• Journal of the Korean Society of Safety
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• v.23 no.6
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• pp.158-163
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• 2008

Although prior researches have been investigated the impact of insured cost(direct cost) on employers and employees, little work has attempted to categorize the items of unsecured cost(indirect cost) by accidents. On this basis, the goal of this study was to achieve a better understanding of the nature of accident cost of unsecured cost. Specifically, this study aimed to categorize the unsecured cost items according to the domestic industry circumstances and use these results for a basis of other accident cost related studies. The results of this study are as follows: (1) accident development steps were categorized as twelve items for improved management according to each step of accident development (2) the points of occurrence and termination of the unsecured cost were identified for the improved management according to each step of accident development and (3) characteristics of each item in unsecured cost were studied and identified for a better control of accident costs. These results provide a basis for further researches on the unsecured cost.

• Health Policy and Management
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• v.7 no.1
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• pp.73-99
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• 1997

This study was carried out by using questionnaires with 126 insurance societies from Sept. 30, 1995 to Oct. 18, 1995. The primary data collected bythe survey have been significantly supplemented by secondary data obtained from sources such as health insurance statistical year books and internal data in the Ministry of Health and Wolfare. Major findings were summarized as follows: Two financial coordinating programs have significantly improved financial status of regional health insurance societies: the catastrophic program for high cost medical care that was initiated in 1991 and the program for hospitalization cost of the aged in 1995. Another finding is that there existed ambiguity and inconsistency of equity index that had been used by stabilization programs and its side effects could not be ignored. Regression analyses were made to identify factors that affect financial transfers. Inde pendent variables in the regression include utilization frequency, dependancy ration, insurance contribution per insured and medical expense per insured. All these variables were statistically significant in the equations of applying distribution rate (distribution/contribution) and transfer rate (transfer/contribution) as dependent variables. Policy suggestions for the catastrophic program for high cost medical care are modifying the definition of catastrophic case and setting the maximum amount of subsidies for each society based on distribution rates. To solve the problems of the financial coordinating program for the aged, we could consider reimbursing more than 50% of the copayment incurred by the aged 65 or more and determining the maximum amount of outpatient copayment at 10,000 Won per day or per visit for the elderly. More fundamental improvement could be made by amending the Welfare Benefit Act to establish and expand medical and welfare facilities for the elderly.

• Korean Journal of Health Education and Promotion
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• v.6 no.2
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• pp.23-39
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• 1989

There have been a lot of considerable. discussion and debate surrounding the management model in the health insurance management system and opinions regarding the management operating cost. It is a well known fact that there have always been dissenting opinions and debates surrounding the issue. The management operating cost varies according to the scale of the management organization and component members characteristics of the insurance carrier. Therefore, it is necessary to examine and compare the management operating cost to the simulated management models developed to cover those eligible for the health insurance scheme in this country. Since the management operating cost can vary according to the different models of management, four alternative management models have been established based on the critical evaluation of existing theories concerned, as well as on the basis of the survey results and simulation attempts. The first alternative model is the Unique Insurance Carrier Model(Ⅰ) ; desigened to cover all of the people with no classification of insurance qualifications and finances from the source of contribution of the insured, nationwide. The second is the Management Model of Large-scale District Insurance Carrier(Ⅱ) ; this means the Korean society would be divided into 21 large districts; each having its own insurance carrier that would cover the people in that particular district with no classification of insurance qualifications arid finances as in Model I. The third is the Management Model of Insurance Carrier Divided by Area and Classified with Occupation if Largescale (Ⅲ) ; to serve the self-employed in the 21 districts divided as in Model Ⅱ. It would serve the employees and their dependents by separate insurance carriers in large-scale similar to the area of the district-scale for the self-employed, so that the insurance qualifications and finances would be classified with each of the insurance carriers: The last is the Management Model of the Multi - insurance Carrier (Ⅳ) based on the Si. Gun. Gu area which will cover their own self- employed people in the area with more than 150 additional insurance carriers covering the employees and their dependents. The manpower necessary to provide services to all of the people according to the four models is calculated through simulation trials. It indicates that the Management Model of Large-scale District Insurance Carrier requires the most manpower among the four alternative models. The unit management operating costs per the insured individuals and covered persons are leveled with several intervals based on the insurance recipients. in their characteristics. The interval levels derived from the regression analysis reveal that the larger the scale of the insurance carriers is in the number of those insured and covered. the more the unit management operating cost decreases. significantly. Moreover. the result of the quadratic functional formula also shows the U-shape significantly. The management operating costs derived from the simulated calculation. on the basis of the average salary and related cost per staff- member of the Health Insurance Societies for Occupational Labours and Korean Medical Insurance Corporation for the Official Servants and Private School Teachers in 1987 fiscal year. show that the Model of Multi-insurance Carrier warrants the highest management operating cost. Meanwhile the least expensive management operating cost is the Management Model of Unique Insurance Carrier. Insurance Carrier Divided by Area and Classified with Occupation in Large-scale. and Large-scale District Insurance Carrier. in order. Therefore. it is feasible to select the Unique Insurance Carrier Model among the four alternatives from the viewpoint of the management operating cost and in the sense of the flexibility in promoting the productivity of manpower in the human services field. However. the choice of the management model for health insurance systems and its application should be examined further utilizing the operation research analysis for such areas as the administrative efficiency and factors related to computer cost etc.

