• Journal of Preventive Medicine and Public Health
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• v.37 no.3
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• pp.260-266
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• 2004

Objectives : To assess the impacts of implementing case payment system (CPS) to Medical Aid (MA) hemodialysis patients on the frequencies and expenditure of dialysis. Methods : Fifty-eight clinics and 35 tertiary care hospitals were identified as having a minimum of 10 hemodialysis patients for each of the MA and Medical Insurance (MI) programs, who received hemodialysis from the same dialysis facilities for both periods of July 2001 and July 2002. From these facilities, a total of 2,167 MA and 2,928 MI patients were identified as the study subjects. Using electronic claims data, the changes in the total number of monthly treatments and charges for outpatient hemodialysis treatments for each patient after the introduction of the CPS were compared between the MA and MI patients. Multiple regression analyses were performed to examine the independent impact of the CPS on the utilization and expenditure of dialysis treatments among the MA patients. Results : There was a significant decrease in the total charges for the hemodialysis treatments of the MA patients, 3.4% (p<0.05), whereas a significant increase was observed for the MI patients, 2.5% (p<0.05). For both the MA and MI patients, the frequency of the monthly hemodialysis treatments were significantly increased, 5.5 (from 12.1 to 12.7) and 7.8% (from 11.6 to 12.5), for the MA and MI patients, respectively. However, a multivariate regression analysis showed no significant difference in the changes in the total number of monthly hemodialysis treatments between the MA and MI patients after implementation of the CPS. Another regression model, regressing on the changes in the monthly claims of dialysis treatments, showed a significant negative coefficient for the MA ((=-70725, p<0.05). Conclusion : The significant decrease in the total charges for hemodialysis treatments among MA as compared to MI patients suggests that there was a cost reduction in the MA program following the introduction of the CPS.

• The Korean Journal of Health Service Management
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• v.8 no.4
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• pp.13-24
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• 2014

This study analyzes the effects of hospital caseload on medical charges and length of stay for inpatients. Hospital caseload, representing the level of concentration of patients, was measured with the Internal Herfindal Index for three diagnosis related group (DRG) codes (appendectomy, operations on anus, and operations on uterus and adnexa). Ordinary least squares regression was used for analysis. Results showed that medical charges per inpatient and average length of stay significantly differed with respect to hospital concentration indices, and that hospital caseload was inversely related to operational performance for appendectomy and operations on uterus and adnexa. The significant negative relationship between concentration index and length of stay may decrease the total medical charges. The results imply that the expansion of the DRG payment system to hospitals will have a negative influence on their gross sales.

• KDI Journal of Economic Policy
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• v.43 no.2
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• pp.103-123
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• 2021

This paper examines the impact of the regional cash subsidies which were granted in some districts in addition to the national universal stimulus payment in South Korea related to the COVID-19 pandemic. We evaluate the effects of the cash distribution per resident on aggregate credit and debit card sales and sales by industry using the difference-in-difference method. The increment in card spending due to the cash subsidy is about 1.58%p in total, and this effect is concentrated within a single month. The consumption stimulating effect is prominent among (semi)-durable goods that do not require close interactions between customers and sellers. In contrast, the effect is relatively small in the high-contact face-to-face service sectors and restaurants, areas the COVID-19 pandemic hit directly. On the other hand, some service sectors where customers could wear face masks, such as education and fitness, experienced a substantial sales boost due to the cash subsidy.

• The Journal of Fisheries Business Administration
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• v.49 no.3
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• pp.85-99
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• 2018

This study is to compare and evaluate the estimating method of WTP(willingness to pay) for the valuation of oceans and fisheries resources with non-market goods characteristics using contingent valuation method. In general, when estimating parameters of the WTP function, we should take into account the assumption of probability distribution, inclusion of covariates, method of inducement of payment, and the treatment of 0 payment intention and resistance responses. This study utilizes survey data that was used to estimate the value of fisheries resource protection zones, with a total of 1,200 samples. The main results of this study are summarized as follows: First, the final willness to pay amount is estimated at a statistical significance of less than 1 percent, and the distribution of the final willness to pay amount is from \6,926 of the double bounded dichotomous model to \10,721 of the spike model. Second, the willness to pay amount based on assumptions about the normal and logistic probability distributions are estimated to be \9,429 and \9,370 respectively, so there was no significant difference. Third, the willness to pay amount of the single bounded dichotomous model and the double bounded dichotomous model are estimated to be \8,951 and \6,926 respectively, making a relatively large difference. Fourth, the willness to pay amount of the model without covariates and the model with covariates are estimated to be \9,429 and \8,951, respectively, so the willness to pay amount is underestimated when the covariates are included. Fifth, the Spike model that considers zero payment intention and resistance response estimates \10,405 as the highest payment in this study. Finally, the CVM analysis guidelines proposed by the Korea Development Institute (KDI) are estimated to be \9,749 and \10,405 respectively, depending on including no covariates and with covariates. Compared to other models, the final willness to pay amount is not estimated underestimated. Therefore this study suggests the use of KDI's guidance under government public policy projects. In view of these results, the estimating model for willness to pay amount model will be selected by considering the sample size, the suitability of the model, the sign of the estimated coefficient, the statistical significance, the ratio of the zero payment intention and the payment rejection. And, for CVMs on government public policy projects, it is desirable to estimate by the method proposed by the KDI.

