• Journal of Gastric Cancer
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• v.12 no.2
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• pp.126-131
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• 2012

Purpose: We developed a standardized critical pathway for gastric cancer surgery and then determined the increase of application, which resulted in an improvement in terms of measurable indices, such as hospital stay and cost. Materials and Methods: A critical pathway was revised and used widely from the 2nd quarter of 2009. We collected clinical data, such as length of stay and complication rate, as clinical indices of quality prospectively. The total cost paid at the patient's discharge, as well as the daily hospital income, were calculated and compared by each quarter from January 2008 to December 2009. Results: The application rate of critical pathway was 11.8% and 87.8% in 2008 and 2009, respectively. There were no perioperative deaths. There was no difference in the complication rates between 2008 and 2009 (P=0.45). However, the mean length of stay was significantly different between the 2 years (P<0.05). Although the total cost was not different, the daily hospital income was significantly higher in the latter year (P<0.05). Conclusions: An increase in the application of critical pathway for gastrectomy resulted in significant decreases in length of stay and increases in the daily hospital income without a compromise on the clinical indices.

• Korea Journal of Hospital Management
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• v.5 no.1
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• pp.200-231
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• 2000

The price systems of the hospital drug services play key roles in the provision of quality services and the development of pharmacy service technologies. Under the premises, this study attempted to determine the costs of hospital drug service, to compare the costs calculated with the fees publicly fixed by the Government, and based on the results of the analysis, to propose directions for the improvement of the price systems. A Costing model for the study was developed based on the cost-fee relationship analysed of the Korean fee-for-service systems. Data on costs and workloads of the 25 hospitals were collected through survey forms designed for the costing' and analysis for the duration of 12 months of 1998. The results of the analysis show that a tremendous unbalance between cost and price levels of the drug services, and that overally the price level of the services is extremely low when compared to the costs of services. Based on these findings, this study suggests that unfairly high or low price level be corrected, and that service items newly developed and being practiced at tertiary hospitals, such as TDM and TPN consultation services, be compensated by fixing a proper level of price.

• Journal of Preventive Medicine and Public Health
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• v.14 no.1
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• pp.3-12
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• 1981

To identify the changes in professional care patterns after the introduction of medical insurance in Korea, professional care in hospitals and clinics of two succeeding years were compared. The hospitals and clinics selected for this study were those which located in Seoul city. Hospitals were classified into 3 categories: university hospital, general hospital and hospital. The diseases selected for this study were acute appendicitis and normal delivery. They were selected because their disease courses are considered to be fairly stable. The variables used for this study were length of stay, total hospital costs, costs of each components of cares. The information used for this study was obtained from the official forms requested by the medical facilities to the Korea Medical Insurance Corporation. The two periods studied were 3 months of each year from March 1st to May 31st in 1979 and 1980, The total number of normal delivery studied was 289 in 1979, 301 in 1980 respectively and the acute appendicitis was 92 and 111 respectively. In order to compare the quantity of medical care between 2 study periods the insurance price scores of 1979 were converted to prices of 1980. For statistical test of difference between 2 periods T-test and Welch's test were used. The result of the study were briefly summarized in below. 1. No significant difference was observed in the average length of stay of both disease between two study periods in all types of hospitals. 2. No significant difference was observed in the average total hospital costs of both diseases in all types of hospital, but in the private clinic the average clinic costs was rather decreased significantly in 1980. 3. More cost decrease were seen than cost increase in 1980 in all types of facilities, More cost changes by items were seen in acute appendicitis than in normal delivery between two study periods. The total hospital costs can be devided into 2 portions: charges for drug and material and for physician. In normal delivery, costs for physician's charges was significantly decreased in almost all the hospitals and costs for drug and material were not changed significantly in all the hospitals in 1980. In the university hospitals, however, the costs for drug and material were increased significantly in 1980. The cost decrease for physician's charge were mainly due to the decrease in the costs of laboratory test, treatment and physical therapy. The increase in the costs for the drug and material in the university hospitals was mainly due to the increase in the cost for drugs for oral administration and injection. 4. The proportion of components of medical care in the hospital has not been changed significantly, however, the cost for injection in normal delivery was characteristically increased in 1980 in all hospitals studied. In general the proportion of the costs for drug and material was tended to increase and the costs for physician was tended to decrease in 1980. The increase in the costs for drug and material were considered to be due to increase in the cost for drugs for oral administration and injection. The decrease in the costs for physician were due to decrease in the costs of laboratory test, treatment and physical therapy. Above mentioned changes in hospital and clinic care patterns are considered to be mostly influenced by the review criteria set by the K.I.C. for the assessment of the fee request made by clinics and hospitals.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.11
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• pp.4951-4957
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• 2016

