• Tuberculosis and Respiratory Diseases
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• v.81 no.3
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• pp.241-246
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• 2018

Background: The "Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Groups)" is a national program for socioeconomically vulnerable tuberculosis (TB) patients. We sought to evaluate the clinical and socioeconomic characteristics of poverty-stricken TB patients, and determined the need for relief. Methods: We examined in-patients with TB, who were supported by this project at the National Medical Center from 2014 to 2015. We retrospectively investigated the patients' socioeconomic status, clinical characteristics, and project expenditures. Results: Fifty-eight patients were enrolled. Among 55 patients with known income status, 24 (43.6%) had no income. Most patients (80%) lived alone. A total of 48 patients (82.8%) had more than one underlying disease. More than half of the enrolled patients (30 patients, 51.7%) had smear-positive TB. Cavitary disease was found in 38 patients (65.5%). Among the 38 patients with known resistance status, 19 (50%) had drug-resistant TB. In terms of disease severity, 96.6% of the cases had moderate-to-severe disease. A total of 14 patients (26.4%) died during treatment. Nursing expenses were supported for 12 patients (20.7%), with patient transportation costs reimbursed for 35 patients (60%). In terms of treatment expenses for 31 people (53.4%), 93.5% of them were supported by uninsured benefits. Conclusion: Underlying disease, infectivity, drug resistance, severity, and death occurred frequently in socioeconomically vulnerable patients with TB. Many uninsured treatment costs were not supported by the current government TB programs, and the "Tuberculosis Relief Belt Supporting Project" compensated for these limitations.

• The Journal of Pediatrics of Korean Medicine
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• v.37 no.3
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• pp.1-16
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• 2023

Objectives We aimed to investigate the effectiveness of the Korean medical critical pathway (CP) in treating childhood anorexia. Methods In total, 21 patients who met the criteria and agreed to provide information were assigned to the CP group, while 24 patients who met the criteria, agreed to provide information, but disagreed with CP application were assigned to the non-CP group. Demographic, clinical, and economic indices were compared between the two groups. Clinical indices before and after treatment were also compared between the two groups. Results In the CP group, height, weight, body mass index (BMI), BMI percentile, and food approach (FAP) increased significantly after treatment, and numeric rating scale (NRS) and food avoidance (FAV) scores decreased significantly. In the non-CP group, height, weight, weight percentile, BMI, BMI percentile, and FAP increased significantly, whereas NRS and FAV decreased significantly after treatment. Compared to the non-CP group, CP application increased FAP and decreased FAV, medical expenses per consultation, and the total treatment period. Conclusions The application of the Korean medical critical pathway for childhood anorexia is an effective cure system that decreases overall medical expenses with good-quality treatment by means of the standardization of medical practices.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.69-90
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• 2021

Purpose : This study explores unmet medical services within a region for patients admitted to a single medical institution in one region and was to analyze the importance and satisfaction of hospital selection attributes. Through this, we tried to solve the unmet medical needs of patients and provide useful basic data in terms of hospital management in the region. Methods : It were collected to a total of 250 questionnaires for patients admitted to the regional integrative medical hospital. However, 232 samples were used for the final analysis, excluding 18 copies not reported in good faith. For the analysis, first, demographic frequency analysis of inpatients and inpatients was performed, and second, characteristics of patients, including frequent disease receiving treatment, were analyzed. Next, descriptive statistics analysis was conducted on unmet medical service intentions. In terms of hospital selection attribute, the items of continuity maintenance (I quadrant), priority visibility (II quadrant), low priority (III quadrant), and excessive effort (IV quadrant) were derived using the IPA (importance-performance analysis) matrix technique. Results : The derived results were classified by item and area. In the priority administration area, it was the reputation and recognition of medical institutions and the service area of medical institutions. In the case of items, there were 6 items including the importance of surgery and medical expenses, and diet at hospitalization. 1) Conclusion : Thus a result of this study, resources are efficiently allocated to priority correction areas with high importance but low satisfaction and circulatory medical treatment is performed in the departments required by patients who use medical care and, various methods, such as preparing a policy to support medical expenses, should be sought.

