• The Journal of the Korea Contents Association
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• v.21 no.4
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• pp.96-110
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• 2021

Korea is faced with the challenge of adapting to the world's fastest - growing low birthrate, aging society, and low growth with low interest rate era. With low fertility and aging population, the factors of financial income of health insurance are decreasing, and the increase of public interest in health, high cost medical technology and the development of medicine are leading to increase expenditure of health insurance. In this study, I will examine the strengthen protection of health insurance, financial stabilization, and fairness of medical care. First, the present status and limitations of health insurance were identified through domestic policy report, domestic and foreign literature, and precedent research. Second, the foreign health insurance policy measures to stabilize the finances were examined separately. Based on this study, in order to maintain sustainable health insurance through reinforcement and financial stabilization of health insurance, the current financial income structure of health insurance must be renovated. It will be necessary to expand government subsidies and discover new tax revenues. In addition, a policy to save finances by reorganizing the medical bill payment system and medical delivery system will also be needed.

• Journal of Convergence for Information Technology
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• v.12 no.4
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• pp.212-218
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• 2022

This study aims to understand health care consumer's information searching behavior according to their presence of chronic diseases. For this purpose, 240 patients' data of university hospital located in Seoul were collected by surveys from 9 February to 11 February 2016. For statistical analysis, we used SPSS Ver. 26.0. The main results of this study are as follows: First, Chi-square test showed that chronic patients used expert information sources and experiential information sources more than those without chronic diseases. Second, chronic patients were found to search nutrition management, exercise management, and patient case. Lastly, in the case of hospital-related searches, patients with chronic diseases searched more waiting time and medical expenses than those without chronic diseases. The significance of this study is to provide basic data for efficient information provision and establishment of marketing strategies reflecting information needs of health care consumers.

• Health Policy and Management
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• v.32 no.2
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• pp.154-163
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• 2022

Background: The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. Methods: We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. Results: In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. Conclusion: High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

• Health Policy and Management
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• v.3 no.1
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• pp.53-83
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• 1993

A small number of high cost patients usually spend a larger proportion of scarce health resources. Korea is no exception. Under the national health insurance, 12% of the insured persons have consumed approximately half of the national health insurance expenditures. Therefore, it is necessary to identify the characteristics of the high cost patient group, if we would like to reduce them. This study has defined high cost patients as those who have spent one and half million won and over per 6 months. The study reveals that high cost users are those who have a longer length of stays(LOS), 40days of LOS in the 6 months, have multiple admissions, 2 to 3 admissions per 6 months and are the elderly patients. They have spent 814.126won per on the average, and commonly suffered from malignant neoplasms, circulatory diseases, fracture, diabetes mellitus, etc. Unlike the case of western developed countries, early readmissions are not the major causes of high cost spending in Korea. Undoubtedly, a lengthy admission is the main cause of large spending. Health policies should vigorously be explored to respond appropriately. There are evidences that hospital beds are often misused. As the Korean health care system is lacking in a mechanism of patient evaluation under the fee-for-service remuneration system, an idea of progressive patient care needs to be tested. The Goverment should set up health policy to diversify the role of long-term care facilities and encourage people to establish them. Further studies are needed to identify factors influencing large medical bills necessary for formulating the health policy on cost containment.

• Journal of Korean Clinical Nursing Research
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• v.16 no.3
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• pp.99-109
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• 2010

Purpose: This study was aimed to examine changes of hospital nurse staffing by hospital characteristics during 2008-2010. Methods: The study sample included 44 tertiary hospitals, 226 general hospitals, and 532 non-general hospitals that were operating during 2008-2010. Grade of nursing management fee was categorized from Grade 1(highest) to 6 (lowest) in tertiary hospitals, l or Grade 7 in general hospitals and non-general hospitals based on the nurse-to-bed ratio. For data analysis, ${\chi}^2$ and GEE were conducted. Results: For three years, the number of tertiary hospitals below Grade 2 were increased from 8 to 12, the number of those above Grade 4 were decreased from 15 to 6. The number of general hospitals above Grade 6 decreased from 123 to 86. Tertiary hospitals and general hospitals had more possibilities to improve nurse staffing grade than general hospital (OR 79.69, 95% CI 50.77~125.09, OR 11.25, 95% CI 8.15~15.53, respectively). Greater likelihood of improvement in grade of nursing management fee was found in university hospital or hospitals with 300 or more beds than other types of hospitals. Conclusion: Differentiating nurse staffing system by hospital type and increasing financial incentives according to the grades are needed to improve hospital nurse staffing.

• The Journal of Korean Medicine
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• v.44 no.2
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• pp.10-19
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• 2023

Objectives: This study aimed to find out the characteristics of patients with facial palsy based on the National Health Insurance(NHI) statistical yearbook and provide the information pertaining to supplement Coverage of NHI. Methods: Based on the data of NHI between 2004 to 2021 for facial palsy(G51) obtained from the Ministry of Health and Welfare, the analyses were carried out according to the distribution of gender and the number of patients, visits, reimbursed days, and medical expenses by using the SAS 9.4. Results: The crude rate of facial palsy was reported as 361.71(2021) comparable with 419.60(2004) and 534.11(2009). The rate of men increased from 293.96(2004) to 302.27(2021) but the rate of women decreased from 450.88(2014) to 420.80(2021). The number of patients maintained around 190,000, however, it declined for patients treated Korean medicine(KM) after 2010. As the medical expenses were elevated, especially Western medicine(WM), that of WM exceeded KM's since 2018. The expenses of women were higher than men's in KM. By contrast, there was no difference with gender in WM. For reimbursed days per visits, it has been increased in WM but there was no difference in KM. Conclusion: Although the rate of patients with facial palsy in KM was high with no difference in the whole number of patients and reimbursed days per visits in KM annually, the number of patients in KM decreased but medical expenses elevated. According to this, it is necessary for reinforcing Coverage of NHI to research other factors related to KM.

