• Title/Summary/Keyword: Healthcare Costs

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Global O2O Matching Platform research based on Clinics (글로벌 클리닉 기반의 O2O 매칭 플랫폼 연구)

  • Park, Jong-Youel;Park, Dea-woo
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.20 no.8
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    • pp.1517-1523
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    • 2016
  • The global medical tourism industry including Asian market has been activating recently. That is as medical tourists are motivated to seek the higher quality of healthcare with lower costs, as well as of travel. The consumers in this field tend to need customized services of medical tourism. It is needed that the consumers get customized information on medical services and traveling, the clinics and hospitals resolve the issues of offering translation and luring medical tourists from overseas, and the guides, who offer tour and translation service, provide the consumers and the clinics with customized services so that they get the services needed for one another. This research studies the Offline to Online, called O2O, matching platform based on global clinics, which connects medical facilities, patients, and guides for traveling and language services. It presents the customized marketing plans by utilizing customers' experiences from medical services and traveling they use.

Problems in the Medical Dispute Medication System and Improvement Plan (의료분쟁조정제도 운영상의 문제점 및 개선방안)

  • Choi, Jang Seop
    • The Korean Society of Law and Medicine
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    • v.15 no.2
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    • pp.91-122
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    • 2014
  • For a variety of reasons, the number of medical disputes is continuously rising. Due to the intrinsic qualities of medical treatments, one would find it more apt to subject medical disputes to general conflict resolution procedures rather than to once-for-all decisions under legal suits. To address the increasing medical disputes with greater professionalism and efficiency, the Medical Disputes Mediation Act was enacted and a medical dispute mediation system put in place, while drawbacks have been blamed to both. The current mediation procedures require the respondent's agreement as a disclosure requirement. A reasonable improvement to this would be to amend the regulation of agreement supposition, or to enforce procedural participation only to public health facilities managed by the national or regional government. Furthermore, small claims cases of 20 million KRW or less in claim may be considered for conciliation-prepositive principle. The concentration on small claim medical disputes is a phenomenon that can be addressed by carrying out maximum authentication commissions or similar measures, one of the solutions by enhancing the public trust in the Korea Medical Dispute Mediation and Arbitration Agency. The proper management of medical authentication teams is one way to address the existing problems in the authentication system. For this, the number of team members shall be increased under more flexible authentication procedures. All indemnity resources for medical accidents of force majeure must be borne by the Government, for it is the body principally responsible for social compensation. Placing this cost on the establisher of the subject medical facility holds the possibility of violating fundamental rights. While the costs for subrogation payment system for damages may be borne by the healthcare facility establisher, a deposit-based system must be created for cases in which the facility shuts down, without holding the responsibility for accident cause. Such change to a deposit-based system will evade the controversies of unconstitutionality, etc.

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Development and Evaluation of Korean Ambulatory Patient Groups (한국형 외래환자분류체계의 개발과 평가)

  • Park, Ha-Young;Kang, Gil-Won;Koh, Young
    • Health Policy and Management
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    • v.16 no.1
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    • pp.17-40
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    • 2006
  • With the prospect of rapidly growing health insurance expenditures, particularly spending for ambulatory care, the introduction of a case-based payment method is discussed as an alternative to the current fee-for-service based method. A system to measure case mixes of providers is a core component of such payment systems. The objective of this study were to develop a classification system for ambulatory care, Korean Ambulatory Patient Group (KAPG) based on the U.S. APG version 2.0 and to evaluate the classification accuracy of the system. A database of 64,258,386 records was constructed from insurance claims submitted to the Health Insurance Review Agency (HIRA) during three months from August 2002. A total of 41,347,307 records with a single visit was used for the development and 7% random sample of the database was used for the evaluation. Additional groups were defined to include both physician and hospital fees in the classification, age splits were added to classify the entire population as well as the population older than 65, and the definition of medical groups used by the HIRA was adopted. The variance reduction in charges achieved by KAPGs was computed to evaluate the accuracy of classification. A total of 474 KAPGs was defined compare to 290 groups in the U.S. APG. The variance reduction for charges of all visits ranged from 20% to 37% depending on the type of provider, and ranged from 22% to 42% for non-outliers, that were better than those achieved by the system currently used by the .HIRA for its internal review purpose. Although further study is required to improve the classification for complicated care in larger hospitals, the results indicated that KAPGs could be used for better management of costs for ambulatory care.

