• Journal of Korean Academy of Nursing Administration
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• v.14 no.4
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• pp.396-403
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• 2008

Purpose: The purpose of this study was to identify experiences when Koreans who reside in Thailand visit Thai health facilities. Methods: The data were collected via direct interview from 36 Korean residents of Thailand. Collected data were analyzed by content analysis. Result: 1) 162 content analysis data were collected from the participants' statements. These data were categorized into 70 attributes and 9 higher attributes. 2) Out of the 70 attributes, the 3 attributes which were most commonly mentioned by the participants were the following: medical expense for foreigners were expensive(66.7%), difficulties in communication with health care providers(36.1%), kindness of nurses(33.3%). 3) The 9 higher attributes were 1) high medical expense to foreigner, 2) difficulties in communication, 3) distrust about medical service, 4) excessive prescription in oral medicine, 5) kindness, 6) good service, 7) difference in medical environment according hospital type, 8) irrational process in medical treatment for out patients, 9) cultural difference in postpartum care. Conclusion: When Korean residents in Thailand use Thailand health facilities, they experience high medical expense, difficulties in communication, low quality in medical service and kindness of the medical staff.

• The Korean Journal of Health Service Management
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• v.10 no.1
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• pp.1-11
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• 2016

Objectives : Medical service specialization could have positive effects on their profits and medical service quality. This study was to examine the relationship between medical service specializations and operational performance in hospitals. Methods : We used the National Inpatient Sample data provided by the Health Insurance Review and Assessment Service from 2010 to 2013. The hospital operational performance was determined by measuring the specialization level of the hospital based on DRGs. Results : The information theory index was 2.38 in 2010, 2.38 in 2011, 2.37 in 2012, and 2.37 in 2013. A multiple regression model was constructed which showed that if the specialization level becomes higher, it decreases the length of stay per case with an increase in medical expense. Conclusions : Differentiation and concentrated medical service specialization strategy have had a positive effect on the operational performance of hospitals.

• Health Policy and Management
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• v.17 no.3
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• pp.1-25
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• 2007

Relative value scales introduced in 2001 remarkably improved health insurance fee schedule, but current relative value scales have many problems. In the beginning the government intended to introduce 'resource based relative value scales(RBRVSs)' like USA, but political adjustment of RBRVS studied in 19.17 weakened the relationship between relative value scale and resource consumption. So unbalance of health insurance fees are existing till now. Also relative value was not divided to physician work and practice expense, and malpractice fee was not divided separately. To correct the unbalance of current relative value scales, the refinement project of health insurance relative value scales started in 2003. The project team divided relative value scales into three components, which are physician work, practice expense, malpractice fee. Physician work was studied by professional organizations like Korean medical association. To develop the practice expense relative value, project team organized clinical practice expert panels(CPEPs) composed of physicians, nurses, and medical technicians. CPEPs constructed direct expense data like labor costs, material costs, equipment costs about each medical procedures. The practice expense relative values of medical procedures were developed by the allocation of the institution level direct & indirect costs according to CPEPs direct costs. Institution level direct & indirect costs were collected in 21 hospitals, 98 medical clinics, 53 dental clinics, 78 oriental clinics, and 46 pharmacies. The malpractice fee relative values were developed through the survey of malpractice related costs of hospitals, clinics, pharmacies. Putting together three components of relative values in one scale, the final relative values were made. The final relative values were calculated under budget neutrality by medical departments, that is, total relative value score of a department was same before and after the revision. but malpractice fee relative value scores were added to total scores of relative values. So total score of a department was increased by the malpractice fee relative value score of that department This project failed in making 'resource based' relative value scales in the true sense of the word, because the total relative value scores of medical departments were fixed. However the project team constructed the objective basis of relative value scale like physician's work, direct practice expense, malpractice fee. So step by step making process of the basis, the fixation of total scores by the departments will be resolved and the resource based relative value scale will be introduced in true sense.

