• Title/Summary/Keyword: Service Review

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Assessment of Appropriateness of Criteria for Insurance Coverage on Systemic Therapy used in Renal Cell Carcinoma (신세포암에 사용되는 전신 항암요법의 요양급여기준에 관한 고찰)

  • Kim, Jeong-Yeon;Park, Eun-Ji;Bae, Min-Kyung;Yoon, Jeong-Hyun
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.4
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    • pp.319-331
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    • 2011
  • Purpose: The purpose of this study is to evaluate current criteria for insurance coverage by Health Insurance Review & Assessment Service (HIRA) on the systemic therapy used in the treatment of advanced or metastatic renal cell carcinoma (RCC), by reviewing all available clinical evidences including a variety of clinical practice guidelines. Methods: We searched clinical databases and collected data from published phase 1 through 3 randomized clinical trials on all systemic therapies used in RCC, including novel targeted therapies. Additionally, current clinical practice guidelines on the management of kidney cancer or RCC were reviewed. Based on the collected data we evaluated the appropriateness of the HIRA criteria for insurance coverage on the systemic therapy of RCC whether they are evidence-based and up to date. Results: On the basis of the collected data we concluded that there was a need for a revision in HIRA criteria for systemic therapy of RCC. Despite recent emerging therapeutic advances and changes in therapeutic strategies of management of RCC, some of anticancer regimens were inappropriately listed even though they were not proven to provide efficacy or safety superior to those of other therapies. We thus proposed an updated recommendation based on current clinical evidences. Conclusion: Systemic therapy of RCC is being rapidly changed with the advancement of understanding of the molecular biology of cancer. Consequently newly developed targeted therapies are becoming the standard therapy in the management of medically or surgically unresectable advanced or metastatic RCC. To provide effective and safe therapy to patients with RCC, the criteria for insurance coverage should be made carefully taking into consideration of most up-to-date and high-quality clinical evidences, and should be continuously reviewed so as to reflect evidence-based clinical practice.

Comparative Analysis of Prescription for Splitted Tablet using the HIRA-NPS (Health Insurance Review & Assessment Service-National Patient Sample) (건강보험심사평가원의 전체환자데이터셋(HIRA-NPS)자료를 이용한 정제의 분할 처방 현황 분석)

  • Kwon, Hyeok-Jin;Jang, Kyoung-Won;Ha, Dongmun
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.4
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    • pp.231-237
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    • 2019
  • Objective: The aim of this study was to analyze the status of split tablet prescription in South Korea. Methods: We conducted this analysis using 2016 National Patient Sample data from the Health Insurance Review and Assessment Service. We computed split tablet prescription rates by sex and age and determined which medicine and medical specialties had the highest split tablet prescribing rates. Results: The proportion of prescriptions that included split tablets was 15.6% (n=6,687,35). The proportion of prescriptions that included split tablets was higher for females (56.7%) than for males (43.3%), while that of prescriptions including split tablets versus total prescriptions for each sex was higher for males (16.4%) than for females (14.9%) (p<0.001). In the age group under 19 years, the proportion of prescriptions including split tablets (53.7%) was more than half of the total. The highest tablet splitting rate was found to be 89.9% for formoterol fumarate (40 ㎍), and pseudoephedrine hydrochloride (60 mg) had the highest number of prescriptions. Pediatrics (65.6%) was the medical field with the highest rate of split tablet prescription. Conclusion: Split tablets were most prescribed to pediatric patients. To minimize the use of split tablets, it is necessary to develop lower dose tablets and establish a policy that promotes prescription of these lower-dose tablets.

Indicators and Qualitative Assessment of Lung Cancer Management by Health Insurance Review and Assessment Service (HIRA) of Korea in 2015

  • Yeo, Chang Dong;Lee, Myoung Kyu;Lee, Seung Hyeun;Kim, Eun Young;Lee, Ik Jae;Park, Heae Surng;Chang, Yoon Soo
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.1
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    • pp.19-28
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    • 2018
  • Cancer is the leading cause of death in the Republic of Korea and cancer death accounts for 27.8% of the total deaths, which is not only a social issue but also a concern for the public. Among the cancer death rates, lung cancer mortality account for 34 deaths per 100,000 populations, making it the number one cancer death rate. In a preliminary report on cancer death in 2012, the lung cancer mortality ratio showed the regional variation indicating that there were differences in the qualitative level and the structure among the medical care benefit agency and in the assessment of the treatment process. Therefore, the Health Insurance Review and Assessment Service (HIRA) had begun evaluation of the assessment of lung cancer treatment since 2014 to improve the quality of lung cancer care through evaluation and feeds back the results of lung cancer care process. In this report, authors described the current Indicators for the lung cancer adequacy assessment proposed by HIRA and results of the evaluation reported in 2017.

