• Health Policy and Management
• /
• v.29 no.1
• /
• pp.40-48
• /
• 2019

Background: As of July 2015, per diem payment was changed from fee for service Therefore, this study aims to analyse changes in medical charges and medical services before and after enforcement of the palliative care, targeting palliative care wards in a general hospital, and provide basic data needed for development of per diem payment. Methods: The subjects of the study were a total of 610 cases consisting of 351 patients of service fee who left hospital (died) from July 2014 to June 2016 and 259 ones of per diem payment at Chosun University Hospital in Gwangju Metropolitan City. Results: The results are summarized as follows. First, after the palliative care system was applied, benefit medical service charges and insurance increased significantly (p<0.001). As benefit medical service charges increased, benefit private insurance payment increased significantly (p<0.001). Second, after the per diem payment was applied, total private insurance payment to medical institutes decreased significantly (p=0.050) and non-benefit also decreased significantly (p=0.001). Conclusion: It is suggested that additional rewards in the obligatory palliative care items should be continuously remedied and monitored to provide good quality hospice palliative care.

• The Journal of the Korea Contents Association
• /
• v.22 no.2
• /
• pp.782-793
• /
• 2022

The rise in chronic disease not only has a negative effect on people's lives, but it also increases the cost of medical care owing to the increased usage of medical care as health and medical technology improves, life expectancy rises, and rapid population ageing. In such context, this study examined the difference in the disease cost of hypertension according to demographic information and the effect of the initial diagnosis age and treatment period on the cost. This study used the Korean Health Panel Survey from 2010 to 2017, and selected subjects based on health insurance beneficiaries between the ages of 30 and under 80. With the selected data, the direct and indirect costs of disease loss were calculated according to the cost of illness approach, and we constructed a disease-loss ratio cohort considering the age of diagnosis and time of treatment for hypertension. From the results of the study, the annual cost of disease loss for hypertensive patients differed by gender by 110,107 won, and it was found that the cost increased by 1.8 times as the treatment time increased. In addition, when comparing disease loss ratios between the same age groups, it was found that the disease loss ratios between those in their 60s and 70s were affected by treatment time. This study confirmed that hypertension significantly affects the cost of the disease, and not only requires early diagnosis and management, but also preventive efforts to lower the incidence of hypertensive disease must be strengthened.

• Health Policy and Management
• /
• v.31 no.2
• /
• pp.217-224
• /
• 2021

The objective of this study is to investigate the healthcare status of South Korea and other member countries of the Organization for Economic Cooperation and Development (OECD) using OECD health statistics 2020. We employed the position value for relative comparison index to measure the healthcare status in five following components: demand, supply, accessibility, quality, and cost. The Mann-Kendall test was used to analyze for increasing or decreasing trend of the position value for relative comparison values from 2000 to the recent year. Results showed that Korea was positioned above than the OECD median values in most of components, but lower than the median values in certain indices including healthcare employment, primary care, and mental health care. This study sheds some light on healthcare issues to be improved and the policy-makes can take into account for prior setting process.

• Clinical and Experimental Pediatrics
• /
• v.51 no.9
• /
• pp.977-986
• /
• 2008

Purpose : This study aims to estimate the financial cost of rotavirus infection in Korea in the year of 2005. Methods : The incidence rates used were from the epidemiological profile at Jeoungeub District (5.8 cases/1,000 children <5 years old for inpatients, and 22.65 cases/1,000 children <5 years old for outpatients, per year). The health care cost per capita of rotavirus infection (ICD code: A08.0) was extracted from the Health Insurance Review and Assessment Service database in Korea. The patient survey was conducted to capture information about non-medical costs and associated productivity loss incurred by adult caregivers. Results : The number of annual national cases among children <5 years old with rotavirus infection was estimated to be 69,122 (i.e., 55,030 outpatients and 14,092 inpatients). The total cost of rotavirus infection was estimated at 13.3 billion Korean won, comprising 11 billion Korean won (82.7%) of direct medical costs, 1.6 billion Korean won (12.0%) of direct non-medical costs (e.g., transportation and supplies), and 0.68 billion Korean won (5.1%) of productivity lost by adult caregivers. Conclusion : Rotavirus infection carries not only medical costs but also non-medical and indirect costs; together, these costs incur a significant burden on South Korean society. The impact of rotavirus on quality of life and health among patient caregivers was not considered in this study, but it does merit further research.