• Health Policy and Management
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• v.31 no.4
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• pp.423-436
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• 2021

This article summarizes the structure of China's current social health insurance system and reviews the development status of China's private health insurance (PHI). China's medical security system is mainly composed of two parts: basic medical insurance (BMI) and PHI. Among them, the BMI provides reimbursement of basic medical expenses for the insured persons according to different proportions. PHI is a necessary supplement to the BMI and provides assistance to the insured persons in the event of illness or accident. By having PHI, people can obtain medical protection outside the coverage of BMI. In the development of PHI in China, the total medical cost is high and the insurance market size is large, but the proportion of PHI expenditure is low and the personal burden is high. Through this Chinese case, it will be helpful for mutual development between Korean PHI and national health insurance, for Korean insurance companies to enter the Chinese market, and for removing the medical burden on the people.

• Korea Journal of Hospital Management
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• v.18 no.2
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• pp.81-103
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• 2013

This study is to research cost accounting practice and to analyze propriety of patients' medical payment in artificiality kidney center. The researched cost datum of the year 2012 are as follows. - Hemodialysis medical treatment was reimbursed as much as 158,001 won in case of health insured patients, but payed-off as much as 135,810 won. - The average figure of the total hospitals and clinic center is 1,603,303 won, and one time cost of hemodialysis treatment is 154,487 won. Optimal treatment pay are suggested as follows. First, Regardless of the notified classification from MOHW(Ministry of Health and Welfare), 136,000 won of fixed price payment classification needs to be reclassified by patients, severity and tobe rearranged by fixed price payment system of hospitals. Second, Fixed payment code notified by the Ministry of Health and Welfare is recommended to be simplifies and to reflect according to contents of the medical treatment rendered to patients. Third, Establishment of artificial kidney center has to be risk managed because of its huge investment. Fourth, Cost analysis model has to be maintained as basis together with appropriate application of conversion index model mixed with SGR model.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.31 no.1
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• pp.132-141
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• 2008

This research was conducted in order to present the strategies of implementing the logistics information system for effective logistics cost management with the case study of a leading global company. The strategy for effective logistics information system can be derived from the 3 different viewpoints, Firstly the effective global logistics management can be insured by means of the efforts of the reinforced total organization. Secondly from the process-oriented perspective, we should recognize the logistics process as the core factor of the competitive strategy and innovate the logistics process itself for the logistics cost reduction. Finally, the logistics cost will be effectively managed through establishing its logistics information strategy which maximizes the utilization of the information technologies. The case study of 'A' electronics company shows that its logistics management system provides the company with various visibilities about its logistics cost and the direct and indirect benefits over billions of wons per year as well. Therefore we can conclude that the research model provided in this research is validated. This study presents the concrete implementation strategies of the logistics information system and verifies the validity of the strategies by means of the case study of a leading company.

• Journal of Preventive Medicine and Public Health
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• v.25 no.4 s.40
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• pp.333-342
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• 1992

The purpose of this study is to estimate the minimum optimal scale(MOS) of the self-employed health insurance associations. Considering the high proportion of operating expenses, the author have selected 254 regional health insurance associations eon the 1990 Finance Report of the self-employed health insurance programs. Both a quadratic function and a hyperbolic function were chosen for the analysis. The dependent variables are the average maintenance cost per insured person and per household, and the independent variables are the number of insured members and of household The minimum optimal scale was obtained from the differentiation of the quadratic function. Major findings are summarized as follows: 1. The M.O.S. was calculated as 166,174 members (27,442 households) for the rural self-employed health insurance associations and 258,462 members (75,446 households) for the urban. Providing that both the rural and urban health insurance associations would be integrated, the M.O.S. be found to become 231,687 members (68,101 households) 2. Compared with the optimal minimum scale, the magnitude of the current health insurance association found to be much smaller, less than half of the optimal scale. 3. In order to reduce the operating cost, it is necessary to enlarge the operational scale of self-employed health insurance associations.

