• Journal of Chest Surgery
• /
• v.49 no.sup1
• /
• pp.37-43
• /
• 2016

Background: While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. Methods: After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected. Results: The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040-an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309-an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario. Conclusion: Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time, effort, and resources; therefore, by analyzing the various factors affecting the supply of cardiovascular surgeons, an active intervention of policies can be prescribed for the areas that have failed to meet the appropriate market distributions.

• Journal of the Korean Association of Geographic Information Studies
• /
• v.23 no.3
• /
• pp.161-173
• /
• 2020

This study analyzed local imbalances in the supply and demand of emergency medical services in Busan using the 119 emergency activity reports of the Busan Fire & Disaster Headquarters. The data for EMS activity reports in 2017 was converted into Jimgyegu units. The spatial distribution of the indicators representing the local imbalance of emergency demand and supply (number of reports, number of reports relative to the population, average coefficient of variation and outlier of on-site arrival time, and number of dispatches outside the jurisdiction) was analyzed using Hotspot analysis of GIS spatial statistics analysis. As a result of the analysis, the hot spot area and the cold spot area where both supply and demand of emergency services are concentrated were clearly distinguished. This means that the supply and demand of emergency services in Busan are locally unbalanced. In particular, there was a difference in the demand and supply of emergency services in the original downtown and its surrounding areas, and in the outskirts of Busan.

• Journal of Families and Better Life
• /
• v.21 no.1
• /
• pp.73-89
• /
• 2003

The goal of this study was to estimate the knowledge on the patient about treating and attitude about their right to know and how they practice. That is the study seek to find how much they claim about their right to know and how they evaluate it. Additionally describe how much the patient carry on their right to know and find out that of each level's associations. This main Purpose of the study was to increase patient's right to know during in medical services. Socio-demographic variables, personal service variables and other used variables which levels of consumers knowledge, demand, evaluation and about right to know on practice level were analyzed statistically. For this purpose, the subjects of this study were consumers who had experienced medical services. The survey was conducted on 551 Korean aged in off-line by self-administered questionnaires. Final analyzed sample sizes are 551. The regression, ANOVA, t-test and other descriptive analyses were used. The obtained results were as When the consumers were estimated the level of Knowledge, the degree of respondent's level was middle state. The level of demand showed low tendency but their practice level was relatively high. On the other hand, consumer's demand for the patient's right to know was very high. The level of knowledge, demand, evaluation have affected positively to the level of consumers practices. Based on empirical research, the statistics of consumers' knowledge level was significant to other variables and effecting highly. It was recommended consumer education should be provided effectively to increase protecting their right.

• Perspectives in Nursing Science
• /
• v.6 no.1
• /
• pp.67-76
• /
• 2009

Recently, small and medium-sized hospitals which are located in rural areas have many difficulties in securing high quality nurses. That is because working environments for nurses in small and medium-sized hospitals in rural areas are poor compared with those of big hospitals in urban. As a result, the migration of nurses from small and medium-sized hospitals in rural areas to big hospitals in urban is continuously happening. In general, big hospitals provide nurses with high level of salary and fringe benefits. To prevent the migration of nurses, chief executive officers of small & medium hospitals in rural areas have been interested in improving nurses' working conditions including wages. Also, they have raised nurses' salary and improved working conditions. But, basically these individualized efforts have some limit. In connection with this, medical interest groups have produced various voices in terms of interpretation and solutions for these issues. However, from the future perspectives, it seems evident that two approaches for both manpower supply and demand plans of nurses are necessary. They should contain not only accurate estimation of the supply-demand of nursing manpower but also the improvement of working conditions and wages of nurses. Estimation of nursing manpower supply-demand depends on the standards and criteria being used. Supply and demand may be met or not in accordance with the points emphasized on the decision. In the articles, issues regarding nursing manpower, levels of salary, other working conditions and social support system for child care are discussed. According to Joe's report (2005), most health institutions did not meet the guidelines of nurse staffing in Medical Law. The wages of nurse vary on every hospital and there is a big difference in wages' range. The average starting salary for a nurse is 22 million won a year. In case of tertiary hospitals, it reaches up to 30 million won a year. Nurse as a profession should have a strong responsibility and should take care of the patients for 24 hours with three working shifts. Also, most of them are female who have the burden of child rearing. Therefore, it is suggested to increase the salary, to provide comfortable working conditions, and to have social support system for nurses with household affairs.

