• 제목/요약/키워드: medical expense

검색결과 207건 처리시간 0.029초

의료기관의 빅데이터 활용방안에 대한 연구 (Study on Big Data Utilization Plans of Medical Institutions)

  • 김성수
    • 디지털융복합연구
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    • 제12권2호
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    • pp.397-407
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    • 2014
  • 의료정보의 급속한 발달로 인하여 막대한 양의 정보가 쌓이고 있다. 이러한 정보를 이용하여 임상연구를 하고자하는 욕구가 늘고 있으며, 고령화와 의료비의 가파른 상승을 해결해야하는 문제에 직면해 있다. 이에 대한 대안으로 빅데이터의 활용에 대한 목소리가 높다. 본 연구는 우리나라 의료기관들의 정보화 현황을 살피고 빅데이터 활용방안에 대한 정책적 시사점을 제공하고자 한다. 문헌조사와 의료기관의 의료정보전문가 면담을 통해 자료를 수집하였으며, 수집기간은 2013년 9월부터 2013년 11까지 4개월간 시행하였다. 연구결과 향후 병원정보시스템은 환자관리 및 행정에서 연구와 정보전략 측면으로 발전하고 있다. 따라서 빅데이터 활용을 위한 시스템 구축과 비정형 데이터의 효과적 활용을 고려하여 전문인력 양성과 더불어 의료비 절감을 위한 국가의 정책지원이 마련되어야 할 것이다.

노인장기요양보험제도가 노인진료비에 미치는 영향 (Effect of the Long-term Care Insurance Policy on Medical Expenditures for the Elderly)

  • 한남경;정우진;김노을;임승지;박종연
    • 보건행정학회지
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    • 제23권2호
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    • pp.132-144
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    • 2013
  • Background: The purpose of this study was to analyze the medical expense change and influencing factors after introducing longterm care insurance system. The study period was 2 years before and after introduction of the system. Methods: We analyzed data collected from two divided group lived in Incheon. Four hundred and eighty-five elderly who received long-term care wage for one year were selected for experimental group. For control group, 1,940 elderly were selected by gender and age stratified random sampling. Difference-In-difference analyses was used for evaluating policy effectiveness. Also multiple regression analyses were conducted to identify the factors associated with total medical expenditures. The control variables were demographic variables, economic status, diseases, and medical examination variables. Results: Difference-in-difference analyses showed that total average medical expenses among long-term patients has decreased by 61.85%. Of these, the hospitalization expenses have decreased by 91.63% and the drug expenses have increased by 31.85%. Multiple regression analyses results showed that total average medical expenses among long-term patients have significantly decreased by 46.5% after introducing the long-term care insurance. The hospitalization expenses have significantly decreased by 148.5%, whereas the drug expenses have increased by 53.6%. And outpatient expenses have increased by 10.4%, but the differences were not statistically significant. Conclusion: The results showed that total medical expenses and hospitalization expenses have decreased after introducing the long-term care insurance. These results could support the opinion that the health insurance spending among long-term patients will be reduced gradually by long-term care insurance through changing medical demand.

외래⦁입원 환산지수에 기초한 2020년도 환산지수 산출 연구 (A Study on the introduction of the outpatient and inpatient conversion factors in the 2020 Physician Fee Contract)

  • 오동일
    • 한국산학기술학회논문지
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    • 제22권4호
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    • pp.183-194
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    • 2021
  • 본 연구에서는 SGR 모형과 AR 모형으로 부터 개발된 유형별 외래 및 입원 환산지수 분리 모형을 바탕으로 실제 건강보험 진료비 자료를 사용하여 2020년도 환산지수를 추정하였다. 또한 유형별 환산지수 계약 하에서 병원의 단일 환산지수 조정률과 외래 및 입원으로 분리된 복수의 환산지수 조정률을 산출하였다. 마지막으로 환산지수 분리 모형이 의료전달체계를 확립하기 위한 수단의 하나로 효과적으로 사용되기 위한 정책적 방안을 제안하였다. 본 연구의 주요 결론은 다음과 같다. 첫째, r=0.1에서 2020년도 병원의 단일 환산지수 조정률은 2.0%이며 병원의 환산지수를 분리하는 경우 외래 및 입원 환산지수 조정률은 각 각 2.2%, 2.3%로 나타났다. 그리고 조정계수를 활용하여 외래 및 입원 환산지수를 결합하는 방안을 제시하였다. 둘째, 의료전달체계 확립을 위한 조치의 하나로 제안된 가산율 조정 방식 대신에 가산율과 환산지수를 연동하여 운영하는 방안을 제안하였다. 셋째, 병원⦁의원 등 유형별로 외래환산지수, 입원환산지수, 조정계수를 도입하는 것에 추가해 진료량에 대한 목표관리를 가능하게 하는 모형 개발이 필요하다.

