• Journal of Korean Academy of Nursing Administration
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• v.9 no.3
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• pp.379-389
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• 2003

Purpose: The objective of our study was to figure out costs of nursing services in general nursing units based on the PCS in order to determine an appropriate nursing fee schedule. Method: The data were collected from 8 hospitals from September 9 to October 8, 2002. The costs of nursing services in general nursing units was analyzed by nursing hours based on the nursing intensity. The inpatient in the general nursing units were classified by Park's PCS tool(2000). Results: The distribution of patients by PCS ranged from class I to Class III in general nursing units. The higher PCS in general nursing units consumed more nursing hours. As a result, the higher nursing intensity, the more the daily average nursing costs in general nursing units. Conclusion: We found that the higher PCS, the more the daily average nursing costs in general nursing units. In conclusion, our study provides the evidence to refine the current nursing fee schedule that it does not differentiated from the volume of nursing services based on the nursing hours.

• Journal of Korean Foot and Ankle Society
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• v.15 no.3
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• pp.165-169
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• 2011

Purpose: The objective of this study was to analyze diabetic foot patients' direct service costs until the cure of the disease. Materials Methods: The subjects of this study were randomly sampled 60 patients who had been treated for diabetic foot at one of two tertiary hospitals and cured of the disease during from January 2008 to December 2009, and whose diagnostic code was E11.5 or E14.5. Data were collected from medical records and direct service costs were analyzed using data on the payments of individual service charges. Direct service costs spent at other medical institutions for the same disease were excluded. Collected data were analyzed using descriptive statistics. Results: The subjects' mean hospital stay was 29 days, and mean period until cure was 132 days. The inpatient cost per patient was 10,844,648 won, outpatient cost was 715,751 won, and home care services cost was 641,854 won, so total direct service cost per patient was 11,913,419 won. The total direct service cost in patients who had their foot amputated was 12,769,822 won, 1.3 times higher than without amputation, who had vascular intervention was 16,219,477 won, 1.9 times higher than non-vascular intervention, who had both infection and artery occlusion was 17,522,435 won, 2.0 times higher than either infection or artery occlusion. Conclusion: In diabetic foot patients, the direct service cost was highest as 17,522,435 won in patients accompanied with both infection and occlusion of lower extremity artery.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1547-1551
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• 2012

Background: Lung cancer is the leading cause of cancer morbidity and mortality. Its management has a significant economic impact on society. Despite a high incidence of cancer, so far, there is no national register for this disease in Morocco. The main goal of this report was to estimate the medical costs of lung cancer in our country. Methods: We first estimated the number of annual new cases according to stage of the disease on the basis of the Grand-Casablanca-Region Cancer Registry data. For each sub-group, the protocol of treatment was described taking into account the international guidelines, and an evaluation of individual costs during the first year following diagnosis was made. Extrapolation of the results to the whole country was used to calculate the total annual cost of treatments for lung cancer in Morocco. Results: Overall approximately 3,500 new cases of lung cancer occur each year in the country. Stages I and II account for only 4% of cases, while 96% are diagnosed at locally advanced or metastatic stages III and IV. The total medical cost of lung cancer in Morocco is estimated to be around USD 12 million. This cost represents approximately 1% of the global budget of the Health Department. According to AROME Guidelines, about 86% of the newly diagnosed lung cancer cases needed palliative treatment while 14% required curative intent therapy. The total cost of early and advanced stages lung cancer management during the first year were estimated to be 4,600 and 3,420 USD, respectively. Conclusion: This study provides health decision-makers with a first estimate of costs and the opportunity to achieve the optimal use of available data to estimate the needs of health facilities in Morocco. A substantial proportion of the burden of lung cancer could be prevented through the application of existing cancer control knowledge and by implementing tobacco control programs.