• The Korean Journal of Health Service Management
• /
• v.12 no.2
• /
• pp.63-73
• /
• 2018

Objectives : This study aimed investigate general characteristics, vaccination status and health beliefs related to vaccination for herpes zoster and to identify variables. Methods : The structured questionnaire was conducted from March 31, 2016 to April 20, 2016 with 312 outpatients who visited a university hospital. The data were analyzed by frequency analysis, t-test, $x^2-test$, correlation analysis and logistic regression analysis via SPSS statistics 22.0. Results : The vaccination rate of the herpes zoster was 16.0% and the vaccination cost was the most common reason for rejecting inoculation. More highly educated people with more than a university degree(OR=4.28, p=.002), those with higher susceptibility to herpes zoster(OR=1.56, p=.000), those more aware of the benefits of vaccination(OR=1.51, p=.009) and those with lower disability for vaccination(OR=0.74, p=.003) were more likely to be vaccinated. Conclusions : Therefore, to increase the vaccination rate of herpes zoster in adults over 50 years old, continuous publicity and education are needed to emphasize the susceptibility of herpes zoster and the benefit of vaccination. In addition, it is necessary to develop policies at the national level for the expensive vaccination cost that obstructs vaccination.

• Korean Journal of Social Welfare
• /
• v.48
• /
• pp.150-178
• /
• 2002

The elderly have higher potential for contracting chronic diseases and suffering from development of a complication. Also, the extended old age period leads the elderly to demand more medical services. All those facts indicate that the elderly need more medical services than any other age groups. Consequently, medical care for the elderly with chronic diseases causes high costs burden. However, there is few studies researching the financial burden of chronic illness of the elderly. This study aimed to 1) understand how much the elderly with chronic diseases pay for medical expenses; 2) find out some specific factors related to health care financial burden; 3) suggest the alternative policies to decrease excessive financial burden of caring for the elderly with chronic illness. National Health and Nutrition Survey, which was surveyed by the Korea Institute for Health and Social Affairs in 1998, was used in this study. 4,707 persons with chronic diseases out of 5385 persons over age 60 were selectively sampled. Using SPSSWIN, correlation analysis, T-test, ANOVA and Regression were used as statistical methods in this study. Stepwise multiple regression was employed to analyze the data with a ratio of health care expenditure to income(financial burden) as a dependent variable. Out of Korean old people, 87% had the chronic diseases and their health care financial burden rate showed the average of 17.9%, which meaned they expended almost 20% income to buy medical services. The variables having a great influence on financial burden were monthly income, activity, limitation and single household of an old person. The excessive financial burden was experienced by people who had more than 4 activity limitations(37.1%) and were in the lowest Income level(32.6%), and single household of an old person(31.4%). The new policies should be considered to 1) reduce the financial burden in these groups and to develop the sliced medical cost system considering the characteristics of chronic illness and income level; and 2) develop the medical management system to care for the elderly with chronic illness.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.5
• /
• pp.3363-3368
• /
• 2013

Background: The burden due to cancers is an emerging public health concern especially in resource-limited countries like Nigeria. The WHO estimates that cancer kills more people than tuberculosis, HIV/AIDS and malaria combined. As people in Nigeria and other developing countries are beginning to survive infectious diseases, there is an observed epidemiologic transition to chronic diseases, such as cancers. In 2008, 75 out of 1,000 Nigerians died of cancer. Despite the rising incidence and public health importance, Nigeria lacks an organized and comprehensive strategy to deal with cancers. Materials and Methods: This article reviewed 30 peer-reviewed manuscripts on cancer care in four countries. It highlights the limitations to cancer care in Nigeria; due to lack of awareness, low health literacy, absence of organized screening programs, inadequate manpower (in terms of quality and quantity) as well as limited treatment options. Results: This review led to the formulation of a proposal for Nigerian National Cancer Policy, mainly drawn from effective strategies used in Canada, Brazil and Kenya. This is a vertical cancer program that is patient-centered with an emphasis on tobacco control and cancer disease screening (similar to Canada and Brazil). Additionally, it emphasizes primary cancer prevention (similar to Kenya). Its horizontal integration with other disease programs like HIV/AIDS will improve affordability in a poor resourced country like Nigeria. Capacity building for health professionals, hub-and-spoke implementation of screening services, as well as investment in effective treatment options and increased research in cancer care are essential. International 'twinning collaborations' between institutions in richer countries and Nigeria will enhance effective knowledge translation and improve the quality of patient care. Conclusions: A national cancer policy must be developed and implemented in Nigeria in order to overcome the present limitations which help contribute to the observed increases in cancer morbidity and mortality rates. Cancer control is feasible in Nigeria if the nation was to consider and employ some of the cost-effective strategies proposed here.

