• 보건행정학회지
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• 제10권4호
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• pp.20-56
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• 2000

The purpose of this article was to evaluate the effects of reimbursement system on the basis of diagnosis-related groups(DRGs). We searched articles which was published from 1970 to 2000 using MEDLINE ； Key words "diagnosis-related groups, DRGs, prospective payment system, PPS. Then we reviewed 97 articles on classifying them into several categories of contents. It seems that the effects of DRGs in controlling hospitals cost in the U.S. was not clear cut. The U.S. Medicare PPS using DRGs remains vulnerable to compensatory increases in ambulatory care and long-term care facilities utilization despite cost per case and cost per admission being reduced. Also some research indicated the possibilities of deterioration in health care service quality. So putting theses results together, much more consideration is needed before the application of DRGs reimbursement system in Korea. Particularly there is the crucial difference between U.S. health care system and Korean, we must be aware of the limitations of DRGs and revise the DRG system to applicable in Korea.orea.

• 보건행정학회지
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• 제30권1호
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• pp.131-138
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• 2020

The purpose of this study was to compare the health status of South Korea with those of Organization for Economic Cooperation and Development (OECD) countries and examine the trends. Position vAlue for Relative Comparison (PARC) was used as a gauge for comparison, and five sectors of the health care system were measured: demand, supply, accessibility, quality, and cost. The Mann-Kendall test was used as a statistical analysis method to examine trend of PARC values obtained from 2000 to recent years. According to the results, the demand, supply, accessibility, and quality sectors were higher than the OECD average, while the cost was lower than the average. However, there is a recent trend of sharp increases in health care costs. Some indicators: health employment, quality of primary care and mental health care were lower than the OECD average, and health determinants showed a worsening trend. Therefore, policy-makers need to take this into account and make efforts for sustainable health care.

• 유통과학연구
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• 제7권2호
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• pp.45-61
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• 2009

서비스 기업에서 이루어지는 서비스는 그 특성상 대기가 발생할 수밖에 없다. 그리고 이러한 대기는 고객의 서비스 품질이나 고객만족에 부정적 요인으로 작용하고 기업의 경쟁력을 약화시키는 원인이 된다. 이를 위해 고객의 서비스 대기 영향요인을 병원서비스 이용목적 고객별로 분류하여 그 차이를 분석하고, 고객의 지각된 서비스 대기에 영향을 미치는 요인으로 새롭게 고객만족을 추가하여 분석하였다. 분석결과 질병치료의 고객과 질병예방을 위한 건강검진을 목적으로 병원을 방문하는 고객 간에는 서비스 이용에 대한 대기비용과 거래의 중요도에서 유의한 차이를 보이고 있었다. 또한 대기시간에 유의한 영향을 미치는 변수는 대기비용, 지속성, 거래중요도 등도 확인할 수 있었지만, 본 연구에서 도출한 고객만족이 대기시간에 영향을 미치는 주요한 변수라는 사실은 기존 연구에서 다루지 않은 내용으로 실질적인 고객의 지각된 대기시간을 관리하는데 시사하는 바가 있다고 판단한다.

• 한국산학기술학회논문지
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• 제15권11호
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• pp.6746-6755
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• 2014

본 논문은 기초생활보장수급자를 대상으로 장기요양서비스 이용 여부가 의료 이용에 미치는 영향을 파악하기 위한 서술적 연구이다. 연구 대상은 장기요양 1등급 판정을 받은 기초생활보장수급자 5,834명을 대상으로 하였다. 기초생활보장수급자의 의료 이용에 미치는 영향을 다중회귀분석으로 분석한 결과 2007-2009년 총 진료비 변화량을 설명하는 $R^2$은 22.6%이었으며, 장기요양 서비스 이용자에 비해 미이용자는 8,297,329원 증가하였다(${\beta}=.29$, p< .001). 입원일 변화량의 $R^2$은 22.4%이었으며, 서비스 이용자에 비해 미이용자는 119.013일 증가하였다(${\beta}=.33$, p< .001). 총 진료비와 입원일 변화량에 영향을 미치는 요인은 장기요양서비스 이용 여부, 수발자 여부, 2009년 일상생활수행능력, 간호처치, 재활기능이 유의한 영향을 미치는 것으로 나타났다. 따라서 장기요양 서비스 미이용자의 의료 이용이 높게 나타남에 따라 미이용자에 대한 적정 의료와 요양서비스 이용을 지원할 수 있는 정책 마련이 필요로 된다.

• 지역사회간호학회지
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• 제27권3호
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• pp.272-283
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• 2016

Purpose: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. Methods: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. Results: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. Conclusion: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.

