• 제목/요약/키워드: health care consumer

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A Study of an effective centralization of medical supply system. In Y University Medical Center (Y의료원의 물류 공급체계 중앙화 관리에 대한 연구)

  • Kwon, Soon-Chang;Kim, Young-Soo
    • Korea Journal of Hospital Management
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    • v.4 no.1
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    • pp.1-20
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    • 1999
  • Since the late 1980s, there have been radical changes in the managerial environment of Y University Medical Center(YUMC). Externally, the competition among hospitals has intensified due to the establishment of universal health insurance in 1939 and the entrance of large enterprises into the health care industry in the early 1990s. In addition, government regulation of medical institution is becoming stricter. Also, consumer groups have continued to demand the respect for patient rights and improvement of the quality of medical services. Internally, the financial condition of YUMC has worsened, not only because weak control and poor mediation in its large-scale structure have made its operation inefficient, but also because the rates of increase in the prices of goods and labor have grown faster than any increases in revenues. This study on materials management at YUMC presents a way for YUMC to reduce costs and increase its productivity, thereby overcoming its financial difficulties and dealing with external pressures. This study utilized the case studies of the materials purchasing and medical supply management in the United States and the comparative analysis of management to suggest short-term and long-term alternatives for innovation in YUMC. The goals of the short-term alternatives for innovation are to centralize the purchasing and supply departments and to simplify the decision-making processes. Through these attempts, it is estimated that YUMC's costs could be reduced by $600,000 per year. In the long-term, it is necessary to consider introducing a Supply Processing Distribution(SPD) system and setting up a centralized electronic system for supply and inventory management, although it is difficult to estimate the effect of cost-cutting because of the lack of analysis data. Thus, YUMC should thoroughly analyze initial investment costs and economical efficiency generated from long-term alternatives.

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Cost-benefit Analysis of Mandatory Prescription in Korea (의약분업의 비용-편익 분석)

  • Kim, Han-Joong;Park, Eun-Cheol;Kang, Hye-Young;Jee, Young-Keon
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.4
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    • pp.484-494
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    • 2000
  • Objective : To evaluate the relative benefits and the costs associated with the introduction of the new pharmaceutical provision called 'Mandatory Prescription System' which separates the role of physicians from that of pharmacists with respect to the prescription and dispensation of from the perspective of consumers (i.e., patients). Methods : The costs of the system were measured by considering both direct and indirect costs. Direct costs included additional payments for ambulatory care and dispensing fees that occurred under the new system. indirect costs consisted of transportation expenses and costs related to time spent for physician consultation, waiting for the prescriptions to be filled, and extra traveling. Benefits identified in this study were the reduction of drug misuse and overuse, and the overall decrease in drug consumption among the Korean population. Sensitivity analysis was peformed for the inclusion of benefits for outpatients of hospitals, price elasticity, and increased fees for established patients. Results : The net benefit was estimated to be about minus 1,862 billion won and the benefit-cost ratio was 0.478. This indicates that the costs of 'Mandatory Prescription' outweigh its benefits, relative to the previous system. The sensitivity analysis results for all the variables considered in this study consistently showed the benefit-cost ratio to be less than 1. Conclusion : The results of this study suggest that implementing Mandatory Prescription System in Korea might be inefficient from the consumer's perspective. The results of this study do not coincide with the results of previous studies, presumably because of the differences in study design and in which items of costs and benefits were considered.

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Concerning the Constitution Court's constitutional decision and the direction of supplemental legislation concerning Article 33 paragraph 8 of the Medical Service Act - With a focus on legitimacy of a system that prohibits multiple opening of medical instituion, in the content of 2014Hun-Ba212, August 29, 2019, 2014Hun-Ga15, 2015Hun-Ma561, 2016Hun-Ba21(amalgamation), Constitutional Court of Korea - ('의료법 제33조 제8항 관련 헌법재판소의 합헌결정'에 대한 평가 및 보완 입법 방향에 대하여 -헌법재판소 2019. 8. 29. 2014헌바212, 2014헌가15, 2015헌마561, 2016헌바21(병합) 결정의 내용 중 의료기관 복수 개설금지 제도의 당위성 및 필요성을 중심으로-)

