• Health Policy and Management
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• v.25 no.2
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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.

• Land and Housing Review
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• v.5 no.1
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• pp.1-10
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• 2014

Health care services in a residential area would accelerate the aging in place. In addition, these changes would play a key role in terms of reducing healthcare costs and leading a healthy lifestyle. The purpose of this study draws the design methodology of community facilities and each dwelling with healthcare services in apartment complex, which the elderly people will enjoy a better health status. This paper presents the result focused on the welfare building in Gayang 7th apartment complex. The intention to receive healthcare services was investigated by occupants. Moreover, design requirements were drawn through in-depth interviews and the state observation to use the service. In the complex, stronger intention to serve the u-Healthcare services was shown to the pre elderly group than the elderly. Both of them had a problem to use and keep the health equipment due to the fact there is not enough space in the unit. Reporting the observation results, the upright-posture furniture attaching the healthcare equipment and the equipment storage should be prepared in the unit. In the public space, the program for these healthcare services can be divided into three parts, i.e. the health status measurement, the healthcare, and the service connected to the surrounding facilities. The health status measurement can be the basic to the health services and its function should be gradually extended. In the complex, the hybrid type with various functions could be applied owing to a new building for welfare; moreover, semi-independent user should be able to receive the home healthcare service.

• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.4
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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.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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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.

• Health Policy and Management
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• v.22 no.1
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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.

• Journal of Preventive Medicine and Public Health
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• v.42 no.3
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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.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.4
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• pp.1318-1324
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• 2010

Recently, U-Healthcare is receiving attentions as a research for reducing the manpower, time in treatment, and etc. Although fundamental technologies, such as sensing, measuring, and etc. are sufficiently investigated. However, Technologies of IT/Medical convergence, which graft IT technologies to medical area, are still in germ. For this, we present a novel healthcare system, which can be applied to the middle sized medical environment, such as private hospital, home, or etc., by means of pre-verified technologies and the expert system. There exist IT element technologies are sufficiently developed in the fields, such as network, database or etc. due to the remarkable developments in IT technologies, and the healthcare is a mission-critical environment. Therefore, it is important not only to investigate novel approaches but also to utilize verified technologies for the U-Healthcare solution. Presented solution provisions automated medical services based on expert system by utilizing the measured data, such as body fat, blood pressure, blood glucose, and etc., in order to provide convenient treatment environment to doctors and nurses. In addition, since people, who do not have medical knowledge, can self-diagnose themselves, it is expected to cut medical costs in various areas. Especially, since each devices communicate with each other through standardized Bluetooth technology, Presented healthcare system is an extensible solution which can easily accept various medical devices. As a result of this, we can safely say that the self measurement and diagnosis services in U-Healthcare are now enhanced by reducing medical cost through our healthcare system.

• Korea Journal of Hospital Management
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• v.15 no.2
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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.

• Health Policy and Management
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• v.31 no.1
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• pp.17-23
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• 2021

With the introduction of national health insurance, the burden of health care costs decreased and choices of medical services widened. However, because of the rapid expansion of non-covered medical services by health insurance, financial security for health care expenditure is still low. This gives patients barriers to choose medical services especially for non-covered medical services, and it becomes narrower. Compared to Korea, Japan has high financial protection in health care utilization, but there exists a limitation using covered and non-covered medical services both together. This is called a prohibition of mixed treatment in health care. This study reviews the Japanese health care system that limits choosing medical services and the burden of health care costs. The prohibition of mixed treatment can alleviate the out-of-pocket burden in the non-benefit sector, but it can be found that it has a huge limitation in that it places restrictions on choices for both healthcare professionals and patients.

• YAKHAK HOEJI
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• v.51 no.5
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• pp.327-335
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• 2007

This study was to evaluate economic impact of a comprehensive pharmaceutical care intervention provided by community pharmacists on drug-related morbidity and mortality in the elderly population, in a societal perspective. Clinical outcomes of pharmaceutical care included compliance increase, inappropriate medication discontinuation, and subsequent drug-related morbidity and mortality reduction. Economic outcomes included cost savings from direct medical costs reduction such as medication and healthcare resource utilization. Input costs for pharmaceutical care included pharmacist time and computerized prescription review supporting program costs. Model parameters of outcomes were derived from published literatures, and costs were from literatures and health insurance statistical data in Korea. Annual costs and benefits were estimated in the year 2005. Current usual care and standardized pharmaceutical care required 0.3 and 2.0 hours per year respectively, for elderly outpatient using average 4.4 prescription drugs per visit and average annual frequency of 17.8 pharmacy visits. Comprehensive pharmaceutical care provided to overall elderly outpatients at community pharmacies would have cost of \74,994 mil. and benefit of \357,002 mil. per year. Benefit:cost ratio was 4.8:1 and net benefit was \282,008 mil/year. It was corresponded to net benefit of \73,816/year for individual elderly patient. In addition, pharmaceutical care was estimated to reduce 1,531 drug-related deaths/year. Conclusively this study, a first attempt in Korea to evaluate an economic value of pharmaceutical care at community pharmacies, proved that it was a cost-effective intervention having significant economic benefit.