• Journal of Korea Society of Industrial Information Systems
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• v.28 no.6
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• pp.11-20
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• 2023

The cost of medical treatment for motor vehicle accidents is increasing every year. In this study, we created a model to predict long-term hospitalization(more than 18 days) among minor patients, which is the main item of increasing traffic accident medical expenses, using five algorithms such as decision tree, and analyzed the factors affecting long-term hospitalization. As a result, the accuracy of the prediction models ranged from 91.377 to 91.451, and there was no significant difference between each model, but the random forest and XGBoost models had the highest accuracy of 91.451. There were significant differences between models in the importance of explanatory variables, such as hospital location, name of disease, and type of hospital, between the long-stay and non-long-stay groups. Model validation was tested by comparing the average accuracy of each model cross-validated(10 times) on the training data with the accuracy of the validation data. To test of the explanatory variables, the chi-square test was used for categorical variables.

• Journal of dental hygiene science
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• v.5 no.4
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• pp.191-198
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• 2005

The present study was attempted to examine the patient satisfaction factors for dental services of several dental clinics to enhance their satisfaction and to provide information that will help dental clinics to have competitive edge over others. This study was conducted an on-site survey to the outpatients of a dentist at Jeollabuk-do, from March 23 to April 10, 2003. The results were as follows: 1. In the event of dental hygienists, their satisfaction with dental hygienists was statistically significantly different according to their occupation. The company employees(4.30) and self-employed people(4.36) were more satisfied with dental hygienists, and the government workers(3.86) were pleased with them the least. 2. Their satisfaction level with internal environments was statistically significantly different according to their age, educational background and occupation. Those who were in their 50s and up(4.23), who received middle-school or lower education(4.11), who were retired or unemployed (4.31), and who were self-employed(4.11) were most pleased with internal environments. 3. Their satisfaction level of external environments varied statistically significantly with their occupation. Those who were retired or jobless (3.57) expressed the most satisfaction, and the government workers(2.83) were pleased the least. 4. Their satisfaction level with treatment process differed statistically significantly with their occupation. Those who were self-employed(3.97) and who were retired or unemployed(3.89) were more pleased, and the public officials(3.34) and professionals(3.54) were satisfied the least. 5. As to satisfaction level with medical bills, those who were in their 50s and up(3.95), who received high-school education(3.80), who were self-employed(3.98), and whose monthly mean income was three million won or more(3.99) expressed the biggest satisfaction. 6. What factors affected their overall satisfaction level with treatment after receiving it was investigated, and it's found that their overall satisfaction level was under the statistically significant influence of dentists, dental hygienists, treatment process and medical bills.

• Journal of dental hygiene science
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• v.6 no.2
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• pp.133-138
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• 2006

To find out influence of water fluoridation program on the economic benefit effect, this study analyzed comparatively dental treatment indicators obtained from dental clinics at Sangdang-gu in Chenongju City, fluoridated community and Manan-gu in Anyang City, non-fluoridated community, from January 1, 2003 to the end of June, and the results are as follows: 1. If water fluoridation program is carried out in Anyang, non-fluoridated community, the number of treatment from caries and disease of tissues around dental pulp and root apex from age 6 to 18 for the first half of year 2003 is expected to decrease by 1,272, 636 for low estimation, and 1,908 for high estimation. And the treatment cost is expected to decrease by 40,888,000 Wons, 20,444,000 Wons for low estimation, and 61,333,000 Wons for high estimation. 2. Assuming that water fluoridation program is spread to all over the country, the number of treatment per year is expected to decrease by 2,492,018, 1,246,009 for low estimation, and 3,738,027 for high estimation. And the treatment cost is expected to decrease by 80,105,075,000 Wons, 40,052,537,000 Wons for low estimation and 120, 157,612,000 Wons for high estimation respectively. 3. For Yeong-un water supply management office which has 48,925 water supply personnel, the benefit/cost rate was 2.9 times, and for Jibuk water supply management office which has 239,751 water supply personnel, the benefit/cost rate was 9.0 times. As the water supply personnel increased, the cost increase of water fluoridation program was little and as the scale got large, the economic effect was very large. Improving national oral health is thought to be associated with expense retrenchment of oral health insurance financial. So it may need to extend using tap water to all the area of the country and additionally establish confidence through an active public relations and education of water fluoridation program.

• Journal of dental hygiene science
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• v.9 no.4
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• pp.443-451
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• 2009

The purpose of this study was to examine the views of dental hygiene students about the possible countermeasure of domestic hospitals for the opening of the medical market. The subjects in this study were 269 dental hygiene sophomores, juniors and seniors at two different colleges in the region of Busan. The findings of the study were as follows: The opening of the medical market and views of possible countermove, whether they agreed to that or not made a statistically significant difference to their opinions on the necessity of customer-oriented marketing strategy(p=0.023), analysis of foreign medical markets/attempt to make inroads into the markets(p<0.000) and the improvement of the quality of medical services/the diversification of the services(p=0.025). As to an intention of going to a foreign hospital, they had a statistically significantly different intention about whether to go to a foreign hospital regardless of medical bills(p<0.000), whether to consult a doctor in a foreign hospital after going to a domestic hospital first (p<0.000), whether to consider the distance between their houses and a foreign hospital(p=0.05) and whether to take considerations on the assistance of an interpreter(p=0.023). In regard to preference for foreign hospitals, American hospitals ranked first(41.9), followed by Australian hospitals(19.9) and Canadian ones(14.2).