• Title/Summary/Keyword: 진료비

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Analysis on the Difference in Efficiencies between Environmental Factors of Regional Public Hospitals in Korea using Super-Efficiency Model (초효율성 모형을 이용한 지방의료원의 환경요인별 효율성 차이 분석)

  • Yang, Dong-Hyun
    • The Journal of the Korea Contents Association
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    • v.12 no.7
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    • pp.284-294
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    • 2012
  • In the study, we estimate efficiencies using CCR model of DEA, Super efficiency(AP) model, and super-SBM model with the data of 32 regional public hospitals in Korea from 205 to 2009. With Wilcoxon-Mann-Whitney statistics, we analyze efficiency differences for environmental factors(regions, type of hospital, type of operations, type of education training, relative importance of madicaids) among regional public hospitals. The results can be summarized as follows. Firstly, technical inefficiencies of regional public hospitals range from 15% to 17% in CCR model, 13% to 15% in AP model, 7% to 12.6% in SuperSBM model. Second, we confirm that environmental factors of hospitals cause different inefficiencies among them. The implication of this study is that policy and institutional change may need to improve the efficiencies along with internal managerial reform.

A Study on the Online-based one-stop private health insurance claims (온라인 기반 원스톱 실손의료보험료 청구에 관한 연구)

  • Lee, Kyounghak;Kang, Min-Soo;Lee, Jae-Yeul
    • Journal of Digital Convergence
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    • v.14 no.4
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    • pp.231-237
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    • 2016
  • The private health insurance covers areas that are not covered by the national health insurance to reinforce insurance guarantee. Realistically, however, many people renunciate small sum insurance claims because the inconvenient claim procedures require a certificate from the hospital for resubmission to the insurance company, which is very time consuming. Therefore, One-stop insurance payout claiming system that is capable of one stop processing of the issuance of e-page safer technology-based certification to claiming of insurance payout by utilizing authorized electronic address (#-mail) through the utilization of private information concealment technology and identification certification technology for the convenience of the subscribers and the simplification of operation was developed.

Analysis of Utilization and Expenses of Medical and Oriental Medical Care Services in a Designated Rural Areas (군보건소의 진료제공량 및 양·한방 진료비 분석)

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.17 no.1
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    • pp.17-24
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    • 1992
  • The medical care insurance system has been adopted in rural areas in 1988, since then, the utilization of medical care services has increased rapidly in rural areas. The government has restructured the 15 health centers, which are located in remoted rural areas and these 15 health centers were strengthend to provide the curative care to the residents in order to meet the curative can demand of the residents. Besides the reorganization of the health centers, the government has implemented the oriental medical care demonstration project at the health center in a designated rural areas. This study was aimed to analyze the utilization and expenses of medical and oriental medical care services in a designated rural areas. Number of annual visits of residents to health centers in 1991 showed slightly decreased compared with that in 1989. However number of annual visits to the hospitalized health centers was an increase of 49.3%~64.5%. Regarding the coverage of curative care for the residents in rural areas, the hospitalized health centers are functioning more effective than that of health center. Expenses per case of medical care rendered by health center was lower than that of oriental medical care, while the expenses of the medical care was quit higher than that of oriental medical care in the hospitalized health centers. According to the above mentioned study results, the hospitalized health centers were more effective and suitable to provide a curative care to the residents than the health centers, and also the oriental medical care could be needed to be provided by public health network in the near future.

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Developing the predictive model for stomach cancer using data mining (데이터마이닝을 이용한 위암 예측모형 개발과 활용)

  • Park, Il-Su;Han, Jun-Tae;Kang, Suk-Bok;Ji, Jae-Hoon
    • Journal of the Korean Data and Information Science Society
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    • v.21 no.6
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    • pp.1253-1261
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    • 2010
  • We develope the predictive model for the incidence of the stomach cancer by utilizing the health screening data of the National Health Insurance in Korea. We also explore the characteristics for the stomach cancer. We perform the logistic regression analysis using the data mining methodology and use SAS Enterprise Miner 4.1. This study shows that there exists a higher rate of the stomach cancer for males than females. Our study confirms that the major influencing factors for the incidence of the stomach cancer are age, drinking and a family history of cancer, lack of exercise. For man, the age is the most important determinant of the stomach cancer incidence, whereas the drinking is the most important determinant of the stomach cancer incidence for women.