Reviewing Efficiency Strategy of Long-term Care System (노인요양보장체계의 효율화에 대한 소고)

  • Shin, Eui-Chul;Im, Geum-Ja;Lee, Eunw-Han;Lee, Yun-Hwan
    • Health Policy and Management
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    • v.21 no.1
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    • pp.115-131
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    • 2011
  • Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.

A Development of Non-Invasive Body Monitoring IOT Sensor for Smart Silver Healthcare (스마트 실버 헬스케어를 위한 비접촉 인체감지 IOT 센서 개발)

  • Kang, Byung Wuk;Kim, Sang Hee
    • Journal of the Institute of Convergence Signal Processing
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    • v.19 no.1
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    • pp.28-34
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    • 2018
  • This paper is composed of a passenger management system using a temperature sensing module, a PIR sensor module for detecting movement inside a room, and a smart breath sensing module for determining a sleeping state. An embedded sensor module and a communication system integrated the sensing part and the algorithm driving part. As the aging society is accelerating and becoming more upgraded, the social cost of Silver Care increases, and in order to protect privacy, it is necessary to reduce costs by developing efficient smart silver care devices. The proposed non - image human body detection IOT sensor system is implemented by hardware and software and has superior performance compared with conventional image monitoring method.

An Analysis on Appropriateness of Health Insurance Fee Using the Activity Based Costing(ABC) Approach (활동기준 원가분석을 통한 건강보험수가의 적정성 분석)

  • Kim, Han-Sung;Shin, Hyun-Woung;Cha, Jae-Young
    • Korea Journal of Hospital Management
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    • v.20 no.3
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    • pp.36-44
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    • 2015
  • The Activity Based Costing(ABC) means the process that makes clear how the actions and input resources have changed into service to calculate medical services costs. These days, the number of hospital which is using the ABC system is increasing to make their policy decision making efficient and run the hospitals more resonable. This study analyzes the unbalance in the level of health insurance service fee and the improvement plans based from 8 hospitals(ABC system) and 95 clinics(ABC survey). The cost recovery ratio has shown different levels according to each service type. A surgery service type recorded 76.8% and an evaluation & management service type is 84.6%, a treatment procedure type(85.8%), a function test type(91.6%) and health insurance fee even did not reach to the original cost. Meanwhile, a laboratory test type and imaging test type show high level of cost recovery ratio. they recorded 188.3% and 158.8%. Resultingly now of unbalance in the level of health insurance service fee accelerates supply of every test. so there is a need to make laboratory test type and imaging test type lower to keep balance with the surgery and medical service. These methods should be performed gradually with monitoring the unbalance fee ratio and for this, a panel medical institution have to be established for generalizations of studying result, fairness of selecting researching sample.

Incidence of Medical Services and Needs for Hospital-based Home Care Nursing in Elder Care Institutions (노인요양시설 내 의료서비스 발생빈도와 병원중심 가정간호 요구도 조사)

  • Kim, Jae-Seung;Lee, Joo-Young;Song, Chong-Rye;Lee, Mi-Gyeong;Hwang, Moon-Sook
    • Journal of Home Health Care Nursing
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    • v.16 no.1
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    • pp.49-58
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    • 2009
  • Purpose: This study aimed to clarify the needs for hospital-based home care nursing medical services in elder care institutions by analyzing the details and frequency of medical services provided by, and the needs for, hospital based home care nursing in select institutions in Korea. Methods: Seventy-seven staffs at elderly care institutions located throughout the country completed self-report questionnaires between February 1 and May 31, 2009. SPSS ver. 14.0 was used for data analysis regarding frequency and percentage, mean and standard deviation. Results: Forty-eight hospital-based home care nursing medical services in eight domains were identified as being needed in elderly care institutions. The most commonly used medical services were providing instruction in oral drug administration, checking drug beneficial/adverse effects, and administering blood glucose test, while the most needed medical services requiring hospital based home care nursing were complex pressure ulcer care, followed by diabetic foot ulcer management and nutrient injection. Conclusion: The present results should provide fundamental data for better healthcare services with hospital based home care nursing at elderly care institutions as part of a 'win-win' strategy through which medical expenses are reduced, insurance costs are kept stable, and safe and high-quality medical services are provided for residents of elder care institutions. Political decisions intended to promote visits by hospital based home care nurses to elder care institutions would be a prudent course.

