• 보건행정학회지
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• 제32권4호
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• pp.389-399
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• 2022

Background: This study aimed to analyze changes in medical utilization and cost before and after long-term care (LTC) implementation. Methods: We used the National Health Information Database from National Health Insurance Service. The participants were selected who had a new LTC grade (grade 1-5) for 2015. Medical utilization was analyzed before and after LTC implementation. Segmented regression analysis of interrupted time series was conducted to evaluate the overall effect of the LTC implementation on medical costs. Results: The total number of participants was 41,726. A major reason for hospitalization in grade 1 was cerebrovascular diseases, and dementia was the top priority in grade 5. The proportion of hospitalization in grade 1 increased sharply before LTC implementation and then decreased. In grade 5, it increased before LTC implementation, but there was no significant difference after LTC implementation. As for medical cost, in grades 1 to 4, the total cost increased sharply before the LTC implementation, but thereafter, changes in level and trend tended to decrease statistically, and for grade 5, immediately after LTC implementation, the level change was decreasing, but thereafter, the trend change was increasing. Conclusion: Long-term care grades showed different medical utilization and cost changes. Long-term care beneficiaries would improve their quality of life by adequately resolving their medical needs by their grades.

• 문화기술의 융합
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• 제4권4호
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• pp.187-199
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• 2018

본 연구는 2012년 한국의료패널자료의 보건의식행태에 응답한 만 18세 이상만으로 처리하였으며 전체 2,757명, 남자 2,614명(44.6%), 여자 143명(2.3%)으로 선정하였다. 흡연으로 의료이용 및 의료비지출 자료를 통하여 흡연자의 응급. 입원, 외래 의료이용횟수에 따른 의료비를 통하여 사회적 비용을 추계하였다. 사회적비용은 보건경제학자인 Rice(1968)의 의해 정립된 사회적관점을 채택하여 의료이용에 따른 의료비와, 보험자(공단)비용, 본인부담금, 비급여, 생산성 비용을 합산하여 사회적비용을 산출하였다. 흡연상태별 연간 응급의료이용률은 인구 백명당 흡연자 7.5%, 이용횟수 9.8회 사회적비용은 809,003원으로 나타나고 있다. 흡연상태별 인구 백명당 연간 입원의료이용률은 인구 백명당 흡연자 9.6%, 이용횟수 9회, 사회적비용은 706,870원으로 나타나고 있다. 흡연상태별 연간 외래이용률은 흡연 68.6%, 연간의료이용건수는 9건, 사회적비용은 706,870원으로 나타났다.

• 동의신경정신과학회지
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• 제29권3호
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• pp.135-144
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• 2018

Objectives: The purpose of this study was to analyze the medical cost for patients with vertigo and to examine associations between chronic vertigo and mental disorder using 2014 Health Insurance Review & Assessment Service-National Patients Sample (HIRA-NPS). Methods: We analyzed sociodemographic characteristics, medical cost and medical care use pattern for vertigo patients. We used hierarchical multiple logistic regression analysis to examine odds ratio between chronic vertigo and mental disorder. Results: A total of 46,502 people and 118,504 claims data were identified for vertigo cases. Characteristics of vertigo patients have significant differences on proportion of female patients (68.36%), patients' average age (54.98) and proportion of medical assistance (5.76%) compared with non-vertigo patients. Results revealed that Korean medicine are one of frequent methods among total treatments for vertigo patients. Total days of medical care and total costs are 2.78 days and 111,362 won, respectively, and days for outpatients in Korean medical care (mean: 2.26 days) are more than those (mean: 5.05 days) in Western medical care. There is significant difference relative to sex between acute vertigo and chronic vertigo. The odds ratio between chronic vertigo and mental disorder is estimated as 1.34, that means risk of becoming chronic is 34% higher for vertigo patients with mental disorder. Conclusions: This study assessed socio-demographic characteristics, medical care use and expenses related to vertigo, and estimated associations between chronic vertigo and mental disorder. Findings provide a basis for economic evaluation studies on vertigo patients and development of clinical practice guidelines for vertigo patients with mental disorder.

• Journal of Preventive Medicine and Public Health
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• 제31권3호
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• pp.460-470
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• 1998

By expanding health insurance, customers will carry a smaller burden of medical costs. As a result, the number of visits to a physician increase and this result in the improvement of medical accessibility. But medical care utilization may be changed not only by insurance status but also by socio-demographic factor, economic status and other factors. The question thus remains, at which level of accessibility and what price of medical care service in health insurance will the customer and the medical care service be satisfied. The price of medical care service ls comprised of the customer's out-of-pocket money and the costs not covered by health insurance. If the price of medical care services in health insurance are appropriate, medical care utilization should not differ because of the difference in income status or the acuteness of illness. But If the price is not adequate, low income groups will receive relatively low medical care utilization, particularly in the case of chronic disease. The purpose of this study is to evaluate the differences in medical care utilization among the various income groups and those with varying acuteness of illness. The major hypotheses to test in this study are : (i) whether there are differences in medical care utilization among different income groups exist, (ii) whether differences in medical care utilization among different income groups exist with the hospital type. (iii) whether differences in medical care utilization among different income groups exist with the acuteness of illness and with age. The data was collected from the JongRo District Health Insurance Society in Seoul. A total of 118,336 persons were selected as the final sample for this study. The major findings of this study were as follows; 1. The volume of ambulatory utilization among users was statistically significant by income level. 2. Among different income groups, the volume of ambulatory utilization was statistically significant by the acuteness of illness. 3. Higher income groups with chronic diseases had a greater volume of ambulatory utilization than other groups.

