• 한국병원경영학회지
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• 제15권2호
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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.

• Journal of Preventive Medicine and Public Health
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• 제39권5호
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• pp.397-403
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• 2006

Objectives: We estimated the asthma-related health care utilization and costs in Korea from the insurer's and societal perspective. Methods: We extracted the insurance claims records from the Korea National Health Insurance claims database for determining the health care services provided to patients with asthma in 2003. Patients were defined as having asthma if they had ${\geq}$2 medical claims with diagnosis of asthma and they had been prescribed anti-asthma medicines, Annual claims records were aggeregated for each patient to produce patient-specific information on the total utilization and costs. The total asthma-related cost was the sum of the direct healthcare costs, the transportation costs for visits to health care providers and the patient's or caregivers' costs for the time spent on hospital or outpatient visits. Results: A total of 699,603people were identified as asthma patients, yielding an asthma prevalence of 1.47%. Each asthma patient had 7.56 outpatient visits, 0.01 ED visits and 0.02 admissions per year to treat asthma. The per-capita insurance-covered costs increased with age, from 128,276 Won for children aged 1 to 14 years to 270,729 Won for those aged 75 or older. The total cost in the nation varied from 121,865 million to 174,949 million Won depending on the perspectives. From a societal perspective, direct health care costs accounted for 84.9%, transportation costs for 15.1 % and time costs for 9.2% of the total costs. Conclusions: Hospitalizations and ED visits represented only a small portion of the asthma-related costs. Most of the societal burden was attributed to direct medical expenditures, with outpatient visits and medications emerging as the single largest cost components.

• 간호행정학회지
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• 제19권4호
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• pp.437-448
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• 2013

Purpose: This study was a retrospective survey to examine economic feasibility of home care services for patients with diabetic foot. Methods: The participants were 33 patients in the home care services (HC) group and 27 in the non-home care services (non-HC) group, all of whom were discharged early after inpatient treatment. Data were collected from medical records. Direct medical costs were calculated using medical fee payment data. Cost-effectiveness ratio was calculated using direct medical costs paid by the patient and the insurer until complete cure of the diabetic foot. Effectiveness was the time required for a complete cure. Direct medical costs included fees for hospitalization, emergency care, home care, ambulatory fees, and hospitalization or ambulatory fees at other medical institutions. Results: Mean for direct medical costs was 11,118,773 won per person in the HC group, and 16,005,883 won in the non-HC group. The difference between the groups was statistically significant (p=.042). Analysis of the results for cost-effectiveness ratio showed 91,891 won per day in the HC patients, and 109,629 won per day in the non-HC patients. Conclusion: Result shows that the cost-effectiveness ratio is lower HC patients than non-HC patients, that indicates home care services are economically feasible.

• The Korean journal of internal medicine
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• 제33권6호
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• pp.1160-1168
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• 2018

Background/Aims: The Republic of Korea is a country where the hemodialysis population is growing rapidly. It is believed that the numbers of treatments related to vascular access-related complications are also increasing. This study investigated the current status of treatment and medical expenses for vascular access in Korean patients on hemodialysis. Methods: This was a descriptive observational study. We inspected the insurance claims of patients with chronic kidney disease who underwent hemodialysis between January 2008 and December 2016. We calculated descriptive statistics of the frequencies and medical expenses of procedures for vascular access. Results: The national medical expenses for access-related treatment were 7.12 billion KRW (equivalent to 6.36 million USD) in 2008, and these expenses increased to 42.12 billion KRW (equivalent to 37.67 million USD) in 2016. The population of hemodialysis patients, the annual frequency of access-related procedures, and the total medical cost for access-related procedures increased by 1.6-, 2.6-, and 5.9-fold, respectively, over the past 9 years. The frequency and costs of access care increased as the number of patients on hemodialysis increased. The increase in vascular access-related costs has largely been driven by increased numbers of percutaneous angioplasty. Conclusions: The increasing proportion of medical costs for percutaneous angioplasty represents a challenge in the management of end-stage renal disease in Korea. It is essential to identify the clinical and physiological aspects as well as anatomical abnormalities before planning angioplasty. A timely surgical correction could be a viable option to control the rapid growth of access-related medical expenses.