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Investigating the Level of Competition between Public Health Centers and Private Clinics in Korea

  • Kim, Hyun Joo;Lee, Jin Yong;Jo, Min-Woo;Eun, Sang Jun
    • Korea Journal of Hospital Management
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    • v.21 no.2
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    • pp.37-49
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    • 2016
  • The purpose of this study is to investigate the level of competition between Public Health Centers (PHCs) and private clinics (PCs) by examining the number of patients that used PHCs vs. PCs, estimating the total amount of revenue generated from outpatient services at both PHCs and PCs, thereby analyzing the financial impacts on PCs derived from the PHCs. We utilized 2011 National Inpatient Sample data (NIS). Using the 20 table containing general information on each individual claims, we integrate it with the 40 table which contains all the diagnostic codes for each claim. Then, we disaggregate the bundled claims into the original individual claims. Overall, 3.1% of outpatient visits are made at PHCs while the rest was made at the PCs (96.9%). Among the total claim costs of 6.34 billion USD (as of 2011), PHCs occupy 2.0% (124 million USD), and 98.0% are contributed to PCs (6.21 billion USD). The estimated economic losses of PCs due to PHCs are summarized as follow; the maximum potential loss is estimated at 198 million USD in total and 7,099 USD per clinic when we include all patient types; the minimum loss is estimated at 71 million USD in total and 2,540 USD per clinic where Medical Aid recipients and the elderly (aged 65 and over) are excluded. Our results confirm the potential economic effect on PCs due to PHCs providing outpatient services. PCs and PHCs are the most important players providing primary care in Korea. Unnecessary competition between PCs and PHCs is not desirable. Health authorities should carefully examine the healthcare services currently provided by PHCs and their impacts on PCs.

A System Design for Real-Time Monitoring of Patient Waiting Time based on Open-Source Platform (오픈소스 플랫폼 기반의 실시간 환자 대기시간 모니터링 시스템 설계)

  • Ryu, Wooseok
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.22 no.4
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    • pp.575-580
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    • 2018
  • This paper discusses system for real-time monitoring of patient waiting time in hospitals based on open-source platform. It is necessary to make use of open-source projects to develop a high-performance stream processing system, which analyzes and processes stream data in real time, with less cost. The Hadoop ecosystem is a well-known big data processing platform consisting of numerous open-source subprojects. This paper first defines several requirements for the monitoring system, and selects a few projects from the Hadoop ecosystem that are suited to meet the requirements. Then, the paper proposes system architecture and a detailed module design using Apache Spark, Apache Kafka, and so on. The proposed system can reduce development costs by using open-source projects and by acquiring data from legacy hospital information system. High-performance and fault-tolerance of the system can also be achieved through distributed processing.

Public Participation in Healthcare Decision Making : Experience of Citizen Council for Health Insurance (보건의료 정책 의사결정과 시민참여 : 『건강보험 보장성 시민위원회』의 사례)

  • Kwon, Soonman;You, Myoungsoon;Oh, Juhwan;Kim, Soojung;Jeon, Boyoung
    • Health Policy and Management
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    • v.22 no.4
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    • pp.467-496
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    • 2012
  • Public participation in the decision making for scarce health resources is important because health policy requires trust based consensus, which can be achieved by public's understanding and involvement of related policies. In the past, opportunities for interaction between health policy decision makers and lay public were rare in Korea. As political impulses towards public participation in health policy have increased, a few of deliberation methods were attempted. However, there is little research, reporting such cases with a critical examination of relevant theories and previous studies. We first critically review the literature on public participation within theories of democracy, governance, and empowerment. Next, we report a case of a citizen council experiment, which was held to examine public's preferences among different benefit options regarding new drugs and medical technologies. Specifically, in an one-day long citizen council with a total of 28 lay public, twelve questions of whether a drug or a technology should be included in the benefit package of health insurance were asked. Pre- and post-surveys investigated participants' perception of public engagement in health policy. Although it was experimental, the citizen council ensured that lay public could be careful enough to rationally compare the costs and benefits of different options and collectively make decisions. Further, results from pre- and post-survey showed a strong willingness of members to be involved in health care decision making. In the conclusion, we emphasize that better theories and methods need to be developed for more cases of citizen participation in health care policy and management.