• 제목/요약/키워드: Health Care Cost

검색결과 801건 처리시간 0.026초

자료포락분석을 활용한 일 병동 간호사의 성과평가 방안 (Performance Evaluation of Nurses in a General Ward Using Data Envelopment Analysis (DEA))

  • 박연홍;임지영
    • 가정∙방문간호학회지
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    • 제25권1호
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    • pp.67-77
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    • 2018
  • Purpose: The purpose of this study was to compare the efficiency of general ward nurses in hospitals using Data Envelopment Analysis (DEA). Methods: Participants were 30 nurses working at a general ward. Input variables were labor cost and time of direct nursing. Output variables were prevention rate of medication error and bedsores, and patient satisfaction. These variables were extracted using literature review and CVI of an expert group. Data were collected from September 18 to October 7, 2017. Data were analyzed using EMS 3.1 program for DEA and descriptive statistics. Results: The average efficiency score of 30 nurses was 0.986, which was very high over all. In the super-efficiency analysis of 11 nurses, their efficiency ranged from 1.0 to 1.047. In addition, when the current output was fixed, the labor cost of nurses did not affect efficiency. Conclusion: This study attempted a new approach concerning performance evaluation of nurses using DEA. This method was useful during appraisal of nurses. We suggest that various input and output variables that were not considered in this study should be added to develop a integrative performance analysis model for nurses.

The Development of New Cost-Effective Optimization Technology for OLED Market Entry

  • Kwon, Woo-Taeg;Kwon, Lee-Seung;Lee, Woo-Sik
    • 유통과학연구
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    • 제17권4호
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    • pp.51-57
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    • 2019
  • Purpose - This study aims to improve the distribution structure of the OLED market and develop cost-effective optimization techniques. Specifically, it is a study on the optimization of ferric chloride to improve the etch of SUS MASK for OLED. Research design, data, and methodology - Applying the optimal conditions of the experiment, the final confirmation was evaluated for improvement by the Process Capability Index (Cpk). It is possible to derive social performance such as improvement of precision of SUS MASK manufacturing, economic performance such as defect rate, reduction of waste generation and treatment cost, technological achievement such as SUS MASK production technology, improvement of profit structure of technology development and process improvement do. Results - The improvement of the Cpk before the improvement was made was confirmed to be 0.57% with a defect estimate of 25.07% with a failure estimate of 0.57% after the improvement, and 8.84% with a failure estimate of 0.57% level after the improvement. Conclusions - If the conclusions obtained from the specimen experiment are applied to the manufacturing process of SUS MASK, it will be possible to expect excellent cost-effective competitiveness due to the improvement of precision and reduction of defect rate to enhance the OLED market penetration.

호스피스의료와 간호윤리 (Hospice Medicine and Nursing Ethics)

  • 문성제
    • 의료법학
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    • 제9권1호
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    • pp.385-411
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    • 2008
  • The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

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Comparison of international medical costs for interventional pain treatment: a focus on Korea and Japan

  • Eun Young Lee;Hyung-Sun Won;Miyoung Yang;Hyungtae Kim;Yeon-Dong Kim
    • The Korean Journal of Pain
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    • 제37권1호
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    • pp.51-58
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    • 2024
  • Background: The rise in national health care costs has emerged as a global problem given the ever-aging population and rapid development of medical technology. The utilization of interventional pain management has, similarly, shown a continued rise worldwide. This study evaluates the differences in the medical costs in the field of interventional pain treatment (IPT) between two countries: Korea and Japan. Methods: Korean medical insurance costs for 2019 related to pain management focused on IPT were compared to those of Japan. Purchasing power parity (PPP) was used to adjust the exchange rate differences and to compare prices in consideration of the respective societies' economic power. Results: The cost of trigger point injections in Japan was 1.06 times higher than that of Korea, whereas the perineural and intraarticular injection prices were lower in Japan. The cost of epidural blocks was higher in Japan compared to Korea in both cervical/thoracic and lumbar regions. As for blocks of peripheral branches of spinal nerves, the cost of scapular nerve blocks in Japan was lower than that in Korea, given a PPP ratio 0.09. For nerve blocks in which fluoroscopy guidance is mandatory, the costs of epidurography in Japan were greater than those in Korea, given a PPP ratio 1.04. Conclusions: This is the first comparative study focusing on the medical costs related to IPT between Korea and Japan, which reveals that the costs differed along various categories. Further comparisons reflecting more diverse countries and socio-economic aspects will be required.