• Journal of Preventive Medicine and Public Health
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• 제39권5호
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• pp.397-403
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• 2006

Objectives: We estimated the asthma-related health care utilization and costs in Korea from the insurer's and societal perspective. Methods: We extracted the insurance claims records from the Korea National Health Insurance claims database for determining the health care services provided to patients with asthma in 2003. Patients were defined as having asthma if they had ${\geq}$2 medical claims with diagnosis of asthma and they had been prescribed anti-asthma medicines, Annual claims records were aggeregated for each patient to produce patient-specific information on the total utilization and costs. The total asthma-related cost was the sum of the direct healthcare costs, the transportation costs for visits to health care providers and the patient's or caregivers' costs for the time spent on hospital or outpatient visits. Results: A total of 699,603people were identified as asthma patients, yielding an asthma prevalence of 1.47%. Each asthma patient had 7.56 outpatient visits, 0.01 ED visits and 0.02 admissions per year to treat asthma. The per-capita insurance-covered costs increased with age, from 128,276 Won for children aged 1 to 14 years to 270,729 Won for those aged 75 or older. The total cost in the nation varied from 121,865 million to 174,949 million Won depending on the perspectives. From a societal perspective, direct health care costs accounted for 84.9%, transportation costs for 15.1 % and time costs for 9.2% of the total costs. Conclusions: Hospitalizations and ED visits represented only a small portion of the asthma-related costs. Most of the societal burden was attributed to direct medical expenditures, with outpatient visits and medications emerging as the single largest cost components.

• 보건행정학회지
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• 제32권4호
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• pp.389-399
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• 2022

Background: This study aimed to analyze changes in medical utilization and cost before and after long-term care (LTC) implementation. Methods: We used the National Health Information Database from National Health Insurance Service. The participants were selected who had a new LTC grade (grade 1-5) for 2015. Medical utilization was analyzed before and after LTC implementation. Segmented regression analysis of interrupted time series was conducted to evaluate the overall effect of the LTC implementation on medical costs. Results: The total number of participants was 41,726. A major reason for hospitalization in grade 1 was cerebrovascular diseases, and dementia was the top priority in grade 5. The proportion of hospitalization in grade 1 increased sharply before LTC implementation and then decreased. In grade 5, it increased before LTC implementation, but there was no significant difference after LTC implementation. As for medical cost, in grades 1 to 4, the total cost increased sharply before the LTC implementation, but thereafter, changes in level and trend tended to decrease statistically, and for grade 5, immediately after LTC implementation, the level change was decreasing, but thereafter, the trend change was increasing. Conclusion: Long-term care grades showed different medical utilization and cost changes. Long-term care beneficiaries would improve their quality of life by adequately resolving their medical needs by their grades.

• 가정간호학회지
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• 제11권1호
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• pp.57-70
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• 2004

Purpose: This study was to develop a cost-effective and efficient curriculum for advanced practice nurse (APN) programs in home health care and hospice. Method: The process was to: (1) compare and analyze the present curriculum in home health care and hospice programs, (2) identify the needs of 7 expert nurses in home health care and hospice, and (3) develop a common curriculum structure and contents between home health care and hospice specialty courses. Result: Out of the 10 credits constituting the home health care and hospice specialty courses respectively, 6 credits were identified the common courses, Common content areas included introduction to hospice, communication skills, pain control. symptom control. teaching methods, and agency management. Conclusion: These results can be utilized in the development of APN programs for home health care and hospice in terms of qualified and cost-effective aspects of education.

• International Journal of Computer Science & Network Security
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• 제21권4호
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• pp.84-92
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• 2021

Care services are a significant asset in human life. Care in its overall nature focuses on human needs and covers several aspects such as health care, homes, personal care, and education. In fact, care deals with many dimensions: physical, psychological, and social interconnections. Very little information is available on estimating the cost of care services that provided to orphans and abandoned children. Prediction of the cost of the care system delivered by governmental or non-governmental organizations to support orphans and abandoned children is increasingly needed. The purpose of this study is to analyze the care cost for orphanage organizations in Saudi Arabia to forecast the cost as well as explore the most influence factor on the cost. By using business analytic process that applied statistical and machine learning techniques, we proposed a model includes simple linear regression, Naive Bayes classifier, and Random Forest algorithms. The finding of our predictive model shows that Naive Bayes has addressed the highest accuracy equals to 87% in predicting the total care cost. Our model offers predictive approach in the perspective of business analytics.

• 한국병원경영학회지
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• 제14권2호
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• pp.60-74
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• 2009

This study purports to verify managerial effectiveness of the integrated delivery system(IDS) of Japanese health care institutions through comparing the managerial performance between hospital groups providing with both acute and nursing care and those with acute care only. Data on the managerial performance of 697 hospitals providing with nursing care together and 819 hospitals providing with acute care only were collected from Japanese Central Social Insurance Medical Councils 2001, 2003, 2005, and were analyzed using mean comparison test(t-test) between the two groups. The results revealed that there were significant differences between the two groups in such indicators as ratio of material cost, labor cost, depreciation rate, total margin, operating margin, average number of outpatient per day, average revenue of an inpatient per day, total amount of labor cost, gross revenue per employee, and labor productivity. However, we could not find out any consistent evidence which support the effect of integrated delivery system on the hospital managerial performance. Further discussion was made on the limitation of the study and future research agenda relevant to the topic.