• Journal of Microbiology and Biotechnology
• /
• v.33 no.8
• /
• pp.1091-1100
• /
• 2023

Human papillomavirus (HPV) types 16 and 18 are the major causes of cervical lesions and are associated with 71% of cervical cancer cases globally. However, public health infrastructures to support cervical cancer screening may be unavailable to women in low-resource areas. Therefore, sensitive, convenient, and cost-efficient diagnostic methods are required for the detection of HPV16/18. Here, we designed two novel methods, real-time ERA and ERA-LFD, based on enzymatic recombinase amplification (ERA) for quick point-of-care identification of the HPV E6/E7 genes. The entire detection process could be completed within 25 min at a constant low temperature (35-43℃), and the results of the combined methods could be present as the amplification curves or the bands presented on dipsticks and directly interpreted with the naked eye. The ERA assays evaluated using standard plasmids carrying the E6/E7 genes and clinical samples exhibited excellent specificity, as no cross-reaction with other common HPV types was observed. The detection limits of our ERA assays were 10⁰ and 10¹ copies/µl for HPV16 and 18 respectively, which were comparable to those of the real-time PCR assay. Assessment of the clinical performance of the ERA assays using 114 cervical tissue samples demonstrated that they are highly consistent with real-time PCR, the gold standard for HPV detection. This study demonstrated that ERA-based assays possess excellent sensitivity, specificity, and repeatability for HPV16 and HPV18 detection with great potential to become robust diagnostic tools in local hospitals and field studies.

• Journal of Hospice and Palliative Care
• /
• v.2 no.2
• /
• pp.109-113
• /
• 1999

Purpose : Because we don't have inappropriate health care system for the terminal cancer patients, there were abnormal behavior patterns of health care utilization. So, There were needs to develop the comprehensive care for terminal cancer patients. Increased attention is being paid to the futility of life-sustaining treatment and high cost of management of terminal cancer patients Materials and Methods : This study was performed on cancer patients, registered in 1996 Central Cancer Registry, who were as insured person of Korea Medical Insurance and died from January 1997 to June 1998. We studied the day of medical care and medical expenses of 151 cancer patients evaluable. Results : The mean day of inpatient care was 39 days, and the mean days of outpatient care was 14 days in study subjects. Mean expenses per day of medical care, day of inpatient, and day of outpatients care were 85,392 won, 105,908 won, and 40,173 won. 95% of medical expenses is paid to the general hospital, and 85% of medical expenses was paid for inpatient care. About half of all medical expenses in th last 6 months were incurred in the last 60 days of life, and about 30 percent were incurred in the last 30 days. Expenses of outpatients care increased between 6 month and 3 months, after which they decreased. Expenses of inpatients care increased during all last 6months Conclusion : The distribution or medical expenses during the last 6 months in our study is similar to the distribution of American Medicare costs. We need to study medical expenses during the last year of life with large scale and details in order to develop the plan about the management of terminal cancer patient.

• Korea Journal of Hospital Management
• /
• v.10 no.1
• /
• pp.48-70
• /
• 2005

The purpose of this study was to make an analysis of the impact of the DRG payment system on medical care pattern and cost of cataract surgery in a general hospital. The subjects were 173 patients whose DRG severity grade was zero, selected from among the hospitalized who underwent cataract surgery before and after the joining to the demonstrational operation of the third year DRG payment system. Their medical records and the details of their medical bills were examined to find out the length of hospital stay, medical care pattern provided to them, the cost of medical care, and the quality of medical care. The length of stay and the amount of medical care supplied during being in hospital dropped significantly for both single-eye and double-eyes cataract surgery groups. The amount of antibiotic use went down during the hospitalization and upon discharge from the hospital, but decreased after discharge. The total medical bills and the rate of basic examination implementation increased in the OPD before hospitalization but after discharge dropped. For double-eyes cataract patients, the rate of double-eyes cataract surgery went down. The total medical bills of DRG payment system converted into the fee-for-service system was greater by 113.3% for the single-eye cataract surgery group and by 102.9% for the doble-eyes cataract surgery group, compared to that by the fee-for-service. The contribution shared by the insurance corporation increased for both single-eye and double-eyes cataract surgery groups, but the copayment by the insured went down. Regarding the treatment outcome, no difference was found in complication rate, resurgery rate and mortality rate before and after the joining to the DRG payment system was implemented. The use of special lens lessened significantly. The amount of medical care supplied during hospitalization decreased but the complication rate didn't increase. But the increased use of low-price artificial cataract and the avoidance of double-eyes cataract surgery was observed. The phenomenon decreased number of OPD visit and the decreased total medical bills of OPD care after discharge in this hospital required further evaluation.