• Safety and Health at Work
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• 제5권2호
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• pp.66-72
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• 2014

Background: The purpose of this study was to enumerate the annual morbidity and mortality incidence and estimate the direct and indirect costs associated with occupational injuries and illnesses in Bangkok in 2008. In this study, data on workmen compensation claims and costs from the Thai Workmen Compensation Fund, Social Security Office of Ministry of Labor, were aggregated and analyzed. Methods: To assess costs, this study focuses on direct costs associated with the payment of workmen compensation claims for medical care and health services. Results: A total of 52,074 nonfatal cases of occupational injury were reported, with an overall incidence rate of 16.9 per 1,000. The incidence rate for male workers was four times higher than that for female workers. Out of a total direct cost of $13.87 million, $9.88 million were for medical services and related expenses and $3.98 million for compensable reimbursement. The estimated amount of noncompensated lost earnings was an additional $2.66 million. Conclusion: Occupational injuries and illnesses contributed to the total cost; it has been estimated that workers' compensation covers less than one-half to one-tenth of this cost.

• 의료법학
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• 제12권2호
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• pp.219-263
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• 2011

"Wrongful conception" is a medical malpractice claim in which the plaintiff is the parent of a normal, healthy infant whose conception was unplanned and unwanted. Medical malpractice in wrongful conception can be the result of a failure to provide informed consent to a patient, failure to properly perform a surgery, or a physician's negligent handling of a patient's problems. In the concrete, wrongful conception cases fall into two categories; those involving pre-conception negligence, such as a failed contraceptive, sterilization or failing of the controlling of embryo-number on the IVF, and those involving post-conception negligence, such as a failure to diagnose a pregnancy or to perform an abortion procedure. In addition, Medical malpractice can be the result of a failure to provide informed consent to a patient. When bad results occur by medical malpractice or failure to provide informed consent to a patient, the range of recovery of damages is decided by a traditional civil liability law. However the calculation of damages for wrongful conception is not easy because the high value of life is included in that case. So many courts opinions in foreign country and Seoul High Court decision in 1996 allow damages for the pregnancy, birthing process and sterilization costs, but refuses to allow damages for child rearing expenses. As to the range of recovery of damages for wrongful conception, one approach says that to allow damages in a suit such as this would mean that the physician would have to pay for the fun, joy and affection which plaintiff will have in the rearing and educating of the plaintiff's baby. To allow such damages would be against the dignity of the baby based on article 10 of the Constitution. However another approach says that damages are recoverable for all expenses related to child birth as well as for child rearing costs. Because the damages that the parents should bear a burden to the tort damage done is not a baby itself but child rearing costs. In other words, although the baby is healthy or not, economic burden of the parents can not be disregard. And denial of compensation for costs of child rearing may invalidate the role of liability law, grant the physician with a exemption certificate of liability. As a result, the medical field of procreation can be easily isolated from a liability of reparation. Therefore, on the liability law like the other medical malpractice action, parents who became pregnant or gave a birth by physician, wrongfully performed sterilization operation, etc. should be compensated for all damages relevant to unplanned and unwanted conception or birth as well as costs of child rearing.

• 보건교육건강증진학회지
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• 제27권4호
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• pp.83-90
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• 2010

objectives: This study was conducted to estimate medical expenditure attributable to overweight and obesity in adults with ischemic heart disease and stroke using Korea National Health and Nutrition Examination survey data and Korea National Health Corporation data. methods : The medical expenditure of ischemic heart disease and stroke related to overweight and obesity were composed of inpatient care costs, outpatient care costs and medication costs. The population attributable risk (PAR) of overweight and obesity was calculated from national representative data of Korea such as the National Health Insurance Corporation cohort data and 2005 Korea National Health and Nutrition Examination survey data. results: The medical expenditure attributable to overweight and obesity of ischemic heart disease were 97.4 billion won(74.1-122 billion won). and stroke were 64.6 billion won(33.1-98.1 billion won). Consequently, these costs corresponded to 11.4% of total medical expenditure due to ischemic heart disease and stroke. conclusion: We conclude that overweight and obesity have increased medical expenditure from ischemic heart disease and stroke in Korea. These findings provide important support for implementing overweight and obesity management strategies in Korea.

