• Korea Journal of Hospital Management
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• v.26 no.2
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• pp.1-16
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• 2021

This study aims to examine the effect of integrated health and welfare(IHW) services on medical use and medical expenses in Korean Veteran Hospitals. Data on the volume of medical use and medical expenses were collected from two patient groups of 5 Veterans' Hospitals: the beneficiary group who has received IHW services and the non-beneficiary group who has not. Each group was composed of 265 patients respectively. The results of the study revealed that the volume of home nursing services, home rehabilitation services, ambulatory services have increased significantly, whereas the average length of stay, number of using emergency services, and average medical expenses have decreased after receiving integrated health services in the beneficiary group. In contrast, the non-beneficiary group showed much more increase both in the volume of inpatient and outpatient services, as well as the average medical expenses, compared to those of the beneficiary group. This results imply that the provision of IHW services have positive impacts on the enhancing the effectiveness of the medical resources utilization for the veteran patients.

• Health Policy and Management
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• v.23 no.2
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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.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.9-15
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• 2005

Objectives : To analyze medical expenses by cancer site and survival time among cancer patients in their last year of life. Method : The study subjects were 45,394 people that had died of cancers in 2002, were registered by the Korea Central Cancer Registry and received National Health Insurance benefit in the last year (360 days) of life. Personal identification data, general characteristics, dates of death and cancer incidence, and site of cancer were collected from the National Statistical Office and the Korea Central Cancer Registry, and merged with the data of the individual medical expenses of the Health Insurance Review Agency. Results : Average monthly cost curves were U-shaped with high costs near the time of diagnosis and death, and lower costs in between. Medical expenses in the last year of life were around 30.3, 16.7, 13.0, and 12.1 million won among leukemia, lymphoma, ovarian cancer, and breast cancer patients, respectively. Digestive organ cancers including stomach, esophagus, liver, pancreas, and colorectal cancers had relatively low medical expenses. Medical expenses in the last year of life were inverse U-shaped with high expenses near one year of survival. Average monthly cost in the 12 months before death among the patients who had survived $10{\sim}15$ years were more than two-fold greater than the cost before diagnosis among those who had survived for less than one year. Conclusions : Leukemia was the most expensive cancer. It is possible that once diagnosed as cancer, medical expenses do not return to the level before diagnosis. Further research will be needed to understand the magnitude and change of the medical expenses among cancer patients with long term follow up data.

• Korea Journal of Hospital Management
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• v.19 no.3
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• pp.1-10
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• 2014

The purpose of this study was to present base data for an efficient management of medical expenses at the hospital management by doing grasp of status of medical expenses from seamen's insurance by voluntary agreements. A Object of study is analyzing the data of medical expenses occurred from the total number of 2,699(inpatients 507, outpatients 2,192)cases who were covered by seamen's insurance at a general hospital which is located in Pusan Metropolitan City during 48 months from January 1, 2009 to Dec 31, 2012. The main results of this study are as follows: accrual medical expenses are the ship management companies member of P&I insurance is the most highest but share of receivables are the Korean ocean-going companies member of P&I insurance is the most highest, therefore, Korean ocean-going companies focus strictly than the payments from accounts receivable management should be considered to reduce the occurrence and concerning the turn around period of medical receivables are 4 months to 6 months during a research period. Therefore, it will be needed for managers of hospitals to prepare differentiated management based on the characteristics of each in insurer and to have recovery strategies of uncollected medical expenses.

• Journal of agricultural medicine and community health
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• v.44 no.4
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• pp.195-208
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• 2019

Objectives: The purpose of this study was to analyze whether there are differences in medical expenses according to medical security type in the use of medical services with high disease burden such as coronary intervention. Methods: Chi-square test and covariance analysis(ANCOVA) were conducted to identify the differences in the characteristics and costs according to medical security type of 1,904 patients who underwent coronary intervention in a university hospital from 2011 to 2012. Hierarchical regression analysis was conducted to determine whether the cost affects medical expenses. Results: In the medical aid group, the proportion of women, those without a job, those without a spouse, and those who received hemodialysis was high, length of stay was high, patients using the emergency room and those who died was high. The medical aid patients were significantly higher in the non-benefit medical expenses, optional medical expenses, physician and admission, meals, medications and injections. National health insurance patients were significantly higher in procedure. The medical security type was found to be significant as a variable affecting the medical expenses. Conclusions: Provision of medical expenses should be managed in advance by providing prevention and education services for the vulnerable, and care services in the region should be provided to suppress the occurrence of medical expenses due to the increase in the number of days spent. In addition, it is necessary to support medical expenses to prevent unsatisfactory medical services from occurring for non-benefit and optional care.

