• Journal of the Korean hospital association
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• v.16 no.10 s.148
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• pp.9-13
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• 1987

• Journal of the Korean hospital association
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• v.18 no.6 s.165
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• pp.42-48
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• 1989

• Journal of the Korean hospital association
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• v.18 no.6 s.165
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• pp.49-55
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• 1989

• 월간산업보건
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• s.26
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• pp.4-12
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• 1990

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.2
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• pp.470-478
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• 2020

In this paper, a theoretical model that separates one single conversion factor into two conversion factors for both outpatients and inpatients is introduced. By using hypothetical numbers, two conversion factors and an adjustment factor were calculated. The major implications are as follows. Firstly, by introducing two conversion factors, a minimum incentive mechanism for admitting outpatients to a clinic and high risk inpatients to a hospital was installed. Secondly, the introduction of two conversion factors decreased the drive to admit outpatients to a hospital by reducing the economic benefits for the hospital. Thirdly, it is possible to make explicit contracts for several factors rather than a single conversion factor, so that it can be used as an appropriate management tool for rapidly increasing medical expenses. Finally, this research can be used to set up policy tools to establish a proper healthcare delivery system in Korea by inducing behavioral changes in healthcare institutions.

• The Journal of the Korea Contents Association
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• v.20 no.3
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• pp.92-105
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• 2020

This study was aimed to identify factors affecting the purchase of indemnity private health insurance and analyze its effect on healthcare utilization by gender. This study analyzed data of the 2010-2016 Korea Health Panel Survey using panel logit model and panel regression model. Men were less likely to purchase indemnity private health insurance than women. Self-rated health and unmet need for healthcare in women were related to insurance purchases. In men, married people and residents of the metropolitan area were more likely to purchase. The indemnity private health insurance did not affect the women's outpatient expenses per visit, but for men it increased. The indemnity private health insurance significantly increased women's inpatient expenses per admission, but it did not affect men's inpatient expenses. This study confirmed gender differences in the factors affecting the purchase of indemnity health insurance and the impact of indemnity health insurance on healthcare utilization. This suggests that gender differences should be taken into account in private health insurance research and institutional operation.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2006.05a
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• pp.1051-1054
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• 2006

Lots of information such as prescription transmitted to the drug store by the result of separation of medical activity from medicine one, EDI for billing medical charge to Health Care Public Cooperation and the returned opinion letter sent to doctor etc is scattered in the Web document made from XML. Especially information containing medical treatment charge is one of the materials that are revised frequently. It is the current situation that document is transmitted or form is made for distribution whenever this kinds of revision is occurred. In this thesis, DTD design and implementation for the information system regarding the rate of medical charge is studied based on XML which is used to calculate charges for the several activities including consulting and prescribing. Patient or patron as well as doctor, pharmacist and nurse are all interested in the information regarding the rate of medical charge. It aims everybody to easily obtain information about the rate of medical charge by querying it anytime, anywhere.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.37-45
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• 1984

This study was conducted to identify the problems in the medical aid program by reviewing the medical care utilization pattern of the beneficiaries. The data were abstracted from the monthly bills and vouchers for medical care of the whole benefi챠aries(17,527) in Gyeongsan Gun submitted by the physicians to county government for the period of 1 calendar year from October 1981 to September 1982. The number of medical aid beneficiary accounted for 12.7% of the total county population, a higher proportion than the national average-9.5%. Monthly primary care utilization rate per 100 beneficiaries was 9.3 persons with 14.0 visits and 42.9 medication days. for the 2nd and 3rd care, there were 1.7 admissions and 9.3 OPD visits per 100 beneficiaries per year. The beneficiaries of the first class medical aid program had a higher utilization rate of both the primary and secondary/tertiary care facilities. Females utilized more the primary care facilities than males while males utilized more the secondary/tertiary care facilities than females. A significantly lower utilization rate was observed in January than in the other months and this was seemed due to the renewal process of the medical aid certificate. Among 1,931 patients utilized the 2nd/3rd care facilities 84.4% was out-patients and the lowest ratios were in the minor specialties including ENT, ophthalmology, dermatology and urology. The average hospital days per in-patient were 21.2 days and OPD days per out patient were 4.7 days. The average hospital days for a psychiatry in-patient was 74.4 days which was the longest average hospital days among all the specialties. Average medical care cost per beneficiary in a year was W9,821:W24,240 for the 1st class and W7,464 for the 2nd class. The medical care cost for the primary care per patient was W3.901 and W840 per day compared with W49,875 per patient and W5,822 per day for the secondary/tertiary care. From the findings of this study following recommendations were made to improve the medical care program: 1) The renewal process of the medical care certificate should be expedited. 2) Minor specialty clinics should be designated as the primary medical care facility for the medical aid program to reduce the expenses by absorbing more patients referred to the secondary/tertiary care facilities directly. 3) The medical care cost for the primary care facility should be escalated to reduce the differential between the primary and secondary/tertiary care facilities.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.4 no.2
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• pp.57-62
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• 2003

In order to implement SGR in Korea, it is necessary to analyse the factors affecting the increase of Korea Medical Insurance Cost. GDP and MEI may substitute the diverse factors affecting the Medical Cost Uprise. In this article, the GDP and MEI influence on the rates of fee schedule is measured when we implement SGR System in Korea. The various cases are made to analyse the rates of fee change. In Korea, if we implement the SGR system successfully. we should make a considerate formula using GDP and MEI because the rate of change in GDP and MEI is much more bigger than that of U.S.

• Journal of the Korea Convergence Society
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• v.8 no.5
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• pp.61-68
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• 2017

This study investigates the differences in medical practices and medical cost according to auto insurance companies based on 8,589,602 cases that were treated by auto insurance corporation for the year of 2015, from the beginning of January to the end of December. The results of this study can be summarized following. First, in terms of the general characteristic in medical treatment, especially the age, the highest figure in both non-life insurance and mutual aid cooperative was shown in the age of 50 to 59 at 22.8 per cent(p<0.001). Second, in terms of a medical cost per a hospital care, classified by clinic, the costs in the department of internal medicine were much higher than those in the surgical department, and the thoracic surgery among parts of the surgical department showed the highest figures in both non-life insurance and mutual aid cooperative. According to the above summarized results of this study, it can be concluded that Health Insurance Review and Assessment Service has to address the problem on the increase of unnecessary costs and the occurrence of social expenses caused by the delay of patients' rehabilitation and return to their daily lives, by carrying out the evaluation for the appropriateness to organizations that ask for payments of auto insurance.