  • KIM, JOON RAE
    • The Korean Society of Law and Medicine
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    • v.20 no.3
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    • pp.143-174
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    • 2019
  • Our Constitution obliges the state to protect the health of the people, and the Medical Law, which embodied Constitution, sets out in detail the matters related to open the medical institution, and one of them is to prohibit the operation of multiple medical institutions. By the way, virtually multiple medical institutions could be opened and operated because the Supreme Court had interpreted that several medical institutions could be opened if medical activities were not performed directly at the additional medical institution which was opened under the another doctor's license. However, some health care providers opened the several medical institutions with another doctor's license for the purpose of the maximization of profit, and did illegal medical cares like the unfair luring of patients, over-treatment, and commission treatment. Also, realistic problems such as the infringed health rights have arisen. Accordingly, lawmakers had come to amend the Medical Law to readjust the system of opening for medical institution so that medical personnel could not open or operate more than one medical institution for any reason. For this reason, the Constitutional Court recently declared a constitutional decision through a long period of in-depth deliberation because the constitutional petition and the adjudication on the constitutionality of statutes had been filed on whether Article 33 paragraph 8 of the revised medical law is unconstitutional. The Constitutional Court acknowledged the "justice of purpose" in view of the importance of public medical institutions, of the prevention from seduction of for-profit patients and from over-treatment, and of the fact that health care should not be the object of commercial transactions. Given the risk that medical personnel might be subject to outside capital, the concern that the holder of the medical institution's opening certificate and the actual operator may be separated, the principle that the human body and life should not be just a means, and the current system's inability to identify over-treatment, it also acknowledged the 'minimum infringement'. Furthermore, The Constitutional Court judged it is constitutional in compliance with the principle of restricting fundamental rights, such as 'balance of legal interests'. In this regard, legislative complements are needed in order to effectively prevent the for-profit management and the over-treatment the Constitutional Court is concerned about. In this regard, consumer groups actively support the need for legislation, and health care providers groups also agree on the need for legislation. Therefore, the legislators should respect the recent Constitutional Court's decision and in the near future complete the complementary legislation to reflect the people's interests.

Setting Priority Criteria for Classification of Self-Testing In Vitro Diagnostic Medical Devices Using Analytic Hierarchy Process Technique (Analytic Hierarchy Process 기법을 활용한 개인용 체외진단의료기기 분류기준에 대한 우선순위 연구)

  • Seol-Ihn Kim;Do-Yun Pyeon;Yong-Ik Jeong;Jahyun Cho;Gaya Noh;Green Bae;Hye-Young Kwon
    • Health Policy and Management
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    • v.33 no.2
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    • pp.173-184
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    • 2023
  • Background: The coronavirus disease 2019 pandemic has been challenging the healthcare service, i.e., the vitalization of the point of care accompanying self-testing in vitro diagnostic medical devices (IVDs). This study aims to suggest priority criteria to classify self-testing IVDs using the analytic hierarchy process technique. Methods: Two dimensions of the characteristics embedded in the IVDs and the diseases to be diagnosed with self-testing IVDs were parallelly considered and independently investigated. In addition, three expert panels consisting of laboratory medical doctors (n=11), clinicians (n=10), and citizens (n=11) who have an interest in the selection of self-testing IVDs were asked to answer to questionnaires. Priorities were derived and compared among each expert panel. Results: First of all, ease of specimen collection (0.241), urgency of the situation (0.224), and simplicity of device operation (0.214) were found to be the most important criteria in light of the functional characteristics of self-testing IVDs. Medical doctors valued the ease of specimen collection, but the citizen's panel valued self-management of the disease more. Second, considering the characteristics of the diseases, the priority criteria were shown in the order of prevalence of diseases (0.421), fatality of disease (0.378), and disease with stigma (0.201). Third, medical doctors responded that self-testing IVDs were more than twice as suitable for non-communicable diseases as compared to communicable diseases (0.688 vs. 0.312), but the citizen's group responded that self-testing IVDs were slightly more suitable for infectious diseases (0.511 vs. 0.489). Conclusion: Our findings suggested that self-testing IVDs could be primarily classified as the items for diagnosis of non-communicable diseases for the purpose of self-management with easy specimen collection and simple operation of devices, taking into account the urgency of the situation as well as prevalence and fatality of the disease.