• 약학회지
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• 제51권5호
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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.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7359-7366
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• 2013

Objective: To assess the effects of perioperative comprehensive supportive care interventions on outcome of Chinese esophageal cancer patients in a prospective study. Methods: 60 patients with primary esophageal carcinoma were randomized into an intervention group (IG, n=31) and a control group (CG, n=29). The Chinese version of symptom checklist-90 (SCL-90) was adopted to assess their psychological status. The interventions, including health education, psychological support, stress management, coping strategies and behavior training, were carried out in 3 phases (preoperative, postoperative I and postoperative II), and psychological effects were thereafter evaluated accordingly before surgery, and 1 week, 4 weeks and 24 weeks post-surgery. Medical costs were estimated at discharge. Survival of patients was estimated each year post-surgery. General health status and satisfaction-with-hospital were surveyed by a follow-up questionnaire 4 years post-surgery. Results: All the subjects demonstrated higher scores in the preoperative phase than the normal range of Chinese population concerning 7 psychological domains including somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety and paranoid ideation. Although no significant difference was observed between the two groups at admission, the scores of IG, which tended to decrease at a faster rate, were generally lower than those of CG at weeks 1, 4 and 24 post-surgery. The length of hospital stay and medical costs of IG were significantly less than those of CG and satisfaction-with-hospital was better. However, there was no significant difference in 4-year survival or health status between two groups. Conclusions: Appropriate perioperative comprehensive supportive care interventions help to improve the psychological state of Chinese patients with esophageal carcinoma, to reduce health care costs and to promote satisfaction of patients and their families with hospital.

• 보건행정학회지
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• 제28권3호
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• pp.257-262
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• 2018

This study reviews the advent of long-term care (LTC) hospitals and its key issues in Korea. For analysis, enforcement ordinances and enforcement rules related to LTC hospitals were reviewed. Official statistic data were used for quantitative analysis and Organization for Economic Cooperation and Development data were utilized for comparative analysis. Various references and expert interviews were conducted for status analysis. As of 2016, the number of LTC hospitals was 1,386 and the number of beds were 246,373. It showed the trend of increasing medical care costs and the cost of care at LTC hospitals increasing from 998.8 billion Korean won in 2008 to 4,745.6 billion Korean won in 2016, accounting for 7.3% of the total National Health Insurance expenditure. From the societal perspective, several issues were pointed out within the current health care system related to LTC hospitals: establishment of roles, concerns about the increase in medical expenses, and the quality of medical personnel.

• 간호행정학회지
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• 제23권2호
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• pp.139-150
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• 2017

Purpose: The purpose of this study was to identify nursing service costs associated with all health care costs incurred by the institution. Methods: This study was an empirical case study research in which the nursing cost was separated from total medical cost. The nursing cost index was calculated through a cost allocation method after summarizing costs for personnel, raw materials and administration of each department in one public hospital. The 2014 budget plan, published in 'Public Hospitals Alert', was used as data and the data were analyzed using the Microsoft Office EXCEL 2013 program. Results: When comparing total medical costs and nursing costs, the nursing cost were 27.14% of the total medical cost. The nursing cost per nurse per hour was calculated as \29,128 The nursing cost per inpatient per day was calculated as \157,970, and the administration cost per patient was calculated as \133,710. Conclusion: The results of the research present the process of cost allocation of specific cost elements in the hospital and evidence for administrative costs which in the past have been only vaguely formulated. These are the significant implications of this study.

• 가정∙방문간호학회지
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• 제21권2호
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• pp.127-138
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• 2014

Purpose: The objectives of this study were to analyze the state of hospital-based home care (HC) services annually and to provide basic information for research and policy regarding home care. Methods: This study is a secondary analysis of the yearly state of HC services from the Health Insurance Review & Assessment Services from 2007 to 2012. Results: The decreased by 34.6%, from 214 agencies in 2007 to 140 in 2012. The annual average number of active home care nurses was 440, which included 6.7% of the licensed home care nurses until 2012. The annual average number of HC patients were 32,000, and this number decreased by 21% in 2012, compared to that of 2008. Of the HC patients, about 70% were over 60 years of age. The chronic diseases among HC patients have been decreasing steadily since 2007. Seventy to eighty percent of the home visits were made in general hospitals or higher level hospitals. The total medical cost for HC services was 21 billion won in 2007, which consisted of 0.06% of the national medical costs, and it was 22 billion won and 0.03% in 2012. Conclusion: Based on the results of this study, further research on HC services is necessary to frame policies for the expansion of HC agencies.

• 가정∙방문간호학회지
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• 제19권2호
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• pp.119-126
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• 2012

Purpose: The purpose of this study is to identify clubhouses general characteristics, core services, funding sources and costs in Korean Clubhouse Model, and to compare with Korean and international clubhouses. We explored the annual budget, cost per member, and cost per visit for 1 year. Methods: The data were collected from 14 Korean clubhouses and analyzed using descriptive statistics and Spearman's rank correlation with the SPSS 14.0 program. Results: The average of clubhouse operating period was 8.2 years. There were an average of 40.4 active members; among them, 84.1% were schizophrenia. In addition, there were an average of 5.8 staff and 15.3 services in each clubhouse. Cost estimates were as follows: annual budget (excluding housing) $223.633, cost per member $5,704, and cost per visit $21.35. There were significant difference among the annual budget, number of staff, number of service, and active members, but hours of Work-Ordered Day and social activities hours were not statistically significant. Conclusion: Findings provide a more understanding of operations, programs, and costs of Korean clubhouses.