• Title/Summary/Keyword: Healthcare costs

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Increased Readmission Risk and Healthcare Cost for Delirium Patients without Immediate Hospitalization in the Emergency Department

  • Ma, I Chun;Chen, Kao Chin;Chen, Wei Tseng;Tsai, Hsin Chun;Su, Chien-Chou;Lu, Ru-Band;Chen, Po See;Chang, Wei Hung;Yang, Yen Kuang
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.398-406
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    • 2018
  • Objective: Hospitalization of patients with delirium after visiting the emergency department (ED) is often required. However, the readmission risk after discharge from the ED should also be considered. This study aimed to explore whether (i) immediate hospitalization influences the readmission risk of patients with delirium; (ii) the readmission risk is affected by various risk factors; and (iii) the healthcare cost differs between groups within 28 days of the first ED visit. Methods: Using the National Health Insurance Research Database, the data of 2,780 subjects presenting with delirium at an ED visit from 2000 to 2008 were examined. The readmission risks of the groups of patients (i.e., patients who were and were not admitted within 24 hours of an ED visit) within 28 days were compared, and the effects of the severities of different comorbidities (using Charlson's comorbidity index, CCI), age, gender, diagnosis and differences in medical healthcare cost were analyzed. Results: Patients without immediate hospitalization had a higher risk of readmission within 3, 7, 14, or 28 days of discharge from the ED, especially subjects with more severe comorbidities ($CCI{\geq}3$) or older patients (${\geq}65years$). Subjects with more severe comorbidities or older subjects who were not admitted immediately also incurred a greater healthcare cost for re-hospitalization within the 28-day follow-up period. Conclusion: Patients with delirium with a higher CCI or of a greater age should be carefully considered for immediate hospitalization from ED for further examination in order to reduce the risk of re-hospitalization and cost of healthcare.

A Cost Benefit Analysis of Individual Home Visiting Health Care (맞춤형 방문건강관리사업의 비용-편익분석)

  • Kim, Jin-Hyun;Lee, Tae-Jin;Lee, Jin-Hee;Shin, Sang-Jin;Lee, Eun-Hee
    • Research in Community and Public Health Nursing
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    • v.21 no.3
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    • pp.362-373
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    • 2010
  • Purpose: The purpose of this study is to evaluate the costs and benefits of individual home visiting health care using secondary data and literature review. Methods: The total number of subjects was 1,008,837. A specific program was classified into disease management, care of infant, child and women, or elderly care. The costs and effects of a program were identified from a societal perspective, and the effects were converted into monetary terms or benefits. The total cost was calculated in the way that medical expenses, travel costs and productivity losses were offset by the decrease in benefits and thus only the program budget was included in the total cost. Results: The total program cost was 47.6 billion won per year and the total annual benefit was estimated at 435.6 billion won. The benefits of arthritis management were the biggest among disease management programs. The net benefit was 388.0 billion won per year and the benefit/cost ratio was 9.16. Conclusion: Home visiting health care was validated to be economically effective. It made a positive contribution to improving the health status of vulnerable populations and reducing medical expenses. These results suggest that home visiting care should be extended more broadly to vulnerable populations.

A Study on e-Healthcare Business Model: Focusing on Business Ecosystem Approach (e헬스케어 비즈니스모델에 관한 연구: 비즈니스생태계 접근 중심으로)

  • Kim, Youngsoo;Jung, Jai-Jin
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.14 no.1
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    • pp.167-185
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    • 2019
  • As most G-20 countries expect medical spending to grow rapidly over the next few decades, the burden of healthcare costs continues to grow globally due to an increase in the elderly population and chronic illnesses, and the ongoing quality improvement of health care services. However, under the rapidly changing technological environment of healthcare and IT convergence, the problem may become even bigger if not properly recognized and not properly prepared. In the context of the paradigm shift and the increasing problem of the medical field, complex responses in technical, institutional and business aspects are urgently needed. The key is to derive a business model that is appropriate for businesses that integrate IT in the medical field. With the arrival of the era of the 4th industrial revolution, new technologies such as Internet of Things have been applied to eHealthcare, and the need for new business models has emerged.In the e-healthcare of the Internet era, it became a traditional firm-based business model. However, due to the characteristics of dynamics and complexity of things Internet in the Internet of things, A business ecosystem-based approach is needed. In this paper, we present and analyze the major success factors of the ecosystem based on the 3 - layer structure of the e - healthcare business ecosystem as a result of research on e - healthcare business ecosystem based on emerging technology such as Internet of things. The three-layer business ecosystem was defined as (1) Infrastructure Layer, (2) Character Layer, and (3) Stakeholder Layer. As the key success factors for the eHealthCare business ecosystem, the following four factors are suggested: (1) introduction of the iHealthcare concept, (2) expansion of the business ecosystem, (3) business ecosystem change process innovation, and (4) business ecosystem leadership innovation.

Medical Profit Planning Model and Innovative Strategies to Improve Profitability Management in Hospitals (병원의 수익성 관리개선을 위한 의료이익계획모형 및 혁신.합리화전략 개발연구)

  • Hwang, In-Kyoung
    • Korea Journal of Hospital Management
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    • v.1 no.1
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    • pp.83-107
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    • 1996
  • This study discusses how to rationalize or innovate the managerial practice of the profitability-deteriorated hospitals in Korea, and attempts to suggest proper planning models and strategies to reorient them. For these purposes, the hospitals' financial indicators were analysed, the process of profit planning were reviewed, and strategic assessment were made, using relevant data. The analysis shows that failures both in proper capital investment to fixed assests and in effective containment of operating costs have been causing the worsening of profitability. For the improvement of the profitability management, seven procedural and behavioral strategies were suggested from the innovative and rationalizing perspectives, together with necessary prerequisite conditions to be equipped with for their implementation. This study concludes that the top management should attempt the changs on their own initiative.

