• 대한간호학회지
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• 제40권3호
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• pp.349-358
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• 2010

Purpose: The purpose of this study was to estimate nursing costs and to establish appropriate nursing fees for long-term care services for community elders. Methods: Seven nurses participated in data collection related to visiting time by nurses for 1,100 elders. Data on material costs and management costs were collected from 5 visiting nursing agencies. The nursing costs were classified into 3 groups based on the nurse's visit time under the current reimbursement system of long-term care insurance. Results: The average nursing cost per minute was 246 won. The material costs were 3,214 won, management costs, 10,707 won, transportation costs, 7,605 won, and capital costs, 5,635 won per visit. As a result, the average cost of nursing services per visit by classification of nursing time were 41,036 won (care time <30 min), 46,005 won (care time 30-59 min), and 57,321 won (care time over 60 min). Conclusion: The results of the study indicate that the fees for nurse visits currently being charged for long-term care insurance should be increased. Also these results will contribute to baseline data for establishing appropriate nursing fees for long-term care services to maintain quality nursing and management in visiting nursing agencies.

• Computational Structural Engineering : An International Journal
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• 제1권1호
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• pp.59-69
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• 2001

This study is intended to propose a systematic approach for reliability-based assessment of life cycle cost (LCC) effectiveness and economic efficiency for cost-effective seismic upgrading of existing bridges. The LCC function is expressed as the sum of the upgrading cost and all the discounted life cycle damage costs, which is formulated as a function of the Park-Ang damage index and structural damage probability. The damage costs are expressed in terms of direct damage costs such as repair/replacement costs, human losses and property damage costs, and indirect damage costs such as road user costs and indirect regional economic losses. For dealing with a variety of uncertainties associated with earthquake loads and capacities, a simulation-based reliability approach is used. The SMART-DRAIN-2DX, which is a modified version of the well-known DRAIN-2DX, is extended by incor-porating LCC analysis based on the LCC function developed in the study. Economic efficiencies for optimal seismic upgradings of the continuous PC segmental bridges are assessed using the proposed LCC functions and benefit-cost ratio.

• 한국철도학회:학술대회논문집
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• 한국철도학회 2010년도 춘계학술대회 논문집
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• pp.1630-1641
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• 2010

LCC can be defined as "the sum of present values of investment costs, capital costs, installation costs, energy costs, operating costs, maintenance costs, and disposal costs over the life-time of the project, product, or measure." LCCA involves estimating the costs and timing associated with each alternative over a selected analysis period and conversion of those costs to economically comparable values considering the time-value of money. The several Excel-Based LCC tools found on the internet are described in this paper. Also, This paper performed an analysis of the existing LCC commercial tools, assessing various aspects of each program. The goal was to evaluate the best features of each tool and to identify the requirements for LCC evaluation of Urban Transit Vehicle. The LCC tools are developed to address problems in many different areas and a tool developed and structured for one area cannot generally be used in another area. No general LCC tool exists and if one is needed for Urban Transit Vehicle it has to be developed by the project. Since a full LCC can be very complex it is likely that this Excel-Based LCC tool should be a small and simple tool for quick cost estimates. This paper presents a LCC tool consisting of eight excel sheets, which are "Project", "CBS", "PBS", "PM", "CM", "Others", "LCC Result" and "Diagram".

• 국제학술발표논문집
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• The 3th International Conference on Construction Engineering and Project Management
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• pp.1254-1259
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• 2009

The purpose of this study is to analyze elemental maintenance costs for educational buildings. The adapted research method selected three school buildings in Seoul as BTL projects. On the basis of the selected case, the study suggested a model to establish a system for each parts and to estimate analyzed maintenance costs through that system. According to the analysis, the study proposed a partial maintenance costs standard and analyzed proper maintenance costs. The results of this study are as follows 1) The system is divided into 8 large-groups and 24 small-groups for the analysis elemental maintenance costs. 2) The average rations followed by analysis of partial maintenance costs of the three school buildings are as followings, the total maintenance costs are analyzed 3,992 million won and each part of average rations is exterior of building 10.9%, interior of building 41.58%, electricity & fire fighting facility 14.22%, water supply & healthy facility 11.39%, heating & water supply facility 12.93%, landscape 6.3%, civil engineering works 2.69%.

• 보건행정학회지
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• 제5권2호
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• pp.35-69
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• 1995