• Journal of Preventive Medicine and Public Health
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• v.22 no.3 s.27
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• pp.380-388
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• 1989

To evaluate the costs of the hypertension screening program of the Korea Medical Insurance Corporation, the records of the screening examinations were used. The sample size was 49,983 of the 906,554 people insured by the Corporation and was obtained by two-stage stratification random sampling. The alternatives for efficiency of the screening program, which were divided into three categories : modification of the screening test package, application of other hypertension diagnostic criteria, and selective approach of tested groups by age, were evaluated according to the cost per patient detected. The results of this study were as follows In the hypertension screening system, the cost per patient detected was Won 30,883. The most nonsensitive test for hypertension detection was ophthalmoscopy, which was examined during the second stage of screening. If the ophthalmoscope examination was excluded, olny one person was not detected, which was 0.2% of detected persons, and the cost per patient detected decreased to Won 28,098. The most efficient modification of the screening test package was measurement of blood pressure through the first and second stages of screening. The cost per patient detected by this modification was Won 24,408. The application of other diagnostic critera, which were more restricted criteria, increased the cost per patient detected by 3.7%-6.7%. The cost per patient detected were Won 170,582 for persons less than 39 years old, Won 20,032 for persons 40 to 59 years old, and Won 8,675 for persons 60 years old and over. In conclusion, the best alternative suggested with respect to efficiency and practical application excluded the ophthalmoscope examination of second stage screening and restricted the target population to persons greater than 40 years old. The application of this alternative decreased 54.9% of the screening costs and the cost per patient detected was Won 15,222. This study was limited in that measurement of effectivenes was not of the ultimate goal of screening, which is decreasing morbidity and mortality, but was of disease detection as the short-term objective.

• Health Policy and Management
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• v.2 no.2
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• pp.194-220
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• 1992

In recent years there has been a rapid influx of high cost MRI equipment into Korea. This diffusion has raised concerns about the changes it will bring for the health care utilization. Therefore, the purpose of this study is to identify socio-economic characteristics of MRI uses in Korea. A structured questionnaire was designed for this purpose, and 1, 091 users were surveyed at the 35 MRI units of 33 hospitals during a week, sometimes March 1992. The study reveals that high cost technology such as MRI, CT scanner is so prevalent in Korea. This is particularly the case in metropolitan areas. Among others, Seoul has the highest percentage of MRI equipment, 51.05%, Pusan 12.10% and Kwangju 11.9%. Unfortunately, most high cost technology equipments are foreign products. Thus, hospitals with such a high cost technology have difficulties in maintenance of the equipment. The average performance of MRI equipment has declined from 10.2 cases per day in 1988 to 7.16 cases in March 1992. Due to the rapid increase, the performance of MRI equipment seems to be deterioration. Male usere are dominant in the case of MRI use. The utilization rate has positively increased with the rise of educational level of users. The same is true for the level of income; the MRI utilization rate by income level shows that it is negatively proportional to income, which indicates that the poor have difficulties in the use of high cost technology. Particularly, the cost of MRI is so high that ordinary patients are unable to pay for it. For example, 86.3% of respondents have answered that the cost is too high even though they are insured by health insurance. This is the first empirical study on the use status of MRI. The information obtained in this study is sufficient to maintain that the Korean health insurance programme is urgently in need of improving the insurance benefit schemes. The easiest way to do this is to include provision of high cost technology service into the benefit package.

• Health Policy and Management
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• v.3 no.1
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• pp.53-83
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• 1993

A small number of high cost patients usually spend a larger proportion of scarce health resources. Korea is no exception. Under the national health insurance, 12% of the insured persons have consumed approximately half of the national health insurance expenditures. Therefore, it is necessary to identify the characteristics of the high cost patient group, if we would like to reduce them. This study has defined high cost patients as those who have spent one and half million won and over per 6 months. The study reveals that high cost users are those who have a longer length of stays(LOS), 40days of LOS in the 6 months, have multiple admissions, 2 to 3 admissions per 6 months and are the elderly patients. They have spent 814.126won per on the average, and commonly suffered from malignant neoplasms, circulatory diseases, fracture, diabetes mellitus, etc. Unlike the case of western developed countries, early readmissions are not the major causes of high cost spending in Korea. Undoubtedly, a lengthy admission is the main cause of large spending. Health policies should vigorously be explored to respond appropriately. There are evidences that hospital beds are often misused. As the Korean health care system is lacking in a mechanism of patient evaluation under the fee-for-service remuneration system, an idea of progressive patient care needs to be tested. The Goverment should set up health policy to diversify the role of long-term care facilities and encourage people to establish them. Further studies are needed to identify factors influencing large medical bills necessary for formulating the health policy on cost containment.