• Title/Summary/Keyword: Health care efficiency

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The Possibility of Expanding Pay-for-Performance Program as a Provider Payment System (성과연동지불제도의 확대 가능성 고찰)

  • Tchoe, Byongho;Lee, Suehyung
    • Health Policy and Management
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    • v.23 no.1
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    • pp.3-18
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    • 2013
  • This paper investigates the possibility of expanding pay-for-performance (P4P) program as a provider payment system, in terms of financial, economical, and political sustainability. In order to expand the sustainable P4P, P4P should have usefulness in terms of economic value as well as efficiency in the financial aspects of health care. More importantly, the P4P would be politically sustainable only when both providers and consumers can accept. Korea's healthcare system seems to have logical ground for the P4P program financially and economically. However, how well the P4P can work remains to be proven in its implementation. After 43 tertiary hospitals applied the P4P program for acute myocardial infarction (AMI) and C-section in 2007, the number of hospitals adopting the P4P program for AMI and C-section has increased to 316 in 2011, and an incentive for hospitals applying the P4P has risen to 2% from 1% of health insurance benefits. This shows that the P4P program introduced by Health Insurance Review and Assessment Service is quite successful. In addition, people are aware of the need for improved P4P program and policy alternatives have been already made. Therefore, it is very important to come up with politically supportable strategies that can make providers and consumers accept the P4P program while maintaining the governance of the existing health insurance policy. To this end, there are some tasks to be considered. First, the expansion of the P4P program should be placed on the agenda of the Health Insurance Policy Review Committee, the highest decision-making body, and a separate agency for P4P planning should be established. Second, for more efficient P4P program, the processes of review and assessment, currently carried out separately, should be integrated into a single process. Third, infrastructure to measure the quality of medical services should be sharply expanded. Fourth, the current paradigm for the assessment should be changed. Lastly, a P4P program for consumers should be considered. Given that the consumers in Korea can use medical services freely, the National Health Insurance Corporation could initiate the P4P program for consumers as a means of controlling excessive use of medical services and adjusting consumer's moral hazard.

A Study on Improvement of Health Center's Function through Cost-Effectiveness Analysis in Korea (1차 보건의료사업의 비용-효과분석을 통한 보건소 기능의 확대 방안 연구)

  • 김종인;윤치근
    • Health Policy and Management
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    • v.5 no.2
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    • pp.70-103
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    • 1995
  • The aim of this study sets out to discover a desirable form of public centers among the alternative ones and make a health center model. Especially, this study attempts; (i) to investigate factors that affect the performance of health centers; (ii) carry out cost-effectiveness analysis (CEA) for the various type of health centers; (iii) identify innovative strategies to increase the use of health center. Cost-effectiveness analysis is used to compare the performance of all the centers. The following is taken to create the index. Wi = Ti x Mi x Eij (Wi: weight for service item I, Ti : time spent for service I, Mi ; number of health personnel involved in service I, Eij : years of schooling for personnel j in providing service I). As a result of these analyses, policy options as follows are recommended; (i) proper manpower, especially public health physician (oriental medical doctor), should be enough to provide health care adequately; (ii) facilities ad equipments in the health center should be provided sufficiently. (iii) the utilization of health centers should be raised by active operation of mobil service, community participation and health education program. Ultimately health centers in public sector are to be fostered for the promotion of health care by enhancing the financial and quality, continuity and efficiency of health services.

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Reform of Health System Governance in South Korea (보건의료체계의 거버넌스 개혁)

  • Tchoe, Byongho
    • Health Policy and Management
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    • v.28 no.3
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    • pp.226-232
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    • 2018
  • The objectives of this study were to evaluate the current state of governance structure and management of the health system to achieve the goals of the health system in South Korea, and to propose reform plan. This study drew implications from the governance of United Kingdom, Germany, and Netherlands, based on the principle of health system proposed by World Health Organization. The presidency and the health ministry should make macroscopic decision-making. The government has to decentralize the enforcement by municipality to operate public health and national health insurance (NHI), and to distribute the centralized NHI fund by municipality. The front line health centers and community centers should provide integrated health and social services. The government has to establish diversified regulatory bodies to enhance both the patient-centered care and the efficiency and equity of health care, and to provide mechanisms for ensuring autonomy of providers. The governance of the health system should be composed of the centralization of macro decision-making, the decentralization of implementation by municipality, the integration of health and social services on the front line, and the well-balanced regulation and autonomy on both consumers and suppliers.

