• 보건행정학회지
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• 제3권1호
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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.

• 보건행정학회지
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• 제25권2호
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• pp.67-70
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• 2015

To establish an appropriate policy for robotic surgery in Korea, the National Evidence-based Collaborating Agency (NECA) and the Korean Society of Health Policy and Administration held a round-table conference (RTC) to gather opinions through a comprehensive discussion of scientific information in gastric cancer. The NECA RTC is a public discussion forum wherein experts from diverse fields and members of the lay public conduct in-depth discussions on a selected social issue in the health and medical field. For this study, representatives from the medical field, patient groups, industry, the press, and policy makers participated in a discussion focused on the medical and scientific evidence for the use of robotic surgery in gastric cancer. According to the RTC results, robotic surgery showed more favorable results in safety and efficacy than open surgery and it is similar to laparoscopy. When the cost-effectiveness of robotic surgery and laparoscopy is compared, robotic surgery costs are higher but there was no difference between the two of them in terms of effectiveness (pain, quality of life, complications, etc.). In order to resolve the high cost issue of the robotic surgery, a proper policy should be implemented to facilitate the development of a cost-effective model of the robotic surgery equipment. The higher cost of robotic surgery require more evidence of its safety and efficacy as well as the cost-effectiveness issues of this method. Discussions on the national insurance coverage of robotic surgery seems to be necessary in the near future.

• 보건행정학회지
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• 제21권2호
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• pp.179-194
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• 2011

Although there have been studies regarding the separating policy of dispensary and medical practice, little study have provided a concrete empirical evidence to what extent the policy objectives are achieved. In this paper, we try to provide empirical evidence whether the policy separating dispensary from medical practice achieved the policy objectives, which representatively are reducing the mis-use or over-use of anti-biotic prescriptions and medicines, and decreasing the government spending for the cost of pharmaceutical support. By comparing the average of the rate of change of the number of medicines prescribed, the rate of anti-biotics prescribed, and the government spending for the cost of pharmaceutical support between the areas where the separation policy was implemented and the exceptional areas, we concluded that it is difficult to conclude that the policy separating dispensary and medical practice achieved its policy objects, as it first announced to achieve in the introduction of the policy in 2000. However, the limitation of this study is that the data, that can thoroughly analyze the effect of separating policy of dispensary from medical practice, cannot be collected as expected. Hence, we could not use a parsimonious empirical model to evaluate the effect of the policy introduced in 2000. Rather we used a simple statistical method to extract enough empirical evidence fro m the data available. In the near future, we would expect to see more research that analyze the exact effect of policy separating dispensary and medical practice with concrete empirical model using more sophisticated dataset.

• 디지털융복합연구
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• 제19권11호
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• pp.327-339
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• 2021

본 연구는 TTAT를 기반으로 정보보안 정책의 관점에서 보안 정책의 특성(정책의 취약성, 정책의 효과성, 정책 준수 비용, 정책 준수 효능감, 사회적 영향력)이 조직의 정보보안 정책 준수 동기에 미치는 영향을 살펴보기 위해 수행되었다. 분석 결과는 다음과 같다. 첫째, 보안 정책의 위협은 정책 준수 동기에 유의한 영향을 미치는 것으로 나타났다. 둘째, 정책의 효과성은 준수 동기에 통계적으로 유의한 영향을 미치지 못하는 것으로 나타났다. 셋째, 정책 준수 비용은 정책 준수 동기에 유의한 영향을 미치는 것으로 나타났다. 넷째, 정책 준수 효능감은 회피 동기에 유의한 영향을 미치지 못하는 것으로 나타났다. 마지막으로, 사회적 영향력은 준수 동기에 유의한 영향을 미치는 것으로 나타났다.