Factors Associated with the Long-Stay Admissions in Geriatric Hospitals - Focused on Dementia's Inpatients - (요양병원 치매노인의 장기입원 관련 요인)

  • Lee, Yun Jin;Lee, Sang Gyu;You, Chang Hoon;Kim, Bomgyeol;Kim, Tae Hyun
    • Korea Journal of Hospital Management
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    • v.25 no.3
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    • pp.29-37
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    • 2020
  • Purposes: The purpose of this study was to identify the factors related to the long-stay hospitalization of dementia patients aged 65 years or older who had received inpatient care at geriatric hospitals according to the minute facility characteristics and patient features. Methodology: This study was conducted on 317,353 cases of 1,512 geriatric hospitals using the Health Insurance Review and Assessment Service dataset. The data collected were processed using the SAS Enterprise Guide 4.3 for descriptive statistics, the chi-square test, and the binary logistic regression analysis. Findings: As a result of the study, in the facility characteristics of geriatric hospitals, the long-stay hospitalization of the aged with dementia were found to be related to the type of facility establishment, the number of hospital beds, the number of medical specialists, the number of nursing personnel, and the number of geriatric hospitals by region and province. In the personal features of patients, the long-stay hospitalization was found to be associated with the gender, age, insurance, and the patient classification groups. Practical Implication: Considering the results of this study, it seems that securing the sufficient medical personnel in a geriatric facility, providing the good quality medical services, and preparing the appropriate discharge plan can reduce the unnecessary long-stay hospitalization and spend the medical expenses for the older patients.

Factors influencing the composite quality score from the quality assessment program for long-term care hospitals (요양병원의 입원급여 적정성 평가 결과에 미치는 영향 요인 분석)

  • Lee, Sang-Kab;Seol, Jin-Ju;Lee, Kwang-Soo
    • Korea Journal of Hospital Management
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    • v.25 no.3
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    • pp.78-86
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    • 2020
  • Purposes: This study purposed to identify factors influencing the composite quality score from the quality assessment program for long-term care hospitals Methodology: The study variables was obtained from HIRA(Health Insurance Review and Assessment Service): the composite quality scores and hospital variables such as number of doctors, nurses, beds, medical technicians, medical equipments, administrative region, ownerships from 3rd (2010) to 7th (2018) quality assessment program. National Statistical Portal(www.kosis.go.kr) provided the number of senior citizens aged over 65 in city·county·district area. SAS 9.4 was used for the data processing and used to analyze the data. Findings: The results showed that composite quality score increased past 9 years. Hospital variables such as number of doctor, nurse, medical technicians, bed and public hospitals had significant positive relationship with the composite quality score. Administrative region(district) showed higher scores compare to that of city. Compare to the score of quality assessment year(2010), as the assessment year move to 2012, 2013, 2015, 2018, results showed higher significant positive coefficients. Practical Implication: Continuously improve the performance of long-term care hospitals, current quality assessment program are needed to update their system such as adopting indicators measuring the service process, or compensating the cost for quality assessment program. It will enable to provide more reasonable and accurate performance assessment scores.

A Study on Technology Commercialization in the 4th Industrial Revolution (제4차 산업혁명의 기술 상용화에 관한 연구)

  • Sung, Tae kyung
    • Journal of Service Research and Studies
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    • v.9 no.1
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    • pp.73-86
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    • 2019
  • This study discusses the 4th industrial revolution and technology commercialization (TC), identifies success factor (SFs) for TC from the literature review, and empirically tests these factors through questionnaires to executives in the 4th industrial revolution industries. Literature review identifies 11 SFs and they are communication, management support, incentives for TC, common goals, understanding business, awareness of TC, cooperation among partners, government support, concreteness of technology, demand-pull technology, and experience of TC. Questionnaires were administered to CEOs and CIOs in 202 companies in the 4th industrial revolution industries and final response rate was 64.4% (260 out of 404) that is considered to be high. Respondents rate cooperation among partners as the most important, followed by management support, communication, common goals, and incentives for TC. To successfully pursue technology commercialization projects in the 4th industrial revolution industries, the attention should be focused on SFs that are evaluated as very important.

An Operation Simulation of MAGLEV using DEVS Formalism Considering Traffic Wave (승객 유동을 고려한 DEVS 기반 자기부상열차 운행 시뮬레이션)

  • Cha, Moo-Hyun;Lee, Jai-Kyung;Beak, Jin-Gi
    • Journal of the Korea Society for Simulation
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    • v.20 no.3
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    • pp.89-100
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    • 2011
  • The MAGLEV (Magnetically Levitated Vehicle) system, which is under commercialization as a new transportation system in Korea, is operated by means of unmanned automatic control system. Therefore the plan of train operation should be carefully established and validated in advance. In general, when making the train operation plan, the statistically predicted traffic data is used. However, traffic wave can occur when real train service is operated, and the demand-driven simulation technology is required to review train operation plans and service qualities considering traffic wave. This paper presents a method and model to simulate the MAGLEV's operation considering continuous demand changes. For this purpose, we employed the discrete event model which is suitable for modeling the behavior of railway passenger transportation, and modeled the system hierarchically using DEVS (Discrete Event System Specification) formalism. In addition, through the implementation and experiment using DEVSim++ simulation environment, we tested the feasibility of the proposed model and it is also verified that our demand-driven simulation technology could be used for the prior review of the train operation plans and strategies.