의료보험 시범지역의 전국민 의료보험실시전후의 진료비증가 기여도 분석 (Analysis of Source of Increase in Medical Expenditure for Medical Insurance Demonstration Area before(1982-1987) and after(1988-1990) National Health Insurance)

  • 차병준;박재용;감신
    • 보건행정학회지
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    • 제2권2호
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    • pp.221-237
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    • 1992
  • The reasons for cost inflation in medical insurance expenditure are classified into demand pull inflation and cost push inflation. The former includes increase in the number of beneficiaries and utilization rate, while the latter includes increase in medical insurance fee and the charges per case. This study was conducted to analyze sources of increases of expenditure in medical insurance demonstration area by the period of 1982-1987 which was earlier than national health insurance and the period of national health insurance(1988-1990). The major findings were as follows: Medical expenditure in these areas increased by 9.4%(15.1%) annually between 1982 and 1990 on the basis of costant price(current price) and for this period, the yearly average increasing rate of expenses for outpatient care[10.5%(15.8%)] was higher than that of inpatient care [7.3%(12.6%)]. Medical expenditure increased by 6.3%(8.9%) annually between 1982 and 1987, the period of medical insurance demonstration, while it increased by 10.7%(18.9%) after implementing national health insurance(1988-1990). Medical expenditure increased by 35.9%(45.9%) between 1982 and 1987. Of this increase, 115.2%(92.1%) was attributable to the increase in the frequencies of utilization per beneficiary and 61.0%(68.1%) was due to the increase in the charges per case, but the expenditure decreased by 76.2%(60.2%) due to the reduction in the number of beneficiaries. Beteen 1988 and 1990, the period of national health insurance, medical expenditure increased by 21.2%(41.4%). Of this increase, 87.5%(46.4%) was attributable to the increase in the frequencies of utilization per beneficiary and 52.4%(73.4%) was due to the increase in the charges per case, and of the increase in the charges per case, 69.6%(40.8%) was attributable to the increase in the days of visit per case. Medical expenses per person in these areas increased by 78.2%(89.0%) between 1982 and 1987. Of this increase, 76.6%(69.1%) was attributable to the increase in the frequencies of utilization per beneficiary and 23.4%(30.9%) was due to the increase in the charges per case. For this period, demand-pull factor was the major cause of the increase in medical expenses and the expenses per treatment day was the major attributable factor in cost-push inflation. Betwee 1988 and 1990, medical expenditure per person increased by 31.2%(53.1%). Of this increase, 60.8%(37.2%) was attributable to the demand-pull factor and 39.2%(62.8%) was due to the increase in the charges per case which was one of cost-push factors. In current price, the attributalbe rate of the charges per case which was one of cost-push factors was higher than that of utilization rate in the period of national health insurance as compared to the period of medical insurance demonstration. In consideration of above findings, demand-pull factor led the increase in medical expenditure between 1982 and 1987, the period of medical insurance medel trial, but after implementing national health insurance, the attributable rate of cost-push factor was increasing gradually. Thus we may conclude that for medical cost containment, it is requested to examine the new reimbursement method to control cost-push factor and service-intensity factor.

