• Title/Summary/Keyword: Medical delivery system

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A Study on the design of the outpatient and inpatient conversion factors based on the medical expenditure budget system (진료비 예산에 기초한 외래 및 입원 환산지수 설계에 관한 연구)

  • O, Dongil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.2
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    • pp.470-478
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    • 2020
  • In this paper, a theoretical model that separates one single conversion factor into two conversion factors for both outpatients and inpatients is introduced. By using hypothetical numbers, two conversion factors and an adjustment factor were calculated. The major implications are as follows. Firstly, by introducing two conversion factors, a minimum incentive mechanism for admitting outpatients to a clinic and high risk inpatients to a hospital was installed. Secondly, the introduction of two conversion factors decreased the drive to admit outpatients to a hospital by reducing the economic benefits for the hospital. Thirdly, it is possible to make explicit contracts for several factors rather than a single conversion factor, so that it can be used as an appropriate management tool for rapidly increasing medical expenses. Finally, this research can be used to set up policy tools to establish a proper healthcare delivery system in Korea by inducing behavioral changes in healthcare institutions.

Estimation of Nursing costs for Hospitalized Patients Based on the KDRG Classification (5개 KDRG(한국형진단명기준환자군)에 대한 간호원가 산정)

  • Park, Jung-Ho;Song, Mi-Sook;Sung, Young-Hee;Ham, Myoung-Lim;Yun, Seon-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.2
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    • pp.151-165
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    • 1997
  • A cost analysis for hospitalized patients was performed based on the KDRG classification in order to determine an appropriate nursing fee under the PPS(Prospective Payment System). The data was collected from 20 nursing units of three tertiary hospitals and two secondary hospitals from August 26 to September 15, 1996. The study consisted of 148 inpatients diagnosed for lens procedures(KDRG 03900), tonsillectomy &/or adenoidectomy(KDRG 16100), Cesarean section(KDRG 37000), or vaginal delivery(KDRG 37300) without any complications. The direct or indirect nursing hours of each patients were measured. Then, direct or indirect nursing expenditures of four nursing units, operating room and delivery room were computed. Finally, the resources used including average total nursing hours, average length of stay and average nursing cost of each KDRG were estimated as follows; 1) The average total nursing hours were 640 minutes for lens procedures, 403 minutes for tonsillectomy &/or adenoidectomy, 934 minutes for appendectomy with complicated principal diagnosis, 1,094 minutes for Cesarean section and 631 minutes for vaginal delivery. Significant differences were found in average total nursing hours among hospitals. 2) The average length of stay in lens procedures were 5 days, 4 days for tonsillectomy &/or adenoidectomy, 6 days for appendectomy with complicated principal diagnosis, 8 days for Cesarean section and 3 days for vaginal delivery. All results were within normal determined by the Ministry of Health and Welfare although significant differences existed among hospitals, especially with average length of stay for leng procedures between tertiary hospitals and secondary hospitals which was greater than for those of others. 3) The average nursing cost were 87,146 Won for lens procedures, 69,600 Won for tonsillectomy &/or adenoidectomy, 128,337 Won for appendectomy with complicated principal diagnosis, 151,769 Won for Cesarean section and 85,403 Won for vaginal delivery. These costs were 7.6%, 13.0%, 13.0%, 16.0% and 22.0%, respectively, of the official price fixed by the Ministry of Health and Welfare under the prospective payment system. Research for the analysis of nursing costs according to the severity of illness for those KDRGs shoud be carried out within the period of the PPS pilot project. In addition, a proper nursing fee schedule for a new reimbursement system based upon the result of the above research should be prepared in the near future.

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Analysis of Abdominal Trauma Patients Using National Emergency Department Information System

  • Song, In-Gyu;Lee, Jin Suk;Jung, Sung Won;Park, Jong-Min;Yoon, Han Deok;Rhee, Jung Tak;Kim, Sun Worl;Lim, Borami;Kim, So Ra;Jung, Il-Young
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.116-123
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    • 2016
  • Purpose: To develop an inclusive and sustainable trauma system as the assessment of burden of injuries is very much important. The purpose of this study was to evaluate the estimates and characteristics of abdominal traumatic injuries. Methods: The data were extracted from the National Emergency Department Information System. Based on Korean Standard Classification for Disease 6th version, which is the Korean version of International Classification of Disease 10th revision, abdominal injuries were identified and abdominal surgeries were evaluated with electronic data interchange codes. Demographic factors, numbers of surgeries and clinical outcomes were also investigated. Results: From 2011 to 2014, about 24,696 patients with abdominal trauma were admitted to the hospitals annually in South Korea. The number of patients who were admitted to regional and local emergency medical centers was 8,622 (34.91%) and 15,564(63.02%), respectively. Based on National Emergency Department Information System, liver was identified as the most commonly injured abdominal solid organ (39.50%, 9,754/24,696, followed by spleen (17.57%, 4,338/24,696) and kidney (12.94%, 3,195/24,696). Conclusion: This study shows that the demand for abdominal trauma care is considerable in South Korea and most of the patients with abdominal trauma were admitted to regional or local emergency centers. The results of this study can be used as good source of information for staffs to ensure proper delivery of abdominal trauma care in trauma centers nationally.

