• The Korean Journal of Health Service Management
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• v.10 no.2
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• pp.49-58
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• 2016

Objectives : The purpose of this study was to find factors affecting the cost-reduction practice of clinical nurses. Methods : The Data were collected from Feb. 25, to Mar. 15, 2015.the Total subjects were 201 nurses working in secondary-care hospitals located in Busan Results : The Meaningful variables that explain the cost-reduction practice in clinical nurses were psychological ownership, religion, and marital status in that order. Total explanation power was 22.1.% and psychological ownership has most explanation power. Conclusions : Psychological ownership and economic consciousness need to improve to develop cost-reduction practices. Additionally, nurses with and low concern about finances need to receive financial-related education.

• 대한예방의학회:학술대회논문집
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• 2005.10a
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• pp.352-352
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• 2005

• Health Policy and Management
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• v.28 no.3
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• pp.315-319
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• 2018

This paper aims to make a step-by-step strategy to formulate an unified health system by clarifying and overcoming challenges facing South and North Korea and to estimate costs needed for South Korea to assist North Korea to recover to normal health delivery system. We explored implications through literature review and estimated costs under the assumption that supportive activities be provided for 5 years in three ways: support for the development of health and medical care manpower; support for health and medical facilities; and support for the provision of both preventive and primary health care. Step-by-step strategy is formulated for a unified health system with the cost estimation resulting as follows: in case of basic scenario, a total of 3 trillion and 341 billion won (at present value of the year 2017) is in need for the 5-year period at the initial 'recovery support stage' with 135.9 billion won for the development of health and medical care manpower, approximately 2 trillion won for health and medical facilities, and 1.2 trillion won for the provision of both preventive and primary health care. Step-by-step approach is more realistic and applicable in formulating unified health system. Suggested stages are 'recovery support stage,' 'system homogenization stage,' and 'unified system stage.' Strategies at 'recovery support stage' suggested in this paper need to be pursued and followed by those at 'system homogenization stage' and 'unified system stage.'

• Korea Journal of Hospital Management
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• v.17 no.2
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• pp.52-72
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• 2012

In this study, we examined the effect of customer satisfaction and switching cost on continuous use intention to suggest how organizations can retain their customers when market growth slows down and competition becomes stronger. We carefully developed and modified survey instruments through a pre-test, and subsequently surveyed 432 dental care users in Seoul and Busan areas. As a result of regression analysis, higher procedural learning switching cost, relational switching cost, and customer satisfaction were manifested in the increased continuous use intention. In contrast, higher financial switching cost and customer satisfaction with insufficient effort for information acquisition led to decreased switching intention. In addition, procedural initial switching cost and residents in Seoul led to increased switching intention. Understanding continuous use intention and switching intention is important for healthcare institutions striving to maintain market position. The findings of this study suggest a paradigm shift from conventional transactional marketing to strategic relational marketing to be effective in the healthcare environment today.

• Journal of Oriental Neuropsychiatry
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• v.30 no.1
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• pp.31-38
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• 2019

Objectives: To identify the cost effectiveness of early dementia diagnosis using the 2014 Health Insurance Review & Assessment Service-National Patients Sample (HIRA-NPS). Methods: The medical costs of dementia between Western medical care and Korean medical care were compared through the reimbursement and non-reimbursement item code for dementia examination. In addition, the medical expenses of patients with dementia and mild cognitive impairment were compared and analyzed with respect to Western and Korean medical care. Results: There were 87,434 claims, of which 16,101 patients were diagnosed with dementia and 38,680,789,560 won was found to be the medical expenses. 12,881 patients (80.0%) with dementia, 3,144 patients (19.5%) with mild cognitive impairment, and 76 patients (0.5%) progressing from mild cognitive impairment to dementia. The proportion of medical expenses was 97.6% for dementia patients, 2.3% for mild cognitive impairment, and 1% for patients progressing from mild cognitive impairment to dementia. 86,070 claims (98.4%) were from Western medical care, with16,824 patients (98.2%), and the medical expenses was 38,546,895,400 won (99.7%). 1,361 claims (1.6%) were from Korean medical care, with 303 patients (1.8%), and the medical expenses was 133,894,160 won (0.3%). Conclusions: This study compared and analyzed the medical costs of dementia patients and the diagnosis of both Korean and Western medical care. The results of this study are expected to be used as basic research data for investigating cost effectiveness of developing early diagnosis of dementia.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.12 no.2
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• pp.63-86
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• 2005

Purpose: This study is a descriptive research which is designed to investigate hospitalized patients' intent to use home care nursing according to the types of medical security. Method: This researcher surveyed 236 patients who were hospitalized at B medical center located in Busan,. Data were collected from Sep. 1 to Nov. 30, 2005 using a questionnaire survey, medical records, face-to-face interviews and observations. Collected data were analyzed in terms of frequency, percentage, mean and standard deviation through $x^2$-test and t-test under SPSS WIN 10.0 Program. Result: Out of the total subjects, 59.3% were medical aid clients and the remaining 40.7%, health insurance ones. The hospitalized period and frequency of the former group were 38.0 days and 4.0 times, respectively, while those of the latter, 37.7 and 3.4. When home care nursing clients were examined using a given classification device, it was found that out of the total 236 subjects, 205(86.9%) were needed to receive home care nursing, 121, medical aid and the other 84, health insurance. 24.0% of medical aid clients heard about home care nursing ever before, lower than 39.3% of health insurance clients. 43.8% of the former clients said cost for home care nursing was high while, 47.6% of the latter group responded expense for the nursing intervention was low. 30.6% of medical aid clients had intent to use home care nursing, lower than 47.6% of health insurance clients. 71.7% of those patients whose monthly income was 99 million won or below had no intent to use home care nursing, higher than 62.5% of those who were 100 million or over in monthly income(p<.05). 76.4% of those clients who had no nursing provider intented to use home care nursing, higher than those who had nursing provider(p<.05). Concerning contents of home care nursing, 85.1% of medical aid clients needed education, training and counseling while, 77.4% of health insurance aids wanted medication and injection. Conclusion: In conclusion, the use of home care nursing by medical aid clients should be promoted through improving conditions for home care nursing in terms of expense, family and residence and making public relations about activities and contents of the home care nursing.