Raise Capital Type and Investment Efficiency of Hospital in Korea (병원의 자본조달 행태와 투자효율)

  • Jung, Yong-Mo
    • The Korean Journal of Health Service Management
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    • v.7 no.3
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    • pp.161-176
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    • 2013
  • This research analyzed Raise Capital type and Investment Efficiency for non-profit hospitals in Korea. 152 cases of financial information from 2007 to 2010 were utilized for analysis. As a result of analysis, Raise Capital for Borrowings to total assets was primarily used, taking around 40% on average, and the method of Raise Capital with significant difference among Medical Institutions was Liabilities in Excluded Borrowings to Total Assets and Capital Stock & Capital Reserves to Total Assets. Besides, the relation between Invested capital and Investment efficiency was opposite each other in the non-profit hospitals, and Region was an important element influencing over Productivity per Value Added. In addition, in the investment activity of non-profit hospitals in the light of Investment Efficiency, only hospitals among Medical Institution types had a character of Capital Intensive, and General Hospital and Geriatric & Long-term Medical Care Hospital among Medical Institution types showed a character of Labor Intensive in the light of Performance.

An Efficiency Evaluation of Public Health Center by Data Envelopment Analysis -Focused on Public Health Centers of Gyeongnam Province- (자료포락분석을 이용한 보건사업의 효율성 평가 -경상남도 보건소를 중심으로-)

  • Yang, Jong-Hyun;Chang, Dong-Min
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.6
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    • pp.2129-2137
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    • 2010
  • In this research, we analyze the efficiency of 20 public health centers of Gyeongnam Province, so the reduction and weakness of input and output factor were found. We used the CCR, BCC model of Data Envelopment Analysis as a method of evaluation, made a choice human resource as the input variable, made a selection the performance of health care center, ward as the output variable. The results show that 12(60%) public health centers in 20 were productive with respective to overall Technical Efficiency(average score 0.868), 14(70%) with respective to overall Pure Technical Efficiency(average score 0.924) and 12(60%) with respective to overall Scale Efficiency(average score 0.933). It is expected that this research can provide a good data for effective management of public health centers.

A study of medical service quality improvement in a medical institution (의료기관(醫療器管)의 의료(醫療)서비스 질(質) 개선(改善)에 관한 연구(硏究) - 환자만족도(患者滿足度)(Patient Satisfaction)를 중심으로 -)

  • Jeon, Byoung-Uk;Hong, Seong-Cheon;Ryu, Byoung-Wan
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.15 no.1
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    • pp.67-76
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    • 2009
  • Quality management is a recent phenomenon. Advanced civilizations that supported the arts and crafts allowed clients to choose goods meeting higher quality standards than normal goods. There are many methods for quality improvement. Health care, refers to the treatment and management of illness, and the preservation of health through services offered by the medical, dental, complementary and alternative medicine, pharmaceutical, clinical laboratory sciences (in vitro diagnostics), nursing, and allied health professions. Health care embraces all the goods and services designed to promote health, including "preventive, curative and palliative interventions, whether directed to individuals or to populations. The overall impact of managed care remains widely debated. Proponents argue that it has increased efficiency, improved overall standards, and led to a better understanding of the relationship between costs and quality. Practices can solicit feedback from patients in a variety of ways: phone surveys, written surveys, focus groups or personal interviews. What do I do with the results? While you don't have to act on every suggestion that your patients give you, you should take action on the key items that are causing dissatisfaction.

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BTX Treatment of a Petrochemical Plant by Sliding Arc Plasma (Sliding Arc Plasma를 이용한 석유공장에서의 BTX 처리효율에 관한 연구)

  • Kwon, Woo-Taeg;Kwon, Lee-Seung;Lee, Woo-Sik
    • Fire Science and Engineering
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    • v.29 no.6
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    • pp.65-70
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    • 2015
  • This research examines the removal efficiency of benzene, toluene, xylene (BTX) and total volatile organic compounds (TVOCs) by flowing VOCs, which are generated at a petrochemical complex in the Ulsan area, in a sliding arc plasma (SAP) reactor. The SAP reactor process is composed of 5 steps and the analysis was conducted using a BTX detector and TVOC measuring instrument. The removal efficiency of BTX was better at high concentration than at low concentration and the emitted TVOC concentration increased in later steps of the reactor. In addition, the removal efficiency improved, as the flow velocity increased. The maximum permissible concentration of TVOCs in the first step was about 481 ppm and showed over 94.83% efficiency when it was operated in the 2nd step at concentrations beyond 481 ppm. Therefore, there are many factors for improving the removal efficiency of SAP reactors at low concentration and measures should be prepared according to the application method for the various types of industrial reactors.