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농촌지역 보건소 한방진료실 확대설치 요구도 및 관련요인 - 일개 군 보건소 한방진료실 내소자를 대상으로 - (Need Assessment for Enlargement of Oriental Medical Care Service Room in Rural Community Health Center)

  • 김대필;송미숙;송현종
    • 농촌의학ㆍ지역보건
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    • 제28권1호
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    • pp.39-51
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    • 2003
  • 본 연구는 2002년 5월부터 9월까지 5개월간 경상남도 일개 군 보건소 한방진료실에 내소한 재진 환자를 대상으로 한방진료실 직원이 직접 설문지를 통한 일대일 면접 조사를 실시하였고, 면접 조사를 꺼리는 대상자에 대해서는 자기기입식 방법으로 자료를 수집하여 한방의료 이용 실태와 주민들의 이해도와 만족도를 파악하고 한방진료실을 한방의료서비스 부족지역으로 확대 설치하는 것에 대한 의견을 수렴하는데 그 목적을 두었다. 총 조사 대상자는 163명이었으며 본 연구의 결과를 요약하면 다음과 같다. 첫째, 보건소 한방진료실을 이용하는 주된 대상은 61세 이상이 전체의 65.0%로 과반수 이상을 차지하고 있으며 대상자의 13.5%만이 자신의 건강상태가 좋다고 인지하고 있었다. 둘째, 보건소 한방진료실의 치료법에 대한 사전인식 분석 결과 보건소 한방진료실에서 시행하는 치료법에 대해 올바르게 인식하는 비율은 54.0%로 나타났으며, 특히 침 시술의 경우에는 조사 대상자 모두가 보건소 한방진료실에서 시술한다는 것으로 인식하고 있었다. 셋째, 보건소 한방진료실 이용행태에 관한 분석 결과로는 한의학적인 치료를 받고 싶어서 한방진료실을 찾은 경우가 66.9%로 가장 많았으며 집에서 보건소까지의 소요시간이 1시간에서 2시간 사이까지 많은 시간이 걸린다고 응답한 사람도 9.2%나 되었다. 넷째, 보건소 한방진료실 이용자의 한방보건의료에 대한 요구도를 조사한 결과 이동진료, 금연프로그램, 거동불능자 방문 프로그램 순으로 한방지역보건사업에 대한 요구률이 높았으며 다른 면지역으로의 한방진료실 확대 설치에 대한 요구도 조사에서는 조사 대상자의 73.7%가 한방진료실 확대 설치가 필요하다고 응답하였다. 다섯째, 한방진료실 확대설치 요구도는 학력이 높은 집단, 집과 보건소와의 거리가 멀다고 생각하는 대상자, 치료비에 대한 만족도가 높은 집단에서 높은 것으로 나타났다. 이상의 결과를 볼 때 농촌지역의 한방진료서비스에 대한 이용도가 높은 것으로 나타났으며 도시지역에 비하여 한방의료자원의 분포가 낙후되어 있는 농촌지역 실정으로 보건소에 한방진료실을 설치하여 시행한 한방진료서비스에 대한 이용자들의 만족도 또한 매우 높다는 것을 파악할 수 있었다. 이러한 주민들의 높은 한방진료서비스에 대한 요구에 부응하기 위해 한방지역보건사업을 합리적으로 실시하고 한방진료실이 설치되어 있지 않은 면지역 보건지소로의 적극적인 확대설치가 적극 검토되어야 할 것이다.

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입원·외래서비스 이용경험이 지역사회 보건복지서비스 이용(욕구)에 미치는 영향 : 저소득 만성질환보유 노인을 대상으로 (A Study on Promoting the Linkage between Hospital Care and Community Health Services for the Low-income Elderly with Chronic Disease)