수술실의 원가배부기준 설정연구 (A Study on the cost allocation method of the operating room in the hospital)

  • 김희정;정기선;최성우
    • 한국병원경영학회지
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    • 제8권1호
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    • pp.135-164
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    • 2003
  • The operating room is the major facility that costs the highest investment per unit area in a hospital. It requires commitment of hospital resources such as manpower, equipments and material. The quantity of these resources committed actually differs from one type of operation to another. Because of this, it is not an easy task to allocate the operating cost to individual clinical departments that share the operating room. A practical way to do so may be to collect and add the operating costs incurred by each clinical department and charge the net cost to the account of the corresponding clinical department. It has been customary to allocate the cost of the operating room to the account of each individual department on the basis of the ratio of the number of operations of the department or the total revenue by each operating room. In an attempt to set up more rational cost allocation method than the customary method, this study proposes a new cost allocation method that calls for itemizing the operation cost into its constituent expenses in detail and adding them up for the operating cost incurred by each individual department. For comparison of the new method with the conventional method, the operating room in the main building of hospital A near Seoul is chosen as a study object. It is selected because it is the biggest operating room in hospital A and most of operations in this hospital are conducted in this room. For this study the one-month operation record performed in January 2001 in this operating room is analyzed to allocate the per-month operation cost to six clinical departments that used this operating room; the departments of general surgery, orthopedic surgery, neuro-surgery, dental surgery, urology, and obstetrics & gynecology. In the new method(or method 1), each operation cost is categorized into three major expenses; personnel expense, material expense, and overhead expense and is allocated into the account of the clinical department that used the operating room. The method 1 shows that, among the total one-month operating cost of 814,054 thousand wons in this hospital, 163,714 thousand won is allocated to GS, 335,084 thousand won to as, 202,772 thousand won to NS, 42,265 thousand won to uno, 33,423 thousand won to OB/GY, and 36.796 thousand won to DS. The allocation of the operating cost to six departments by the new method is quite different from that by the conventional method. According to one conventional allocation method based on the ratio of the number of operations of a department to the total number of operations in the operating room(method 2 hereafter), 329,692 thousand won are allocated to GS, 262,125 thousand won to as, 87,104 thousand won to NS, 59,426 thousand won to URO, 51.285 thousand won to OB/GY, and 24,422 thousand won to DS. According to the other conventional allocation method based on the ratio of the revenue of a department(method 3 hereafter), 148,158 thousand won are allocated to GS, 272,708 thousand won to as, 268.638 thousand won to NS, 45,587 thousand won to uno, 51.285 thousand won to OB/GY, and 27.678 thousand won to DS. As can be noted from these results, the cost allocation to six departments by method 1 is strikingly different from those by method 2 and method 3. The operating cost allocated to GS by method 2 is about twice by method 1. Method 3 makes allocations of the operating cost to individual departments very similarly as method 1. However, there are still discrepancies between the two methods. In particular the cost allocations to OB/GY by the two methods have roughly 53.4% discrepancy. The conventional methods 2 and 3 fail to take into account properly the fact that the average time spent for the operation is different and dependent on the clinical department, whether or not to use expensive clinical material dictate the operating cost, and there is difference between the official operating cost and the actual operating cost. This is why the conventional methods turn out to be inappropriate as the operating cost allocation methods. In conclusion, the new method here may be laborious and cause a complexity in bookkeeping because it requires detailed bookkeeping of the operation cost by its constituent expenses and also by individual clinical department, treating each department as an independent accounting unit. But the method is worth adopting because it will allow the concerned hospital to estimate the operating cost as accurately as practicable. The cost data used in this study such as personnel expense, material cost, overhead cost may not be correct ones. Therefore, the operating cost estimated in the main text may not be the same as the actual cost. Also, the study is focused on the case of only hospital A, which is hardly claimed to represent the hospitals across the nation. In spite of these deficiencies, this study is noteworthy from the standpoint that it proposes a practical allocation method of the operating cost to each individual clinical department.