Prevalence of Depressive Disorder of Outpatients Visiting Two Primary Care Settings

  • Jo, Sun-Jin;Yim, Hyeon Woo;Jeong, Hyunsuk;Song, Hoo Rim;Ju, Sang Yhun;Kim, Jong Lyul;Jun, Tae-Youn
    • Journal of Preventive Medicine and Public Health
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    • v.48 no.5
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    • pp.257-263
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    • 2015
  • Objectives: Although the prevalence of depressive disorders in South Korea's general population is known, no reports on the prevalence of depression among patients who visit primary care facilities have been published. This preliminary study was conducted to identify the prevalence of depressive disorder in patients that visit two primary care facilities. Methods: Among 231 consecutive eligible patients who visited two primary care settings, 184 patients consented to a diagnostic interview for depression by psychiatrists following the Diagnostic and Statistical Manual of Mental Disorders-IV criteria. There were no significant differences in sociodemographic characteristics such as gender, age, or level of education between the groups that consented and declined the diagnostic examination. The prevalence of depressive disorder and the proportion of newly diagnosed patients among depressive disorder patients were calculated. Results: The prevalence of depressive disorder of patients in the two primary care facilities was 14.1% (95% confidence interval [CI], 9.1 to 19.2), with major depressive disorder 5.4% (95% CI, 2.1 to 8.7), dysthymia 1.1% (95% CI, 0.0 to 2.6), and depressive disorder, not otherwise specified 7.6% (95% CI, 3.7 to 11.5). Among the 26 patients with depressive disorder, 19 patients were newly diagnosed. Conclusions: As compared to the general population, a higher prevalence of depressive disorders was observed among patients at two primary care facilities. Further study is needed with larger samples to inform the development of a primary care setting-based depression screening, management, and referral system to increase the efficiency of limited health care resources.

Development of Riding Robot System and Body State Index for Healthcare Service (승마용 헬스 케어 로봇 시스템과 신체 상태 지수 관리기술)

  • Lim, Mee-Seub;Lim, Joon-Hong
    • The Journal of Korea Robotics Society
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    • v.4 no.4
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    • pp.327-333
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    • 2009
  • This paper describe the riding robot system named by "RideBot" which is a riding robot like as a horse. In order to simulate the riding motions, we develope the saddle mechanism which can generate 3 DOF motions including pitch, roll, and bounce movement, and also we controlled the riding motions and the intention of horseman. To generate the riding motions with the bodily sensation, we developed Novel Washout Filter and the algorithms for motion control. And also, we developed some health care service for the health care of horseman. A body state index was proposed that evaluates the personal health state from both the measured physiological variables and the surveyed questions. The physiological variables such as weight, blood pressure, heart rate variability (HRV), accelerated state photoplethysmograph(APG), body fat, and happiness index were measured by the specially designed bio-handle system and survey questions. The efficiency of the proposed ride robot is evaluated in the experiments.

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Oral healthcare quality and measurement of quality indicators (치과의료의 질과 질지표 측정)

  • Shin, Hosung
    • Journal of Korean Academy of Dental Administration
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    • v.8 no.1
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    • pp.8-14
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    • 2020
  • To provide high-quality oral health services, the concept of measurable oral health quality must first be defined. Owing to reports of significant preventable adverse events in the healthcare service provision process, the recognition and consensus of patient safety and patient-centered health service provision was formed. Six areas that are important medical care have been identified, including the quality along with existing concepts such as timeliness, effectiveness, equity, and efficiency of medical services. While there is ongoing research on the quality of oral health, there is not yet any internationally accepted definition. The purpose of this study is to introduce the ideas of oral healthcare quality and quality indicators that have been developed and announced in the field of dentistry.