• 보건행정학회지
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• 제27권2호
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• pp.121-127
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• 2017

The effort to measure and improve the quality of healthcare is a common health policy issue worldwide. Korean Value Incentive Programme is one of that effort, but some concerns exist. Compared to pay for performance program in other countries, it measures healthcare quality with relatively narrow performance domain using a small number of clinical indicators. It was designed without involving hospitals and other key stakeholder, and program participation was mandated. Highest and lowest performers get bonus and penalty using relative ranking. As a suggestion for development, the direction for quality management at the national level should be given first. Therefore the philosophy or strategy for quality improvement should be reflected to the program. And various domains and indicators of healthcare quality should be developed with active communication with healthcare providers. The evaluation method is necessary to be changed to provide achievable goal to the healthcare providers and attract quality improvement.

• 보건행정학회지
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• 제27권3호
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• pp.247-255
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• 2017

Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

• 에너지공학
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• 제11권4호
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• pp.342-349
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• 2002

본 논문은 캘리포니아 테스트를 이용하여 직접부하제어 프로그램의 적정 인센티브 수준 결정 방법을 제시한다. 대부분의 수요관리 프로그램의 경우 연간 혹은 수요관리 프로그램의 수명기간 동안 모든 고려 변수들이 상수로 주어지지만, 직접부하제어의 경우 연간 직접부하제어의 실행 회수 및 각 직접부하제어 실행 시간에 대하여 종속적인 값이 되기 때문에, 이러한 문제를 극복하고 직접부하제어의 경제성 평가에 효과적으로 적용하기 위해서 캘리포니아 테스트 방법론을 새롭게 정식화한다. 이 정식화를 사용하여 다양한 시나리오에 대한 사례연구를 수행하며, 현행 직접부하제어 프로그램의 인센티브 수준을 재검토하고 경쟁적 전력시장에서 직접부하제어 프로그램이 활성화될 수 있는 방안을 제안한다.

• 한국IT서비스학회지
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• 제16권3호
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• pp.17-45
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• 2017

Health Information Exchange (HIE) is expected to improve the quality and efficiency of care by allowing providers online access to healthcare information generated by other providers at the point of care. However, the adoption of the technology in Korea has been slow since its pilot program in 2007~2010 at Seoul National University Bundang Hospital. The objective of this study was to survey stakeholders on the incentive program for the facilitation of HIE adoption. We surveyed 39 experts representing 6 categories of stakeholders-provider, insurer, government, information service firms, customers, and medical informatics experts for the interviews. Interview questions included program objectives, program participation requirements, incentive payment method, and administrative burden for program participation. Experts indicated that the quality of care was the most important value the program should aim to achieve through the HIE adoption. They suggested that the requirements and administrative burden for participation should be kept at minimum to recruit a large number of providers to the program, which is an indicator of program success. Experts were divided on the payment method whether the incentive should be paid as a part of the fee payment scheme operated by the National Health Insurance (NHI) or should be a payment made independent of the NHI. The source of the divide was conflict of interest among stakeholders as to who pays for the program, and the insurer and consumer groups were against the NHI taking the financial burden. It appeared to be the most significant factor for the successful program launching to resolve the gap in perceptions about benefits of the technology among stakeholders and to win the willingness to pay for the program.

• 보건행정학회지
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• 제10권1호
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• pp.95-110
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• 2000

The purpose of this study is to evaluate work values of hospital employees. Their work values was compared with that of other corporate's employees or among that of specialties in hospital. It was surveyed to 893 persons; 164 in hospital and 709 in others. The work values of hospital employees are similar to that of other corporate's employees. But they have first priority to working environment, and emphasize monetary incentive much more than hierarchical development. There are some gap in work value between age groups in hospital, different from other corporate. That means hospital manager need to development the more developed work value in hospital. The work values are different in monetary incentive, hierarchical development, safety, working environment, creativity among specialties in hospital. The more special employees emphasize much more to monetary incentive, hierarchical development, working environment and the less special employees have priority to safety work value. Specially, because the hospital managers want to have safety than creativity, it must to make some changing program of work value for advance of future hospital.