• 한국산업정보학회논문지
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• 제20권3호
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• pp.71-79
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• 2015

우리나라에서는 손상 질환에 대한 발생률 및 인구사회학적 특성에 관한 연구는 찾기 어려운 실정이어서 본 연구는 한국의료패널(2008)의 설문조사 자료와 사회 경제적비용을 추계하여 분석하였다. 특히, 사고 손상 중독 유형별 사회적 비용과 의료이용 형태에 따른 사회적 비용을 추계하였다. 향후, 손상 발생률 감소와 의료비 감소를 위한 연령, 교육, 경제소득. 사고 발생장소 등에 맞는 구체적인 예방프로그램을 개발하고 또한 지속적인 손상예방 교육이 필요하고, 우리나라 손상의 사회경제적비용을 줄이기 위한 건강보험의 효율적 운영과 개인의 참여와 사회적, 국가적 노력이 필요하다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3159-3163
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• 2012

Background: For cervical cancer the epidemiological profile is poorly known in Morocco and no data is available concerning the direct medical costs. The purpose of this work is to estimate the direct cost of medical management of invasive cervical cancer during the first year after diagnosis in Morocco. Methods: The estimation of direct costs of medical management of invasive cervical cancer during the first year after diagnosis in Morocco is based on the estimation of individual cost in each stage which covers diagnosis, treatment and follow-up during first year. The cost was estimated per patient and whole cycle-set using the costs for each drug and procedure as indicated by the Moroccan National Agency for Health Insurance. Extrapolation of the results to the whole country was used to calculate the total annual cost of cervical cancer treatments in Morocco. Results: Overall approximately 1,978 new cases of cervical cancer occur each year in Morocco. The majority (82.96%) of these cases were diagnosed at a late stage (stageII or more). The cost of one case of cervical cancer depends on stage of diagnosis, the lowest cost is $382 for stageCis followed by the cost of stageIA1 for young women (< 40 years) which is $2,952. The highest cost is for stageIV, which is $7,827. The total cost of cervical cancer care for one year after diagnosis is estimated at $13,589,360. The share allocated to treatment is the most important part of the global care budget with an annual sum of $13,027,609 whereas other cost components are represented as follows: $435,694 for annual follow-up activity and $126,057 for diagnosis and preclinical staging. 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.

• 한국병원경영학회지
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• 제5권1호
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• pp.129-155
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• 2000

This empirical study, activity-based costing, a newly introduced approach that has proved to be an improvement over the conventional costing system in product or service costing, is applied at department of clinical pathology in K university hospital. The study subjects were 233 test procedures done in clinical laboratory of K university hospital. Activity analysis was done by interview, questionnaires, and time study, and the amount of resources consumed by each activity and their costs are then traced and applied to the laboratory tests. The main purpose of this study were to compare the test costs of activity-bases costing with those of conventional costing, and test fees of medical insurance, and to provide accurate cost informations for the decision makers of hospital. The major findings of this study were as belows. 1. The cost drivers for application of activity-based costing at clinical laboratory were cases of sample collection, case of specimen, cases of test, and volume-related allocation bases such as direct labor hours and total revenue of each test. 2. The profits of each clinical laboratory fields analyzed by conventional costing were different from the profits analyzed by activity-based costing, especially in the field of Urinalysis(approximately over estimated 750%). 3. The standard full costs by conventional costing were quite different from the costs computed by using activity-based costing, and the difference is most significant with the tests of long labor time. 4. From the comparison between costs computed by using activity-based costing and medical insurance fees, some test fees were significantly lower than the costs, especially in the non-automated fields. As described in this study, activity-based costing provides more accurate cost information than does conventional costing system. The former approach is especially important in the health care industry including hospitals in which planning and controlling the costs services provided are the key to maintaining a healthy financial status for the organization. Despite the contribution of activity-based costing the economic as well as technical feasibilities of implementing such a cost accounting system in an organization must be evaluated. In the development of activity-based costing systems, an activity analysis has to be conducted to identify activities that consume resources. This involves a detailed study of the organization's logistics and accounting information systems, and it is an expensive project in itself. Besides, it can be quite difficult and time consuming to identify and trace resource consumption to a specific activity. Thus the activity-based costing system should be implemented only when the decrease in cost of error far exceeds the increase in cost of measurement. By combining activity-based costing with standard costing, health care administrators can better plan and control the costs of health services provided while ensuring that the organization's bottom line is healthy.