• 제목/요약/키워드: inpatient treatment

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의료기관 종류별 자동차보험 환자의 진료비 성향 분석 (Analysis of the propensity of medical expenses for auto insurance patients by type of medical institution)

  • 하오현
    • 융합정보논문지
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    • 제12권2호
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    • pp.184-191
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    • 2022
  • 본 연구는 자동차보험 이용환자들의 효율적 관리방안을 모색하는데 필요한 기초정보를 제공하고자 보건의료빅데이터개방시스템에 등록된 2016년부터 2020년까지 5개년 자동차보험 진료비 심사자료를 대상으로 분석하였다. 분석결과, 자동차보험 입원진료비 내역 구성비율 1순위는 상급종합병원은 처치 및 수술료, 종합병원·병원·의원은 입원료, 한방의료기관(한방병원, 한의원)은 처치 및 수술료, 치과병원은 처치 및 수술료 이었다. 외래진료비 내역 구성비율 1순위는 양방의료기관(상급종합병원, 종합병원, 병원, 의원)은 진찰료, 한방의료기관(한방병원, 한의원)과 치과의료기관(치과병원, 치과의원)은 처치 및 수술료 이었다. 자동차보험 입원 건당 진료비에는 투약료, 마취료, 특수장비 비율이 영향요인이었으며, 외래 건당 진료비에는 이학요법료 비율이 영향요인으로 확인되었다.

ARIMA모델에 의한 피용자(被傭者) 의료보험(醫療保險) 수진율(受診率), 건당진료비(件當診療費) 및 건당진료일수(件當診療日數)의 추이(推移)와 예측(豫測) (Trend and Forecast of the Medical Care Utilization Rate, the Medical Expense per Case and the Treatment Days per Cage in Medical Insurance Program for Employees by ARIMA Model)

  • 장규표;감신;박재용
    • Journal of Preventive Medicine and Public Health
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    • 제24권3호
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    • pp.441-458
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    • 1991
  • 공무원 및 사립학교교직원 의료보험과 직장의료보험에서 입원, 외래별 수진을, 건당진료비 (1985년 기준 불변가격), 건당진료일수 등의 장래예측을 통해 의료보험 진료비 안정화 방안을 마련하는데 기초자료로 제시하기 위하여, 이들의 $1979{\sim}89$년간 월별 통계자료를 이용, Box-Jenkins model인 ARIMA 모델을 적용하여 1994년 까지의 수진을, 건당진료비 및 건당진료일수를 예측한 결과를 요약하면 다음과 같다. 수진을, 건당진료비 및 건당진료일수의 ARIMA 모형을 제시하면 다음 표와 같다. 상기의 ARIMA 모형을 기초로하여 향후 5년간의 수진율을 예측한 결과, 공교의료보험 입원의 경우, 1989년의 실측치는 0.068건 이었으며, 1990년과 1991년은 0.068건, 1992년과 1993년은 0.069건, 1994년은 0.070건으로 연평균 0.7%정도 증가될 것으로 예측되었으며, 외래의 경우, 1989년의 실측치는 3.487건이었으나 1990년은 3.530건, 1994년은 3.668건으로 연평균 1%정도 증가될 것으로 예측되었다. 직장의료보험 입원의 경우, 1989년의 실측치는 0.063건이었으며, 1990년부터 1994년까지 모두 0.063건으로 안정될 것으로 예측되었으며, 외래의 경우 1989년의 실측치는 2.984건이었으나, 1990년은 3.016건, 1994년은 3.154건으로 연평균 1.1% 정도 증가될 것으로 예측되었다. 건당진료비의 향후 예측치는 12월을 기준으로하여 1985년 불변가격으로 공교의료보험 입원의 경우, 1989년의 실측치는 332,751원이었으나, 1990년은 345,938원, 1994년은 354,511원으로 연평균 0.6%정도 증가될 것으로 예측되었으며, 외래의 경우, 1989년의 실측치는 11,925원이었으나, 1990년은 12,638원, 1994년은 12,904원으로 연평균 0.5%정도 증가될 것으로 예측되었다. 직장의료보험 입원의 경우, 1989년 실측치는 281,835원이었으나, 1990년은 282,524원, 1994년은 293,973원으로 연평균 1%정도 증가될 것으로 예측되었으며, 외래의 경우, 1989년 실측치는 11,599원이었으나, 1990년부터 1994년까지 11,585원으로 안정될 것으로 예측되었다. 건당진료일수의 향후 예측치는 12월을 기준으로 하여 공교의료보험 입원의 경우, 1989년의 실측치는 13.79일이었으며, 1990년은 13.82일, 1993년과 1994년은 13.85일로 거의 안정될 것으로 예측되었으며, 외래의 경우, 1994년까지 5일 정도로 안정될 것으로 예측되었다. 직장의료보험 입원의 경우, 1989년의 실측치는 12.23일이었으나, 1990년은 12.30일, 1994년은 12.85일로 연평균 1.1%정도 증가될 것으로 예측되었으며, 외래의 경우 1989년의 실측치는 4.61일이었으며 1990년부터 1994년까지 4.60일로 안정될 것으로 예측되었다.

