• Journal of Korean Academy of Nursing
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• v.39 no.4
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• pp.574-583
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• 2009

Purpose: This paper analyzed alternative methods of calculating the conversion factor for nurse-midwife's delivery services in the national health insurance and estimated the optimal reimbursement level for the services. Methods: A cost accounting model and Sustainable Growth Rate (SGR) model were developed to estimate the conversion factor of Resource-Based Relative Value Scale (RBRVS) for nurse-midwife's services, depending on the scope of revenue considered in financial analysis. The data and sources from the government and the financial statements from nurse-midwife clinics were used in analysis. Results: The cost accounting model and SGR model showed a 17.6-37.9% increase and 19.0-23.6% increase, respectively, in nurse-midwife fee for delivery services in the national health insurance. The SGR model measured an overall trend of medical expenditures rather than an individual financial status of nurse-midwife clinics, and the cost analysis properly estimated the level of reimbursement for nurse-midwife's services. Conclusion: Normal vaginal delivery in nurse-midwife clinics is considered cost-effective in terms of insurance financing. Upon a declining share of health expenditures on midwife clinics, designing a reimbursement strategy for midwife's services could be an opportunity as well as a challenge when it comes to efficient resource allocation.

• Journal of Society of Preventive Korean Medicine
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• v.13 no.1
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• pp.105-115
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• 2009

Background: The resource-based relative value scale has been applied to Korean medicine services as part of the National Health Insurance, yet the proper scoring method for physician's work needs to be developed. Objectives: To measure physician's work for Korean medicine services using Analytical Hierarchy Process(AHP) and to compare results abstracted by AHP with those by Magnitude Estimation method. Methods: We developed the AHP questionnaires for Korean Medicine services and administered it to 12 Korean medicine insurance experts. Weighted scores were calculated and were converted into physician's work scores. Results: In AHP measurement, the physician's work scores for acupuncture activities, especially special acupunctures, far increased, while those for diagnosis and basic consultations decreased. Variations in the scores enlarged. Conclusions: As an alternative, AHP method can be considered for measuring the physician's work for Korean medicine services with careful management of scoring variation.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.7 no.2
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• pp.1-14
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• 2012

Objectives : The aim of this study was to prepare the validity and relevance for National Health Insurance of Chuna manual therapy through measurement of resource-based relative value scale(RBRVS) scores. Methods : To prepare for National Health Insurance, we studied it about standardized classification of the practice and definition, and speciality by difficulty and safety of Chuna manual therapy. Results : Classification of the practice could be classified to 7 of Chuna manual therapy and 24 traditional manual therapy, it also categorized as one of 3 kinds(basic, simple, special). The RBRVS scores of Chuna manual therapy were measured to 283.28, 566.57 and 1133.14. Conclusions : This study could be used to basis data for National Health Insurance of Chuna manual therapy, but further studies must be needed more objective investigation and data to calculate RBRVS scores.

• Journal of Preventive Medicine and Public Health
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• v.31 no.4 s.63
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• pp.875-884
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• 1998

Missing observations are common in medical research and health survey research. Several statistical methods to handle the missing data problem have been proposed. The EM algorithm (Expectation-Maximization algorithm) is one of the ways of efficiently handling the missing data problem based on sufficient statistics. In this paper, we developed statistical models and methods for survey data with multivariate missing observations. Especially, we adopted the EM algorithm to handle the multivariate missing observations. We assume that the multivariate observations follow a multivariate normal distribution, where the mean vector and the covariance matrix are primarily of interest. We applied the proposed statistical method to analyze data from a health survey. The data set we used came from a physician survey on Resource-Based Relative Value Scale(RBRVS). In addition to the EM algorithm, we applied the complete case analysis, which uses only completely observed cases, and the available case analysis, which utilizes all available information. The residual and normal probability plots were evaluated to access the assumption of normality. We found that the residual sum of squares from the EM algorithm was smaller than those of the complete-case and the available-case analyses.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1580-1591
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• 2000

