• The Journal of the Korea institute of electronic communication sciences
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• v.12 no.2
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• pp.401-410
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• 2017

This study aimed to identify appropriateness and efficiency in the DRG payment system by analysing the hospital length of stay and changes in fees before and after the application of DRG payment system. The subjects of the study were a total of 398 patients consisting of 204 for the fee for service system and 194 for the DRG payment system. They received surgery in the Obstetrics and Gynecology (OBGY) department of a general hospital in G metropolitan city between January and December 2013. The mean hospital length of stay was significantly decreased after application of the DRG payment system(p=0.013). Total fees, insurance charges, and deductions increased significantly(p<0.001), and non-payment charges and total deductions decreased significantly(p<0.001). Application of the DRG payment system reduced length of stay, non-payment charges and total patient's cost sharing and increased out-of-pocket, insurance charges, and total fees.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.10 no.3
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• pp.300-306
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• 2003

Purpose: This study was done to help provide patients with information on medical insurance cost through medical insurance education for nurses, to increase effective management, check on omissions in treatment and appropriateness and accuracy of fees, and to contribute to the economic growth of hospital by providing nurses with necessary knowledge about medical insurance cost. Method: The participants in this study were clinical nurses in general hospitals. The study instrument was a questionnaire developed by the researcher through reference to data for medical insurance education. The data were analyzed with percentages, means, ANOVA, and Duncan method using SPSS PC+10. Result: The results on knowledge of medical insurance according to general characteristics of the nurses showed that there were significant differences according to age: (p=.0036) highest level of education (p=.0007), position (p=.0010) and place where education on medical insurance was received (p=.0093). Conclusion: Continuous in-service education for clinical nurses is reflected in increased knowledge about medical insurance costs but special attention needs to be given to younger nurses and nurses with less education, as well as staff nurses, and those nurses who only received education on medical insurance during their schooling. Accordingly, in-service education is necessary for nurses at the time of orientation so that they have knowledge on standards for recuperation allowance, guidelines to calculate material costs, and guidelines to calculate drug rates. In addition, as medical insurance cost frequently change, all nurses need continuous in-service education.

• The Journal of the Korean dental association
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• v.48 no.6
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• pp.459-468
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• 2010

International Classification of Disease (ICD-10) is widely used as a crucial reference not only in the medical diagnosis of diseases but also within the health insurance system. It makes possible for medical personnel to make decisions systematically and for the people working in the health insurance or public health industries to better understand medical issues. However, this classification is often not enough or acceptable in a clinical setting. Many countries amend in their own way to make it more appropriate for their people. Korean Classification of Disease (KCD-5) was made by adding a 5 digit code for some diseases to clarify the conditions of the patients. The authors found problems of KCD-5 in temporomandibular disorders and several related medical problems. Medical treatment for these problems had not been covered even by public health insurance until 2000 in Korea. For the last decade, private insurance companies have introduced new items for reimbursement of the treatment fees the patients actually pay. The authors assumed that many patients with these medical problems encountered difficulties in the reimbursement from private insurance companies because KCD-5 did not classify these medical conditions appropriately. An overview of KCD-5 and suggestions for improvement are introduced in this study.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.8
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• pp.162-170
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• 2017

This study analyzed the current situation of medium and small-sized hospital nursing staff and related policies, and identified the factors that affect staffing level to provide evidence for planning and adopting policy. By analyzing the statistical data published by public institutions such as the Ministry of Health and Welfare and Health Insurance Review and Assessment Service, the result was viewed based on the understanding of various internal and external health care environments. The number of active nurses was less than 50% of the number of licensed nurses and has decreased every year. This means that the cost-effectiveness of increases in nursing college enrollment should be reconsidered. Inpatient nursing fees by staffing grades has caused nurses to move from medium and small-sized hospitals, where there is a severe lack of staff, to more advanced general hospitals. As a result, the lack of nursing staff in medium and small-sized hospitals has worsened. In conclusion, reexamination is needed to improve effectiveness of inpatient nursing fees by staffing grades as a policy to secure the workforce of medium and small-sized hospitals. Furthermore, the tracking management system of licensed nurses must be able to solve the imbalance between demand and supply of nursing staff.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.7
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• pp.357-366
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• 2016

This study evaluated the standardization of the outpatient management process in several regions of South Korea. The hospital workers in the administration department of the different medical institutions that are registered with the Korean Hospital Association were surveyed. These institutions can be standard hospitals or hospitals greater in size. A summary of the research results are as follows. There was no significant correlation in their registration procedures in relation to the institution's founder, number of sickbeds, number of staff employed in the administration department, and average number of outpatients per day. On the other hand, the prepayment of medical fees occurred more frequently when the number of sickbeds was larger. In addition, there was no large difference in their appointment procedures in relation to those features. Nevertheless, the prepayment of medical fees accounted for 11.8 % of the entire payment in institutions with less than five hundred beds, while fifty percent of the payment was made in advance in larger institutions with five hundred or more beds. From this research, there was only a small difference among the institutions' outpatient management, but a notable difference was observed in their electronic data processing systems and facilities. Therefore, more financial support should be generated for the implementation of a more integrated process. As a follow-up study, to provide patients with quality medical services, it will be necessary to apply the standardized procedure to an actual medical institution and analyze the expected effect.

