• Journal of Preventive Medicine and Public Health
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• 제42권1호
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• pp.5-11
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• 2009

Objectives : This study was conducted to estimate the socioeconomic cost of injuries in South Korea. Methods : We matched claims data from national health insurance, automobile insurance and industrial accident compensation insurance(IACI), and mortality data obtained from the national statistical office from 2001 to 2003 by patients unique identifier. Socioeconomic cost included both direct cost and indirect cost: the direct cost was injury-related medical expenditure and the indirect cost included loss of productivity due to healthcare utilization and premature death. Results : The socioeconomic cost of injuries in Korea was approximately 1.9% of the GDP from 2001 to 2003. That is, 12.1 trillion KRW(Korean Won) in 2001, 12.3 trillion KRW in 2002, and 13.7 trillion KRW in 2003. In 2003, direct medical costs were 24.6%(3.4 trillion KRW), the costs for loss of productivity by healthcare utilization were 13.0%(1.8 trillion KRW), and the costs for loss of productivity by premature death were 62.4%(8.6 trillion KRW). Conclusions : In this study, the socioeconomic cost of injuries in Korea between 2001 and 2003 was estimated by using not only health insurance claims data, but also automobile insurance, IACI claims and mortality data. We conclude that social efforts are required to reduce the socioeconomic cost of injuries in Korea, which represented approximately 1.9% of the GDP for the time period specified.

• 한국병원경영학회지
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• 제5권1호
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• pp.200-231
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• 2000

The price systems of the hospital drug services play key roles in the provision of quality services and the development of pharmacy service technologies. Under the premises, this study attempted to determine the costs of hospital drug service, to compare the costs calculated with the fees publicly fixed by the Government, and based on the results of the analysis, to propose directions for the improvement of the price systems. A Costing model for the study was developed based on the cost-fee relationship analysed of the Korean fee-for-service systems. Data on costs and workloads of the 25 hospitals were collected through survey forms designed for the costing' and analysis for the duration of 12 months of 1998. The results of the analysis show that a tremendous unbalance between cost and price levels of the drug services, and that overally the price level of the services is extremely low when compared to the costs of services. Based on these findings, this study suggests that unfairly high or low price level be corrected, and that service items newly developed and being practiced at tertiary hospitals, such as TDM and TPN consultation services, be compensated by fixing a proper level of price.

• 보건행정학회지
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• 제25권2호
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• pp.67-70
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• 2015

To establish an appropriate policy for robotic surgery in Korea, the National Evidence-based Collaborating Agency (NECA) and the Korean Society of Health Policy and Administration held a round-table conference (RTC) to gather opinions through a comprehensive discussion of scientific information in gastric cancer. The NECA RTC is a public discussion forum wherein experts from diverse fields and members of the lay public conduct in-depth discussions on a selected social issue in the health and medical field. For this study, representatives from the medical field, patient groups, industry, the press, and policy makers participated in a discussion focused on the medical and scientific evidence for the use of robotic surgery in gastric cancer. According to the RTC results, robotic surgery showed more favorable results in safety and efficacy than open surgery and it is similar to laparoscopy. When the cost-effectiveness of robotic surgery and laparoscopy is compared, robotic surgery costs are higher but there was no difference between the two of them in terms of effectiveness (pain, quality of life, complications, etc.). In order to resolve the high cost issue of the robotic surgery, a proper policy should be implemented to facilitate the development of a cost-effective model of the robotic surgery equipment. The higher cost of robotic surgery require more evidence of its safety and efficacy as well as the cost-effectiveness issues of this method. Discussions on the national insurance coverage of robotic surgery seems to be necessary in the near future.

