• Journal of Preventive Medicine and Public Health
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• v.33 no.4
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• pp.393-401
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• 2000

Objectives : To evaluate the impacts of the DRG payment system on the behavior of medical insurance claimants. Specifically, we evaluated the case-mix index, the numbers of diagnosis and procedure codes utilized, and the corresponding rate of diagnosis codes before, during and after implementation of the DRG payment system. Methods : In order to evaluate the case-mix index, the number of diagnosis and procedure codes utilized, we used medical insurance claim data from all medical facilities that participated in the DRG-based Prospective Payment Demonstration Program. This medical insurance claim data consisted of both pre-demonstration program data (fee-for-service, from November, 1998 to January, 1999) and post-demonstration program data (DRG-based Prospective Payment, from February, 1999 to April, 1999). And in order to evaluate the corresponding rate of diagnosis codes utilized, we reviewed 820 medical records from 20 medical institutes that were selected by random sampling methods. Results : The case-mix index rate decreased after the DRG-based Prospective Payment Demonstration Program was introduced. The average numbers of different claim diagnosis codes used decreased (new DRGs from 2.22 to 1.24, and previous DRGs from 1.69 to 1.21), as did the average number of claim procedure codes used (new DRGs from 3.02 to 2.16, and previous DRGs from 2.97 to 2.43). With respect to the time of participation in the program, the change in number of claim procedure codes was significant, but the change in number of claim diagnosis codes was not. The corresponding rate of claim diagnosis codes increased (from 57.5% to 82.6%), as did the exclusion rate of claim diagnosis codes (from 16.5% to 25.1%). Conclusions : After the implementation of the DRG payment system, the corresponding rate of insurance claim codes and the corresponding exclusion rate of claim diagnosis codes both increased, because the inducement system for entering the codes for claim review was changed.

• The Journal of Society for e-Business Studies
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• v.27 no.2
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• pp.105-135
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• 2022

As COVID-19 has led to a surge in e-commerce Buy Now Pay Later(BNPL) has become preferred choice among millennials. In Korea Coupang followed by Naver Pay offers a deferred payment, aiming to create customer lock-in effect, save credit card processing fee and lay the groundwork for entering into new financial services. However the literature related to the influential factors of customers' usage intention toward a deferred payment is scarce. For the study, a multi-group analysis was carried out to find differences between Naver shopping and Coupang. The results revealed that the important factors that affect a deferred payment adoption were compatibility, impulsive buying tendency in Naver shopping, whereas compatibility, relative advantage, additional value in Coupang(listed in order of most important). In addition, impulsive buying tendency had a positive effect on adoption intention in Naver shopping and on perceived risk in Coupang. The results imply that Naver shopping need to focus on managing delinquency while Coupang should provide sufficient information on how late fees and credit rating downgrade work and try not to make a deferred payment option stand out. In order to increase adoption rate it is recommendable to narrow down target segment of a deferred payment and expand it to a specialized vertical such as travel.

• Korea Journal of Hospital Management
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• v.5 no.1
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• pp.129-155
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• 2000

This empirical study, activity-based costing, a newly introduced approach that has proved to be an improvement over the conventional costing system in product or service costing, is applied at department of clinical pathology in K university hospital. The study subjects were 233 test procedures done in clinical laboratory of K university hospital. Activity analysis was done by interview, questionnaires, and time study, and the amount of resources consumed by each activity and their costs are then traced and applied to the laboratory tests. The main purpose of this study were to compare the test costs of activity-bases costing with those of conventional costing, and test fees of medical insurance, and to provide accurate cost informations for the decision makers of hospital. The major findings of this study were as belows. 1. The cost drivers for application of activity-based costing at clinical laboratory were cases of sample collection, case of specimen, cases of test, and volume-related allocation bases such as direct labor hours and total revenue of each test. 2. The profits of each clinical laboratory fields analyzed by conventional costing were different from the profits analyzed by activity-based costing, especially in the field of Urinalysis(approximately over estimated 750%). 3. The standard full costs by conventional costing were quite different from the costs computed by using activity-based costing, and the difference is most significant with the tests of long labor time. 4. From the comparison between costs computed by using activity-based costing and medical insurance fees, some test fees were significantly lower than the costs, especially in the non-automated fields. As described in this study, activity-based costing provides more accurate cost information than does conventional costing system. The former approach is especially important in the health care industry including hospitals in which planning and controlling the costs services provided are the key to maintaining a healthy financial status for the organization. Despite the contribution of activity-based costing the economic as well as technical feasibilities of implementing such a cost accounting system in an organization must be evaluated. In the development of activity-based costing systems, an activity analysis has to be conducted to identify activities that consume resources. This involves a detailed study of the organization's logistics and accounting information systems, and it is an expensive project in itself. Besides, it can be quite difficult and time consuming to identify and trace resource consumption to a specific activity. Thus the activity-based costing system should be implemented only when the decrease in cost of error far exceeds the increase in cost of measurement. By combining activity-based costing with standard costing, health care administrators can better plan and control the costs of health services provided while ensuring that the organization's bottom line is healthy.