An Efficiency Management Scheme using Big Data of Healthcare Patients using Puzzy AHP (퍼지 AHP를 이용한 헬스케어 환자의 빅 데이터 사용의 효율적 관리 기법)

  • Jeong, Yoon-Su
    • Journal of Digital Convergence
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    • v.13 no.4
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    • pp.227-233
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    • 2015
  • The recent health care is growing rapidly want to receive offers users a variety of medical services, can be exploited easily exposed to a third party information on the role of the patient's hospital staff (doctors, nurses, pharmacists, etc.) depending on the patient clearly may have to be classified. In this paper, in order to ensure safe use by third parties in the health care environment, classify the attributes of patient information and patient privacy protection technique using hierarchical multi-property rights proposed to classify information according to the role of patient hospital officials The. Hospital patients and to prevent the proposed method is represented by a mathematical model, the information (the data consumer, time, sensor, an object, duty, and the delegation circumstances, and so on) the privacy attribute of a patient from being exploited illegally patient information from a third party the prevention of the leakage of the privacy information of the patient in synchronization with the attribute information between the parties.

A Study of the Digital Healthcare Industry in the Fourth Industrial Revolution (4차 산업혁명시대의 디지털 헬스케어 산업에 대한 연구)

  • Kim, Ki-Bong;Han, Kun-Hee
    • Journal of Convergence for Information Technology
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    • v.10 no.3
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    • pp.7-15
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    • 2020
  • As the paradigm shifts from treatment and provider-centered healthcare to prevention and consumer-centered healthcare, the integration of ICT convergence technology is calling for an era of digital healthcare industry revival in the Fourth Industrial Revolution. It is possible to provide individual customized medical services utilizing various medical data, and it is possible to provide various medical services that transcend time and space through integration with other industries. Such digital healthcare includes health, nutrition, exercise, and patient care, while the digital healthcare industry includes healthcare and IT related to medical devices, medical information systems, and healthcare platforms that can provide personal health and medical information. Due to the social demands of the aging and the increase of chronic diseases, digital healthcare is considered as an important policy in the fourth industrial revolution in Korea. In order for the digital healthcare industry to contribute to the prolongation of human life and the improvement of quality of life, it is urgent to develop related infrastructures, legal institutions, and prepare policies. In addition, it is important to activate convergent education to foster talents who will lead the digital healthcare industry. The purpose of this study was to examine the trends of the digital healthcare industry in the era of the fourth industrial revolution and the direction of government R & D policies, and to derive directions and suggestions for future development.

Bundled Discounting of Healthcare Services and Restraint of Competition (의료서비스의 결합판매와 경쟁제한성의 판단 - Cascade Health 사건을 중심으로 -)

  • Jeong, Jae Hun
    • The Korean Society of Law and Medicine
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    • v.20 no.3
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    • pp.175-209
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    • 2019
  • The bundled discounting which the dominant undertakings engage in is problematic in terms of competition restraint. Bundled discounts generally benefit not only buyers but also sellers. Specifically, bundled discounts usually costs a firm less to sell multiple products. In addition, Bundled discounts always provide some immediate consumer benefit in the form of lower prices. Therefore, competition authorities and courts should not be too quick to condemn bundled discounts and apply the neutral and objective standard in bundled discounting cases. Cascade Health v. Peacehealth decision starts ruling from this prerequisite. This decision pointed out that the dominant undertaking can exclude rivals through bundled discounting without pricing its products below its cost when rivals do not sell as great a number of product lines. So bundled discounting may have the anticompetitive impact by excluding less diversified but more efficient producers. This decision did not adopt Lepage case's standard which does not require the court to consider whether the competitor was at least as efficient of a producer as the bundled discounter. Instead of that, based on cost based approach, this decision said that the exclusionary element can not be satisfied unless the discounts result in prices that are below an appropriate measures of the defendant's costs. By adopting a discount attribution standard, this decision said that the full amount of the discounts should be allocated to the competitive products. As the seller can easily ascertain its own prices and costs of production and calculate whether its discounting practices exclude competitors, not the competitor's costs but the dominant undertaking's costs should be considered in applying discount attribution standard. This case deals with bundled discounting practice of multiple healthcare services by the dominant undertaking in healthcare market. Under the Korean healthcare system and public health insurance system, the price competition primarily exists in non-medical care benefits because public healthcare insurance in Korea is in combination with the compulsory medical care institution system. The cases that Monopoly Regulation and Fair Trade Law deals with, such as cartel and the abuse of monopoly power, also mainly exist in non-medical care benefits. The dominant undertaking's exclusionary bundled discounting in Korean healthcare markets may be practiced in the contracts between the dominant undertaking and private insurance companies with regards to non-medical care benefits.