• 토지주택연구
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• 제5권1호
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• pp.1-10
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• 2014

주거 공간에 건강관리에 필요한 서비스가 제공되는 것은 'aging in place'의 실현을 가속화할 것이다. 그리고 이러한 주거공간의 변화는 의료비를 절감하고 삶의 질을 향상하는 복지 측면에서도 중요하다. 본 연구에서는 고령자가 스스로 건강을 관리할 수 있도록 헬스케어 서비스(Healthcare service)를 아파트 단지 내에 적용하는 계획방안에 대해 도출하고 주거복지동의 첫 사업 대상지인 가양 7단지 영구임대주택 단지를 중심으로 내용을 전개하고자 한다. 먼저 거주자의 헬스케어 서비스 이용의향에 대해 조사하고 관심이 높은 응답자를 중심으로 실제 시범사업이 적용된 서비스의 사용모습 관찰 및 심층 인터뷰를 통해 추후 계획시 고려할 사항에 대해 도출하였다. 가양 7단지의 경우 유헬스케어 서비스에 대한 요구는 고령자보다는 고령자 진입층에서 더 강력하게 나타나지만 공통적으로 주호의 협소함으로 기기 설치 및 측정에 어려움을 느끼고 있었다. 관찰조사 결과 주호는 사용자세의 불편함으로 입식구조의 측정공간 계획이 필요하며 장비보관장소도 필요하다. 그리고 헬스케어 서비스를 위한 프로그램은 건강측정, 건강관리, 외부 시설과 연계된 시설로 나눠 계획할 수 있으며, 이는 건강측정 공간을 기본형, 즉 최소형으로 하여 점차 확대 적용할 수 있다. 가양 7단지의 경우, 별도의 복지 건물이 신축되므로 기능을 복합적으로 구성하는 혼합형의 프로그램을 적용할 수 있으며, 반자립 사용자에 대한 서비스까지 확대 적용하는 계획이 필요하다.

• 동의생리병리학회지
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• 제28권4호
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• pp.440-445
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• 2014

Korean medical system is unique system that has two medical system, Western medical institution and Korean medical institution. In this environment, patients who use each medical institution have different selection factors. The study explores the selection factors' difference of korean/western medical institutions. The empirical analysis of the surveyed data produced the following outcomes. The result of factor analysis, four factors were extracted. That was Human services, Costs and Physical Environment, Prestige and reputation, Public relations and reliability. Overall, the four selection factor importance scores of Korean medical institution were higher than western medical institution's. These findings show that there is a difference between korean and western medical institutions in terms of selection factors. After this study, More study about medical management and healthcare policy including korean medical characteristics is needed.

• Journal of Preventive Medicine and Public Health
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• 제42권3호
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• pp.190-198
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• 2009

Objectives : The objective of this study is to estimate the economic costs of cancer on society. Methods : We estimated the economic burden of people with cancer in South Korea. To perform the analysis, we reviewed the records of people who were cancer patients and those who were newly diagnosed with cancer. The data was compiled from the National Health Insurance Corporation, which included the insurance claims database, a list of cancer patients, a database that records the cancer rates, the Korea Central Cancer Registry Center s cancer patient registry database and the Korea National Statistical Office s causes of death database. We classified the costs as related to cancer into direct costs and indirect costs, and we estimated each cost. Direct costs included both medical and non-medical care expenses and the indirect costs consisted of morbidity, mortality and the caregiver's time costs. Results : The total economic costs of cancer in South Korea stood at 14.1 trillion won in 2005. The largest amount of the cost 7.4 trillion won, was the mortality costs. Following this were the morbidity costs (3.2 trillion won), the medical care costs (2.2 trillion won), the non-medical care costs (1.1 trillion won) and the costs related to the caregiver's time (100 billion won). As a result, the economic cost of cancer to South Korea is estimated to be between 11.6 trillion won to 14.1 trillion won for the year 2005. Conclusions : We need to reduce the cancer burden through encouraging people to undergo early screening for cancer and curing it in the early stage of cancer, as well as implementing policies to actively prevent cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2317-2322
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• 2015