This study was conducted to assess the amount of nursing services for psychiatric inpatients and to estimate psychiatric nursing costs by using the RBRVS. Full details of medical services, including physician and nursing services, for psychiatric inpatients were surveyed and data of general characteristics of hospitals and patients were also collected. The cost of nursing activities was estimated by the multiple conversion factor which was drawn from the Korean RBRVS Development Project to the RBRVS score of each nursing activities, which was drawn from the results of Korean Nurses Association (KNA)'s projects about nursing RBRVS development and cost of nursing activities. The data about 89 inpatients from 3 general hospitals with psychiatric departments were analyzed. The total cost of nursing activities for each patient per admission day was from KRW 22,185 to KRW 27,954 by hospital, and KRW 25,220 in average. The percent of nursing cost to the total cost of medical services was from 36% to 48% by characteristics of patients and 41.4% in average. The cost of nursing activities estimated in this study was between the existing NHI fee schedule and the one suggested by KNA. It is considered as appropriate and acceptable level compared to the total amount of medical services. In the process of KNA's activities to get nursing fee in NHI fee schedule, results of additional studies to estimate the cost of nursing activities balanced with total cost of medical services in every departments should be found and utilized.

• Korean Management Science Review
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• v.26 no.1
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• pp.113-126
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• 2009

By the newly emerging network access technology, we face the new heterogeneous network environment. Focusing on the co-existence of multiple access network technology and the complex service needs of users, the wireless service operators should present the stable service quality for every user. For this, the service operators should build the new operation framework which combine the pre-established network and newly adopted one. Our problem is finding the optimal heterogeneous network operation framework. We suggest market-based marginal cost function for evaluating the relative value of resource of each network and develop the whole new heterogeneous network operation framework. To test the applicability of developed operation framework, we build large-scale JAVA simulator. By this development, we can easily test the new network environment in practical engineering field.

• Journal of Korean Academy of Nursing Administration
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• v.16 no.4
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• pp.399-408
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• 2010

Purpose: The purpose of this study was to compare the cost using different methods of costing nursing activities for patients with chronic otitis media having surgery. Method: Data were collected from 30 patients who had mastoidectomy and tympanoplasty. To compare the cost, the researchers used three different costing methods; consumed time, resource based relative value scale (RBRVS), and critical pathway (CP). Results: Twenty-six nursing activities for surgical patients with chronic otitis media were found. Total cost was 83,843.7 won using RBRVS. The costliest activity was recording at 9,734.4 won, followed by confirmation of doctors' orders at 9,302.4 won, and injection with infusion pump at 9,072.0 won. There was a difference in nursing activities performed according to the length of hospital stay, and the cost was highest on the surgery day at 13,417.8 won. Comparatively, the total cost was 72,014.4 won using CP. Conclusions: Nursing activities are performed in various forms according to the disease and patient's condition, and different nursing activities are executed according to the length of hospital stay. In order to measure the load of nursing activities and distribute it appropriately, it is necessary to analyze the cost of nursing activities by the process of nursing services performed.

• Korean journal of food and cookery science
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• v.23 no.4 s.100
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• pp.511-529
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• 2007

