You, Chang Hoon;Kang, Sungwook;Kwon, Young Dae;Choi, Ji Heon
Asian Pacific Journal of Cancer Prevention
/
v.14
no.11
/
pp.6985-6989
/
2013
Background: This study aimed to examine out-of-pocket expenditure for cancer treatments of hospitalized patients and to analyze changing patterns over time. Materials and Methods: This study examined data of all cancer patients receiving inpatient care from two tertiary hospitals from January 2003 to December 2010. Medical expenditures per admission were calculated and classified into those covered and uncovered by the Korean National Health Insurance (NHI) and co-payment. Results: The medical expenditure per admission increased slowly from 3,455 thousand Korean won (KRW) to 4,068 thousand KRW. While expenditures covered by the NHI have increased annually, co-payments have generally decreased. The out-of-pocket expenditure ratio, which means the proportion of uncovered expenditure and co-payment among total medical expenditure dropped sharply from 2005 to 2007 and was maintained at a similar level after 2007. Medical expenditures, NHI coverage, and the out-of-pocket expenditure ratio differed across cancer types. Conclusions: It is necessary to continually monitor the expenditure of uncovered services by the NHI, and to provide policies to reduce this economic burden. In addition, an individual approach considering cancer type-specific characteristics and medical utilization should be provided.
TRINH, Nam Hoang;TRAN, Ha Hong;VUONG, Quan Duc Hoang
The Journal of Asian Finance, Economics and Business
/
v.8
no.4
/
pp.949-958
/
2021
This study aims to develop a theoretical model in order to determine factors affecting consumer intention to use credit cards by combining Theory of perceived risk and Technology acceptance model. Despite of perspective of consequences in prior studies on related research fields, this study focuses on the sources of perceived risk, including transaction, payment and credit risks, which are proposed and measured in a preliminary research. A measurement model and a structural model with the presence of perceived risk in sources are tested in a formal research with data collected from 538 bank customers. An analysis results show that payment risk, usefulness, transaction risk, ease of use, and credit risk influence significantly Vietnamese consumers' intention to use credit cards in decreasing order of influence. These factors account for 64.6% of the variation in intended use. All three dimensions of perceived risk have a negative effect on the intention to use, with the total impact greater than the level of influence of the other two factors of usefulness and ease of use. These findings can be beneficial to banks in enacting policies to attract more consumers and to allocate resources for improving their credit card business.
This study compares the physician payment of national fee schedule for Korean Medical Insurance with that of the United States based on Resource Based Relative Value Scales (RBRVS) which Hsiao developed in 1988 for the Medicare reimbursement. Through the comparison of two fees schedules, this study is purposed to evaluate the appropriateness of relative values which assigned to each physician services of Korean fee schedule. A total of 264 physician services are selected for the comparison. The ratio of Korean schedule to RBRVS is selected as an index of appropriateness. It the score of index shows large variation among services, the relative value of Korean fee schedule is inappropriate with U.S. RBRVS which was developed recently. The Ratios of Korean schedule to RBRVS are widly variated ; the range of those is 8.1 to 379.3. In subgroups which are regrouped to controll systematic differences between two national fee schedules, these ratios are also variated. Services which are relatively less compensated are management/evaluation services, while services which are relatively more compensated are invasive and imaging services. By the way, the service classification of Korean fee schedule is unclear, specially in management/evalutaion services. Therefore, Korean Medical Insurance fee schedule should be modified to be more balanced and rational.
In this investigative study, the unit mass discharge for the major water quality parameters such as flowrate, SS, BOD, CODmn, CODcr, TN, TP from textile spinning/weaving industry nearby Nakdong river basin was estimated. To represent the respective industries, three companies from hundreds of textile spinning/weaving industries located in Nakdong river basin was carefully selected based on its manufacturing goods, flowrate and location for the estimation of unit mass discharge based on unit operation and process. There was a drastic decrease of unit mass discharge estimation between influents and effluents of water quality parameters, which represents the removal capacity of wastewater treatment plant. With the advent of new regulation on the imposed payment proportional to the total amount of pollutants discharge into the water body, the concept of cleaner production technology should be employed in the unit operation/process in wastewater treatment plant as well as textile manufacturing procedure to minimize the levy on the pollutants discharge. Unit mass discharge estimations of unit process (estimated in this study) in major water quality parameters (SS, BOD, COD, TN and TP) based on land were similar to those of composite process (estimated by National Institute of Environmental Research). But the unit mass discharge estimations of unit process in BOD and CODmn based on total sale were much higher than those of composite one while in SS, TN and TP similar to each other. For the detailed estimation of the imposed payment, unit mass estimation based on unit process should be further emphasized.
Kim, Seong Il;Hong, Sung Kwon;Kim, Jae Jun;Kim, Tong Il
Journal of Korean Society of Forest Science
/
v.90
no.4
/
pp.573-581
/
2001
The purposes of this study are to estimate mean willingness to pay (WTP) for preventing forest fires by contingent valuation method (CVM), and to calibrate the variables affecting WTP. The forest fire prevention fund was utilized as a payment vehicle to elicit respondents' willingness to pay (WTP). A total of 500 adults who reside in Seoul Metropolitan area were selected by two-stage cluster sampling and conducted the face-to-face interview. The scenario was designed to meet the requirements for double-bounded dichotomous choice CVM. More than half of the respondents (64.6%) have a willing to pay for the fund. The mean WTP was \4,532. Therefore a total WTP for the population was \34,165,758,000. The calibration of Weibull proportional hazard model showed that education level, environmental conservation intention and negative consciousness about the effect of forest fire were independent variables strongly influencing the WTP.