• Journal of Korean Ophthalmic Optics Society
• /
• v.13 no.4
• /
• pp.25-30
• /
• 2008

Purpose: In this paper, we have analyzed the problems of the Oh's report which is used to the basic data for supply and demand of medical technicians and studied a proposal for improvement to control system and supply and demand of korean optometrists. Methods: We have analyzed errors of Oh's report including supply and demand for medical technicians and management policy, expecting number for future optician, inaccurate estimation by limited data (employment rate, retirement rate, mortality rate) and an incorrect method of measurement for future supply and demand. Results: Oh's report showed the 18% error for estimation of supply which exclude the irregular entrance students. The estimation of supply was calculated by graduation rate 62.6% (college and University of Technology are 78.9% and 85.98% respectively), employment rate 65.8% (the average employment between 2002 and 2007 is 73.96%) and retirement rate is 2.3% (the retirement of pharmacists is 1.3%) but it showed the significant differences to objective data. For estimate the suitable ratio of optometrists to the population, the ratio use of medical facilities by an age group was used, and suggested spectacle wearers 1,280 persons (populations 2,928 persons) per optometrist but the different from reference of Germany (4,706 persons), America (1,789 persons) and Korea (1,825 persons/an optometrist) are applied to estimation on supply. This report applied the low employment rate and argued that maintain the present situation, but claimed that utilize unemployment persons. The above result has induced double weighting effect on estimation of supply. Conclusions: To solve the related problems of supply and demand, we have to make a search for exact data and optimum application model, have to take an example of nation similar job category as Germany and the research result of the job satisfaction into consideration. After we get the integrated research result, we must carried out the policy with fairness and balance for the estimation of supply and demand. Therefore exact research is required prior to beginning policy establishment, government and related group have to make a clear long-term plan and permanent organization for medical technician to establish supply and demand of medical technician.

• Health Policy and Management
• /
• v.1 no.1
• /
• pp.136-152
• /
• 1991

The study was conducted to project supply and demand of the physicians from year 1991 to year 2010 based on the analysis of supply and demand of the physicians up to year 1989. Results of the study will provide information for the physicians manpower planning of the 7th 5-year Economic Social Development Planning(1992-1996) and contribute to the overall health manpower planning for the 21the century. It is projected that physician will be oversupplied from the very near future based on the current productivity or underestimated based on the optimal productivity. Thus, it is desirable not to change size of training and education during the 7the 5-year planning period and re-examine the status of the physician manpower at the end of the 7th 5-year period taking into consideration medical services utilization pattern, patients' satisfaction, and physicians' productivity.

• Journal of Society of Preventive Korean Medicine
• /
• v.17 no.1
• /
• pp.149-162
• /
• 2013

Objectives : This study was conducted to estimate the future demand and supply of physicians for korean medicine from 2016 year to 2026 year in order to make an adequate manpower policy in a way of keeping a balance between demand and supply. Methods : Baseline projection method and trend analysis(a polynomial log power equation model) were used in the estimation of future supply and demand respectively. We used data about the amount of oriental doctors from Ministry of Health and Welfare Statistics Yearbook and the treatment days from HIRA Statistics Yearbook. Results : It was projected that the total number of physician of Korean medicine will be 25,178 registered and 18,967 available in clinical setting. According to polynomial equation model which explained the trend of demand and had the highest score of $R^2$ among the equation models, 3,800~5,600 physician in Korean medicine will be oversupplied in 2016 year, 9,000~10,700 physicians in 2021 year and 15,700~17,000 persons in 2026 year depends on annual working days which is 265days, 255days or 239days. Log equation model also showed that overall excess supply of physician manpower in Korean medicine. Conclusions : Alternative manpower policies for Korean medicine doctors should be implemented in a way of both dwindling supplies and growing demand in Korean medical service in terms of Korean medical services utilization and improving physician's productivity.

• Journal of Information Technology Services
• /
• v.10 no.3
• /
• pp.265-284
• /
• 2011

The purpose of this study is to analyze the demand for telemedicine and telehealthmanagement services, which are key elements of home based u-health. The conjoint analysis, which is a conventional method for demand analysis for newly introduced products, is employed, utilizing the survey data on 500 seoul citizens. Further, multivariate probit model is used to estimate the demand. The result shows that the demand for telemedicine services is greater than that of telehealthmanagement services. Further, home-based u-health services will play a role as a complementary for face-to-face medical treatments, rather than a substitute. Meanwhile, the demand for home-based u-health services is found to be very sensitive to price.