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Classification for intraclass correlation pattern by principal component analysis

  • Chung, Hie-Choon;Han, Chien-Pai
    • Journal of the Korean Data and Information Science Society
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    • v.21 no.3
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    • pp.589-595
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    • 2010
  • In discriminant analysis, we consider an intraclass correlation pattern by principal component analysis. We assume that the two populations are equally likely and the costs of misclassification are equal. In this situation, we consider two procedures, i.e., the test and proportion procedures, for selecting the principal components in classifica-tion. We compare the regular classification method and the proposed two procedures. We consider two methods for estimating error rate, i.e., the leave-one-out method and the bootstrap method.

A Study on the Factors Influencing Medication Compliance At Community Pharmacies - Based on The 3rd (2005) Korea National Health and Nutrition Examination Survey Data - (외래약국 복약이행도에 영향을 미치는 요인 연구 - 제3기(2005년) 국민건강영양조사자료를 근거로 -)

  • Kwon, Jin-Won;Park, Eun-Ja;Sohn, Hyun-Soon
    • YAKHAK HOEJI
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    • v.55 no.6
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    • pp.500-509
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    • 2011
  • This study was to identify factors influencing drug compliance based on the subjects' interview regarding community pharmacy utilization for 2 weeks, in 2005 KNHANES. Good compliance was regarded as important factors in improving the effectiveness and minimizing adverse drug reaction, resulting in reducing the medical costs. 83% of total 11,208 pharmacy visits in 7,066 subjects showed good compliance. Good satisfaction for pharmacist's medication counseling (OR=2.23, 95% CI 1.92-2.58), higher out-of-pocket money (OR=1.32, 95% CI 1.14-1.54), and users of prescription drugs than non-prescription (OR=2.21, 95% CI 1.91-2.57) drugs were significant factors for better compliance. Disease of nervous system and mental and behavioral disorders showed lower drug compliance.

An empirical study on the material distribution decision making

  • Ko, Je-Suk
    • Journal of the Korean Data and Information Science Society
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    • v.21 no.2
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    • pp.355-361
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    • 2010
  • This paper addresses a mathematical approach to decision making in a real-world material distribution situation. The problem is characterized by a low-volume and highly-varied mix of products, therefore there is a lot of material movement between the facilities. This study focuses especially on the transportation scheduler with a tool that can be used to quantitatively analyze the volume of material moved, the type of truck to be used, production schedules, and due dates. In this research, we have developed a mixed integer programming problem using the minimum cost, multiperiod, multi-commodity network flow approach that minimizes the overall material movement costs. The results suggest that the optimization approach provides a set of feasible solution routes with the objective of reducing the overall fleet cost.

Conditional bootstrap confidence intervals for classification error rate when a block of observations is missing

  • Chung, Hie-Choon;Han, Chien-Pai
    • Journal of the Korean Data and Information Science Society
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    • v.24 no.1
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    • pp.189-200
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    • 2013
  • In this paper, it will be assumed that there are two distinct populations which are multivariate normal with equal covariance matrix. We also assume that the two populations are equally likely and the costs of misclassification are equal. The classification rule depends on the situation whether the training samples include missing values or not. We consider the conditional bootstrap confidence intervals for classification error rate when a block of observation is missing.

Cost-Utility Analysis of Bosentan Versus Iloprost in Korean Patients with Pulmonary Arterial Hypertension (우리나라 폐동맥고혈압환자에 대한 Bosentan과 Iloprost의 비용-효용 분석)

  • Sohn, Hyun-Soon;Lee, Tae-Jin
    • YAKHAK HOEJI
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    • v.54 no.2
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    • pp.126-133
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    • 2010
  • This study was conducted to analyze cost-utility of bosentan versus iloprost indicated for pulmonary arterial hypertension (PAH) in a Korean healthcare setting from a payer's perspective. We constructed a Markov model to estimate total costs and outcomes for 1-year time horizon in a hypothetical cohort of 50-year-old patients with PAH. Base analysis showed that bosentan resulted in KW 5.5 billions saving and 18 quality-adjusted life year (QALY) gains per 100 patients compared to iloprost. Bosentan as a dominant strategy was found to be robust through various sensitivity analyses.

Financial Structural and Operational Characteristics and Management Decision-making Behavior of the Red-figured Hospitals (적자병원의 재무구조 및 운영적 특성과 경영의사결정 행태)

  • Hwang, In-Kyoung
    • Korea Journal of Hospital Management
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    • v.4 no.2
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    • pp.305-329
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    • 1999
  • Financial ratio indicators of the 46 sample hospitals provided by the Korea Health Industry Development Institute, together with the survey data responded by the 57 sample hospitals, were analysed to identify the characteristics of the red-figured hospitals' financial structure, financial operational efficiency and management decision-making behavior, The financial characteristics identified through the analysis include high dependency to liabilities, high salary expenses and overhead costs, low profitability of the unduly large amount of fixed assets, and low managerial efficieny of inventory. The hospitals, in face of the IMF economic impasse, took the necessary decision-making and counter measures to cut down salary expenses, to increase the number of patient and medical revenue, and to reduce investment to fixed assets. Based on these findings this study suggested that the hospitals should take more active cost containment measures, financial structural reorganization, and developoment of the strategies that can contribute to increase of the number of patient and medical revenue and that do not. require much capital funds.

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