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장루보유자의 자가 간호정도 및 문제점에 관한 연구 (A Study on Self Care and the Problems in Patient with Ostomy)

  • 고윤희;최미라;이명순;한승민;한금영;임은선;안혜진;김귀분
    • 동서간호학연구지
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    • 제10권1호
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    • pp.95-105
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    • 2004
  • This study was conducted to confirm the degree of self care and problems in patients with ostomy. The subjects were 80 patients with ostomy who were visiting to OPD in K University Medical Center and were members in the Ostomy Association of Korea. Data were collected from August, 2004 to September. The research tools were a self care measure for ostomy patient developed by Park (1996) and a problem measure for ostomy patient developed by Lee (1996). Data were analyzed by t-test, ANOVA, and Pearson's correlation. The results were as following: 1. Male (65.8%) and female (34.2%) had the ostomy in the most. Age was the most 61 years old and over. 68.5% of the subjects had managed the ostomy by themselves. 2. The mean score of self care in ostomy was 3.57 score. Hygiene of skin care around ostomy in the behavior of self care was the highest as mean 4.47 score. 3. The problems were as following: 1) expense 2) a decline on Activity of Daily Living 3) discomfort in travel 4) worry about ostomy 5) trouble of workplace 4. In the relationship between self care and religion there was significant difference in religion(t= 2.727, P=.008). 5. The relationship between self care and problem with ostomy was found to have statistically significant negative correlation(r= -.237, P=.041).

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지역의료보험조합의 재정 상태에 영향을 미치는 요인분석 (An analysis of contributing factors to financial status of regional health insurance)

  • 문종국;박명호;김용준
    • Journal of Preventive Medicine and Public Health
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    • 제24권2호
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    • pp.211-220
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    • 1991
  • Finances of health insurance can be explained by factors determining benefit expense and premium collection. This study was conducted to analyze factors contributing to the financial status of rural health Insurance. Nationwide 134 health insurance associations except the six pilot project counties were analyzed and obtained the followings. 1. In univariate analysis, statistically significant variables that explain 1) outpatient benefit expenditures include public health center utilization, proportion of pregnant women. premium and collection rate of premium 2) inpatient benefit expenditures include public health center utilization, Proportion of old age, proportion of pregnant women, premium and collection rate of premium 3) profits include public health center utilization, proportion of old age, proportion of pregnant women and collection rate of premium. 2. In multiple regression analysis, statistically significant determinants in 1) outpatient benefit include premium and public health utilization 2) inpatient benefit include premium 3) profit include public health center utilization, premium and collection rate of premium.

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유방암 생존자의 피로와 디스트레스가 자기효능감에 미치는 영향 (The Effects of Fatigue and Distress on Self-efficacy among Breast Cancer Survivors)

  • 서미혜;임경희
    • 성인간호학회지
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    • 제28권4호
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    • pp.378-387
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    • 2016
  • Purpose: The purpose of this study was to describe the impact of fatigue and distress on self-efficacy among breast cancer survivors and to provide a base for development of nursing intervention strategy to improve self-efficacy. Methods: A descriptive research design was used. The subjects were 158 patients who were either being treated or were receiving follow-up care at a university breast center in D City from May 30 to August 30, 2014. Structured questionnaires, Revised Piper Fatigue Scale, Distress Thermometer, and Self-Efficacy Scale for Self-Management of Breast Cancer were used to measure fatigue, distress, and self-efficacy. Data were analyzed using t-test, ANOVA, Pearson's correlation coefficients, and multiple regressions. Results: The mean scores of fatigue, distress, and self-efficacy were 3.83, 4.31, and 3.77, respectively. There were significant differences among participants in terms of educational background, current treatment methods, perceived health status, economic burden for fatigue and perceived health status for distress. Self-efficacy was impacted by age, educational background, marital status, average monthly income, perceived health status, and medical expenses. Fatigue, age, and the burden on medical expense had the most impact on self-efficacy, accounting for 17% of the variance. Conclusion: Fatigue should be managed to improve self-efficacy of breast cancer survivors. Therefore, nursing programs designed to decrease fatigue may be helpful.

가구소득불평등에 민간보험수입과 의료비본인부담지출이 미친 영향 (Impact of the Private Insurance Benefits and the medical Care Expenditure on Household Income Inequality)

  • 이용재;김형익
    • 디지털융복합연구
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    • 제15권12호
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    • pp.625-633
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    • 2017
  • 본 연구는 가구소득의 불평등에 민간보험수입과 의료비본인부담지출이 어떠한 영향을 미치는지를 확인하기 위하여 2015년 의료패널조사데이타에 대하여 소득계층별 집중지수와 집중곡선 분석을 실시하였다. 주요 분석결과는 다음과 같다. 첫째, 가구소득 집중지수가 0.3580으로 소득이 고소득층에 집중되어 있어서 불평등 정도가 상당히 큰 것으로 나타났다. 둘째, 민간보험수입이 고소득층에 집중하여 적지만 고소득층 가구의 소득집중현상을 강화시킨다. 셋째, 저소득층의 의료비 본인부담지출이 많은 것으로 나타났다. 끝으로 가구소득에서 전체 의료비본인부담지출을 제외한 소득에 대한 집중지수가 0.3676으로 나타나서 의료비본인부담지출 후에도 소득이 고소득층에 크게 집중되어 있었다. 따라서 민간보험수입과 의료비본인부담지출은 모두 가구소득불평등을 심화시키는 요인으로 작용하고 있어서 융 복합적 연구 및 정책방안 마련을 통한 개선이 요구된다.