The managerial environment of hospitals in Korea characterized by low levels of medical insurance fees is worsening by increasing government regulations as to the utilization of medical services, rising costs of labor, material, and medical equipments, growing patient expectations concerning the quality of services, and escalating competitions among large hospitals in the market. Hospitals should seek for their survival strategies in this harsh environment and they should have information about costs of their products in doing so. However, it has not been available due to the complexity of the production process of hospital services. The objectives of this study were to develop a service-based cost accounting model and to apply the developed model to a study hospital to obtain cost information of hospital services. A model commonly used for the job-order product cost accounting in the manufacturing industry was modified for the use in hospitals in Korea. Actual costs, instead of standard costs, incurred to produce a unit of services during a given period of time were estimated in the model. Data required to implement the model included financial information, statistics for the allocation of supportive cost center costs to final cost centers, statistics for the allocation of final cost center costs to services, and the volume of each services charged to patients during a study period. The model was executed using data of a university teaching hospital located in Seoul for the fiscal year 1992. Data for financial information, allocation statistics fo supportive service costs, and the volume of services, most of them in electronic form, were available to the study. Data for allocation statistics of final cost center costs were collected in the study. There were 15 types of evaluation and management service, 2, 923 types of technical service, and 2, 608 types of drug and material service charged to patients in the study hospital during the fiscal year 1992. Labor costs of each of seven types of pesonnel, material costs of 611 types of drugs and materials, and depreciation costs of 212 types of medical equipments, miscellaneous costs, and indirect costs incurred in producing a unit of each services were estimated. Medical insurance fees for basic services such as evaluation and management of inpatients and outpatients, injection, and filling prescriptions, and for operating procedures were found to be set lower than costs. Infrequent services which use expensive medical equipments showed negative revenuse as well. On the other hand, fees for services not covered by the insurance such as CT, MRI and Sonogram, and for laboratory tests were higher than costs. This study has a significance in making it possible for a hospital to obtain cost information for all types of services which produced income based on all types of expenses incurred during a given period of time. This information can assist the management of a hospital in finding an effective cost reduction strategy, an efficient service-mix strategy under a given fee structure, and an optimum strategy for within-hospital resource allocations.

• Journal of Preventive Medicine and Public Health
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• 제14권1호
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• pp.3-12
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• 1981

To identify the changes in professional care patterns after the introduction of medical insurance in Korea, professional care in hospitals and clinics of two succeeding years were compared. The hospitals and clinics selected for this study were those which located in Seoul city. Hospitals were classified into 3 categories: university hospital, general hospital and hospital. The diseases selected for this study were acute appendicitis and normal delivery. They were selected because their disease courses are considered to be fairly stable. The variables used for this study were length of stay, total hospital costs, costs of each components of cares. The information used for this study was obtained from the official forms requested by the medical facilities to the Korea Medical Insurance Corporation. The two periods studied were 3 months of each year from March 1st to May 31st in 1979 and 1980, The total number of normal delivery studied was 289 in 1979, 301 in 1980 respectively and the acute appendicitis was 92 and 111 respectively. In order to compare the quantity of medical care between 2 study periods the insurance price scores of 1979 were converted to prices of 1980. For statistical test of difference between 2 periods T-test and Welch's test were used. The result of the study were briefly summarized in below. 1. No significant difference was observed in the average length of stay of both disease between two study periods in all types of hospitals. 2. No significant difference was observed in the average total hospital costs of both diseases in all types of hospital, but in the private clinic the average clinic costs was rather decreased significantly in 1980. 3. More cost decrease were seen than cost increase in 1980 in all types of facilities, More cost changes by items were seen in acute appendicitis than in normal delivery between two study periods. The total hospital costs can be devided into 2 portions: charges for drug and material and for physician. In normal delivery, costs for physician's charges was significantly decreased in almost all the hospitals and costs for drug and material were not changed significantly in all the hospitals in 1980. In the university hospitals, however, the costs for drug and material were increased significantly in 1980. The cost decrease for physician's charge were mainly due to the decrease in the costs of laboratory test, treatment and physical therapy. The increase in the costs for the drug and material in the university hospitals was mainly due to the increase in the cost for drugs for oral administration and injection. 4. The proportion of components of medical care in the hospital has not been changed significantly, however, the cost for injection in normal delivery was characteristically increased in 1980 in all hospitals studied. In general the proportion of the costs for drug and material was tended to increase and the costs for physician was tended to decrease in 1980. The increase in the costs for drug and material were considered to be due to increase in the cost for drugs for oral administration and injection. The decrease in the costs for physician were due to decrease in the costs of laboratory test, treatment and physical therapy. Above mentioned changes in hospital and clinic care patterns are considered to be mostly influenced by the review criteria set by the K.I.C. for the assessment of the fee request made by clinics and hospitals.

• 한국건설관리학회논문집
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• 제11권1호
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• pp.142-150
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• 2010

본 연구는 교육시설물의 부위별 공사비 및 유지관리비 분석을 목적으로 수행되었다. 이를 위해 BTL 사업으로 발주된 서울지역에 위치한 초등학교 4곳을 사례 대상으로 선정하였다. 이렇게 선정된 사례 대상을 바탕으로 부위별 체계 정립을 위한 모델을 제시하였으며, 정립된 부위별 체계에 따라 공사비 및 유지관리비를 분석하였다. 이에 따라 부위별 공사비 분석표와 유지관리비 분석표 그리고 교육시설물의 적정 공사비 및 유지관리비를 제시하였다. 상기와 같은 목적과 방법에 따라 진행된 본 연구의 결론을 요약하면 다음과 같다. 1)사례 대상 학교 4곳의 부위별 공사비 산정에 따른 평균 금액 비율을 살펴보면 다음과 같다. 총 공사비 6,666백만원 대비 구조체 47.15%, 건물외부 8.34%, 건물내부 23.37%, 전기 소화 5.74%, 급수 위생 4.27%, 난방 급탕 5.25%, 옥외시설 1.36%, 토목 4.51%를 차지하는 것으로 분석되었다. 2)사례 대상 학교 4곳의 부위별 유지관리비 분석에 따른 평균 금액 비율을 살펴보면 다음과 같다. 총 유지관리비 4,309백만원 대비 건물외부 11.02%, 건물내부 41.81%, 전기 소화 14.81%, 급수 위생 11.22%, 난방 급탕 12.76%, 옥외시설 5.75%, 토목 2.63%를 차지하는 것으로 분석되었다.

