospital costs in patients with respiratory and cardiovascular diseases. Methods: Medical data from the National Health Insurance Service and the monthly average of PM10 from National Institute of Environmental Research were used to identify the effects of PM10 on hospital visits, admissions and hospital costs. We applied Poisson regression and linear regression to perform the analysis. Results: The relative risks for admissions per $10{\mu}/m^3$ increase in PM10 were 23.11%, 10.2% and 6.9% increases for acute bronchiolitis, asthma and bronchitis, respectively. The relative risk for hospital visits per $10{\mu}/m^3$ increase in PM10 were 10.4%, 6.7% and 5.9% for chronic obstructive pulmonary disease, asthma and chronic sinusitis, respectively. For cardiovascular disease, the relative risk for admissions per $10{\mu}/m^3$ increase in PM10 were 2.2% and 2.1% increases in angina and acute myocardial infarction, respectively. A $10{\mu}/m^3$ increase in the monthly average of PM10 corresponded to 170,723,000 won (95% CI: 125,587,000-215,860,000 won), 123,636,000 won (95% CI: 47,784,000-199,487,000 won) and 78,571,000 won (95% CI: 29,062,000-128,081,000 won) increases in hospital costs for asthma, acute tonsillitis and chronic sinusitis, respectively. Conclusion: Hospital admissions for respiratory and cardiovascular disease were associated with PM10 levels. PM10 exposure is also associated with increased costs for respiratory diseases.