• Journal of Korean Neurosurgical Society
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• v.62 no.1
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• pp.71-82
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• 2019

Objective : To determine the prevalence of osteoporosis (OP) and osteoporotic vertebral fracture (OVF) in people with Parkinson's disease (PD) in Korea and its association with socioeconomic status. Methods : Using Health Insurance Review and Assessment Service-National Inpatient Sample (HIRA-NIS) data from 2009 to 2013, we estimated the annual prevalence of PD, OP, and OVF and investigated its association with socioeconomic status using data from National Health Insurance (NHI) beneficiaries and Medical Aid (MA) recipients. This study was supported by research funding from Korean Society for Bone and Mineral Research 2015. There were no study-specific biases related to conflicts of interest. Results : The number of PD patients in the HIRA-NIS increased each year from 2009 to 2013. Among patients with PD, the standardized prevalence rates of OP and OVF increased from 2009 to 2013; from 23.2 to 27.8 and from 2.8 to 4.2, respectively. Among patients with PD with OP, the prevalence of OVF were 12.2% and 15.1% in 2009 and 2013, respectively. The standardized prevalence rates of PD with OP and PD with OVF were significantly higher in MA recipients than in NHI beneficiaries. Conclusion : The prevalence of PD both with OP and with OVF increased and the prevalence was higher in MA recipients than in NHI beneficiaries. These findings may suggest that age over 65 years, female and low income may be a significant factor related to PD occurring with OP and OVF.

• The Korean Journal of Health Service Management
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• v.12 no.2
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• pp.125-134
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• 2018

Objectives : The purpose of this study was to analyze factors related to the functional state of stroke patients after discharge from hospital. Methods : The data was provided from a hospital in Wonju, Gangwon-do. The subjects of the analysis were those who were admitted to the emergency room due to stroke from July to December 2016. The dependent variable was the patient's functional status as measured by the modified Rankin Scale(mRS). Independent variables were demographic factors (age, sex, and marriage status), transportation and distance factors (transportation, travel distance), inpatient factors (lengths of stay, Charlson Comorbidity Index (CCI), Tissue plasminogen activator, National Institute of Health Stroke Scale (NIHSS). Hierarchial regression analysis was applied for the analysis. Results : In the hierarchical regression analysis, Model 3, including socio-demographic factors, transportation, distance factors, and inpatient factors, was the best fitted model. It showed that functional status of stroke patients was positively associated with age, length of stay, CCI, NIHSS, and negatively associated with unmarried status. Conclusions : Results indicated that management of stroke requires care from the pre-disease stage, and a customized education program policy is needed for high-risk stroke patients who are older and have comorbid illness.

• Korea Journal of Hospital Management
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• v.22 no.3
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• pp.1-17
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• 2017

Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.

• The Journal of the Korea Contents Association
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• v.10 no.12
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• pp.190-204
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• 2010

This study firstly examined the socioeconomic and health factors associated with infiltration of private health insurance. Secondly, we compared health behavior, outpatient and inpatient use of private health insured with uninsured. The method of this study is that secondary analysis of the 2008 Korea National Health and Nutrition Survey was conducted for 7178 respondents aged 19 over. We use the logistic regression and t-test for data analysis. The first dependent variable was dichotomy which is divided to private health insured or uninsured and the second dependent variable was the presence and frequency of outpatient and inpatient use. The descriptive variables was gender, age, marital status, income, education, occupation, type of national health insurance, residential area, self confidence of health, prevalence rate of common disease, activity limitation, drinking and smoking status. The result of the major findings are as follows. First, 59 under aged person, married person, people in the higher brackets of income, national employee insured were more likely to infiltrate private health insurance. The poor self confidence of health, activity limitation, person with hypertension or allergic rhinitis and smoker were negatively related in infiltrating private health insurance. Second, private health insured did more preventive behavior such as self-paid health examination, cancer screening, regular exercise than uninsured. Third, private health insured was positively related with the presence of outpatient use and frequency of inpatient use

• The Korean Journal of Health Service Management
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• v.4 no.1
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• pp.99-110
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• 2010

The purpose of this study is to analyze the internal factors that influence the performance of local government hospitals in Korea. Out of 34 Local Government hospitals, 6 hospitals were selected as sample hospitals. Then hospitals were divided into two groups(3 hospitals each), one of which was profit-making and the other loss-making. The criteria in selecting profit or loss-making hospitals was Normal Profit to Total Assets. The major findings of this study were as follows : The headcount per 100 bed of the profit-making hospitals was 8.8 persons less than the loss-making hospitals and the ratio of payroll expenses to total revenue 14.7% less. Inpatient bed occupancy ratio of the profit-making hospitals was 92.8%. This result is higher 21.8% than loss-making hospitals.