Background: Apart from reducing occupational exposure to cytotoxic hazards, the PhaSeal(R) closed-system transfer device (CSTD) can extend the beyond-use dates (BUDs) of unfinished vials of antineoplastic drugs for up to 168 hours (seven days). In this study, the total material cost incurred by its use in a Malaysian government-funded hospital was calculated. Methods: A list of vial stability following initial needle punctures of 29 commonly-used antineoplastic drugs was compiled. The amount of the materials used, including drugs, infusion bottles, the PhaSeal(R) CSTD and other consumables, was recorded on a daily basis for three months in 2015. The total cost was calculated based on the actual acquisition costs, and was compared with that of a hypothetical scenario, whereby conventional syringe-needle sets were used for the same amounts of preparations. Results: The use of the PhaSeal(R) CSTD incurred a cost of MYR 383,634.52 (USD 92,072.28) in three months, representing an average of MYR 170.5 (USD 40.92) per preparation or an estimated annual cost of MYR 1,534,538.08 (USD 368,289.14). Compared with conventional syringe-needle approach, it is estimated to lead to an additional spending of MYR 148,627.68 (USD 35,670.64) yearly. Conclusion: Although there was a reduction of drug wastage achieved by extending BUDs of unfinished vials using the PhaSeal(R) CSTD, cost saving was not observed, likely attributable to the wide use of lower-priced generic drugs in Malaysia. Future studies should further evaluate the possibility of cost saving, especially in health settings where branded and high-cost antineoplastic drugs are more commonly used.

• Proceedings of the Korean Society for Quality Management Conference
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• 1998.11a
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• pp.673-679
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• 1998

The paper aims to apply a model of continuous quality improvement (CQI) to Taiwan provincial Pin Ton hospital. Tools of quality control were used both total quality management (TQM) and quality control circle (QCC) in order to approach the objective of ${\ulcorner}$higher quality, higher efficiency, lower cost${\lrcorner}$. During two years, this hospital has organized thirteen QC circles that were classified three categories according to that objective: four circles work for higher quality; the other four circles work for higher efficiency; five circles for lower cost. After implementation, several results were found from two viewpoints. From viewpoint of tangibility, one of the most outcomes is to reduce labor cost from 56 persons to 28 persons of temporary employees. From viewpoint of intangibility, the result was evaluated using radar chart to compare the difference after improvement. This paper is going to report the process of CQI for the hospital management because it is a new issue in Taiwan since 1997

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.3753-3757
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• 2016

Background: The aim of this study was to investigate whether electrochemotherapy is a clinically and cost-effective treatment option against skin tumors. Materials and Methods: We performed an analysis of the current literature based on database searches in PubMed/MEDLINE and we included articles till July 2012. Terms used for the search were 'electrochemotherapy', 'skin cancer', 'recurrence', and 'cutaneous and subcutaneous tumors'. Only papers published in English were included. In addition, we performed an analysis of the cost effectiveness of the method. Results: The combination of physics and chemistry is the foundation for electrochemotherapy and its efficacy, independent of the tumor histology. Clinical data showed that ECT is well tolerated and can be used in difficult cases without other available treatment options. The analysis also showed that the treatment is feasible and cost-effective. Conclusions: Electrochemotherapy is a clinically efficient safe and cost-effective treatment and clinicians should not hesitate to use it as alternative therapeutic modality or as palliative treatment.