Physicians' behavior and attitude toward Review system of National Health Insurance claim in Korea (진료비 심사제도에 대한 개원의 들의 태도 및 만족도)

  • Jo, Heui-Sug;Jeong, Heon-Jae;Hwang, Moon-Sun
    • Korea Journal of Hospital Management
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    • v.10 no.2
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    • pp.45-63
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    • 2005
  • The purposes of this study are to understand the doctors' attitude and satisfaction about the review system of national health insurance claim in Korea and to suggest the way to improve this system This study conducted a survey of the doctors registered in the medical association in Seoul city. The survey was performed as a form of self-administered questionnaire from January 2004 to February 2004. The contents of questionnaire dealt with doctors' attitude and satisfaction about the review system of medical service claim. Totally, 1,037 members replied to our survey and we analysed 981 doctors' data, excluding incomplete responses. As a result, 89.7% of repliers showed a negative attitude about the influences of the review system on improvement of medical service quality, 98.0% of repliers have had experiences that they have given distorted insufficient medical services in order to evade the curtailment of service claim. Also, 91.6% of repliers stated that they have had experiences of intentional modification or alteration of diagnostic code to shun the curtailment. Most of the doctors showed negative attitude to the curtailment procedure and the review system of service claim originally intended to be one of the quality control methods of medical service in Korea also, the development of both scientific and reasonable parameters and criteria for claim is needed. 'Through the improvement of review system for appropriate medical service, there is a need of a way to increase the satisfaction of medical service providers, and to encourage the motivation for quality control. Also, education is strongly needed to provide doctors with sufficient information about review criteria and curtailment cases.

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Analysis on Home Care Services and Home Health Care Cost of CVA Patients in Korea (뇌혈관질환자의 가정간호 서비스 및 진료비 분석)

  • Kim, Eun-Kyung;Shin, Suk-Youn;Hwang, Jeong-Hae
    • Journal of Korean Academy of Nursing Administration
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    • v.12 no.2
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    • pp.225-232
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    • 2006
  • Purpose: The purpose of this study was to analyze the services and cost of CVA patients in hospital-based home health care and compare the differences of home health care cost by hospital types. Methods: The subjects of this study were 5,756 home care patients with cerebrovascular disease. Data were collected by using home health care medical expense claims from 127 hospitals in 2004. Results: The home care service 'indewelling catheterization' was the highest(19.28%), and then 'nasogastric tube insertion and change(16.72%)', 'bladder irrigation(15.98)', 'wound management(simple dressing)(10.42%)' followed. Average home health care cost per visit was 39,943 won, and the highest 46,058 won in general hospitals and the lowest 33,922 won in tertiary hospitals, so there were statistically significant among the types of hospitals(F=1112.47, p<0.0001). Conclusions: The number of home health care patients has been rapidly growing with the increase of aged population and demand for home care services is rising. So, it could be urgent to develop a reasonable cost reimbursement system for home health services and to expend scopes of the roles of home care specialist nurses. Amid the demand of more detail understanding the present status of home care, our study can be contributed to provide fundamental information of home care in Korea.

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Change of Medical Utilization Claims in Self-employees before and aster the Economic Crisis in Korea (IMF 경제위기 전.후 지역의료보험가입자들의 진료비 청구내용의 변화)

  • Lee, Sin-Jae;Jhang, Won-Ki;Choi, Soon-Ae;Lee, Sang-Yi;Kim, Nam-Soon;Jeong, Baek-Geun;Moon, Ok-Ryun
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.1
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    • pp.28-34
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    • 2001
  • Objectives : To investigate the changing pattern of medical utilization claims following the economic crisis in Korea. Methods : The original data consisted of the claims of the 'Medical insurance program of self-employees' between 1997 and 1998. The data was selected by medical treatment day ranging between 8 January and 30 June. Medical utilizations were calculated each year by the frequency of claims, visit days for outpatients, length of stay for inpatients, total days of medication, and the sum of expenses. Results : The length of stay as an inpatient in 1998 was decreased 4.7 percent in comparison to 1997. However, inpatient expenses in 1998 increased 10.8 percent as compared to 1997. Inpatient hospital claims in 1998 increased 6.2 percent over 1997, although general hospital inpatient claims in 1998 decreased 3.3 percent in comparison to 1997. The outpatient claim frequency decreased 7.3 in 1998 percent as compared to 1997 Outpatient visit days of in 1998 were decreased 8.5 percent in comparison to that recorded in 1997. Outpatient claim frequencies of 'gu region' in 1998 decreased 10.5 percent comparison to that in 1997, but 'city and gun region' decreased less than 'gu region'. Conclusions : Medical utilization in 1998 deceased in relation to 1997 Medical utilization by outpatients decreased more than that of inpatients. Medical utilization by 'gu region' decreased mere than the other regions.

