• Title/Summary/Keyword: medical expense

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The Empirical Ambulatory Care Sensitive Conditions Study & its Potential Health Insurance Applicability in Korea (한국형 ACSC에 대한 실증분석 및 건강보험 적용 가능성에 관한 연구)

  • Kim, Yang Yun;Sung, Joo Ho
    • Health Policy and Management
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    • v.15 no.3
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    • pp.79-93
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    • 2005
  • The purpose of the study is to identify Ambulatory Care Sensitive Conditions (ACSC) and their potential health insurance applicability in Korea, using the correlation and regression analysis with the empirical data provided by Korean Health Insurance Review Agency(KHIRA). Here, ACSC would be thought of as conditions that when timely and effectively treated in the outpatient medical services can help reduce the risk of hospitalizations. As for ACSC, reducing accessibility for outpatient visit results in increasing hospitalization. In this respect, the ACSC concept is popularly adopted as one of the performance indicators of the national health system. As one of main results, fortifying the accessibility to necessary health care in a way of sharing appropriately the role with private health insurance can lead to the efficiency of national health care delivery systems in view of total health care expense, in particular in a case of ACSC children. Lastly, we would like to strongly suggest that the disease treatment data set reported to KHIRA needs to be opened to private insurance companies only for illness experience investigation.

The Study of the External Qigong Therapy(EQT) - Based on the Survey of 100 Inpatients in Oriental Medical Hospital - (한방병원 입원환자 100명을 대상으로 한 외기요법(外氣療法)에 대한 연구)

  • Lee, Eun-Jung;Yoon, Il-Ji
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.2
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    • pp.145-173
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    • 2010
  • Objectives : The purpose of this study is to analyze remedial value of External Qigong Therapy(EQT), to investigate the primary factors influencing EQT and the demend of EQT. Methods : This study took the data analysis from the questionnaire to the patients and therapists of EQT in oriental medical hospital attached Dae-Jeon University from April to September in 2009. The therapist, who is in college of oriental medicine, Dae-jeon University, was explained of the operation of EQT, and then operated EQT to the patients. The therapists and patients took the questionnaire twice, before and after EQT. Results and Conclusions : 1. Accoding to the research, the patients consider that their symptoms get better after EQT and that the unexpectable effect of EQT is stability of mind. 2. The primary factors influencing on remedy effect is patient's faith in the therapist & EQT, patient and therapist's positive expectation on EQT, patient's will to treated on EQT and therapist's effort to form the rapport with patient. 3. It is KRW 5463 that the patient group consider as resonable expense of EQT and it is 23 minutes that patient group consider as proper time of EQT.

Medical Expenses for Trauma According to the Type of Medical Insurance (외상환자의 보험체계에 따른 진료비 분석)

  • Park, Heeseung;Jung, Yooun Joong;Kim, Young-Hwan;Kim, Tae-Hyun;Km, Min Ae;Kyoung, Kyu Hyouck;Kim, Jung Jae;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.178-187
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    • 2012
  • Purpose: In Korea, the nation's medical expenses were 12 billion won in 2010. The medical costs for individuals can also be overwhelming. If a patient has sustained severe trauma, his/her insurance company responsible may pay only part of the medical bills. In Korean, there are diverse types of medical insurance, such as health insurance, automobile insurance, and industrial accident compensation insurance. And each insurance system has a different type of payment system. Our study will be essential for establishing the optimal medical expense payment system. Methods: From January to December 2011, we retrospectively reviewed the medical charts of 161 patients who were admitted to our hospital's emergency room after having undergone severe trauma. Of those 161 patients, 125 were retrospectively reviewed. Written permission was obtained from all of the patients. We analysed the demographic characteristics, clinical outcomes, data of the trauma, type of the patient's insurance, and the entire bill when the patient was discharged. Results: Seventy-one patients had health insurance, 48 automobile insurance, and six industrial accident compensation insurance. High-deductible insurance included health insurance and industrial accident compensation insurance, with the deductibles up to 20.6% and 19.1%, respectively. We attempted to analyze the cause of the high deductible rate. In patients with health insurance, medicines, primarily sedatives, pain killers, antibiotics, and fluids. comprised a large proportion. On the other hand, industrial accident compensation insurance deducted for a high-grade hospital room charge. Conclusion: We found that medical expenses were diverse according to the type of insurance. In particular, health insurance forced patients to pay too much of the medical expenses. Therefore, in Korea we should try to identify the insurance problems and improve the wage system.