• Journal of Korean society of Dental Hygiene
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• v.20 no.5
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• pp.707-716
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• 2020

Objectives: This study aims to provide basic data for high-quality dental services. In addition, we will promote the operation of preventive dentistry that implements preventive measures. It was conducted to study the change of patient's treatment behavior and treatment cost due to the discontinuation of preventive dentistry in university dental hospitals. Methods: This study collected data using the integrated medical information system of the C University Dental Hospital. From September 1, 2017 to August 31, 2019, data were analyzed using frequency, percentage, mean, standard deviation, chi-square test using SPSS version 24.0 statistical program, and T-test. Results: There was a significant difference in the number of preventive dental treatment cases from 58.3% of preventive dental operation periods to 41.7% of preventive dental operation periods. As a result of comparing the medical expenses, the total medical expenses during the preventive dental operation period decreased from 521,308,872 won to 379,724,995 won during the discontinuation period, 141,583,877 won. The number of medical treatments by treatment behavior decreased 3,835 (28.4%) from a total of 13,520 preventive dental operation periods to 9,685. Conclusions: This study is meaningful as the first study to confirm the change in the treatment behavior and the change in the cost of treatment due to the discontinuation of the operation of preventive dentistry at university dental hospitals. In conclusion, it is thought that there is a possibility of the lack of accessibility and the limitation of professional preventive care due to the discontinuation of preventive dentistry.

• Journal of Preventive Medicine and Public Health
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• v.25 no.4 s.40
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• pp.399-412
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• 1992

This study was designed to investigate factors relating to fiscal deficit for regional health insurance. The financial statements for the fiscal year 1990 of nationwide 254 regional medical insurance societies were analyzed. Important findings are summarized below: 1. There were differences in the main reason fur the financial deficit among regions when deficit and surplus societies were compared by regions. The total revenue per enrollee, especially revenue from the premium contribution of a deficit society was significantly smaller than that of a surplus society in large cities and counties. On the other hand, the total expenditure per enrollee of a deficit society was larger than that of a surplus society in small cities. 2. Both low premium rate at the beginning of health insurance program and less effort to increase the premium rate were main factors for the smaller revenue from the contribution of a deficit society in large cities and counties. 3. Larger expenditures per covered person of a deficit society in small cities were explained with larger medical expenditures especially for out-patients services rather than larger administrative expenses. 4. A regression analysis showed that utilization rates in out-patient services were significantly associated with income and numbers of total medical care institution per capita within a region where a health insurance society located. Also expenses paid by insurer per visit were associated with the proportion of utilization for tertiary care hospitals as well as the proportion of utilization of public health centers.

• Research in Community and Public Health Nursing
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• v.21 no.3
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• pp.362-373
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• 2010

Purpose: The purpose of this study is to evaluate the costs and benefits of individual home visiting health care using secondary data and literature review. Methods: The total number of subjects was 1,008,837. A specific program was classified into disease management, care of infant, child and women, or elderly care. The costs and effects of a program were identified from a societal perspective, and the effects were converted into monetary terms or benefits. The total cost was calculated in the way that medical expenses, travel costs and productivity losses were offset by the decrease in benefits and thus only the program budget was included in the total cost. Results: The total program cost was 47.6 billion won per year and the total annual benefit was estimated at 435.6 billion won. The benefits of arthritis management were the biggest among disease management programs. The net benefit was 388.0 billion won per year and the benefit/cost ratio was 9.16. Conclusion: Home visiting health care was validated to be economically effective. It made a positive contribution to improving the health status of vulnerable populations and reducing medical expenses. These results suggest that home visiting care should be extended more broadly to vulnerable populations.

• The Korea Journal of Herbology
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• v.21 no.4
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• pp.1-10
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• 2006

Objectives : Recently, the total medical expenses of the korean oriental medical service in national health insurance is on the increase every year. Herbal medicines are one of the major methods of the medical treatment. But the expenses of these herbal preparations that can receive benefits from insurance system are decreasing. Methods : In this research, we obtained statistical data of the benefit states of herbal preparations in herbal heath insurance during year 2001-2003 from Health Insurance Review Agency. We analyzed top twenty main diseases in herbal health insurance and mainly used prescription in these diseases. Results : There were wide differences in the application of prescriptions among diseases. For example, musculoskeletal diseases occupied an important position and Ojucksan took more than 50 percentage. Conclusion : We hope that this study could be a basic data for improving the benefit system of herbal health insurance and further studies should be carried out subsequently.