Utilization Patterns and Determinants of Oriental Medical Services : Focused on the Residents of Taegu City (한방의료의 이용행태 및 이용결정요인 분석 - 일부 대도시 지역주민을 중심으로 -)

  • Yoo Wang-Keun;Ryu Kyung-A
    • Journal of Society of Preventive Korean Medicine
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    • v.4 no.2
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    • pp.1-24
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    • 2000
  • This study was conducted to examine utilization patterns and determinants of oriental medical services. Data were collected from 545 residents in Taegu city The results of this study are summarized as follows 1) 37.8% of subjects used oriental medical services in the past year. Especially, the female, the ages of 50 and 60 over, the single. low-educated. high-income class, white-collar class, medical insured tended to use more oriental medical services than another groups. 2) 46.7% of users of oriental medical services reported that number of visits in the past year was 2 - 5 times 37 1% of them was 1 times, and 4.5% over 10 times. 3) According to the reasons to choose the oriental medical facilities, most was 'on their own judgement'(48.8%) and 'by the advice of relatives and friends'(42.0%) Regarding to the objectives of using oriental medicine, 68.3% was 'treatment', 31.7% 'health counselling and promotion'. And among diseases of users, diseases of musculo-skeletal system was the highest(54.5%). 4) 57.9% of oriental medical services users had experience of utilizing western medicine on the same diseases. Among peoples with experiencing western medicine on the same diseases. 54.4% received oriental medical services 'in addition to western medicine', 45.6%'in place of western medicine 'And 41.2% of using both services reported that they had difficulty in deciding to choose the type of services -oriental medical services or western medicine-for their diseases. 37.3% of them answered that 'providing relevant information' was the most desirable measure to solve this problem, 27.3% 'establishment of effective referral system between oriental and western medical facilities '23.6% 'cooperative medical treatment systems in the same facilities', 11.8%'integration of oriental medicine into western medicine 5) According to the satisfaction level with each items of oriental medical services, the respondents had positive views on efficacy, kindness, and side-effects. They, however, had negative view on the cost of oriental medical services. 6) In regarding to the priority of improvement of oriental medical system,'expansion of insurance benefit package 'ranked first. 'expansion of insurance benefit Package 'ranked second, 'improvement of scientific methods and diagnostic technique 'third, and 'safety of herbal medicine' fourth in order. 7) The significant factors influencing the utilization of oriental medical services were kindness of oriental medical practitioners, efficacy , travel time, age To be brief, utilization rate of oriental medical services in urban area generally tends to be high. There, however, have been various barriers to limit oriental medical services, such as incomplete benefit package of oriental medical insurance and lack of coordination and referral system between oriental and western medical services, lack of scientific diagnostic procedures, high price etc . For the development of oriental medical services, Much attention to remove these limiting factors should be placed. In addition, kindness of oriental medical practitioners , which is expected to be more important factor in the consumer - focused health care environment than ever, should be kept high consistently. Since this study was conducted for specific residents of an urban city. further research including more sampling in different urban areas should be required to generalize the results of the study.