• Journal of Preventive Medicine and Public Health
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• v.29 no.1 s.52
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• pp.51-65
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• 1996

The purpose of this study was to examine the trends of length of hospital stay (LOS), which is most likely to be a major attribute to hospital performance. From 1984 to 1994, an average LOS of each hospital was analyzed by factors such as medical departments, bed size, occupancy rate, region and ownership. This study was analyzed changing rate of LOS during 11 years. This rate was calculated by simple regression, which was used only with hospital without missing data during 11 years. This study findings are as follows. 1. The results indicated that the average LOS was steadily increased until 1990 but it was slightly decreased after 1990. 2. This trend could be found in all hospital scale and all group of occupancy rate. Specifically this trends of LOS were found in internal medicine, corporate owned hospitals, and hospitals in major city. But LOS of individual owned hospital was continuously increased until 1994. 3. Means of changing rates of LOS were calculated from 1984 to 1994. If we devided it into two parts, before 1990 and after 1990, most changing rates of LOS before 1990 except individual owned hospital were found positive sign. The changing rates after 1990 were negative sign but small hospital(lesser then 200 bed), individual owned hospital, national & public hospital and hospital in small urban have little change of LOS after 1990. Finally from this results we thought that most hospitals in Korea began to be concerned with LOS. Nevertheless LOS of several hospital such as small hospital or individual owned hospital was increased. And this trend may be caused by a few patients, low occupancy rate, or low profit. This trend of LOS is different from that of other countries. Perhaps this phenomenon is resulted from the reimbursement method. Because of fee for service reimbursement system in Korea the hospitals didn't need to shorten LOS in order to save the cost and increase the profit. Therefore reform of hospital cost reimbursement method will be needed to reduce hospital cost in Korea. We thought that the Korean health authority should consider the reimbursement method by unit of bundle of services, for example DRG and prepayment in the United States. This study presents some limitations such as no insight of severity of disease, case-mix measurement of hospital, and other clinical characteristics that can. possibly affect LOS. However, this study reports an important trend in LOS from 1984 to 1994.

• Journal of Digital Convergence
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• v.12 no.6
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• pp.385-396
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• 2014

The purpose of this study was to examine the recognition of citizens in Busan on the doctor-designation system, the awareness of medical consumers with experience of using this system and their satisfaction in an effort to seek ways of improving this system. The subjects in this study were the selected citizens in Busan who were at the age of 20 and up. As a result, it's found that the largest group of the respondents was female, in their 20s, received college or higher education, students and in the service industry, and that the most common monthly mean income was between two and 2.99 million won. 27.7 percent were aware of the doctor-designation system, and 23.7 percent became cognizant of the system through others who had used it. The rate of knowing the rules of the doctor-designation system (the right answer) stood at 66.3 percent. They got to know about the system through mass media(31.9%), and used it since it offered highly specialized treatment(57.5%). The respondents who had used it intended to reuse it(76.3%), and the reason was that they were provided with high-class medical services (35.2%). The respondents who had used this system got a mean of 2.96 in satisfaction level, which was not high in general. They mentioned more publicity efforts(91.2%), offering information in a conspicuous place (96.7%) and cutting doctor-designation treatment fee as a means of improving this system. As for how to ensure the operating efficiency of the system, sustained publicity seem to be necessary to raise awareness of the system among patients, and it's required to take measures to relieve patients of financial burden caused by medical bills.