• Health Policy and Management
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• v.22 no.1
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• pp.29-48
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• 2012

The purpose of this study is to analyze medical expenses by decedents in their last year of life and compare them with those by survivors during the year 2008. This study is conducted firstly in Korea, except some studies focusing on medical cost of decedents from specific diseases. To study this, national health insurance(NHI) claims data was used with medicaid claims data. The study group(decedents) was selected from the insurance entitlement file who were dropped out from January to December of 2008. The control group(survivors) was selected from the entitlement file by stratified sampling with keeping age-sex composition of the study group. The medical expenses of decedents during one year before death were measured and compared with those of survivors by sex and age. And the medical expenses were analyzed by causes of death, and also the expenses were examined by each item of medical services. On average, the medical expense amounted to 11 million Korean Won per decedent during their last year of life in 2008. The medical expense per decedent was 9.3 higher than that of survivor. The death-related expense of under the age 35 was about 16 million Won, compared with 4 million Won in the case of over the age 95, in average. The death-related expense is higher in younger ages. This means that more medical resources are put in to save life in younger ages. Total death-related expenditure took 8.3 percent in total NHI expenditures. Of the death-related medical expenses, the largest one was injection-related cost which shares twenty five percent, and the second largest one was hospitalization charges, and then the third one was surgery cost. The results of this study suggested that we should pay attention to the medical expenses in the last of year of life when we study health care expenditure in Korea. In addition, we have to deliberate health care policy to cope with medical expenditures before death in more efficient way.

• Health Policy and Management
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• v.25 no.2
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• pp.80-89
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• 2015

Background: This study aims to identify the monthly average medical expenses of public pension recipients, and analyze the determinants of total health and medical expenses and Western and Oriental medicine expenses, medical service expenses, and medical supplies expenses. Methods: This study used the fifth year data of 2013 out of the raw data of the Korean Retirement and Income Study collected by the National Pension Research Institute. This study conducted t-test, analysis of variance, and linear regression to verify publicly the relevance between pension recipients' general characteristics and health and medical expenses status using IBM SPSS ver. 21.0 for data analysis. Results: It was analyzed that there is a difference in the spending of expenditure and health care costs according to public pension recipients. Medical expenses of the national pensioners was higher compared to the special corporate pensioners. The national pensioner is related expenditure size, education level, family members living together, residential areas, status of spouse, number of chronic illness, and status of limitation in daily life with psychological health status. Conclusion: Therefore, fairness does not occur fire to the medical use between the special corporate pensioners and national pensioners, aggressive of government such as health policy and financial support for the retiree pension policy that reflects the reality intervention would be required.

• Journal of agricultural medicine and community health
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• v.17 no.2
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• pp.113-121
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• 1992

In order to estimate the pattern of medical care utilization and recognition for health factor among the inhabitants in Wan-do district which is located off the southern seashore from mainland Korea, household interview survey was performed from January 15 to 30, 1990 in Wan-do Gun area. The results observed were following: 1. Among the users of medical facilities 40.8% used public health facility as first contact facility. Lower the income level was and longer the residency duration was, the utilization rate of public health facilities was higher. By age groups and medical security status the utilization pattern was likely to disperse to local clinic and secondary contact medical resources. 2. Medical expense and access time were significantly different between primary contact and secondary contact medical resources. 3. Public health facility was recognized as the favoured institute having advantage of geographic and economic accessibility. 4. Statistically significant determinants in public health facility utilization among total medical service were the region, the medical expense, and the access time.