An Analysis of Cost and Profit of a Nursing Unit using Performance-Based Costing: Case of a General Surgical Ward in a General Hospital (시행기준 원가계산을 적용한 간호단위 원가 및 수익 인식에 관한 연구: 1개 종합병원 일반외과병동 사례를 중심으로)

  • Lim, Ji-Young
    • Journal of Korean Academy of Nursing
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    • v.38 no.1
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    • pp.161-171
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    • 2008
  • Purpose: The aim of this study was to analysize net income of a surgical nursing ward in a general hospital. Method: Data collection and analysis was conducted using a performance-based costing and activity-based costing method. Result: Direct nursing activities in the surgical ward were 68, indirect nursing activities were 10. The total cost volume of the surgical ward was calculated at \119,913,334.5. The cost volume of the allocated medical department was \91,588,200.3, and the ward consumed cost was \28,325,134.2. The revenue of the surgical nursing ward was \33,269,925.0. The expense of a surgical nursing ward was \28,325,134.2. Therefore, the net income of a surgical nursing ward was \4,944,790.8. Conclusion: We suggest that to develop a more refined nursing cost calculation model, a standard nursing cost calculation system needs to be developed.

Preliminary Study on the Detection of Late Potentials using High-Resolution Electrocardiography (HRECG에 의한 Late Potential의 검출에 관한 예비 연구)

  • Woo, Eung-Je;Park, Seung-Hun
    • Proceedings of the KOSOMBE Conference
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    • v.1993 no.05
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    • pp.63-65
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    • 1993
  • We have done a preliminary study on the detection of ventricular late potentials using high-resolution electrocardiography. We designed a battery powered low-noise ECG amplifier. We used the XYZ lead system and the amplifier provides 3 channels of X, Y, and Z signals with a conventional gain and another 3 channels of the amplitude-limited X, Y, and Z signals with high-gain. 12-bit data acquisition system interfaces the amplifiers to a personal computer for further signal analysis. Beat alignment algorithm was implemented on the low-gain signals to synchronize the signal averaging of the high-gain amplitude-limited signals. We suggest the use of the weighted vector sum of X', Y', and Z' signals based on the SNR of each channel. We speculate that this new method will increase the accuracy of the LP detector at the expense of more complicated hardware.

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Health Beliefs and Elderly Medical Expense Preparation for Baby Boomers (베이비부머의 건강에 대한 인식 및 노후의료비 준비에 관한 연구)

  • Cho, Hye-Jin
    • Journal of Family Resource Management and Policy Review
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    • v.16 no.2
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    • pp.123-143
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    • 2012
  • This study, based on a health belief model, examines how baby boomers perceive health and how they are financially preparing for future medical expenses. In addition, the study analyzes which factors influence baby boomers' preparation behaviors for future medical expenses and their perceived sufficiency of the preparation for medical expenses. Through such activities, this study examines baby boomers' current preparation status for future medical expenses, and based on this outcome, will turn the attention of individuals and society toward becoming more concerned with health and increasing health expectancy. For this study, an online survey was conducted targeted at men and women who were born between 1955 and 1963 and live nationwide, and its resultant data were collected. After conducting a 15-day survey in November 2011, a total of 418 questionnaire responses were used for the final analysis. The major findings of this study and their implications are as follows: First, baby boomers' health beliefs and their perceptions of health identified by subjective health conditions were very positive. Second, while there were some partial differences in the influencing factors, health beliefs and perceived health influenced the sufficiency of future medical expenses in the three groups, which were segmented according to how they prepare for future medical expenses-insurance-based, pension-based, and insufficiently prepared groups. Third, the baby boomers selected the national health insurance as the primary means of preparing for post-retirement medical expenses, and backed it up with private health insurance or the national pension. In addition, when baby boomers' perceived sufficiency of future medical expenses were examined, 57.6% of the respondents expressed that their old-age medical expenses were not sufficient. Fourth, in terms of baby boomers' preparation behaviors for future medical expenses, it was revealed that as one recognizes old-age health more seriously, he/she has a higher chance of using insurance and lower chance of using a pension to prepare for medical expenses. Fifth, regarding baby boomers' sufficiency of preparations for future medical expenses, economic factors such as total assets, the sufficiency of retirement assets, and the number of insurance policies, as well as health perceptions, including health beliefs and subjective health conditions, were important influencing factors.