This study aims to analyse determinants of payment balance of Korea, targeting 65 countries which concluded FTA with Korea in 2012 or are pursuing it with Korea( effectuation, agreement, negotiation and joint research). For an analysis model, economic and geographical variables of target countries were included in explanatory variables of the gravity model and divided values which indicate surpluses or deficits in trade with Korea were marked in dependent variables to perform a logistic analysis. If payment balance in trade between Korea and specific countries is a surplus, a value of 1 is given and if it is a deficit, a value of 0 is given. As a result of estimating the logit model, it was discovered that variables of GDP, GDP per person, total trade with trade partners, petroleum, landlocked countries and maritime powers were not statistically significant. However, variables of total trade, export dependency, import dependency, distance and mineral were statistically significant.
Due to the existence of asymmetry of information between doctor and patient, it has been believed that doctor might affect patient's decision making process of purchasing medical care. Based on this notion, doctor's reimbursement method has been suggested as an effective policy device of improving efficiency of patient's medical care use by way of its affecting doctor's practice pattern. By using the Community Tracking Study (CTS) household and physician data set, which includes not only various information on patient's medical care use, but doctor's practice arrangements and sources of practice revenue, this paper investigates the effect of community doctor's characteristics of reimbursement method on community patient's medical care use under the control of patient's socio-demographic characteristics and community doctor's practice type. In the process of estimating econometric model, the endogeneity problem of individual health insurance purchase was corrected by using 2818. And due to the existence of sample selection problem, Heckman's two-step estimation method was used for strengthen the robustness of estimation which was adversely affected by sample selection problem The empirical results show that as the average value of community doctor's portion of practice revenue determined by prospective method out of total revenue increases, the community patient's total out-of-pocket medical cost decreases. This results suggest, as doctor's practice revenues are mainly determined by prospective method, such as capitation, doctors would be more conscious about practice cost, which might affect doctor's practice pattern and by which his/her patient's use of medical care would decrease.
With the prospect of rapidly growing health insurance expenditures, particularly spending for ambulatory care, the introduction of a case-based payment method is discussed as an alternative to the current fee-for-service based method. A system to measure case mixes of providers is a core component of such payment systems. The objective of this study were to develop a classification system for ambulatory care, Korean Ambulatory Patient Group (KAPG) based on the U.S. APG version 2.0 and to evaluate the classification accuracy of the system. A database of 64,258,386 records was constructed from insurance claims submitted to the Health Insurance Review Agency (HIRA) during three months from August 2002. A total of 41,347,307 records with a single visit was used for the development and 7% random sample of the database was used for the evaluation. Additional groups were defined to include both physician and hospital fees in the classification, age splits were added to classify the entire population as well as the population older than 65, and the definition of medical groups used by the HIRA was adopted. The variance reduction in charges achieved by KAPGs was computed to evaluate the accuracy of classification. A total of 474 KAPGs was defined compare to 290 groups in the U.S. APG. The variance reduction for charges of all visits ranged from 20% to 37% depending on the type of provider, and ranged from 22% to 42% for non-outliers, that were better than those achieved by the system currently used by the .HIRA for its internal review purpose. Although further study is required to improve the classification for complicated care in larger hospitals, the results indicated that KAPGs could be used for better management of costs for ambulatory care.
This study focused on finding the variation of medical service utilization, paths of medical service utilization and medical payments of the patients died by cerebrovascular diseases. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of stays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. This study is useful in reviewing the equity of medical service utilization because it analyzed variance in utilization by episodes. In oder to collect accurate data of the patients died by cerebrovascular diseases in 2004 the 2004 reimbursement data of all medical institutions were matched to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005. The major results of the study are as follows. The variation of medical service utilization of cerebrovascular diseases was influenced by supplier factors suppliers, such as types and locations of medical institutions and user factors such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. On the basis of analyzing results this study suggests that the factors of suppliers and utilizers should be reviewed to reduce the under use and over use expressed by variations of medical service. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization and also. alternative medical services would be recommended to reduce the high medical payment. Additionally to find other causes of variation further in depth study controling the severity of diseases, socio-economic status of the users and the system factors is required.
This study focused on finding the variation of medical service utilization and medical payments of the patients died by three, cancers, stomach, breast, and colon cancer. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of slays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. The data of the patients died by cerebrovascular diseases and cancer in 2004 were selected. To select the dead by cerebrovascular diseases and cancer in 2004, were matched the 2004 reimbursement data of all medical institutions to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005 for the death in 2004. The results of the analysis were as follow. The variation of medical service utilization of the dead by cancers were not small in Korea. The current study found that the variation of medical care utilization was influenced by the factors of suppliers, such as types and locations of medical institutions and the factors of users, such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. The results of the study suggested that tile factors of suppliers and utilizers should he reviewed to reduce the under use and over use expressed by variations of medical service utilization. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization. Additionally, prospective payment could he recommended to reduce the high variation of medical service Use. To find the variation caused by under use and over use, further study need to control the severity of diseases, socio-economic status of the users and the system factors.
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