• Health Policy and Management
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• v.31 no.3
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• pp.344-354
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• 2021

Background: The purpose of this study was to analyze the effect of national health insurance coverage of Chuna therapy in April 2019 on the costs and service uses in automobile insurance. Methods: This study used the claim data from Health Insurance Review and Assessment Service. A total of 189,912 inpatients and 1,550,497 outpatients who received Chuna therapy covered by automobile insurance in oriental medical institutions were included. The analysis period was from July 2018 to December 2019, and a total of 18 months before and after April 2019, when Chuna therapy was covered by national health insurance. Interrupted time series analysis was applied to analyze the impact on the costs and service uses of Chuna therapy in automobile insurance before and after April 2019. Results: From July 2018 to December 2019, for 189,912 inpatients the cost and the number of times for Chuna therapy per capita were increased by 22.0% and decreased by 7.3% respectively right after the implementation of the policy. In the case of 1,550,497 outpatients, the cost of Chuna therapy per capita tends to be increased by 0.4% in overall study periods and increased 28.4% immediately after the implementation of the policy. Meanwhile, the number of times and visits for Chuna therapy per capita tends to be increased by 0.4% in overall study periods but decreased by 0.4% after the implementation of the policy. Conclusion: Results suggest that if the national health insurance coverage of oriental medicine services increases according to the policy stance for benefit expansion in national health insurance, the criteria for providing national health insurance benefits should be considered with the comprehensive impacts on the costs and service uses of automobile insurance.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1845-1850
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• 2015

Background: Cancer is recently one of the major concerns of the public health both in the world and Iran. To inform priorities for cancer control, this study estimated years of potential life lost (YPLL) and productivity losses due to cancer-related premature mortality in Iran in 2012. Materials and Methods: The number of cancer deaths by sex for all cancers and the ten leading causes of cancer deaths in Iran in 2012 were obtained from the GLOBOCAN database. The life expectancy method and the human capital approach were used to estimate the YPLL and the value of productivity lost due to cancer-related premature mortality. Results: There were 53,350 cancer-related deaths in Iran. We estimated that these cancer deaths resulted in 1,112,680 YPLL in total, 563,332 (50.6%) in males and 549,348 (49.4%) in females. The top 10 ranked cancers accounted for 75% of total death and 70% of total YPLL in the males and 69% for both death and YPLL in the females. The largest contributors for YPLL in the two genders were stomach and breast cancers, respectively. The total cost of lost productivity due to cancer-related premature mortality discounted at 3% rate in Iran, was US$ 1.93 billion. The most costly cancer for the males was stomach, while for the females it was breast cancer. The percentage of the total costs that were attributable to the top 10 cancers was 67% in the males and 71% in the females. Conclusions: The YPLL and productivity losses due to cancer-related premature mortality are substantial in Iran. Setting resource allocation priorities to cancers that occur in younger working-age individuals (such as brain and central nervous system) and/or cancers with high incidence and mortality rates (such as stomach and breast) could potentially decrease the productivity losses and the YPLL to a great extent in Iran.

• Health Policy and Management
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• v.30 no.3
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• pp.418-429
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• 2020

Background: This study aims to analyze the cost and the length of stay (LOS) of acute myocardial infarction (AMI) patients with coronary artery stenting according to the characteristics of individuals and institutions. Methods: The data was collected from Korean National Health Insurance Service's customized database in 2010 and 2015. Chi-square test, t-test, analysis of variance, and multilevel analysis were performed. Results: The intraclass correlation coefficients for cost were 7.02% in 2010, 5.61% in 2015 and for LOS were 3.17%, 1.40%, respectively. The average costs were 9,067,000 won in 2010 and 9,889,000 won in 2015 (p<0.0001). However, the cost in 2015 was lower than the cost applying increased fee. The costs increased in aged 50-59 years, 60-69 years, and aged ≥70 years versus in aged under 49 years. The cost was higher in Charlson comorbidity index (CCI) 3 to 4 and ≥5 than in CCI 0. The costs were lower in male, medical aid recipients, metropolises, and local hospitals in other regions in 2010. LOS decreased from 8.1 days in 2010 to 7.4 days in 2015. It decreased in male, high income group, and the group of admission via emergency room. However, it increased in higher ages and medical aid recipients, and it also increased when CCI rose. The Internal Herfindahl Index was related to LOS in 2010. Conclusion: The variation of hospital level was small compared to the patient level. Therefore, it is important to implement applicable policies at the patient level in order to reduce cost and LOS of AMI patients.