Home - Visiting Physical Therapy (가정 방문 물리치료)

  • Lee Han-Suk;Park Don-Mork;Kim Choung-Sik
    • The Journal of Korean Physical Therapy
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    • v.8 no.1
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    • pp.91-98
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    • 1996
  • It is urgent to introduce home visiting physical therapy in order to prevent the unnecessary increase of demand and extravagance for the nation-wide execution of medical insurance and for the medical demand and supply of medical delivery system. We think that it is very important for us, as a physical therapist preparing 21 centry, to clearly undersand the necessity of home visiting physical therapy, which will be needed as the new therapeutic field in the future. When the terms for a new health and medical system, that is, useful trained-manpower, well-equipped facilities, financial and legal support, well-prepared design for this project, positive cooperation between people involved in this project and rational development of the project is held and this project is settled by sieving tile expected problems, this project will give a contribution to the promotion of national health and social welfare

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마이크로머시닝 기술의 의학 및 생물학 응용

  • 장준근;김용권
    • The Magazine of the IEIE
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    • v.24 no.10
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    • pp.63-72
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    • 1997
  • Application of MEMS to biologic system mainly categorized into bio-electronics and micro-medical systems, Bio-electronics concerns on the biocompatible electronic device, in-vivo sensors, the sensors based on biological materials, biological materials for electronics and optics, the concepts and materials Inspired by biology and useful for electronics, the algorithm inspired by biology, artificial sense, and the biologic-inorganic hybrids. Micro-medical systems are utilited into the drug delivery systems, micro patient monitoring systems, micro prosthesis and artificial organs, cardiology related prothesis, analysis systems, and the minimal invasive surgery tools based on the m icrom achining technology.

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Medical Laser (의료용 Laser)

  • 김덕원
    • Korean Journal of Optics and Photonics
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    • v.1 no.1
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    • pp.107-113
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    • 1990
  • Characteristics and applications of three major types of lasers are discussed. They are chemical-metabolic, thermal destructive, and nonthermal mechanical lasers. The thermal destructive lasers ($CO_2$, Argon, and Nd:YAG) are especially explained in detail with regard to energy density, wavelength, fluence, stage of thermal destruction, and advantages of laser surgery. Excimer and Q-swiched lasers are discussed as nonthermal mechanical ones. Delivery system, optical fiber and articulated arm, is also discussed. Finally, recent advancements of medical laser are included in the conclusion.

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Synthesis, Characterization and in vitro Anti-Tumoral Evaluation of Erlotinib-PCEC Nanoparticles

  • Barghi, Leila;Asgari, Davoud;Barar, Jaleh;Nakhlband, Aylar;Valizadeh, Hadi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10281-10287
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    • 2015
  • Background: Development of a nanosized polymeric delivery system for erlotinib was the main objective of this research. Materials and Methods: Poly caprolactone-polyethylene glycol-polycaprolactone (PCEC) copolymers with different compositions were synthesized via ring opening polymerization. Formation of triblock copolymers was confirmed by HNMR as well as FT-IR. Erlotinib loaded nanoparticles were prepared by means of synthesized copolymers with solvent displacement method. Results: Physicochemical properties of obtained polymeric nanoparticles were dependent on composition of used copolymers. Size of particles was decreased with decreasing the PCL/PEG molar ratio in used copolymers. Encapsulation efficiency of prepared formulations was declined by decreasing their particle size. Drug release behavior from the prepared nanoparticles exhibited a sustained pattern without a burst release. From the release profiles, it can be found that erlotinib release rate from polymeric nanoparticles is decreased by increase of CL/PEG molar ratio of prepared block copolymers. Based on MTT assay results, cell growth inhibition of erlotinib has a dose and time dependent pattern. After 72 hours of exposure, the 50% inhibitory concentration (IC50) of erlotinib hydrochloride was appeared to be $14.8{\mu}M$. Conclusions: From the obtained results, it can be concluded that the prepared PCEC nanoparticles in this study might have the potential to be considered as delivery system for erlotinib.