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전침 및 추나 요법을 병행한 족근관 증후군 증례보고 (A Case Report of Patient with Tarsal Tunnel Syndrome Treated by Korean Medicine Treatment in Combination with Electro-acupuncture and Chuna Manual Treatment)

  • 이형은;허동석
    • 한방재활의학과학회지
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    • 제23권2호
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    • pp.175-184
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    • 2013
  • This study is to observe the effect of Korean medicine treatment combined with electro-acupuncture and chuna manual treatment on tarsal tunnel syndrome inpatient. The patient, diagnosed as tarsal tunnel syndrome, was treated by Korean medicine treatment in combination with electro-acupuncture and chuna manual treatment. We measured visual analogue scale(VAS). Neuropathic pain scale(NPS) was adopted as a method of measuring the treatment results of pain & hypoesthesia. Rt. sole numbness & pain decreased from VAS 10 to VAS 4. Rt. foot paresthesia decreased from VAS 10 to VAS 4 and Rt. ankle pain was disappeared. NPS score decreased from 80 to 62. Korean medicine treatment in combination with electro-acupuncture and chuna manual treatment is proved to be helpful to improve the symptoms of the tarsal tunnel syndrome patient.

소아청소년 양극성장애 입원 환자의 약물 사용 특성 : 후향적 차트 분석 연구 (Prescribing Patterns for Treatment of Pediatric Bipolar Disorder in a Korean Inpatient Sample)

  • 권오향;박수빈;이수민;김재원;신민섭;유희정;조수철;김붕년
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제25권1호
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    • pp.14-19
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    • 2014
  • Objectives : This study was conducted in order to describe prescribing practices in treatment of pediatric bipolar disorder in a Korean inpatient sample. Methods : We performed a retrospective chart review of 66 youths who had been hospitalized and diagnosed with bipolar disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Demographics, clinical characteristics, medications used, doses, and related adverse events were examined. Results : Mood stabilizers and/or atypical antipsychotic medications were the primary treatment. Risperidone, valproate, and lithium were the most commonly used. Thirty seven patients (58.1%) were treated with combination therapy of an atypical antipsychotic and mood stabilizer for improvement of manic/mixed symptoms. Conclusion : Combination pharmacotherapy was necessary for most patients in this admission sample group. Conduct of further studies will be needed for evaluation of treatment response according to the clinical characteristics, and the safety and efficacy of treatment for child and adolescent bipolar disorder.

흉요추 압박골절로 입원한 환자에 대한 한의학적 치료 효과 (Effect of Oriental Medicine Treatment on Inpatient with Thoracolumbar Compression Fracture)

