• Journal of Preventive Medicine and Public Health
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• 제55권4호
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• pp.389-397
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• 2022

Objectives: This study examined the effect of out-of-pocket (OOP) payment reduction on the potential utilization of low-value magnetic resonance imaging (MRI) across income groups. Methods: We conducted an experimental vignette survey using a proportional quota-based sample of individuals in Korea (n=1229). In two hypothetical vignettes, participants were asked whether they would be willing to use MRI if they had uncomplicated headache and non-specific low back pain, each before and after OOP payment reduction. To account for the possible role of physician inducement, half of the participants were initially presented with vignettes that included a physician recommendation for low-value care. The predicted probability, slope index of inequality (SII), and relative index of inequality (RII) were calculated using logistic regression. Results: Before OOP payment reduction, the lowest income quintile was least likely to use low-value MRI regardless of physician inducement (36.7-49.6% for low back pain; 30.5-39.3% for headache). After OOP payment reduction, almost all individuals in each income quintile were willing to use low-value MRI (89.8-98.0% for low back pain; 78.1-90.3% for headache). Absolute and relative inequalities concerning potential low-value MRI utilization decreased after OOP payments were reduced, even without physician inducement (SII: from 8.15 to 5.37%, RII: from 1.20 to 1.06 for low back pain; SII: from 6.99 to 0.83%, RII: from 1.20 to 1.01 for headache). Conclusions: OOP payment reduction for MRI has the potential to increase low-value care utilization among all income groups while decreasing inequality in low-value care utilization.

• 보건행정학회지
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• 제14권2호
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• pp.78-98
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• 2004

The purpose of this study was to categorize the contribution evasion and develop the expected models for contribution arrears in National Health Care System. The modified logistic regression model in non-payments was used as logistic regression model based on the statistical method. By using this model, we arranged non-payment types and typical branches those are appeared by statistical technique. First fact, sex and age branches those are able to take a part in economy had effect mostly. Also they had difference in non-payment probability by existence of their incomes and property. Especially people who didn't have their own house and car were appeared in high non-payment probability, disease and reduction characteristic(rare diseases, reduction of seniors, handicaps, numbers of medical treatments) didn't effect much in probability. The reason for some characteristic of non-payment which is higher than the correct threshold value of Logistic Regression Model (a suggested model for predicting non-payment)'s distribution of probability was mostly moral hazard. Living difficulty was the bigger reason for non-payment, but moral slackening was the bigger reason for non-payment. But it is careless to decide that moral hazard is just the reason, there is a necessity to examine on the side of sociology based in family. By the reason, the member's non-payment reason can be classified by economy, population, and psychology, but there was a comprehension that losing of work desire could be one reason. So we analyzed informations for composition of family of members. In conclusion, we grasped that family conflict makes non-payment and conversion of member in the National Basic Livelihood Protection System difficult.

• Journal of Preventive Medicine and Public Health
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• 제34권4호
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• pp.347-353
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• 2001

Objectives : To determine the impacts of Diagnosis-Related Groups/Prospective Payment System (DRG/PPS) on the quality of care in cases of Cesarean section and to describe the policy implications for the early stabilization of DRG/PPS in Korea. Methods : Data was collected from the medical records of 380 patients who had undergone Cesarean sections in 40 hospitals participating in the DRG/PPS Demonstration Program since 1999. Cesarean sections were peformed in 122 patients of the FFS(Fee-For-Service) group and 258 patients of the DRG/PPS group. Measurements of quality used included essential tests of pre- and post-operation, and the PPI(Physician Performance Index) score. The PPI was developed by two obstetricians. Results : Univariate analysis demonstrated significant differences in PPI scores according to the payment systems. With respect to the mean of PPI scores, a higher score was found in the DRG/PPS group than in the FFS group. However, the adjusted effect did not show significant differences between the FFS group and the DRG/PPS group. Conclusion : This study suggested that the problem of poor quality may not be related to the implementation of DRG/PPS in Cesarean section. However, this study did not consider the validity and reliability of the process measurement, and it did not exclude the possibility of data emission in medical records.

• 산업경영시스템학회지
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• 제33권4호
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• pp.130-137
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• 2010

This paper analyzes the main factors affecting user selection of a small-sum electronic payment system using survey data of 396 users. Several findings emerge. First, users consider three pillars and eight factors in adopting a new system : system features(stability, security, and flexibility), transaction cost(payment commission and settlement period), and financial capability of provider(stability of financial structure, risk management capability, and funding capability). Second, the stability of the financial structure of the system provider is the most important factor to user acceptance of a new e-payment system. Users tend to consider uncertainty risk more seriously than transaction cost. This reflects the reality that electronic payment system service industry has not fully fledged yet. Third, some moderating effects exist according to payment methods and business usages. As for payment methods, speedy settlement cycle for wired/wireless phone payment, system stability for credit card and account transfer payment, and security for advance payment means are crucial factors. As for business usages, the stability of financial structure for online game content, system stability for music and video content, proxy payment commission for e-learning content, flexibility of the payment system for digital adult content, and security for public services are decisive ones.

• 디지털융복합연구
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• 제4권2호
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• pp.127-142
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• 2006

This paper uses a Mobilans case based on software system to derive the results of our study. Recently, the mobile phone payment entered its matured stage and became most frequently used payment method in all internet sites. And, in order to prepare for the future ubiquitous market, every mobile phone payment methods has different speed of development, market status and target segments in the market. This paper also discusses about the background and current status of Korean mobile phone payment market using SMS(Short Message Service) to purchase items on internet which is growing sharply every year. Also, we try find the key factors to succeed in this growing market. In addition to safety, delayed payment and the immediateness for use of mobile phone, we also suggest that a highly developed hardware system is an additional factor under the increased demands for the convenience with various applications.