• The Korean Society of Law and Medicine
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• v.9 no.1
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• pp.461-503
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• 2008

The right to live is the most valuable benefit and protection of the law. And Medical science is the study considering value of life as the top priority. As modern medical science has progressed and expanding lifespan skills have developed, the number of symptom, called a human vegetable, has been also increased. As a result, people concerns whether euthanasia should be permitted. (1) Active euthanasia is prohibited and a doctor who conduct it is punished. (2) Indirect euthanasia can be permitted unless it is against a patient's intention. (3) Permission of passive euthanasia depends on intention of a patient. In other words, when a patient accepts, a doctor respects the right of self determination of patient and irreversible situation such as brain death happens, treatment stop is permitted. Even a patient who is in the last stage of cancer has a right to die in the dignity and elegance. Solutions for ceasing medical treatment are as follows; First, establishment of 'Bioethics Committee'. Second, setting procedures to empower a court a right to decide whether medical treatment is ceased. Third, setting procedure a government to assist treatment fees. In this paper, direction for social agreement of legal policy regarding the ceasing treatment is provided.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.29 no.1
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• pp.5-17
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• 2022

Purpose: This study aimed to investigate the role of hospital-based home health nursing in community care by examining the institutional progress of hospital-based home health nursing and the current status of home health nursing in Korea. Methods: Korean research data, national statistical data, government press releases, and related laws were investigated to clarify the role of hospital-based home health nursing in community care. Results: Korean visiting medical care services, including hospital-based home health nursing, was not found to be sufficient nationwide. The supply of home health nursing did not increase due to the nature of the visiting services that required transportation time, poor profitability due to insufficient insurance fees, and increase in acute beds. Conclusion: The nature of the Korean medical environment and visiting medical care makes it challenging to establish a visiting medical supply system for community care. Therefore, hospital-based home health nursing is an important infrastructure for visiting medical care, and will be a valuable resource to link discharged patients returning to the community when moving health care services. Hence, laws and institutional supplementation to expand the role of home health nursing agencies nationwide are needed along with addressing the limitations in the supply of home health nurses.

• The Journal of Korean Medicine
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• v.32 no.2
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• pp.79-91
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• 2011

Objectives: The purpose was to study the market of traditional Korean medical devices and survey, list and number medical devices in traditional Korean medical clinics. Methods: we researched in three ways. 1. We investigated the list of devices regarded as traditional Korean medical devices in 'Report on production, export, and import of medical devices.' 2. We investigated the statistics of medical devices equipped in traditional Korean medical clinics through the website of the Health Insurance Review & Assessment Service. 3. We surveyed medical devices in traditional Korean medical clinics by mail. Results: 1. We could not directly investigate the market for traditional Korean medical devices because they were not categorized as such ('traditional Korean medical devices'). 2. The number of medical devices in traditional Korean medical clinics has increased alongside the increase of traditional Korean medical clinics. 3. Traditional Korean medical clinics hold over 64,962 medical devices and have below 50 percent of traditional Korean medical diagnosis devices. 4. Meridian function testing machines, pulse diagnosis devices, and yangdorak showed ranking of equipment-ratio equal to ranking of insurance fees. Conclusions: Traditional Korean medical device regulations should be enacted following definitive and concrete Korean traditional medical concepts by the Korean traditional medical society.

• Journal of information and communication convergence engineering
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• v.2 no.3
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• pp.157-160
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• 2004

The paper's suggestion is about hereditary facts between family members. Diagnosing patients from the point of patients temporary conditions, and so performing primitive examinations and treatments, can lead not only to frequent wrong diagnoses, and to huge medical expenses and times to the patients, but even to critical situation of patients or taking lives away. As a means to cut these cases down to a minimum, sharing medical treatment information between family members is suggested. This approach makes possible understanding physical constitution and environment between family members, and can result in bringing a faster treatment effect if some family member suffers from a similar disease. This approach, since a participation in a family membership effectuates all of family members, can minimize the membership fees, thus enabling inter-family health care on a home doctor basis.

• International Journal of Contents
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• v.1 no.2
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• pp.18-21
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• 2005

The following suggested algorithm is completed care report for the family medical history. Rn=$U\;Pnj+U\;Dn^i$ : (j=1,2,...,j), (i=1,2,...,i), (n=1,2,...,n) The Rn(completed care report) integrates comprehensive patients reports ranging from patient $P^2\;to\;P^j$ including $P^1$ (oneself) with the doctors' care reports up to the care No. no by i number of doctors ($D^1$ =doctor in charge, $D^{2,3...i}$=doctors on corporation program.) This approach, since a participation in a family membership effectuates all of family members, can minimize the membership fees, thus enabling inter-family health care on a home doctor basis.