• Journal of Preventive Medicine and Public Health
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• 제39권5호
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• pp.397-403
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• 2006

Objectives: We estimated the asthma-related health care utilization and costs in Korea from the insurer's and societal perspective. Methods: We extracted the insurance claims records from the Korea National Health Insurance claims database for determining the health care services provided to patients with asthma in 2003. Patients were defined as having asthma if they had ${\geq}$2 medical claims with diagnosis of asthma and they had been prescribed anti-asthma medicines, Annual claims records were aggeregated for each patient to produce patient-specific information on the total utilization and costs. The total asthma-related cost was the sum of the direct healthcare costs, the transportation costs for visits to health care providers and the patient's or caregivers' costs for the time spent on hospital or outpatient visits. Results: A total of 699,603people were identified as asthma patients, yielding an asthma prevalence of 1.47%. Each asthma patient had 7.56 outpatient visits, 0.01 ED visits and 0.02 admissions per year to treat asthma. The per-capita insurance-covered costs increased with age, from 128,276 Won for children aged 1 to 14 years to 270,729 Won for those aged 75 or older. The total cost in the nation varied from 121,865 million to 174,949 million Won depending on the perspectives. From a societal perspective, direct health care costs accounted for 84.9%, transportation costs for 15.1 % and time costs for 9.2% of the total costs. Conclusions: Hospitalizations and ED visits represented only a small portion of the asthma-related costs. Most of the societal burden was attributed to direct medical expenditures, with outpatient visits and medications emerging as the single largest cost components.

• 보건행정학회지
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• 제15권1호
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• pp.78-96
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• 2005

The purpose of this empirical study is to investigate whether costs are 'sticky' -that is, whether costs increase more when revenues rises than they decrease when revenues falls by an equivalent amount by using the financial data fromf korean general hospital Financial data used in this study were obtained from the Database of Korean Health Industry Development Institute and analyzed using multiple regression model in dummy variables. The main results of this study are as follows: First, we found, for 69 Korean general hospitals for 3 years(2000~2002), that total hospital costs, hospital labor costs, hospital administrative costs were sticky, these costs provided strong support for the sticky costs hypothesis 1, but hospital material costs were shown to be proportional to sales revenues. Second, this results provided strong support for the hypotheses that the' degree of stickiness was lower in sales revenues declining that were preceded by revenue-declining periods (hypothesis 2-1), and that stickiness was less pronounced in a second successive year of revenue decline(hypothesis 2-2). Third, this results provided strong support for the hypothesis(hypothesis 3) that stickiness was greater hospitals that employ relatively more people to support their sales revenues(hypothesis 4) that stickiness was greater for hospital that used relatively more assets to support their sales revenues. After all, a managerial implication of this study was that sticky cost, for the general hospital, could be recognized and controlled.

• Journal of Preventive Medicine and Public Health
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• 제43권4호
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• pp.352-361
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• 2010

Objectives: This study estimated the annual socioeconomic costs of food-borne disease in 2008 from a societal perspective and using a cost-of-illness method. Methods: Our model employed a comprehensive set of diagnostic disease codes to define food-borne diseases with using the Korea National Health Insurance (KNHI) reimbursement data. This study classified the food borne illness as three types of symptoms according to the severity of the illness: mild, moderate, severe. In addition to the traditional method of assessing the cost-of-illness, the study included measures to account for the lost quality of life. We estimated the cost of the lost quality of life using quality-adjusted life years and a visual analog scale. The direct cost included medical and medication costs, and the non-medical costs included transportation costs, caregiver's cost and administration costs. The lost productivity costs included lost workdays due to illness and lost earnings due to premature death. Results: The study found the estimated annual socioeconomic costs of food-borne disease in 2008 were 954.9 billion won (735.3 billion won-996.9 billion won). The medical cost was 73.4 -76.8% of the cost, the lost productivity cost was 22.6% and the cost of the lost quality of life was 26.0%. Conclusions: Most of the cost-of-illness studies are known to have underestimated the actual socioeconomic costs of the subjects, and these studies excluded many important social costs, such as the value of pain, suffering and functional disability. The study addressed the uncertainty related to estimating the socioeconomic costs of food-borne disease as well as the updated cost estimates. Our estimates could contribute to develop and evaluate policies for food-borne disease.