• Health Policy and Management
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• v.16 no.4
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• pp.147-168
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• 2006

Technological innovation has been regarded as the core competence for the economic growth of individual, as well as organization and country. Pharmaceutical innovation, what we call new medicines, influence people's longevity and productivity by increasing output per hour worked. Therefore, using claims data on virtually all the drugs and diseases of over 550,000 people enrolled in National Health Insurance Program in Korea, we examined the impact of the vintage (original FDA and KFDA approval year) of drugs used to treat a patients from July 1st to December 31st in 2002 on the patient's mortality at the end of 2004, controlling for demographic characteristics(age and sex), utilization of medical services, and the nature and complexity of illness. We found that people using newer drugs are less likely to die at the end of 2004, conditional on covariates. The estimated mortality rates were declining with respect to drug vintage for 1970s, 1980s and 1990s and highly significant. In addition to estimating the model for the entire sample, we estimated the model separately for several disease categories classified by Korean Classification of Disease. Estimates of three drug vintage variables for subgroups of people with (1)neoplasms, (2)endocrine, nutritional and metabolic diseases, and (3)the diseases of circulatory system displayed similar patterns.

• Health Policy and Management
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• v.20 no.3
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• pp.21-35
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• 2010

This study examined the changes in the service mix of Korean hospitals in 6 metropolitan cities between 2003 and 2005, and assessed whether the sample hospitals exhibit consistent trend or chance variation in multiple years. Three measures of hospital service mix, focusing on the specialization of services, were applied: information theory index, internal Herfindahl index, and number of distinct diagnosis-related groups (DRGs) treated. National Health Insurance claims were used to calculate the indexes. Specialization indexes were calculated in each year, and then examined to identify the pattern over time. Kappa analysis was applied to assess the agreements of specialization score between two years after hospitals were categorized into 4 groups with quartiles. Kappa score showed that the service mix of hospitals were changed during the study years. Specialization scores were increased given the market structure for three years. Hospitals which showed higher or lower specialization scores than the average of the scores consistently classified into the same group. Specialization indexes showed relatively consistent pattern over 3 years, and such consistencies were evident for hospitals regardless of the specialization status. Policy makers can identify the degree of specialization with the indexes, and it could provide a picture of how hospital services were mixed and changed over time.

• Health Policy and Management
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• v.18 no.2
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• pp.67-85
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• 2008

This study evaluated the specialization status of Korean hospitals by applying index measures that were developed to determine how hospitals are specialized. In addition, multivariate regression analysis was applied to assess how the measures responded to the internal and external factors of hospitals. National Health Insurance claims for 2004 were used to calculate the information theory index, internal Herfindahl index, number of distinct diagnosis-related groups (DRGs) treated, and percent of the five most common DRGs. Data from the Ministry of Health and Welfare and Korean Hospital Association were used to determine the size, ownership, teaching status, organization type, and location of the hospitals. The four indexes analyzed showed that there were significant differences in the specialization status of providers, depending on the provider size, organization type, and location. Hospitals that were smaller and located in metropolitan areas tended to provide specialized services; this is considered to constitute a competitive strategy for hospitals. It is expected that specialized hospitals will increase given the current market structure. Therefore, policy makers will need an index for measuring how hospital services are specialized. Information from such an index could provide a picture of how hospital services are mixed and change over time.

• Research in Community and Public Health Nursing
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• v.26 no.1
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• pp.11-17
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• 2015

Purpose: This study was to ascertain whether there are differences in health care utilization and expenditure for Type I Medical Aid Beneficiaries before and after applying Copayment. Methods: This study was one-group pretest posttest design study using secondary data analysis. Data for pretest group were collected from claims data of the Korea National Health Insurance Corporation and data for posttest group were collected through door to-door interviews using a structured questionnaire. A total of 1,364 subjects were sampled systematically from medical aid beneficiaries who had applied for copayment during the period from December 12, 2007 to September 25, 2008. Results: There was no negative effect of copayment on accessibility to medical services, medication adherence (p=.94), and quality of life (p=.25). Some of the subjects' health behaviors even increased preferably after applying for copayment including flu prevention (p<.001), health care examination (p=.035), and cancer screening (p=.002). However, significant suppressive effects of copayment were found on outpatient hospital visiting days (p<.001) and outpatient medical expenditure (p<.001). Conclusion: Copayment does not seem to be a great influencing factor on beneficiaries' accessibility to medical services and their health behavior even though it has suppressive effects on outpatients' use of health care.

• Korea Journal of Hospital Management
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• v.25 no.3
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• pp.53-66
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• 2020

This study is aimed at investigated and compared the differences in the affect of hospital specialization according to hospital size using claims data of the Health Insurance and Review Assessment National Inpatient Sample in 2018 for diseases of the musculoskeletal system and connective tissue. To this end, we used multivariate hierarchical linear models(a.k.a., multi-level models) using two-tier data from 106,599 patients discharged after diseases of the musculoskeletal system and connective tissue from 734 hospitals. Multivariate results indicate that patients who were discharged with diseases of the musculoskeletal system and connective tissue from specialized hospitals with 200 beds or less stayed shorter and paid less inpatient charge than those who were discharged from less specialized hospitals. But for hospitals with 201-300 beds, no positive impact relationship was found between hospital specialization and operational performance. This finding may be limited evidence that the affect of a hospital's specialization strategy may vary depending on the size of the hospital. We discussed several managerial and health policy implications below.