• The Korean Journal of Health Service Management
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• v.7 no.3
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• pp.225-235
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• 2013

This study purposed to analyze the productivity of regional medical capacity in attracting medical tourist between 2009 and 2011. Data envelopment analysis (DEA) and Malmquist productivity index (MPI) were applied to test the productivity and changes in study periods. The DEA model included a number of doctors, nurses, and beds as input factors, and a number of inpatient and outpatient, and hospital income as output factors. The result of the study were as follow. Jeju had efficiency value of 1 for three years. Seoul, Busan, Daegu, Daejeon, Ulsan, Gyeonggi, Gangwon, Jeonnam, Gyeongbuk, and Gyeongnam showed an increasing trend of efficiency value over three years. Seoul had the efficiency value, 1, in 2011. But, Incheon, Gwangju showed decreasing efficiency score during the study period. MPI showed overall productivity decrease during the period. Further studies will be needed by collecting more time-series data.

• The Korean Journal of Health Service Management
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• v.8 no.4
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• pp.13-24
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• 2014

This study analyzes the effects of hospital caseload on medical charges and length of stay for inpatients. Hospital caseload, representing the level of concentration of patients, was measured with the Internal Herfindal Index for three diagnosis related group (DRG) codes (appendectomy, operations on anus, and operations on uterus and adnexa). Ordinary least squares regression was used for analysis. Results showed that medical charges per inpatient and average length of stay significantly differed with respect to hospital concentration indices, and that hospital caseload was inversely related to operational performance for appendectomy and operations on uterus and adnexa. The significant negative relationship between concentration index and length of stay may decrease the total medical charges. The results imply that the expansion of the DRG payment system to hospitals will have a negative influence on their gross sales.

• The Korean Journal of Health Service Management
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• v.3 no.2
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• pp.1-15
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• 2009

The purpose of this study is to analyze the internal factors that influence the performance of local government hospitals in Korea. There are 34 hospitals in korea as of 2008. Among these hospitals 5 are profit-making and the other loss-making in terms of profitability. Data was collected by Institute of local government hospital union. The major findings of this study was as follows : Firstly, 7 hospitals are high level, over than 100% of fixed ratio. But that result was better than the other study 5 years ago. Secondly, 29 hospitals are bellow 85% of bed occupancy rate. There are a number of hospitals didn't use the facilities and the personnel cost in total costs are high. And lastly, as a result of multiple regression analysis, the factors had on significant effect on normal profit to total assets are personnel cost(-), liability to total assets(-), average length of stay(-), outpatient visits to inpatient days(-). In conclusion, to improve the profitability of hospitals, the efforts to reduce personnel cost and to increase bed occupancy rate.

• Korea Journal of Hospital Management
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• v.14 no.2
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• pp.21-40
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• 2009

The importance-performance analysis (IPA) is a widely used analytical technique that produces a priority of managerial attention for the customer satisfaction. This study attempted to compare various different approaches of IPA such as direct and indirect measurement of importance, and traditional four quadrants grid model and diagonal grid model of IPA. Data on 17 inpatient service quality attributes were collected from 234 inpatients of a general hospital. Eight IPA grids were produced to compare the result of each model. Based on the study results the strength and weakness of each model were discussed, and a set of recommendations for practical application of the IPA in hospital settings was suggested.

• Journal of East-West Nursing Research
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• v.15 no.2
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• pp.63-70
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• 2009

Purpose: The purpose of this study was to evaluate hospital service utilization by the types of hospitals in Type I Medicaid claims frequently cited by elderly beneficiaries. Methods: Three frequently claimed inpatient diseases were selected: cerebral infarction, hypertension and diabetes mellitus. Relevant data were collected for the year 2008 from the computer database of the National Health Insurance Corporation. The data was analyzed using SPSS by descriptive statistics, ANOVA and coefficient of variation. Results: The coefficient of variance of hospitalization per episode was higher than daily hospital expenditure among hospitals for all three diseases. The coefficient of variance of hospitalization per episode was highest for cerebral infarction. The coefficient of variation of hospital expenditure per hospital day was highest for hypertension. Conclusions: Evaluating of the volume and pattern of hospital service utilization and the appropriateness for hospital admission for Type-I Medicaid elderly beneficiaries is important for Medicaid-based case management.