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The Effects of the Revised Elderly Fixed Outpatient Copayment on the Health Utilization of the Elderly (노인외래정액제 개선이 고령층의 의료이용에 미친 영향)

  • Li-hyun Kim;Gyeong-Min Lee;Woo-Ri Lee;Ki-Bong Yoo
    • Health Policy and Management
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    • v.34 no.2
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    • pp.196-210
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    • 2024
  • Background: In January 2018, revised elderly fixed outpatient copayment for the elderly were implemented. When people ages 65 years and older receive outpatient treatment at clinic-level medical institutions (clinic, dental clinic, Korean medicine clinic), with medical expenses exceeding 15,000 won but not exceeding 25,000 won, their copayment rates have decreased differentially from 30%. This study aimed to examine the changes of health utilization of elderly after revised elderly fixed outpatient copayment. Methods: We used Korea health panel data from 2016 to 2018. The time period is divided into before and after the revised elderly fixed outpatient copayment. We conducted Poisson segmented regression to estimate the changes in outpatient utilization and inpatient utilization and conducted segmented regression to estimate the changes in medical expenses. Results: Immediately after the revised policy, the number of clinic and Korean medicine outpatient visits of medical expenses under 15,000 won decreased. But the number of clinic outpatient visits in the range of 15,000 to 20,000 won and Korean medicine clinic in the range of 20,000 to 25,000 won increased. Copayment in outpatient temporarily decreased. The inpatient admission rates and total medical expenses temporarily decreased but increased again. Conclusion: We confirmed the temporary increase in outpatient utilization in the medical expense segment with reduced copayment rates. And a temporary decrease in medical expenses followed by an increase again. To reduce the burden of medical expense among elderly in the long run, efforts to establish chronic disease management policies aimed at preventing disease occurrence and deterioration in advance need to continue.

The limitation of Medical Underwriting on the definition of Critical cancer in Critical Insurance (CI보험중 '중대한 암'(Critical cancer)의 정의에 관한 Medical Underwriting의 제한적요소에 관한 고찰)

  • Chung, Hun-Jong
    • The Journal of the Korean life insurance medical association
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    • v.25
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    • pp.63-77
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    • 2006
  • The definition of 'critical cancer' in critical insurance(CI) is more insurance meanings than medical meanings. The difference between critical cancer of insurance and critical cancer of medical cancer is made difficult problem to the underwriting of insurer, contractor and medical doctor. The limited factors of underwriting in critical cancer of critical insurance as follows: (1) the limitation factors in the definition of 1st item critical cancer in CI 1) the definition differences of meanings in insurer, contractor, and medical doctor 2) the meanings of "the table of malignance" 3) the definition difference between 'critical cancer' and 'a large of medical expense cancer' (2) the limitation factors in the definition of second item critical cancer in CI 1) The limitation in the change of cancer character 2) The missing malignancy in pathological result due to localized cancer 3) The differences in the test result of hospital (3) the limitation factors in the definition of third item critical cancer in CI. 1) the lower items disobey the higher items 2) clinical malignancy of benign cancer pathologically 3) others: (1) low grade of malignant melanoma (2) early prostate cancer. (3) malignancy related HIV (4) all skin cancer excepted malignant melanoma (5) accepted clinically and a medical certificate by medical doctor as critical cancer of premalignant lesion, carcinoma-in-situ, and borderline cancer.

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Comparison of 64 Channel 3 Dimensional Volume CT with Conventional 3D CT in the Diagnosis and Treatment of Facial Bone Fractures (얼굴뼈 골절의 진단과 치료에 64채널 3D VCT와 Conventional 3D CT의 비교)

  • Jung, Jong Myung;Kim, Jong Whan;Hong, In Pyo;Choi, Chi Hoon
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.605-610
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    • 2007
  • Purpose: Facial trauma is increasing along with increasing popularity in sports, and increasing exposure to crimes or traffic accidents. Compared to the 3D CT of 1990s, the latest CT has made significant improvement thus resulting in higher accuracy of diagnosis. The objective of this study is to compare 64 channel 3 dimensional volume CT(3D VCT) with conventional 3D CT in the diagnosis and treatment of facial bone fractures. Methods: 45 patients with facial trauma were examined by 3D VCT from Jan. 2006 to Feb. 2007. 64 channel 3D VCT which consists of 64 detectors produce axial images of 0.625 mm slice and it scans 175 mm per second. These images are transformed into 3 dimensional image using software Rapidia 2.8. The axial image is reconstructed into 3 dimensional image by volume rendering method. The image is also reconstructed into coronal or sagittal image by multiplanar reformatting method. Results: Contrasting to the previous 3D CT which formulates 3D images by taking axial images of 1-2 mm, 64 channel 3D VCT takes 0.625 mm thin axial images to obtain full images without definite step ladder appearance. 64 channel 3D VCT is effective in diagnosis of thin linear bone fracture, depth and degree of fracture deviation. Conclusion: In its expense and speed, 3D VCT is superior to conventional 3D CT. Owing to its ability to reconstruct full images regardless of the direction using 2 times higher resolution power and 4 times higher speed of the previous 3D CT, 3D VCT allows for accurate evaluation of the exact site and deviation of fine fractures.