  • 정기훈;차정호;황희상;전재천;이태호;이은용;노정두
    • Journal of Acupuncture Research
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    • 제26권1호
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    • pp.81-90
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    • 2009
  • Objectives : This Study was to investigate the tendency of inpatient with Thoracolumbar Compression Fracture. Also we investigated effectiveness of Pharmacopuncture and Warming Acupuncture on Thoracolumbar Compression Fracture. Methods : We investigated 48 cases of patients with thoracolumbar compression fracture. We distributed inpatint with age, sex, number of injured vertebra, level of injured vertebra, admission duration, grade of clinical symptom, result of treatment and applied treatments. And we calculated statistically signification with this data. Results : 1. Female is prominent in distribution of sex, the average age bracket is 70's, and the largest group was accidental fall in the distribution of causes. 2. In regard to level of injury, T12 was found to be most prominent, followed in turn by L2, L1, T12. In regard to grade of clinical symptoms, Grade III was most Prominent, followed in turn by Grade IV, Grade II. In regard to grade of result of treatment, Good was most prominent. 3. There was not statistically significantly correlation about admission duration and result of treatment with number of injured vertebra, grade of clinical symptom, applied treatments. Conclusions : Most inpatients with thoracolumbar compression fracture was cured by oriental medicine treatment.

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Effects of Muscle Energy Technique of Upper Trapezius and Sternocleidomastoid Muscles on Bell's Palsy

  • Park, Jong-Hyeon;Lee, Yoon-Joo;Ryu, Hye-Min;Lee, Seung-Jeong;Park, Eun-Jin;Song, Choon-Ho;Kim, Cheol-Hong;Yoon, Hyun-Min
    • Journal of Acupuncture Research
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    • 제34권4호
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    • pp.190-196
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    • 2017
  • Background: The purpose of this study was to investigate the efficacy of muscle energy techniques (MET) of upper trapezius and sternocleidomastoid muscles on Bell's palsy. Methods: In this retrospective study, we screened the medical records of patients with Bell's palsy who had received inpatient and outpatient treatment at the Department of Acupuncture & Moxibustion, Korean Medicine Hospital Dong-Eui University between November 28, 2016 and April 30, 2017. A total of 34 out of 93 Bell's palsy patients met the inclusion criteria. The 34 patients were divided into two groups: Group A patients had undergone Korean-Western combination treatment and MET of upper trapezius and sternocleidomastoid muscles; Group B patients had undergone Korean-Western combination treatment only. MET of upper trapezius and sternocleidomastoid muscles had been performed three times a week during the inpatient period, and two to three times a week during the outpatient period. Yanagihara scores had been assessed at the first visit, and 1, 2, 3, and 4 weeks after the first visit. Results: Group A Yanagihara scores were significantly improved during each interval from the first visit to 4 weeks later. Group B Yanagihara scores were also significantly improved except during the first week. During every period, the improvements observed in Yanagihara score were significantly higher in Group A than in Group B. Conclusion: These results suggest that MET of upper trapezius and sternocleidomastoid muscles may be effective treatment for Bell's palsy.

선택진료제도 개선이 폐암환자 의료이용 및 본인부담액에 미치는 영향 (The Effects of Changed Selective Treatment System on Medical Service Usage and Payments for Lung Cancer Patients)

  • 전인숙;이해종
    • 한국병원경영학회지
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    • 제22권4호
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    • pp.61-73
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    • 2017
  • In the Health Insurance System of South Korea, patients must pay high out-of-pocket expenditures for the medical service by uninsured medical benefits. So, the government implemented a policy to relieve the burdens of patients by lowering the uninsured selective-medical treatment costs in August, 2014. This study investigate the policy effects of selective-medical treatment(SMT) on the medical service's usage and cost with severe lung cancer patients. The patients are selected in one university hospital(with 1,000 beds), between one year before and after policy implementation. The study find that the usages of outpatient(visit number) and inpatient (length of stay) are not changed by statistically significant. It means that there are no effect in medical service behavior between before and after the policy. In medical expenses, outpatients decreased in their out-of-pocket payments by policy, but total medical expenses and insured medical benefits is not changed, because of the increased another medical insurance fees. For inpatient, although the SMT costs are statistically significant decrease, the total out-of-pocket payments and insured medical expenses are not changed statistically significant. Those findings show that the political decision making about SMT made lowing the selective-medical expenses, but total insured cost and patient's out-of pocket money were not changed by the new increased medical insurance fees. It means that the policy about SMT gave no particular benefit for patients. So, it need another benefit plans to lower the medical expenses of severe lung cancer patients with a high medical service usage and much total medical expense.