This study was conducted to investigate traditional Kyunggi area Korean foods suitable for standardization and commercialization as well as to investigate the perceptions of experts about these foods, and to analyze the important value factor characteristics according to classified traditional food groups by residents of the Kyunggi(n=104)areas of Korea. We determined the degree of value of various traditional foods by asking respondents to 13 items based on a 5 point Likert scale, and used the total scores of the items to determine their value. Based on the results of the total scores and frequently chosen foods, we attempted to select the foods suitable for standardization and commercialization. The results are summarized as follows. For main dishes Ogok-bap was selected as the primary suitable for standardization and commercialization. Next were Incheon yeong yang bap, Hobak-beombek, Hobak-juk, Gesungpyeonsu, Tteokguk, Kimchibap, Kimchimandu, and bap, respectively. Of the side dishes Bossam-kimchi was selected as the primary suitable food for standardization and commercialization followed by Bindaetteok, Sondubu, Samgyetang, Baekkimchi, Doenjang-jjigae, Suwongalbi, Japchae, and Cheonggukjang-jjigae, respectively. Finally, for favorite foods, Duteop-tteok was selected as the primary food suitable for standardization and commercialization. Next were Jeungpyeon, Yakgwa, Yaksik, Maejakgwa, Ssuk-tteok, Yeongeunjeonggwa, Songpyeon, and Osaekdasik, respectively. This study shows that a resident's evaluation of a traditional Kyunggi Korean food is affected by the their sense of value of the food, as well as by the social structure, which includes the population, economic condition, food policies, industrial technology, and culture. This research was conducted to preserve traditional Kyunggi Korean foods and to improve this area's regional income from the prospect of sellable goods. We expect that this research to be used as basic data in the development of new commercial traditional foods by the food industry, by offering a better understanding of diverse consumer sense and to also be used with dietary education data relative to following traditional meal patterns for diverse age groups.

• Journal of Korean Academy of Nursing Administration
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• v.13 no.4
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• pp.407-420
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• 2007

Purpose: The objective of this literature review study was to identify research's trends and methodological issues of cost analysis on nursing services. Methods: Researches which analyzed nursing services cost, were selected from journal articles and master or doctoral dissertation studies. The total numbers of the collected studies were 23. Results: The number of studies on nursing services cost has been increased rapidly since middle-1990. The 5 methodological frameworks to classify the cost analysis researches was found. 4 researches were using the traditional costing method. 6 researches were using the clinical patient classification systems. 4 researches were using the Korean Diagnosis Related Group (KDRG). 5 researches were using the Resource Based Relative Value Scale (RBRVS). 4 researches were using the Activity Based Costing (ABC). Conclusion: These results will be used to provide the basic data for developing a more refined cost analysis method on nursing services. For further studies, we will suggest that the consent criteria of cost items need to measure nursing services be developed and the conducting cost analysis on nursing services be networked a hospital's cost management system.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1543-1555
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• 2000

Home health care is moving into a set of new realities. An era of competition and cost containment has arrived. Before nurses are able to contain costs or describe the relationship between nursing activities, cost must be accurately measured based on the nurse's workload. Nurses in home health care usually desire to measure expenses for one of three reasons : reimbursement, management, or research. The purpose of the study was to investigate the work input by Registered Nurse in each of the home health care activities by relative value units and identify the factors affecting the nurses' total work input in health care services. To measure the work input by nurses, work was defined by four dimensions: time, physical effort, mental effort, and stress. This study used a descriptive-correlational design. Data collection consisted of two phases. In phase I, data on home health activities performed by nurses were collected. In phase II, data on nurses' time, physical effort, mental effort, and stress in each of home health care activities discovered phase I were collected. In this method, the respondent was asked to rate a service in relation to a reference service using a ratio scale. The sample included 39 home health care nurses. The results of the study indicated that home health care activities performed by the nurses were in 10 categories and 69 items. Measuring the relative work inputs in each of home health care activities, and foley catheterization was selected as the reference to service. In terms of time and physical effort dimensions, full bath service was rated as the most strenuous among 69 activities by the respondents, and intramuscular injection was rated as least. It was found that emergency treatment required the highest mental effort and the highest stress, while blood sugar tests required the lowest mental effort. Approximately 91.3% of the variance in total work input was accounted for by the linear combination of time, physical effort, mental effort judgement, and stress. Examining the regression coefficients of those variables, physical effort, time, and stress were found as the predictors which were significantly associated with the total work of nurses in home health care. Professional nursing's next step in the conundrum of economic volatility is to develop a tool to reflect the interaction of functional deficiency and direct professional nursing care. And this will be a more accurate predictor of nursing resource use and ultimately a great forcaeter cost.