• Korea Journal of Hospital Management
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• v.9 no.3
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• pp.49-70
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• 2004

This study analyzes the effect of separation of dispensary from medical practice on hospital management performance. The results are as follow. The earning ratios of large size hospitals become deteriorated significantly after the separation of dispensary. The growth ratios of revenues from inpatient were unchanged, but the growth ratios of revenues from outpatient of large and middle size hospitals were decreased significantly. Hospitals can't sell the medicines to the outpatient after the separation of dispensary, but they can do to the outpatient. The labor cost ratios of small and large size hospitals are increased significantly after the separation of dispensary. There are two reasons for increase of labor cost ratios. One is the decrease of material cost ratio. The other is the increase of doctor's salary. The material cost ratios of every size hospital are decreased significantly after the separation of dispensary. Because medicines costs of outpatients are decreased. The labor cost and doctors' salary per patient of middle and large size hospitals are increased significantly after the separation of dispensary. And average treatment fees per day of inpatients of middle and large size hospitals are increased significantly after the separation of dispensary. But those of outpatients are decreased significantly. Average numbers of outpatients per bed of small and large hospitals are decreased significantly after the separation of dispensary. And average numbers of inpatients per bed of large hospitals are decreased significantly. In summary, as a consequence of separation of dispensary from medical practice, management performances of large size hospitals become deteriorated significantly.

• Korea Journal of Hospital Management
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• v.28 no.1
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• pp.1-13
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• 2023

Purpose: This study purposed to analyze the economic feasibility of introducing a third party logistics system as a strategic alternative to hospital management. Methods: Economic analysis was performed by measuring changes in costs and benefits before and after implement the third party logistics system and estimating the size of net benefits for the next five years for the target hospital. A questionnaire survey and in-depth interview with stake-holders were conducted to find out the satisfaction and effectiveness of the system. Findings: According to results, the cost-benefit ratio for the implementation of the system was 1.18. For the next five years, the cost-benefit ratio was 1.48, the net present value was about 1.7 billion won, and the internal rate of return was 64%. The satisfaction of internal stake-holders was relatively high, in terms of improving the concentration of unique tasks and increasing the efficiency of inventory management. Practical Implications: It was found that the increase in benefits had a greater effect on the change in the cost-benefit ratio than the increase in costs resulting from the expansion of logistics, and the increase in the present value of net benefits gradually decreased as the cost increased. In addition, overall job satisfaction and satisfaction with outsourcing companies were relatively low, which means that stabilization of the new system is important. Further study is needed for more accurate economic analysis.

• Journal of Korean Academy of Nursing Administration
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• v.16 no.4
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• pp.409-418
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• 2010

Purpose: The purpose of this study was to compare the costs and benefits of home nursing care services between public health centers (PHC) and private hospitals. Method: Participants were 105 patients who had received home nursing care services from a private hospital or public health center. From a societal perspective, the researcher identified the costs and benefits of the services using performance data and calculated the net benefit and benefit/cost ratio. Result: The net benefit of the home nursing care service based in the PHC was 165.9 million won and benefit/cost ratio was 2.0, while the net benefit of the home nursing care services by the private hospital was 141.1 million won and benefit/cost ratio was 1.7. Both types of programs were economically validated. Conclusion: Home nursing care services were basically efficient as the results showed a positive net benefit. A cost-benefit analysis indicated that the PHC-based home nursing care services were more efficient than that of the private hospital. With limited human resources and management standards in public health centers, results suggest the need for a more systematic management of the home nursing care service to improve the health of this vulnerable community population.

• Health Policy and Management
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• v.8 no.2
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• pp.76-87
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• 1998

This study analyzed the effect of foreign currency exchange rate on the increasing rate of medical care cost by items of fee schedule of Korean Medical Insurance. This study uses the data of cost analysis including cost of imported goods and the data of for a university hospital National Federation's Medical Insurance for a trend of claim. The method of cost analysis is as same as that used in the study of the development of Korean RBRVS(Resource Based Relative Valus Scale). The main findings of this study are as follows; 1. The proportion of imported goods in cost related to Medical Insurance fee schedule is 7.93%, and in case of substitution of available domestic goods 6.96%. 2. If foreign currency exchange rate changes from 800wen per $1 to 1,300won, the affecting rate of Medical Insurance fee schedules is 5.00%. If the imported goods will be substituted with available domestic goods, the rate 4.35%. Our results can be used a data for updating Medical Insurance fee schedule. But this result is limited to be generalized, because this study used the cost analysis for a university hospital.