• Journal of the Korea Convergence Society
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• v.9 no.6
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• pp.99-106
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• 2018

The purpose of this study is to investigate incidence rates of complications in response to the introduction of quality evaluation of the DRG(diagnosis related group) payments, focusing on an increasing number of patients with lens surgery as the population aging increases.Fourthly, there were three dependent variables ('vitreous prolapse', 'IOP elevations', and 'other complications') in this study, and therefore multivariate logistic regression was performed. The result of the analysis indicates that as the number of hospitalized days increased, vitreous prolapse decreased to 0.27 times(95% CI 0.08~1.00) and IOP elevation decreased by 0.14 times(95% CI 0.03~1.59), compared to other complications, and this was statistically significant. From the above results, this study is meaningful in that it has compared the evaluation results of the appropriateness of DRG payment and the medical quality for lens surgery complications patients, in response to the introduction of quality evaluation by DRG payment.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.31 no.1D
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• pp.51-63
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• 2011

This study suggests that prior to construction of the 2nd Changwon tunnel and implementation of the demanded free of charge on Changwon tunnel, it is recommended to improve the traffic facilities and management of the traffic condition in order to create an efficient road that will keep traffic flow to a minimum and maintain the facilities proper working order. It has been generally accepted that the 2nd Changwon tunnel is necessary to construct and open as soon as possible. This is due to the service level of current traffic volume in the Changwon tunnel pay toll road which have been so congested that the fees have increased causing a public complaint to be filed, demanding a early free of charge be implemented for the Changwon tunnel. Furthermore, the objective and impartial analysis of the traffic situation based on a simulation of the alternative and traffic congestion fees has been provided to make the early free of charge on toll road as soon as possible. Finally, careful attention should be paid to seek to make the early free of charge on toll road in order to minimize the damages both specified and unspecified that may arise the prompt settlement of construction repayments and security of minimum management fees should be given priority over other alternatives.

• Health Policy and Management
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• v.12 no.4
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• pp.91-113
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• 2002

We report and analyze the Korean physicians' recent general strike over the implementation of the Separation of Prescribing and Dispensing Practice (SPDP) in which more than 18,000 private clinics and 280 hospitals participated. Utilizing game-theoretic models of bargaining we explain why the Korean physicians were so successful in organizing intense collective action against the government and securing very favorable policy outcomes. In particular, we highlight the role of distributional conflict among social actors in shaping the details of institutional reform. The introduction of the SPDP was a necessary first step in the overall reform of health care system in Korea. However, the SPDP was perceived to be a serious threat to the economic viability of their profession by the vast majority of Korean physicians who had long been relied on the profits from selling medicines to compensate for the loss of income due to the low service fee under the previous health care system. The strong political coalition among heterogeneous physicians enabled them to organize an intense form of collective action, the general strike. Thus, physicians were successful not only in dragging the government to a bargaining table, but also winning in the bargaining and securing an outcome vastly favorable to them. On the other hand, the lack of an overall reform plan in the health care policy area, especially the finance of the National Health Insurance and the need for maintaining an image as a successful reform initiator, motivated the government to reach a quick resolution with the striking physicians.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.2
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• pp.154-163
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• 2017

This study aims to investigate the utilization status of dental services by foreign children living in Seoul and their level of satisfaction with the treatments. We developed a structured questionnaire with 35 questions, which comprised 14 questions (demographic characteristics) and 21 questions (oral hygiene and dental experience of the child). In this study, the distribution of nationality of 391 participants differed from the actual statistics in Korea. It consisted of high percentage of participants from African countries (23.6%), as well as North American countries (24.1%). In addition, the education status of most parents was above the level of college graduate. Despite the relatively high socioeconomic status of the participants, they showed minimal dental health knowledge regarding the aspect of oral hygiene. Utilization of dental health services and the types of dental clinics visited by them were similar before and after coming to Korea. The participants showed overall satisfaction with the care, but many of them expressed the need for improvement with regard to treatment fee and communication. In conclusion, foreign children living in Seoul require appropriate dental health education and governmental support to promote regular dental check-ups, to improve their overall oral health, and prevent the incidence of dental caries.

• Journal of Korea Port Economic Association
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• v.39 no.4
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• pp.127-145
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• 2023

As the importance of strengthening port security is increasing, it is necessary to conduct a perceptual study on port facility users who pay for port security services first. This study aims to identify improvements in the port security function of Busan Port and contribute to the future development of port security in Korea. A total of 125 questionnaires were collected from port facility security fee collectors at Busan Port. Based on the collected data, exploratory factor analysis, traditional IPA, and modified IPA were conducted. In conclusion, first, the physical function of port security is the most important and should be continuously maintained and strengthened. Second, improving the professionalism of port security personnel is most urgent, and the port security education system needs to be improved. Finally, it is necessary to gradually develop the port security information service function in consideration of future development possibilities.