• Research in Community and Public Health Nursing
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• v.26 no.3
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• pp.278-291
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• 2015

Purpose: This study was conducted to examine differences in health care utilization and related costs between before and after the introduction of the designated doctor system, and to find out factors making the differences. Methods: Data were collected from 200 medical aid beneficiaries having one or more chronic diseases, registered in the designated doctor system during the year of 2012, and the relationship between the use of health services and claimed medical expenses was analyzed through paired t-test and multiple regression analysis using the SPSS 18.0 program. Results: There was a decrease in the number of total benefit days and the number of outpatient and medication days, but some cases showed an increase after the designation of medical institution. In general, hospital stay increased after the introduction of the system. However, the number of medical institutions utilized was reduced in most cases after designation. Conversely, medical expenses increased in most cases after the designation of medical institution. Conclusion: These results suggest that a detailed scheme to designate medical institutions should be made in consideration of the seriousness of illness and classification of medical institutions not only for the beneficiaries' enhanced health but for the effective management of medical aid fund.

• Journal of Preventive Medicine and Public Health
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• v.34 no.1
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• pp.28-34
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• 2001

Objectives : To investigate the changing pattern of medical utilization claims following the economic crisis in Korea. Methods : The original data consisted of the claims of the 'Medical insurance program of self-employees' between 1997 and 1998. The data was selected by medical treatment day ranging between 8 January and 30 June. Medical utilizations were calculated each year by the frequency of claims, visit days for outpatients, length of stay for inpatients, total days of medication, and the sum of expenses. Results : The length of stay as an inpatient in 1998 was decreased 4.7 percent in comparison to 1997. However, inpatient expenses in 1998 increased 10.8 percent as compared to 1997. Inpatient hospital claims in 1998 increased 6.2 percent over 1997, although general hospital inpatient claims in 1998 decreased 3.3 percent in comparison to 1997. The outpatient claim frequency decreased 7.3 in 1998 percent as compared to 1997 Outpatient visit days of in 1998 were decreased 8.5 percent in comparison to that recorded in 1997. Outpatient claim frequencies of 'gu region' in 1998 decreased 10.5 percent comparison to that in 1997, but 'city and gun region' decreased less than 'gu region'. Conclusions : Medical utilization in 1998 deceased in relation to 1997 Medical utilization by outpatients decreased more than that of inpatients. Medical utilization by 'gu region' decreased mere than the other regions.

• Korea Journal of Hospital Management
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• v.6 no.2
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• pp.138-155
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• 2001

This study was designed to find out the factors which influence on the financial performance of the hospital. Out of 32 provincial hospitals which were established by the government, 10 hospitals were selected as sample hospitals. Ten hospitals were divided into two groups(5 hospitals each), one of which was profit-making and the other loss-making. The criteria in selecting profit or loss-making hospitals was net profit to total revenue. The major finding of the study was as follows; 1. Whether or not a hospital had specialized in certain departments was proved to be the major factor influencing on the financial performance. Three out of five profit-making hospitals could harvest following results by operating specific departments. (1) Man powers needed for the operation of specific departments were 14.6 persons per 100 bed, which was only 1/7 of the general hospital. (2) The number of doctors has not increased in proportion to the increase of the number of beds. (3) Ratio of total revenue to MD.'s payroll expenses of the profit-making hospitals was 75.0% higher than the loss-making hospitals. (4) The average length of stay of specific department was very long(388.1 days). However, the specific departments were found to have contributed much to the financial performance because the occupancy rate of such departments was very high(94.5%). 2. The headcount per 100 bed of the profit-making hospitals was 23.9 persons(24.0%) less than the loss-making hospitals and the ratio of payroll expenses to total revenue 15.1% less. 3. Averagel revenue per specialist of the profit-making hospitals was 100 million(25.1%) more than loss-making hospitals and the ratio of total revenue to MD's payroll expenses of profit-making hospital was 75.0% higher. 4. Profit-making hospitals have introduced new systems or renovation in 36 fields, such as incentive payment system, utilization of contracted man powers, change of the payroll structure of the nurses, specialization in certain departments, etc; however, loss-making hospitals introduced only 25 new systems or renovations. These kind of renovation could not be achieved without the cooperation of the labor union and the strong will of the top management. Therefore, it could be said that the labor union of the profit-making hospitals seems to have been very cooperative compared with that of loss-making hospitals.