• Korean Journal of Construction Engineering and Management
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• v.12 no.3
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• pp.121-130
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• 2011

Real option values of early termination payment for selected BTO PPI projects are studied using binomial models. Two cases of early termination payments are considered; an option with the condition of private participants' default, and an option without the condition. Values vary depending upon parameter values such as revenues, costs, discount rates, debt ratio, and volatility of revenues. For selected projects, the option values without the default condition are estimated as 1%~7% of total project costs, whereas the option values with the default condition are estimated as 0%~1.89% of total project cost. When actual revenues differ from the forecasted revenues, apparently the option values deviate from the values based upon the forecasted revenues. When actual revenues fall short of the forecasted revenues, the option values increase by a large amount whereas the option values decrease by a small amount in the opposite case. This implies that the option values can be quite bigger than the values based upon the forecasted revenue especially when the revenue forecast uncertainty is large. This study is expected to play an important role in improving the early termination payment option policy of the government in PPI projects in Korea.

• Journal of Preventive Medicine and Public Health
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• v.27 no.1 s.45
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• pp.107-116
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• 1994

The United States adopted DRG based prospective payment system (PPS) in order to control the inflation of health care costs. No study used statistical test while many studies reported the cost containing effect of the PPS. To study impacts of the PPS on the Medicare expenditure, this study set the following three hypotheses (1) The PPS decelerated the increase in the hospital expenditure (Part A), (2) the PPS accelerated the increase in the expenditure of outpatients and physicians (Part B), (3) the increase in total expenditure was decelerated inspite of the spill over (substitution) effect because saving in the Part A expenditure were greater than losses in the Part B expenditure. The dependent variables are per capita hospital expenditure, per capita Part B expenditure, and per capita total expenditure for the Medicare beneficiaries. An intervention analysis, which added intervention effect to the time series variation on the Box-Jenkins model, was used. The observations included 120 months from 1978 to 1987. The results are as follows : (1) The annual increase in the per capita Part A expenditure was $5.11 after the implementation of DRG where as that before the PPS had been $11.1. The effect of the reduction ($5.99) was statistically significient (t=-3.9). (2) The spill over (substitution) effect existed because the annual increase in the per capita Part B expenditure was accelerated by $1.73 (t=1.91) after the implementation of the PPS. (3) The increase in the total Medicare expenditure per capita was reduced by $4.26 (t=-2.19) because the spill over effect was less than cost savings in the Part A expenditure.

• 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.

• Journal of the Korean Data and Information Science Society
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• v.22 no.2
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• pp.171-177
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• 2011

With the development of the actuarial and insurance industries, the distributions of the insurance payments data are deeply studied by many authors. It is known that theses types of distribution are very highly positively skewed and have a long thick upper tail such as Pareto or lognormal distribution. In 2005, Cooray and Ananda proposed a new model which is composed lognormal distribution and Pareto distribution. They said it as composite lognormal-Preto distribution. They showed that the proposed distribution was better fitted than lognormal or Pareto distribution. On the other hand many agreements about the insurance payment have some options for a trivially small payment or extremely large one because of the limits of total payment. Appling these cases, in this paper we consider the parameter estimation on the composite lognormal-Pareto distribution based on doubly censored samples.

• Journal of the Korean Operations Research and Management Science Society
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• v.18 no.2
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• pp.175-182
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• 1993

The probabilistic order level inventory model is developed when a supplier allows some credit period T for settling the accounts for purchase quantity. The credit period T is known constant. Mathematical models are derived for both the cases i) T'.leq. T and ii) T'>T. Expressions are derived for average expected total cost of the system, the optimum cycle time and for obtaining optimum order level S = S$_{0}$ in each case. The exmaples are given to illustrate the model.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.2
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• pp.281-295
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• 1999

The purpose of this study is to provide the basic data for the development of new pay system of hospitals by analyzing the status and problems of current pay system. The pay systems of 20 nationwide hospitals were analyzed and compared with the average pay level in Korea. In addition, the annual trend of pay system was analyzed. Based on this study, the following suggestions can be made. First, the pay levels of hospitals are, in some types of workers, lower than average. Hospitals should take much efforts to improve the payment capability through the effective management. Second, the effort to raise the proportion of basic pay to the total pay and to simplify the pay system on the basis of basic pay rather than the allowance and bonus should be made. Third, the pay system based on the length of service should be revised into the one based on work capability, achievement and performance in case of professional, clerical and managerial jobs. Fourth, the pay system determined depending on the power relationship between the labor unions and the management should be improved into the one, with which workers can feel reliable and satisfied through the revealing of the payment ability and the management improvement.