병원의 수익성 관련 요인 분석 - 의료수익의료이익율을 중심으로 - (Factors Affecting Profitability of General Hospitals Focused on Operating Margin)

  • 박병상;이용균;김윤신
    • 한국콘텐츠학회논문지
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    • 제9권6호
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    • pp.196-206
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    • 2009
  • 병원의 수익성이란 병원이 회계년도 기간동안 환자 진료 및 기타 경영활동을 통해 달성한 경영성과를 말한다. 본 연구는 병원의 수익성 측정 지표로 병원을 운영하여 얻은 의료수익에서 의료비용을 뺀 순수한 의료이익인 의료수익의료이익율을 사용하였다. 이를 통해 수익성에 영향을 미치는 다양한 지표를 대상으로 병원 수익성 관련 요인을 도출하였다. 이 결과를 토대로 병원의 수익성 제고 방안을 강구할 수 있는 보다 유용한 기초자료를 산출하고자 하였다. 분석결과 공공병원이 민간병원보다 수익성이 낮았다. 각 지표의 수익성을 적자병원군과 흑자병원군으로 구분하여 분석한 결과 인건비 비율, 관리비 비율, 전문의 1인당 수술건수, 의료장비 회전율와 관련한 지표에서 유의한 차이를 보였다. 관련 지표가 수익성에 미치는 영향을 보면 모형에 따라 설명력은 25%-74.5%였다.

대전·충청지역 치과건강보험 요양급여비용 청구자의 인식도 분석조사 (Analysis research about awareness of demanders of recuperation allowance for dental clinic health insurance in Daejun and Chunchung area)

  • 김성희;김민자;남용옥
    • 한국치위생학회지
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    • 제11권2호
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    • pp.275-289
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    • 2011
  • Objectives : The recognition rate for issues and improving resolution for the recuperation income expense claim policy was examined. Methods : 1,135 copies of survey have been sent to the group of people who have claimed the dental recuperation income expense to dental recuperation institutions in Daejeon, Chungcheong Do that are registered to the health insurance evaluation and estimation office as of the May 2010 and 207 surveys that were regarded to be sincere for answering were analyzed. Results : Majority of respondence were belonged to the dentist institutions with more than 5 years of claim experiences as well as 10~50% of claim rate. The recognition of medical fee evaluation guideline was normal level, and negative recognition was higher to the health center with daily charge policy compare to the dental hospital and university affiliated dental center with treatment charge policy, Highest opinion for inappropriateness of dentist with significance was found (p<0.05). The openness of evaluation cases are regarded to be discharged through the transparent evaluation and most of the opinions for insurance claim evaluation adjustment are within the both 'Do not understand the evaluation guideline and program error of disease category, code and program' with significance(p<0.05). The reaction after the evaluation adjustment was high in reflection on the claim process after examining the reason for the evaluation adjustment through the evaluation and estimation office and university affiliated dental institution and dental center was regarded to be most active and deputy reclaimment was seemed to be most actively discharge the objection registration task (p<0.05). The claim error improving resolution recognition was highly prioritized to the accurate charting for the disease title and treatment description, improving the setting of claim program, and most highly recognized by the university affiliated dental hospital/dental center and comparably low by health center(p<0.05). and although the most of the responds of treatment description and browsing the medical fee was positive, 50% of dentists disagreed the idea so that this was creating a significant discrepancy with other groups(p<0.05). Conclusions : From this research, the recognition of medical fee evaluation guideline for dental (university) hospital and dentists were negative and high adjustment experience was examined as lacking of evaluation guideline understanding and error of disease name, code and programs and deputy reclaimment, university affiliated dental hospital/dental center were most actively handle the objection registration tasks and dentists have objection on the treatment description and browsing the treatment fee so that if these indexes can be referred to implement into the recuperation income claim process, this can be regarded to be a opportunity to create mutual credibility between recuperation institution, treatment pensioner and the evaluation institutions.