• Journal of Preventive Medicine and Public Health
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• 제45권3호
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• pp.148-155
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• 2012

Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poorquality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.

• 한국병원경영학회지
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• 제27권1호
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• pp.20-30
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• 2022

Purposes: This study purposed to evaluate the effect of a value incentive program(VIP) on the in-hospital mortality of acute stroke. Methodology: Study period was from January 2010 to December 2018. This study included 63 hospitals for acute hemorrhagic stroke that the mortality rate per month was more than one during study period. Independent variables were time variables and hospital characteristics such as hospital type, district and bed number. Interrupted time series analysis was applied to analyze the data. Findings: In case of general hospitals, the in-hospital mortality rate per month for acute hemorrhagic stroke tends to be increased by 0.03% in overall study periods but decreased by 0.32% after the implementation of the policy. On the other hand, tertiary hospital changes are not statistically meaningful. Conclusion: This study provides evidences how the VIP was effective in improving quality of acute hemorrhagic stroke care. General hospitals showed higher policy effect compare to that of tertiary hospitals.

• Journal of Preventive Medicine and Public Health
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• 제45권3호
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• pp.127-136
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• 2012

The challenge facing the Korean National Health Insurance includes what to spend money on in order to elevate the 'value for money.' This article reviewed the changing issues associated with quality of care in the Korean health insurance system and envisioned a picture of an effective pay-for-performance (P4P) system in Korea taking into consideration quality of care and P4P systems in other countries. A review was made of existing systematic reviews and a recent Organization for Economic Cooperation and Development survey. An effective P4P in Korea was envisioned as containing three features: measures, basis for reward, and reward. The first priority is to develop proper measures for both efficiency and quality. For further improvement of quality indicators, an electronic system for patient history records should be built in the near future. A change in the level or the relative ranking seems more desirable than using absolute level alone for incentives. To stimulate medium- and small-scale hospitals to join the program in the next phase, it is suggested that the scope of application be expanded and the level of incentives adjusted. High-quality indicators of clinical care quality should be mapped out by combining information from medical claims and information from patient registries.

• 전기학회논문지
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• 제58권3호
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• pp.455-461
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• 2009

This paper proposes Direct Load Control(DLC) operation scheme using a bidding system and the methodology to value proper quantity decided by the DLC program, which is a kind of resources for stabilization of electricity market price during peak times by managing consumer electricity demand. Since DLC program in Korea is based on the contract with the customers participating in this program, it is difficult to anticipate voluntary participation. That is, incentive for participants in DLC program is insufficient. To cope with this point, it is necessary to develop a new market mechanism and market compatible operation scheme for DLC programs. DLC market mechanism is deemed to be equipped with iterative bidding system, independent operation from energy market, and interactive with bidding information on energy market. With this market mechanism, it is important to find the optimal operation point of DLC allowing for the factors of stabilizing the electricity market price and compensating DLC implementation. This paper focuses on the mathematical approaches for the bid-based DLC operation scheme and examines several scenarios for the following technical justifications: 1) stabilization of electricity market price during peak times, 2) elasticity of demand.

• Journal of Electrical Engineering and Technology
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• 제13권6호
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• pp.2220-2226
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• 2018

Electric vehicles (EVs) are significant resources for demand response (DR). Thus, it is essential for EV aggregators to quantitatively evaluate their capability for DR. In this paper, a concept of dynamic equivalent battery (DEB) is proposed as a metric for evaluating the DR performance using EVs. The DEB is the available virtual battery for DR. The capacity of DEB is determined from stochastic calculation while satisfying the charging requirements of each EV, and it varies also with time. Further, a new indicator based on the DEB and time-varying electricity prices, named as value of DEB (VoDEB), is introduced to quantify the value of DEB coupled with the electricity prices. The effectiveness of the DEB and the VoDEB as metrics for the DR performance of EVs is verified with the simulations, where the difference of charging cost reduction between direct charging and optimized bidding methods is used to express the DR performance. The simulation results show that the proposed metrics accord well with the DR performance of an EV fleet. Thus, an EV aggregator may utilize the proposed concepts of DEB and VoDEB for designing an incentive scheme to EV users, who participate in a DR program.