• Korea Journal of Hospital Management
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• v.23 no.2
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• pp.42-53
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• 2018

Purpose: this study investigates the effect of private health insurance on healthcare utilization. Methodology: For the analysis, we employed the three level nested two part model. Findings: the private health insurance adoption was associated with higher health care utilization. In particular, indemnity and fixed insurances adoption was associated with higher probability of outpatient visit, the number of outpatient visit and outpatient cost. While indemnity insurance adoption was associated with higher inpatient admission probability and inpatient days, fixed insurance adoption was associated only with higher inpatient admission probability. Practical Implications: indemnity and fixed insurance adoption were related with the adverse selection as well as moral hazard.

• Quality Improvement in Health Care
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• v.5 no.1
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• pp.152-165
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• 1998

Background : In this paper patient outcomes research is going to be reviewed and described, to be compared with relevant studies, and to consider the application in Korea. Methods : We compiled and reviewed the articles and materials related to patient outcomes research especially by PORT(Patient Outcomes Research Team) and rearranged them for seeking the main point and comparing with relevant studies. Results : Patient outcomes research emphasizes patient outcomes as well as conventional clinical outcomes. It is prospective study observing effectiveness in real situation instead of efficacy in ideal condition. Patient outcomes research comprises of 6 fields ; literature review and meta-analysis, use of claims data, decision modeling, outcomes assessment, cost of care, dissemination of research findings. SAA(small-area variations analysis), appropriateness study and clinical practice guideline are connected with patient outcomes research. Conclusion : In view of the fact that current medical policy in Korea is shifting its focus from accessibility to the improvement in quality and cost containment, and is stressing patient-based research, patient outcomes research is one direction for which the medicine is accountable and assessable. Considering that the number of patient receiving medical treatment in Korea is higher than the West, patient outcomes research has competitive power as against the West.

• International Journal of Computer Science & Network Security
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• v.22 no.3
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• pp.364-374
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• 2022

Health information systems (HIS) are facing security challenges on data privacy and confidentiality. These challenges are based on centralized system architecture creating a target for malicious attacks. Blockchain technology has emerged as a trending technology with the potential to improve data security. Despite the effectiveness of this technology, still HIS are suffering from a lack of data privacy and confidentiality. This paper presents a blockchain-based data storage security architecture integrated with an e-Health care system to improve its security. The study employed a qualitative research method where data were collected using interviews and document analysis. Execute-order-validate Fabric's storage security architecture was implemented through private data collection, which is the combination of the actual private data stored in a private state, and a hash of that private data to guarantee data privacy. The key findings of this research show that data privacy and confidentiality are attained through a private data policy. Network peers are decentralized with blockchain only for hash storage to avoid storage challenges. Cost-effectiveness is achieved through data storage within a database of a Hyperledger Fabric. The overall performance of Fabric is higher than Ethereum. Ethereum's low performance is due to its execute-validate architecture which has high computation power with transaction inconsistencies. E-Health care system administrators should be trained and engaged with blockchain architectural designs for health data storage security. Health policymakers should be aware of blockchain technology and make use of the findings. The scientific contribution of this study is based on; cost-effectiveness of secured data storage, the use of hashes of network data stored in each node, and low energy consumption of Fabric leading to high performance.

• Journal of Korean Biological Nursing Science
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• v.21 no.2
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• pp.133-140
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• 2019

Purpose: The purpose of this study was to check the degree of residual microbial contamination after disinfection of reusable suction containers, used in an intensive care unit (ICU) and present basic data for efficient use through cost analysis in comparison to disposable suction containers. Methods: This study was conducted on 32 reusable suction containers used in an ICU on a selected specific day. After disinfection and washing, specimens were collected from the used containers and cultured to check for microbial contamination. Additionally, a comparative narrative study analyzes the cost of using reusable suction containers and disposable suction containers. Data were analyzed with the SPSS WIN 20.0 program using real numbers and percentage ${\chi}^2$-test. Results: As a result of the study, microorganisms were found in all samples where in 30 were gram-positive (62.5%) while 13 were gram-negative (27.1%). Based on level of contamination, microorganisms were less than 10CFU/ml in 18 samples (56.3%); 11-99CFU/ml in six samples (18.8%); and more than 100CFU/ml in eight samples (25%). Cost per day for a reusable suction container was $10,655+{\alpha}$ while cost per day for a disposable suction container was 10,666 won. Conclusion: This study found that reusable suction containers, even after disinfection, accounted for factors of potential infection as well as microbial contamination. So, disposable suction containers are superior in cost-effectiveness and highly efficient for use with infected patients.