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Comparison of Hospital Charges and Patient's Satisfaction between Ambulatory Surgical Procedures and Inpatient Surgery in Vitrectomy and Tonsillectomy Patients (수정체적출술과 편도절제술에 대한 통원수술과 입원수술의 진료비 및 만족도 비교)

  • Seo, Jae-Myung;Yu, Seung-Hum
    • Korea Journal of Hospital Management
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    • v.4 no.2
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    • pp.41-59
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    • 1999
  • Objectives: This study was done to compare patient satisfaction and hospital charges of surgery performed in an outpatient basis(ambulatory surgical procedures). Methods : This retrospective study was performed in 20(vitrectomy 11, tonsillectomy 9) randomly selected ambulatory surgical procedures patients and 50(vitrectomy 26, tonsillectomy 24) inpatients who. received the same procedure at a general hospital in Seoul since January 1, 1998 to October 31, 1998. The operative procedures were vitrectomy and tonsilletomy which could be performed on a ambulatory surgical procedures basis or on an inpatient basis. Results: The results of this study shows that the patients thought the expenses and the surgical operative time was an important factor in a ambulatory surgical procedures but there were no differences in the patient satisfaction by the method of surgery. The charges of vitrectomy and tonsilletomy were reduced up to 495,000 won and 380,000 won from l,589,000 won 842,000 won inpatient surgery respectively. Conclusions: This study focused only on the charges of the surgical procedures and did not include the cost of patient helper, the lost salary due to missing days of work to care for a member of the family, transportation costs, and other indirect costs. Therefore, if those fees were included, ambulatory surgical procedures would be more economical. Therefore, by giving incentives at the fee schedule, the government health policies it would reduce the total hospital charges.

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The effect of a malocclusion status of a patient for orthodontic treatment, a fee for orthodontic and oral health behavior on orthodontic satisfaction (치과교정환자의 부정교합상태·교정진료비·구강보건행태가 치과교정만족도에 미치는 영향)

  • Jeong, In-Ho;Lee, Sook-Jeong;Lim, Si-Duk;Kim, Byung-Sik;Park, Young-Dae;Park, Ji-Young;Lee, Jong-Hwa
    • Journal of Technologic Dentistry
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    • v.35 no.4
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    • pp.395-403
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    • 2013
  • Purpose: This article examined the affecting factors of a malocclusion status of a patient for orthodontic treatment, orthodontics medical expenses and oral health behavior on orthodontic satisfaction. Methods: This paper conducted a survey from the 15th of July to 30th of September 2012 for the patients who were under orthodontic treatment at three dental clinics where are in Deagu, and distributed a total of 210 questionnaires and analyzed 194 questionnaires, excepting for some questionnaires that were answered unfaithfully. Results: This study classified the related factors into a feeling of satisfaction with treatment and mental satisfaction for finding orthodontic satisfaction. There were the effect of the right tooth-brushing method, a periodic scaling and orthodontics medical expenses on a feeling of satisfaction with treatment, and power of explanation was 16.7%. Conclusion: There were the effect of a malocclusion status, matters that requires attention during orthodontic treatment, a periodic scaling during orthodontic treatment and orthodontics medical expenses on mental satisfaction, and power of explanation was 16.9%. Based on the result above, this paper concluded that preventive treatment and early treatment should be emphasized through developing a program for regular oral examination suited to each medical type, including the method for improving the medical treatment condition and care service for increasing orthodontic satisfaction, which the dental medical-service providers could consider the patients and secure trust.

A Study on Drug awareness information, Usage and Misusage on Elderly Inpatients of Veterans Hospital (보훈병원입원노인환자의 약물정보인식, 약물사용 및 오용실태에 관한 연구)

  • Heo, Young Hi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.9
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    • pp.4326-4334
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    • 2013
  • This study is descriptive research, attempts to determine the status of elderly inpatients of veterans hospital' of drug awareness information, drug use status and drug Misusage. The subjects were 220 patients of aged 65 and over only five metropolitan areas nationwide in drug use in the Veterans Hospital, national merit, the study is from May to June. SPSS Win 18.0 program was used as the data analysis and a statistical statement by mean, standard deviation, t-test and ANOVA, and multiple regression analysis. As a results, there was showed a statistically significant level 'age', 'type of marriage', 'education', 'triage', 'health status' as the general characteristics of the subjects. It showed the 'age' of the variables that influence recognition in the area of drug awareness information, and drug Misusage and drug use status factors seemed to affect the 'health status'. Therefore, It need for a comparative study of elderly inpatients and inpatients of veterans hospital, the research should be qualitative research of veterans medical services to the on reasonable support measures in the Veterans Affairs health care system and national merit.