• Journal of Oriental Neuropsychiatry
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• v.29 no.3
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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.

• The Korean Journal of Health Service Management
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• v.8 no.4
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• pp.209-220
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• 2014

This study found a relationship between the characteristics of the elderly with disabilities and extra health care monthly costs caused by disability and suggests methods for effectively managing health care spending of the elderly with disabilities. This study used data from the 2011 Survey on the Disabled conducted by the Ministry of Health and Welfare and the Korea Institute for Health and Social Affairs. The results of the analysis indicate that the relations between the socio-demographic characteristics of the elderly with disabilities and extra health care monthly costs caused by disability of the elderly are influenced by factors such as gender, age, members of the household, average monthly income and type of health insurance. Elderly people with disabilities spend too much for their medical care. To solve this problem, the government needs to find a variety of policy approaches to improve administrative procedure, establish a medical delivery system and enhance health care services.

• The Journal of Pediatrics of Korean Medicine
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• v.30 no.4
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• pp.60-65
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• 2016

Objectives The purpose of this study is to emphasize the importance of preventing precocious puberty. This study assessed current number of the patients with early puberty and their medical expenses from 2010 to 2015. Methods Using the data from Korean Statistical Information Service and Heathcare Bigdata Hub, number of patients diagnosed with precocious puberty by gender, age, and year from 2010 to 2015 were reviewed. Also, annual medical insurance expenses and the incidence of leuprorelin use were reviewed. Results Number of the patients with precocious puberty has increased from 29,251 in 2010 to 75,945 in 2015. Total medical insurance expenses have increased from 25,716,431 won in 2010 to 56,367,981 won in 2015. The use of lueprorelin also has increased annually from 11,097,590,000 won in 2010 to 21,617,585,000 won in 2015. Conclusions As a result, the patients diagnosed with precocious puberty are increasing in number, and their medical costs have been rising as well. It may be necessary to control the environmental causes of precocious puberty to reduce not only the physical and psychosocial health problems, but also the social costs.

• Management & Information Systems Review
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• v.17
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• pp.107-133
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• 2005

The purpose of this study was to analyze a trend of profitability classified by characteristics of hospitals and to analyze related factors. The data for this study were derived from survey material conducted by the Korean Hospital Association on 33 hospitals in Korea between 1993 and 2002. Profitability was measured in the aspect of investment profit rate and operation profit rate with net profit to total assets, normal profit to total assets and operating margin to gross revenue as dependent variables. Independent variables were classified by general factors (ownership, number of beds, period of establishment, region), financial factors (total asset turnover, liabilities to total assets, current ratio, fixed ratio, inventories turnover, personnel costs per operation profit, material costs per operation profits), composition of manpower and facilities(personnel and area per beds), productivity index(the number of daily patients per medical doctor, the number of daily patients per nurse), the score of quality assurance activities. First, Concerning the specialists per beds or area per beds and profitability of hospitals there was not statistically significant. Second, Those hospitals having the most daily patients per nurse had significantly higher profitability than the others, but the number of daily patients per medical doctor had little effect on the profitability. Thirds, Those hospitals having a higher proportion total asset turnover tended to show significantly higher profitability compared to other hospitals, but the liabilities to total assets and liquidity ratio had a little difference to the profitability. Those hospitals having a higher proportion personnel costs per operation profit and material costs per operation profits tended to show significantly lower hospital profitability compared to other hospitals. Fourth, In regression analysis, hospital profitability had negative relationship with personnel costs per operation profit or material costs per operation profits. While it had positive relationship with total asset turnover, the number of daily patients per nurse. In conclusion, private hospitals had higher profitability than that of public hospitals. Though factors related to profitability of hospital were different according to ownership, it is important for securing appropriate profitability by operating appropriate number of nurse, raising total asset turnover, and reducing personnel costs, material costs per operation profits. This study can be used as a baseline data for planning of hospital management. But the study may be limited in that the results cannot be generalized due to its small sample size. However, this longitudinal observation of 33 hospitals over ten year period has significant merit alone.