Background: Despite the increasing number of screening examinations performed for cervical cancer utilizing the Papanicolaou smear test (Pap test), few studies have examined whether this strategy is cost-effective in Korea. Objective: This study was conducted to evaluate the cost-effectiveness of cervical cancer screening strategies incorporating the Pap test based on age at the start and end of screening as well as screening interval. Materials and Methods: We designed four alternative screening strategies based on patient age when screening was started (20 or 30 years) and discontinued (lifetime, 79 years). Each strategy was assessed at screening intervals of 1, 2, 3, or 5 years. A Markov model was developed to determine the cost-effectiveness of the 16 possible cervical cancer screening strategies, and this was evaluated from a societal perspective. The main outcome measures were average lifetime cost, incremental quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). Results: Compared with various strategies comprising younger starting age, discontinuation age, and longer screening intervals, strategies employing annual screening for cervical cancer starting at a target age of 30 years and above were the most cost-effective, with an ICER of 21,012.98 dollars per QALY gained (with a Korean threshold of 30,000,000 KRW or US$27,272). Conclusions: We found that annual screening for cervical cancer beginning at a target age of 30 years and above is most cost-effective screening strategy. Considering the potential economic advantages, more intense screening policies for cervical cancer might be favorable among countries with high rates of cervical cancer and relatively low screening costs.

• 보건행정학회지
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• 제22권1호
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• pp.65-84
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• 2012

Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.

• 한국산학기술학회논문지
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• 제11권4호
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• pp.1318-1324
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• 2010

최근들어, U-헬스케어는 진료에 있어 인력 및 시간 등 많은 비용을 절감할 수 있는 연구로 주목받고 있다. 그러나, 센싱, 측정 등 헬스케어에 대한 기반 기술들은 충분히 연구된 반면, IT 기술이 의료 기술과 접목된 IT/의료 융합 기술은 아직 초기 단계에 있다. 이에 본 논문에서는 이미 검증된 기술들과 전문가 시스템을 기반으로 개인 병원이나 가정 등의 중소형 의료 환경에 적용 가능한 U-헬스 케어 솔루션으로서의 헬스케어 시스템을 제안한다. 그 동안 IT 분야의 눈부신 발전으로 네트워크 및 데이터베이스 등 타 분야에 융합 가능한 IT 요소 기술들이 충분히 발전해 있고, 헬스케어의 경우 시간보다는 임무 수행이 중요한(Mission-Critical) 환경이므로, 새로운 기술 개발도 중요하지만 이미 검증된 기술들을 활용하는 것이 바람직하다. 제안된 솔루션은 전문가 시스템을 기반으로 체지방, 혈압, 그리고 혈당 등의 측정된 데이터를 이용해 자동화된 의료 서비스를 제공한다. 또한 의사와 간호사, 관계자등에게 편리한 진료 환경을 제공한다. 또한, 필요시 전문 지식이 없는 사람들도 자가 진단이 가능하므로 향 후 다양한 방면에서 의료 서비스 비용 절감이 기대된다. 특히, 각 장비들이 표준화된 블루투스 기술을 통해 통신하므로, 다양한 의료기기로 확장 가능한 솔루션이다. 이로부터, 우리는 전문가 시스템을 통한 비용 절감에 의해 U-헬스케어의 자가 측정 및 진단 서비스가 향상되었다고 말할 수 있다.

• 한국병원경영학회지
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• 제15권2호
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• pp.15-26
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• 2010

Stroke is a high-risk disease. The future of the medical environment is that the proportion of elderly population is increasing, the average life expectancy is being increased, while the fatal rate of stroke will be low. These situation will due to the financial burden on medical insurance. The most important factor that affects on the medical costs of stroke patients is the length of stay. In this study the mean length of hospital for stroke stay was 21.81days(37.97days for intracerebral hemorrhage, 18.89 days for cerebral infarction). The payment per case of stroke was 6.86 million won(12.6 million won for intracerebral hemorrhage, 5.72 million won for cerebral infarction). The payment per case of intracerebral hemorrhage was 2.2 times more than that of cerebral infarction. The payment in the day of hospitalization was the highest and until the second day medical costs was high. After the third day medical costs tended to decline, after that seemed to show an almost constant level. The length of hospital stay was found to be the most important determinant of inpatient charges for stroke. Accordingly rational management of the length of stay will be beneficial to health care consumers, providers, states.