Health promotion services of health care center at some universities in California, the U.S. (미국 대학보건실의 건강증진 서비스 제공체계 - 캘리포니아 주에 소재한 일부 대학의 운영사례를 중심으로 -)

  • Kim, Young-Bok;Park, Chun-Man
    • The Journal of Korean Society for School & Community Health Education
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    • v.12 no.2
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    • pp.113-127
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    • 2011
  • Background: University health services have provided comprehensive medical care, counseling, health promotion, and public health services to their students and several other local institutions. To their faculty and staff, university health care centers have served occupational health services and employee assistant program. Purpose: We performed this study to review the health promotion services on two kinds of health care center with different style of university formate. Methods: We tried to collect the data by literature review and interview with executive and provider at health care center in University of California at Berkeley and San Jose State University. Results: Our results were as followed. First, students could use the medical services just as they would their regular doctor's office and urgent care center. Second, the health promotion unit offered programs and services for keeping students healthy and safe, including many opportunities for students to get involved in shaping the public health of the campus. Third, the health promotion recommendation offered from ACHA was useful guideline to improve health status of their member in university campus. Finally, the student satisfaction surveys were used for evaluation and quality improvement. Conclusions: The systematic approach to improve health status of students, faculty and staff can use to maintain a state of optimum health among the diverse student community in support of academic excellence. Coupled with health promotion and public health programs, university health service have to reach all segments of the healthy campus community. To achieve study goals in university, the health care center contributes to promote accountability and responsibility for the health and well being of the members in their campus.

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Image Transfer Using Cellular Phones and Wireless Internet Service

  • Shin, Dong-Ah;Doo, Tae-Hoon;Kim, Hyo-Jun;Kim, Hyoung-Ihl
    • Journal of Korean Neurosurgical Society
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    • v.39 no.6
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    • pp.471-474
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    • 2006
  • Objective : Neuroimaging data are of paramount importance in making correct diagnosis. We herein evaluate the clinical usefulness of image transfer using cellular phones to facilitate neurological diagnosis and decision-making. Methods : Selected images from CT, MRI scans, and plain films obtained from 50 neurosurgical patients were transferred by cellular phones. A cellular phone with a built-in 1,300,000-pixel digital camera was used to capture and send the images. A cellular phone with a 262,000 color thin-film transistor liquid crystal display was used to receive the images. Communication between both cellular phones was operated by the same wireless protocol and the same wireless internet service. We compared the concordance of diagnoses and treatment plans between a house staff who could review full-scale original films and a consultant who could only review transferred images. These finding were later analyzed by a third observer. Results : The mean time of complete transfer was $2{\sim}3\;minutes$. The quality of all images received was good enough to make precise diagnosis and to select treatment options. Transferred images were helpful in making correct diagnosis and decision making in 49/50 [98%] cases. Discordant result was caused in one patient by improper selection of images by the house staff. Conclusion : The cellular phone system was useful for image transfer and delivery patient's information, leading to earlier diagnosis and initiation of treatment. This usefulness was due to sufficient resolution of the built-in camera and the TFT-LCD, the user-friendly features of the devices, and their low cost.

Building Linked Big Data for Stroke in Korea: Linkage of Stroke Registry and National Health Insurance Claims Data

  • Kim, Tae Jung;Lee, Ji Sung;Kim, Ji-Woo;Oh, Mi Sun;Mo, Heejung;Lee, Chan-Hyuk;Jeong, Han-Young;Jung, Keun-Hwa;Lim, Jae-Sung;Ko, Sang-Bae;Yu, Kyung-Ho;Lee, Byung-Chul;Yoon, Byung-Woo
    • Journal of Korean Medical Science
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    • v.33 no.53
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    • pp.343.1-343.8
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    • 2018
  • Background: Linkage of public healthcare data is useful in stroke research because patients may visit different sectors of the health system before, during, and after stroke. Therefore, we aimed to establish high-quality big data on stroke in Korea by linking acute stroke registry and national health claim databases. Methods: Acute stroke patients (n = 65,311) with claim data suitable for linkage were included in the Clinical Research Center for Stroke (CRCS) registry during 2006-2014. We linked the CRCS registry with national health claim databases in the Health Insurance Review and Assessment Service (HIRA). Linkage was performed using 6 common variables: birth date, gender, provider identification, receiving year and number, and statement serial number in the benefit claim statement. For matched records, linkage accuracy was evaluated using differences between hospital visiting date in the CRCS registry and the commencement date for health insurance care in HIRA. Results: Of 65,311 CRCS cases, 64,634 were matched to HIRA cases (match rate, 99.0%). The proportion of true matches was 94.4% (n = 61,017) in the matched data. Among true matches (mean age 66.4 years; men 58.4%), the median National Institutes of Health Stroke Scale score was 3 (interquartile range 1-7). When comparing baseline characteristics between true matches and false matches, no substantial difference was observed for any variable. Conclusion: We could establish big data on stroke by linking CRCS registry and HIRA records, using claims data without personal identifiers. We plan to conduct national stroke research and improve stroke care using the linked big database.