공황장애 한의 단독 치료 치험 1례 (One Case Report of Panic Disorder Patient Improved by Korean Medicine Treatment Alone)

  • 백지유;장상철;배재룡
    • 대한의료기공학회지
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    • 제22권1호
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    • pp.83-96
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    • 2023
  • Objective : The purpose of this study is to report that patients with panic disorder were able to discontinue the psychotropic medication through Korean Medicine treatment alone. Methods : The patient diagnosed with panic disorder were hospitalized on the 9th and were treated steadily through outpatient treatment afterwards with herbal medicine, acupuncture, cupping therapy, and Whidam's Sugi therapy while taking the chemical. Treatment effects were evaluated through BAI, BDI, STAI-X-1, CSEI-s, GIS, NDI-K, and EQ-5D measurements. Results & Conclusions : The patient's anxiety was relieved and the psychotropic medication was discontinued, but it did not recur. And after inpatient treatment, he has been steadily receiving outpatient treatment on a regular basis, maintaining an improved state and leading a normal daily life.

장애 유형별 의료서비스 이용의 차이 (Differences in Utilization of Health Care Services by the Type of Disability)

  • 윤태호;정백근;강윤식;이상이;김철웅
    • 보건행정학회지
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    • 제17권2호
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    • pp.33-51
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    • 2007
  • The disabled population is a vulnerable group, having very complex medical conditions, but little is known about differences in the level of access by type of disability. This study was performed to investigate the differences of health care utilization by the type of disability. The database was constructed from registry of the disabled and health insurance and medical aid claims data submitted to the Korea Health Insurance Cooperation during in the year 2003. The disability classified three groups according to the Disabled Welfare Act; physically disability with external dysfunction, physically disability with organic disease, and mentally disability. There were huge differences in health care utilization by the type of disability. For the inpatient care, those with a mental disability were more likely to utilize health care services in terms of average visit number of medical facilities and visit days per case, but the treatment amount per case was the highest in physically disabled with organic disease. For the outpatient care, those who the physically disabled with organic disease were more likely to utilize health care services in terms of average visit number of medical facilities, treatment amount per case, and the treatment days per case. Also, those who physically disabled with organic disease were more likely to utilize general hospital for both inpatient and outpatient care, and spent more out-of-pocket expenditure. As the number of persons with disabilities rises, the need to consider new approaches to protecting their health grows increasingly. Especially, Korean health care system should be refined to be more responsive to the needs of the type of disability.

보건의료 빅데이터를 이용한 얼굴마비환자의 의료비용에 관한 연구 (Medical costs for patients with Facial paralysis : Based on Health Big Data)

  • 홍민정;엄태웅;김신아;김남권
    • 대한한의학회지
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    • 제36권3호
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    • pp.98-110
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    • 2015
  • Objectives: The purpose of this study was to analyze the medical cost of facial paralysis in payer perspective and to estimate the practice pattern of patient using 2011 Health Insurance Review & Assessment Service-National Patients Sample(HIRA-NPS). Methods: Basic statistical system was used for descriptive analysis of NPS dataset. A table for general information (table20) was extracted by disease code, and social demographic characteristics, distribution of the use among inpatients and outpatients, utilization of each kind of medical care institutions, medical cost were analyzed. Subgroup analysis was conducted for assuming the practice pattern of korean medicine and western medicine. Results: A total of 8,219 people and 64,345 claims data were identified as having facial paralysis. Proportion of outpatient was 95.23%, inpatient 0.84% and patient using both services 3.93%. Mean patient charges was 44,229 won per outpatient, 178,886 won per inpatient and 523,542 won per patient using both services. Utilization of korean medical care institutions was 68.81%(claims), 40.46%(patients), utilization of western medical care institutions was 31.19%(claims), 59.54%(patients). The amount charged by korean medical care institutions was 52.61% and western medical care institutions was 47.39%. Cost per claim was higher than those of the korean treatment and cost per patient of western treatment was lower than those of the korean treatment. Conclusions: The research assessed the medical cost and practice pattern associated with facial paralysis. These findings could be used in health care policy and subsequent studies.