• 보건행정학회지
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• 제30권2호
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• pp.178-184
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• 2020

Background: Korea set up a new diagnosis-related group as a demonstration project in 2009. The new diagnosis-related group was reformed in 2016. The main purpose of the study is to identify the effect of reform on coverage of national health insurance. Methods: This study collected inpatient data from a hospital that contains medical information and cost from 2015 July to 2016 June. The dependent variable was the coverage of national health insurance. The dependent variable was divided by total, internal medicine partition, surgical partition, and psychiatric partition. To analyze the effect of the reform, this study conducted an interrupted time series analysis. The final sample included 23,695. Results: The health insurance coverage of internal medicine has the highest, followed by surgery and psychiatry. The health insurance coverage of bundle payment is higher than that of unbundled payment. The proportion of bundled payment and non-benefit decreased and the proportion of unbundled payment increased. The coverage of national health insurance significantly increased after policy reform in internal medicine partition (p-value=0.0356). Conclusion: The results of the study imply that policy reform enhanced the coverage of national health insurance in internal medicine. The government needs to monitor side effects such as an increase of unbundled payment.

• 융합보안논문지
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• 제15권2호
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• pp.25-31
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• 2015

정보통신의 발전과 금융서비스의 첨단화로 전자적 방식의 지급수단이 증가하고 혁신기술을 보유한 IT비금융권의 지급결제 참여가 활발해지고 있다. 시대적 요구에 부합하기 위해 정부에서도 최근 지급결제 간소화와 비금융기관 진출 여건 마련 정책을 발표한 바 있다. 그러나 전자금융 침해사고 빈도가 높은 국내 환경에서 안전성 담보가 없는 간소화 정책과 무분별한 비금융기관의 참여 확대는 보안과 책임문제에 있어 많은 문제점을 내포하고 있다. 당국에서는 비금융 참여기관의 요건을 강화하는 등의 조치를 마련하고 있으나, 강제성에 있어 민간차원의 자율에 맡기고 있는 실정이다. 본 연구는 정부의 전자상거래 규제완화 정책에 부응하여 지급결제시스템의 핀테크 활성화를 유도하기 위한 문제점과 해결방안을 검토해 보려는 것이다. 이를 위해 기존 지급결제서비스에 혁신기술을 접목함에 있어 발생할 수 있는 안전성 문제와 비금융회사의 법적 지위에 따른 책임 문제 등을 짚어보고 바람직한 법제 개선 방향을 제안하고자 한다.

• 한국디지털정책학회:학술대회논문집
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• 한국디지털정책학회 2004년도 춘계학술대회
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• pp.545-558
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• 2004

Payment Systems is one of critical infrastructures, which is increasingly dependent on IT. Failure to provide the payment services can bring disaster to national economy, which is the reason why business continuity of payment system receive much attention these days. Payment Systems are complex systems, which consist of multiple players: central bank, commercial banks, clearing house. The main purpose of this paper is to propose some business continuity strategies for the payment systems. First, in order to provide financial stability, this paper clarifies the concepts of business continuity plan(BCP). Second, this paper illustrates the processes to come up with business continuity strategies for the payment systems based on risk analysis and business impact analysis. Business continuity strategies are proposed in terms of two dimensions: vertical and horizontal.

• 국제학술발표논문집
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• The 5th International Conference on Construction Engineering and Project Management
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• pp.181-187
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• 2013

The construction market condition is getting worse because of global constructions slow down, low profit, market contraction and so on. For these reason, most construction companies depend on public construction projects which possible to protect construction fee, known as progress payment, by laws. Despite this law, problems of progress payment are constantly occurring and it has been main factors that hinder the construction cost's cash-flow in construction project. To solve this problem, many researchers suggested various solutions but most of solutions were focused on specific target as owner, general contractor, and subcontractor. So, most of solutions were insufficient consider about interaction between contractors. Because of these reasons, it was hard to reflected policy. This research aimed to use system dynamics to develop the model for the application and payment based on the regulations and papers. Also, performed a developed model's verification based on progress payment regulation's basic objectives.

• 보건행정학회지
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• 제29권1호
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• pp.40-48
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• 2019

Background: As of July 2015, per diem payment was changed from fee for service Therefore, this study aims to analyse changes in medical charges and medical services before and after enforcement of the palliative care, targeting palliative care wards in a general hospital, and provide basic data needed for development of per diem payment. Methods: The subjects of the study were a total of 610 cases consisting of 351 patients of service fee who left hospital (died) from July 2014 to June 2016 and 259 ones of per diem payment at Chosun University Hospital in Gwangju Metropolitan City. Results: The results are summarized as follows. First, after the palliative care system was applied, benefit medical service charges and insurance increased significantly (p<0.001). As benefit medical service charges increased, benefit private insurance payment increased significantly (p<0.001). Second, after the per diem payment was applied, total private insurance payment to medical institutes decreased significantly (p=0.050) and non-benefit also decreased significantly (p=0.001). Conclusion: It is suggested that additional rewards in the obligatory palliative care items should be continuously remedied and monitored to provide good quality hospice palliative care.