• 한국경영과학회지
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• 제34권3호
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• pp.71-84
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• 2009

This paper considers a remanufacturing and purchasing planning problem, in which either used products(or wastes) are remanufactured or remanufactured products(or final products) are purchased to satisfy dynamic demands of remanufactured products over a discrete and finite time horizon. Also, as remanufactured products are purchased more than or equal to a special quantity Q, a discount price policy is applied. The problem assumes that the related cost(remanufacturing and inventory holding costs of used products, and the purchasing and inventory holding costs of remanufactured products) functions are concave and backlogging is not allowed. The objective of this paper is to determine the optimal remanufacturing and purchasing policy that minimizes the total cost to satisfy dynamic demands of remanufactured products. This paper characterizes the properties of the optimal policy and then, based on these properties, presents a dynamic programming algorithm to find the optimal policy. Also, a network-based procedure is proposed for the case of a large quantity of low cost used products. A numerical example is then presented to demonstrate the procedure of the proposed algorithm.

• 대한안전경영과학회지
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• 제19권3호
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• pp.89-95
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• 2017

This paper presents another maintenance policy for a group of units under finite operating horizon. A group of identical units are subject to random failures. Group maintenances are performed to all units together at specified intervals, and the failed units during operation are remained idle until the next group maintenance set-up. Unlike the traditional assumption of infinite operating horizon, we adopt the assumption of the finite operating horizon which reflect the rapid industrial advance and short life cycle of modern times. The units are under operation until the end of the operating horizon. Further, the operation of units are extended to the first group maintenance time after the end of the horizon. The total cost under the proposed maintenance policy is derived. The optimal group maintenance interval and the expected number of group maintenances during the horizon are found. It is shown that the proposed policy is better than the classical group maintenance policy in terms of total cost over the operating horizon. Numerical examples are presented for illustrations.

• 산업경영시스템학회지
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• 제33권2호
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• pp.170-175
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• 2010

Maintaining a complex repairable system can be achieved by repairing, replacing, or any other activities. This paper proposes a joint optimization policy that is composed with ordering and replacing under minimal repair for the complex system. For this purpose, we derive the expected cost due to the minimal repair, ordering, downtime, inventory costs, and salvage value of units that follow generally distribution. Some properties about the optimum ordering policy that are suggested for our purpose shows that the optimum ordering policy minimizing the expected cost is either one of the two typical policies : (1) the original unit is replaced as soon as the ordered spare is delivered, or (2) the delivered spare is used as inventory part until the original unit fails.

• 산업경영시스템학회지
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• 제20권43호
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• pp.357-364
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• 1997

After the buyer purchases the product, the seller's role does not end. If the product fails to function properly before the end of the warranty period, the seller is responsible for its repair or replacement under the seller's warranty policy. There are two common types of warranty policies: the free replacement warranty and the rebate warranty. Under the free replacement warranty policy, replacement or repairs during the warranty period are provided by the seller free of charge to the buyer. Under the rebate warranty policy, a failed item is replaced by a new one or is repaired at a cost to the age of the failed item. The rebate warranty is most often used for items such as a battery or an automobile tire which wear out and must be replaced at failure. This paper proposes a easy way of estimating the warranty cost under the free replacement warranty policy assuming an exponential product failure function on repairable products.

• 산업경영시스템학회지
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• 제10권16호
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• pp.129-132
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• 1987

Multi-item inventory problems can be well characterized by the nature of interaction of the quantities and timing. This interaction may be due to the effect of certain combination of orders. It is that the set-up cost of ordering individual items can be saved by jointly ordering at a time. This study finds a decision criteria of optimum inventory policy through the comparisons of individual multi-item order policy(IMP), joint multi-item order policy(JMP), augmented multi-item order policy(AMP) in cost ratio. Subsequently we assume that there exists a unique optimum order level corresponding to an optimum reorder range for the augmented multi-item order, at which a cost saying is maximum.

• 보건행정학회지
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• 제9권1호
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• pp.1-29
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• 1999

The Government has recently planned to improve the medical insurance drug price systems by removing the drug margin occurring from the difference between the official and purchasing prices, and instead by setting prices through adding drug administration casts calculated to the purchasing costs. In the circumstances, the major policy and implementing issues are how to define the drug administrance cost and how to calculate them. This study attempts to provide for the conceptional and operational definitions and thereby develop a costing model for the cost. The relationship between the current systems of medical services costs and prices were reviewed to define the concept of the costs. The study defined the costs from the narrow and wide prospective of meaning, and three operational definitions were provided. The costing model was developed applying the departmental costing principles. Finally, several prerequisites that have to be considered for the implementation of the definition and the model from the practical viewpoint.