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Spatial and temporal trends in food security during the COVID-19 pandemic in Asia Pacific countries: India, Indonesia, Myanmar, and Vietnam

  • Yunhee Kang;Indira Prihartono;Sanghyo Kim;Subin Kim;Soomin Lee;Randall Spadoni;John McCormack;Erica Wetzler
    • Nutrition Research and Practice
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    • v.18 no.1
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    • pp.149-164
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    • 2024
  • BACKGROUND/OBJECTIVES: The economic recession caused by the coronavirus disease 2019 pandemic disproportionately affected poor and vulnerable populations globally. Better uunderstanding of vulnerability to shocks in food supply and demand in the Asia Pacific region is needed. SUBJECTS/METHODS: Using secondary data from rapid assessment surveys during the pandemic response (n = 10,420 in mid-2020; n = 6,004 in mid-2021) in India, Indonesia, Myanmar, and Vietnam, this study examined the risk factors for reported income reduction or job loss in mid-2021 and the temporal trend in food security status (household food availability, and market availability and affordability of essential items) from mid-2020 to mid-2021. RESULTS: The proportion of job loss/reduced household income was highest in India (60.4%) and lowest in Indonesia (39.0%). Urban residence (odds ratio [OR] range, 2.20-4.11; countries with significant results only), female respondents (OR range, 1.40-1.69), engagement in daily waged labor (OR range, 1.54-1.68), and running a small trade/business (OR range, 1.66-2.71) were significantly associated with income reduction or job loss in three out of 4 countries (all P < 0.05). Food stock availability increased significantly in 2021 compared to 2020 in all four countries (OR range, 1.91-4.45) (all P < 0.05). Availability of all essential items at markets increased in India (OR range, 1.45-3.99) but decreased for basic foods, hygiene items, and medicine in Vietnam (OR range, 0.81-0.86) in 2021 compared to 2020 (all P < 0.05). In 2021, the affordability of all essential items significantly improved in India (OR range, 1.18-3.49) while the affordability of rent, health care, and loans deteriorated in Indonesia (OR range, 0.23-0.71) when compared to 2020 (all P < 0.05). CONCLUSIONS: Long-term social protection programs need to be carefully designed and implemented to address food insecurity among vulnerable groups, considering each country's market conditions, consumer food purchasing behaviors, and financial support capacity.

A Plan to Improve Consumer Satisfaction and Reliability of Opticians by Analyzing Consumers' Spectacles Purchasing Behavior (소비자의 안경 구매 행태 분석을 통한 만족도 및 신뢰도의 향상 방안)

  • Park, Jee-Hyun;Lee, Eun-Hee;Koo, Eun-Hye;Kim, Hee-A;Song, Da-Hye;Hyun, Jin-Hee;Kim, Hyojin
    • Journal of Korean Ophthalmic Optics Society
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    • v.15 no.1
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    • pp.1-7
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    • 2010
  • Purpose: To plan and improve consumers' satisfaction by analyzing consumers' purchasing behavior of spectacles. Also this will show the need of improvement in reliance of an optician. Methods: A total of 307 people (10 to 60 years) participated in individual questionnaires. Questionnaires comprised of general characteristic of surveyed people, purchasing spectacles behavior, satisfaction after purchasing spectacles, reliability of optician, and improvement points of optician. Results: Most important points in selecting the product were the design and the price of the spectacles. 142 people (46.3%) replied "average" and 140 people (45.6%) replied "satisfying" out of maximum point of satisfaction level which was 5 points. 72.3% of people have regularly visiting optical shop due to the high accessibility, after-sales care, and courteous optician. On the contrary, 27.7% replied "never visit same optician shop again" because of the low accessibility, minimal range of products, and high price. Data showed that people had high re liability about the opticians' knowledge of product, and their technique of eye refraction. Data revealed that people did not show high satisfaction about opticians' knowledge of ophthalmology, and price of products. Most important improvement points were accurate spectacle prescription by Opticians rating 42% of reply. Factors most considered during spectacle selection among the 10 to 20 age group were design by 34.8% and price by 10.1%. Among the 40 to 50 age group, most considered factors were design by 14% and spectacle frame material by 10.1%. Conclusions: Satisfaction rate of purchasing spectacles for the total participant group was 4.2 average grades. Reliability of opticians' eye refraction result and prescription was 50.5%. However consumers wanted to obtain more accurate eye refraction result and prescription with more comprehensive explanations. Also, consumers wanted opticians to be sensitive and have appreciative eye in select spectacles for customers, and to offer precise spectacle dispensing services and courteous after-sales care.