• Korean Journal of Health Education and Promotion
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• v.7 no.1
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• pp.1-9
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• 1990

This paper discusses a new perspective in health approach and the effect of health life on health status, and suggests some points to be improved in the establishment of health policies hereafter. Today's health problems changed from the acute epidemic diseases caused by simple factor to the multifactorial chronic diseases. Therefore, the health approach tries the holistic health approach, that is, the integrative approach by the interdisciplinary cooperation. With the advent of holistic health and holistic medicine in 1970's, the behavioral medicine was born in 1977, which is the interdisciplinary field concerned with the development and integration of behavioral and biomedical science knowledge and techniques relevent to prevention, diagnosis and treatment. As a means to the reducement of the unnecessary medical utilization and medical expense, the medical self care and self-help movement is well under way in the countries of America, England, and Canada, in which lay persons are encouraged to actively function for themselves to prevent, detect and treat common illnesses and to promote positive health habits through the health activation programs such as The Course for Activated Patients and The Health Activated Person. This study shows that the individual health life gives great positive effect to his health status with the reducement of medical expense. These above facts suggest that the preventive health programs such as health education should be developed and strengthened instead of medical care-oriented health policy.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.4
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• pp.61-72
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• 2022

Objectives The purpose of this study was to analyze the Chuna manual therapy usage status after the application of Chuna manual therapy health insurance. Methods This study analyzed the health insurance data (2019-2021). From April 2019 to December 2021, monthly data were collected by simple Chuna, complex Chuna (own expense 50%), complex Chuna (own expense 80%), and special (dislocation) Chuna. Results The major results are as follows. First, in hospital-level medical institutions, simple Chuna and complex Chuna (own expense 50%) occupied a similar proportion. In clinic-level medical institutions, simple Chuna occupies the largest proportion. Second, the amount of use decreased in all medical institutions after September, which is thought to be the result of restrictions on Chuna manual therapy health insurance. Conclusions Therefore, it is necessary to conduct research by receiving more detailed data onr Chuna manual therapy health insurance. Through this, an improved policy of Chuna manual therapy health insurance should be discussed.

• The Journal of the Korea Contents Association
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• v.16 no.10
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• pp.411-419
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• 2016

This study tried to find the relationship between household income level and medical expense to household income ratio. For data analysis, it used 2010 and 2011 yearly data beta version of Korea Health Panel, co-managed by Korea Institute for Health and Social Affairs and National Health Insurance Corporation. To find out how the effect of independent variable changes in 2010 and 2011, the interaction effect between year and independent variable was examined, and separating the factors that showed interaction effect into each year, linear regression analysis was conducted using generalized estimating equations method. As a result of reviewing the factors that were related to medical expense to household income ratio among the people who used medical services, it was found that the higher the household income level, the lower the medical expense. It indicates that policy measures are needed to lessen the medical burden of low-income families.

• Health Policy and Management
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• v.4 no.1
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• pp.107-122
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• 1994

Many alternatives have been discussed to reduce the medical expenditure and to use the medical resources effectively. Many studies about the economies of scale have been done for the last several decades. This study has analyzed the relationship between the number of beds and the mean expense per hospitalization day in Korea. A Cost Function Model was identified and we wanted to see the minimum optimal size with the cheapest mean expense per hospitalization day. The result is as follows; 1. In the Cost Function Mode, (the number of beds)$^{2}$, the number of personnel, productivity and training institutions are the factors that statisticaly influence the mean expenses. 2. By the univariate analysis the mean expense proved to be the smallest as the level of 150-200bed, The breaked down of the components of expenses shows that the mean labor cost is much different from the mean value of material and administration costs, and that hospital with 150-200 beds also have the minimal expense. The mean expense goes up dramatically in hospitals of 450 beds or more. 3. When the other conditions are constant, according to the multiple regression analysis of the mean expense per adjusted hospitalization day the minimum optimal size with the cheapest expense is a hospital with 191 beds and the hospital with 230 beds takes the lowest mean labor cost. The material or administration costs are not influenced by hospital size. This research has limitation in measuring the variables that influence hospital xpenses, in estimating hospital output by the number of beds in considering outpatient cost and in securing representativeness of hospitals because many hospitals made no responses to the research questionnare. But it is valuable and helpful for development of health policy to figure out the number of beds with the cheapest expense per hospitalization day.