Cost Analysis of Nursing Services in the Delivery Room Using Activity-Based Costing (활동기준원가시스템을 이용한 분만실 간호활동 및 원가 분석)

  • Kim, In-Sook;Kang, Kyeong-Hwa;Lee, Hae-Jong;Kim, Mi-Jung;Kang, Su-Jin;Joo, Young-Mi
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.1
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    • pp.17-29
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    • 2002
  • The purpose of this study was to examine the application of the Activity-based Costing(ABC) system to analyze the cost of nursing services in the delivery room in a major medical center.The results of this study are as follows;1. In order to calculate the cost of nursing activities, 67 activities of staff nurses on a delivery room were identified and classified as direct nursing activities(45.2%), the indirect activities(32.1%), general management activities(13.9%) and others(8.8%).2. Nursing cost in the delivery room was classified into activity cost(29.9%) and common cost(70.1%). Activity cost involved direct activity cost of staff nurses. The common costs were categorized into indirect activity & general management cost of staff nurses, management cost of the head nurse and activity cost of assistants.3. The final cost objects of nursing services in the delivery room were nursing service for women who had normal vaginal deliveries and nursing service for women who had preterm labor.The total cost of nursing service for a woman who had a normal vaginal delivery was 165,710 won (100.0%). The cost incurred through direct activity cost of staff nurses(58,242 won, 35.1%), indirect activity & general management cost of staff nurses (55,643 won, 33.6%), management cost of head nurse (16,211 won, 9.8%), activity cost of assistants (35,614 won, 21.5%).If the number of days of hospitalization was presumed to be 14 days, the total cost of nursing service for woman who had preterm labor would be 1,845,901 won (100.0%). The cost incurred by direct activity cost of staff nurses in the activity cost (341,349 won, 18.5%), indirect activity & general management cost of staff nurses in the common cost(779,002 won, 42.2%), management cost of head nurse(226,954won, 12.3%), activity cost of assistants in the common cost(498,596 won, 27.0%).In this study, the cost of the nursing services in the delivery room was calculated based on the ABC system. The results of this study showed that resources are assigned to the nursing activities in the delivery room and the mechanisms for assigning the cost of activities for nursing services.

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A Critical Analysis of the Perspectives on Health Care Reform in Korea (의료개혁 논의의 비교분석)

  • 조병희
    • Korean Journal of Health Education and Promotion
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    • v.15 no.2
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    • pp.217-233
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    • 1998
  • This paper analyzed four different perspectives on health care reform in Korea in terms of the basic values, formulated problems and reform plans, implementation methods, and supporting groups. The medical security plan was insisted by social security specialists and social activists focusing on the integration of medical insurance coops in order to enhancing equity and right of the people. However, its perspective was limited to promoting security instead of reforming health care system. The government proposed the health care reform plans in 1994 and in 1997, focusing on promoting efficiency by remedying many problems in health care delivery system. However, its implementation was not successful due to the lack of organizational and financial supporters. Recently, two opposite proposals were issued. The market reform plan paid attention to revitalizing the market function to promoting efficiency by allowing hospitals to treat private patients instead of applying the medical insurance regulation. The government reform plan focused on intensifying governmental planning and intervention in the health care sector in order to removing inefficiency and promoting equity with the supports of social activists and labor unions. Finally, this paper proposed an alternative plan to promote harmonious social relationship between actors in the health care system.

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A Study on Improvement of Emergency Medical Service System in Kwangju (광주광역시 응급의료체계 개선에 관한 연구)

  • Lee, Young-Hyun
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.2
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    • pp.29-38
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    • 2005
  • The purpose of this study was to provide the basic data for improvement of Emergency Medical Service System in Kwangju. The EMSS can be defined as the complete chain of human and physical resources that provides patient care in cases of sudden illness and injury. To provide effective emergency care through the EMSS in a region, the issue of training especially as it relates to EMT in EMSS delivery is more important than emergency medical equipment and facilities for pre-hospital emergency care. The transport of emergency medical patients carried out almost by 119 Emergency Medical Services. But out of all the employees at 119 EMS only 19.0% have graduated with a major in Emergency Medical Technology. It would seem prudent then that the graduates of EMT programs should gradually replace employees working at 119 EMS that do not have an EMT degree to ensure the best possible pre-hospital care for emergency medical patients. Therefore it can be expected that in the future there should an enormous demand for qualified EMT professionals to meet the growing needs for a superior level of emergency medical care for civilian.

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