  • 이수연;배지영
    • 사회복지연구
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    • 제42권2호
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    • pp.303-322
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    • 2011
  • 만성질환보유 저소득 노인의 삶의 질 향상과 의료비절감을 위해서는 지역사회 보건복지서비스와 병의원서비스간의 연계가 중요하다. 본 논문은 서울시 복지패널데이터를 이용하여 병의원 의료서비스와 지역사회 보건복지서비스간의 연계 욕구 및 실태를 분석하기 위하여 병의원서비스 이용경험이 지역사회 보건복지서비스 이용(욕구)에 미치는 영향을 로짓분석하였다. 분석결과 입원경험이 있는 노인들은 입원경험이 없는 노인에 비해 지역사회 보건복지서비스에의 욕구가 더 높음에도 불구하고 실제로 해당 서비스를 더 많이 받지 못하고 있었다. 또한 외래이용경험이 없는 저소득 만성질환노인은 외래경험이 있는 노인에 비해 지역사회 보건서비스에의 욕구는 더 높았으나 실제 이용률은 더 높지 않았다. 결론적으로 볼 때 우리나라 병의원 의료서비스와 지역사회 서비스간의 연계가 긴밀하게 이루어지지 않고 있음을 알 수 있다.

가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교 (A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients.)

  • 김용순;임영신;전춘영;이정자;박지원
    • 대한간호
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    • 제29권2호
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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간호 관련 비용의 실증적 사례분석 연구 (An Empirical Analysis of Costs related to Nursing Practice)

  • 고유경;박보현
    • 간호행정학회지
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    • 제23권2호
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    • pp.139-150
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    • 2017
  • Purpose: The purpose of this study was to identify nursing service costs associated with all health care costs incurred by the institution. Methods: This study was an empirical case study research in which the nursing cost was separated from total medical cost. The nursing cost index was calculated through a cost allocation method after summarizing costs for personnel, raw materials and administration of each department in one public hospital. The 2014 budget plan, published in 'Public Hospitals Alert', was used as data and the data were analyzed using the Microsoft Office EXCEL 2013 program. Results: When comparing total medical costs and nursing costs, the nursing cost were 27.14% of the total medical cost. The nursing cost per nurse per hour was calculated as \29,128 The nursing cost per inpatient per day was calculated as \157,970, and the administration cost per patient was calculated as \133,710. Conclusion: The results of the research present the process of cost allocation of specific cost elements in the hospital and evidence for administrative costs which in the past have been only vaguely formulated. These are the significant implications of this study.

환자의 바이오인포매스틱 정보를 속성수에 따라 계층적으로 분류한 효율적인 의료서비스 모델 (An Efficient Hospital Service Model of Hierarchical Property information classified Bioinformatics information of Patient)

  • 서인규;이상호
    • 중소기업융합학회논문지
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    • 제5권4호
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    • pp.17-23
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    • 2015
  • 정보통신 기술의 발전으로 인하여 헬스케어 서비스가 대중화되면서 환자의 바이오인포매틱스 저보를 활용한 다양한 서비스가 환자에게 제공되고 있다. 특히, 바이오인포매틱스 정보를 활용한 헬스케어 서비스는 다양한 의료서비스 트랜드로 변화하고 있다. 그러나, 환자의 바이오인포매틱스 정보를 이용한 헬스케어서비스는 질병의 복잡성과 새로운 질병(SARS, AIDS 등)의 등장으로 인하여 의료비용이 증가하고 있고 환자에게 건강 증진 서비스가 원활하게 제공되지 못하고 있다. 본 논문에서는 저비용의 의료 서비스와 빠른 환자의 바이오인포매틱스 정보 접근을 위한 의료 서비스 모델을 제안한다. 제안 모델은 환자의 바이오인포매틱스 정보를 빅 데이터화하여 환자가 언제/어디서나 자신의 질병 관리를 위해 가까운 병원이나 자택에서 의료서비스를 제공받을 수 있도록 한다. 특히, 제안 모델의 의료서비스는 환자의 질병 정보를 손쉽게 분석하여 의료기관에게 전달함으로써 의료기관의 업무 부담을 줄이고 업무 효율성을 향상시키는 특징이 있다.

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