• Health Policy and Management
• /
• v.2 no.2
• /
• pp.221-237
• /
• 1992

The reasons for cost inflation in medical insurance expenditure are classified into demand pull inflation and cost push inflation. The former includes increase in the number of beneficiaries and utilization rate, while the latter includes increase in medical insurance fee and the charges per case. This study was conducted to analyze sources of increases of expenditure in medical insurance demonstration area by the period of 1982-1987 which was earlier than national health insurance and the period of national health insurance(1988-1990). The major findings were as follows: Medical expenditure in these areas increased by 9.4%(15.1%) annually between 1982 and 1990 on the basis of costant price(current price) and for this period, the yearly average increasing rate of expenses for outpatient care[10.5%(15.8%)] was higher than that of inpatient care [7.3%(12.6%)]. Medical expenditure increased by 6.3%(8.9%) annually between 1982 and 1987, the period of medical insurance demonstration, while it increased by 10.7%(18.9%) after implementing national health insurance(1988-1990). Medical expenditure increased by 35.9%(45.9%) between 1982 and 1987. Of this increase, 115.2%(92.1%) was attributable to the increase in the frequencies of utilization per beneficiary and 61.0%(68.1%) was due to the increase in the charges per case, but the expenditure decreased by 76.2%(60.2%) due to the reduction in the number of beneficiaries. Beteen 1988 and 1990, the period of national health insurance, medical expenditure increased by 21.2%(41.4%). Of this increase, 87.5%(46.4%) was attributable to the increase in the frequencies of utilization per beneficiary and 52.4%(73.4%) was due to the increase in the charges per case, and of the increase in the charges per case, 69.6%(40.8%) was attributable to the increase in the days of visit per case. Medical expenses per person in these areas increased by 78.2%(89.0%) between 1982 and 1987. Of this increase, 76.6%(69.1%) was attributable to the increase in the frequencies of utilization per beneficiary and 23.4%(30.9%) was due to the increase in the charges per case. For this period, demand-pull factor was the major cause of the increase in medical expenses and the expenses per treatment day was the major attributable factor in cost-push inflation. Betwee 1988 and 1990, medical expenditure per person increased by 31.2%(53.1%). Of this increase, 60.8%(37.2%) was attributable to the demand-pull factor and 39.2%(62.8%) was due to the increase in the charges per case which was one of cost-push factors. In current price, the attributalbe rate of the charges per case which was one of cost-push factors was higher than that of utilization rate in the period of national health insurance as compared to the period of medical insurance demonstration. In consideration of above findings, demand-pull factor led the increase in medical expenditure between 1982 and 1987, the period of medical insurance medel trial, but after implementing national health insurance, the attributable rate of cost-push factor was increasing gradually. Thus we may conclude that for medical cost containment, it is requested to examine the new reimbursement method to control cost-push factor and service-intensity factor.

• Health Policy and Management
• /
• v.29 no.4
• /
• pp.482-495
• /
• 2019

Background: An important function of the regional public hospital is to satisfy the basic medical needs of the community through the stable provision of high-quality medical services. The purpose of this study was to identify the relevance index (RI) of the regional public hospital and to identify the factors that affect the RI. Methods: Data were obtained from the 2017 regional public hospital operation evaluation report and 2017 medical monitoring report for vulnerable area. RI of the regional public hospital was a dependent variable, and multiple regression analysis was performed with observed variables of medical supply-demand condition, medical supply, and medical supply structure. Direct effects and indirect effects were confirmed by the analysis of structural equation models (SEM) to see if there were mediating effects. Results: The RI was 13.1%, and the average of all percentage refined diagnosis-related group (RDRG) was 29.4%. Factors affecting RI were medical supply-demand conditions, medical supply, and medical supply structure. As a result of multiple regression analysis, RI was higher when high percentage RDRG of the regional public hospital (t=4.117, p<0.05), the size of regional public hospital location (t=-2.554, p<0.05), and the population of regional public hospital location (t =-2.415, p<0.05) were smaller. The results of the SEM analysis show that the higher the medical supply-demand conditions, the more direct effect of decreasing the RI and the indirect effect of decreasing the effect of reduction through the medical supply (direct effect=-1.322, total effect=-0.573, p<0.01). The higher the medical supply structure, the more direct effect on the RI (direct effect=1.047, p<0.05) and the higher the medical supply, the more indirect effect of RI through the medical supply structure (total effect=direct effect=0.619, p<0.05). Conclusion: It has been confirmed that the provision of medical services can affect the RI the regional public hospital which should be considered in carrying out future policies.