• Proceedings of the Korean Institute Of Construction Engineering and Management
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• 2007.11a
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• pp.479-482
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• 2007

The volume of Construction project is increasing now in Korea. The complexity and variety makes the project many problems. But there are few construction contract experts. This results in a lot of managerial conflicts. Specially Engineer/Designer confront gigantic risk related to their job. So, to classify and to identify the risk practical investigation about Engineer/Designer's job. Therefore, to avoid and to prevent the claims for Engineer/Designer, clarification of the scope of service, use of external claim expert, and introduction of professional liability insurance should be accomplished.

• Journal of Preventive Medicine and Public Health
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• v.35 no.4
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• pp.322-330
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• 2002

Objective: This study was conducted to automatically improve the completeness and validity of the Daegu Cancer Registry, using cross record linkage of many data sources, and to develop a computerized patient enrollment system for efficient communication among cancer researchers via the internet. Method: We analyzed 10,229 cancer patients who were reported in the National Cancer Registry, and from pathological reports, health insurance cancer claims lists, cancer patient records at hospital information centers and death certificates from the Korea National Statistical Office. Result: We confirmed 4,624 cancer patients and found 897 of new cases from a review of medical chart. The new cases were detected efficiently using cross record linkage. We developed a computerized patient enrollment system, based on a client-sewer model, for the input of cancer patients, and then developed a web-based reporting homepage and patient enrollment system for the internet. Conclusion: This system could manage cancer databases systematically, and could be given to other researchers as a basic database.

• Health Policy and Management
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• v.11 no.2
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• pp.123-140
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• 2001

Hypotheses In health services research are becoming increasingly more complex and specific. As a result, health services research studies often include multiple independent, intervening, and dependent variables in a single hypothesis. Nevertheless, the statistical models adopted by health services researchers have failed to keep pace with the increasing complexity and specificity of hypotheses and research designs. This article introduces a statistical model well suited for complex and specific hypotheses tests in health services research studies. The covariance structure modeling(CSM) methodology is especially applied to regional relevance indices(RIs) to assess the impact of health resources and healthcare utilization. Data on secondary statistics and health insurance claims were collected by each catchment area. The model for RI was justified by direct and indirect effects of three latent variables measured by seven observed variables, using ten structural equations. The resulting structural model revealed significant direct effects of the structure of health resources but indirect effects of the quantity on RIs, and explained 82% of correlation matrix of measurement variables. Two variables, the number of beds and the portion of specialists among medical doctors, became to have significant effects on RIs by being analyzed using the CSM methodology, while they were insignificant in the regression model. Recommendations for the CSM methodology on health service research data are provided.

• The Korean Journal of Health Service Management
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• v.6 no.4
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• pp.1-12
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• 2012

The objective of this study was to identify the current status of use and respective work scopes of dental hygienists and nursing assistants as perceived by dentists, thereby obtaining a model for how to efficiently use oral health assistance personnel. This study was based on a self-reported survey administered to a total of 126 dentists. The following findings were observed. Where competition among neighborhood clinics was relatively high, nursing assistants tended to be used as a resource to assist dental hygienists, whereas where it was relatively low, they were more likely to be considered to work as full substitutes for regular dental hygienists. Looking at the scopes of practice, dental hygienists were allowed to deal with matters of preventive care, oral health education, and health insurance claims. On the other hand, nursing assistants were allowed to be in charge of taking X-ray pictures from the outside and inside of mouth and keeping medical devices clean and safe. This study is expected to contribute to establishing more reasonable oral heath personnel structure design decisions.

• YAKHAK HOEJI
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• v.58 no.3
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• pp.200-207
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• 2014

This study aimed to assess the quality of outpatient antibiotic consumption in Korea compared with other countries. We used the National Health Insurance claims data for outpatient services in March, June, September, and December in 2012 and calculated nine indicator values based on the 12 European Surveillance of Antimicrobial Consumption (ESAC) drug-specific quality indicators. Indicator values in this study reflect the yearly use of antibiotic expressed in defined daily doses for 1,000 inhabitants per day (DID) and the use of main subclasses of antibiotics expressed in DID and as percentage of the total antibiotic use. Korea showed lower quality in the consumption of total antibiotics (J01), especially in the use of Cephalosporins (J01D) expressed in DID. Korea also showed low quality with regard to the use of narrow/broad spectrum antibiotics. The percentage of the use of narrow-spectrum Penicillins (J01CE) was lowest in Korea. The quality on the use of the third- and fourth-generation cephalosporin (J01(DD+DE)) was the fourth lowest among 26 countries. High rates of antibiotic resistance and payment system based on fee-for-service might have influenced on the high consumption of the broad spectrum antibiotics in Korea. It needs to further investigate the use of broad-spectrum antibiotics to identify the target of strategies promoting quality use of antibiotics in Korea.