• The Journal of Korean Medicine
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• v.43 no.1
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• pp.60-72
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• 2022

Objectives: This study aimed to analyze the Korean medical utilization and Korean medical expenses by characteristics of multicultural family members to investigate whether it affects Korean medical utilization. Methods: This study utilized The Korea Health Panel data in 2018, with 238 final participants. We performed a t-test and ANOVA on the difference between Korean medical utilization and Korean medical expenses according to Anderson's Model of Health Service Utilization variables. Logistic regression analysis and generalized linear model analysis were conducted to analyze Korean medical utilization factors. Results: The Korean Medical utilization was 12.61% among the multicultural family members. As a result of regression analysis, the female had high Korean medical utilization(p=.008), and rural area residents had low utilization(p=.017). Korean medical expenses were high when they were female or married. Including the utilization of western medical services by outpatients, Korean medical expenses were high when they were female or outpatients who received western medical services. Conclusions: As a result of this study, the factors influencing Korean medical utilization were gender and residence area. There were differences in Korean medical expenses depending on western medical services use or gender. Therefore, it is necessary to use these factors to expand the Korean Medical utilization by multicultural family members, and research of the Korean medical utilization by disease is needed.

• Journal of Digital Convergence
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• v.10 no.11
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• pp.493-502
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• 2012

This study aimed to determine the management and environmental factors affecting medical expense reduction. For analysis, medical expenses were divided into hospitalization expenses and outpatient treatment expenses, and the rate of medical expense reduction was classified into initial and final reduction rates. Data were collected through a direct survey among 205 directors of independent health insurance review departments of hospital-level medical institutions in Korea. The results of the study are discussed below: In the analysis, differences in the initial and final reduction rates of hospitalization expenses and outpatient treatment expenses were compared. The results showed that, in hospitalization expenses, the initial and final reduction rates were both significantly affected by the following management factors: number of beds, number of departments, number of personnel reviewing health insurance cases, and total number of employees. Further, in outpatient treatment expenses, the initial and final reduction rates were both affected significantly by the following management factors: management of medical records, number of beds, number of departments, number of personnel reviewing health insurance, and total number of employees. The management factors significantly affecting both the initial and final reduction rates were higher number of beds for hospitalization expenses and electronic medical record management for outpatient treatment expenses. The environmental factors significantly affecting both the initial and final reduction rates of hospitalization expenses were a highly cooperative work environment, better implementation of indicator management systems, and overtime pay. Better implementation of indicator management system and a committee for handling medical expenses had significant effects on the initial reduction rate for outpatient treatment expenses. A highly cooperative work environment, better implementation of indicator management system, and overtime pay had significant effects on the final reduction rate for outpatient treatment expenses.

• Journal of agricultural medicine and community health
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• v.14 no.1
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• pp.16-29
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• 1989

The general objective of this study is to grasp the treatment expenses of common diseases by character of medical care institutions. The specific objective is to find out the treatment expenses for selected common diseases by type of medical care institutions and also by level of symptom. A record review method was employed to obtain required information for the analysis of expenses. A total of 40,000 cases treated by 85 medical care institutions were selected by the study team during the period 22 June to 14 July 1988. The 85 medical care institutions were sampled by stratified proportionate random sampling method. The major findings obtained from the information collected by the study team are as follows ; 1) Treatment expenses were composed of physical examination, medication, injection anesthesia, rehabilitation surgical intervention, lab test, X-ray and diagnosis. The highest expenses was for medication, accounted for 36.7% of the total: 13.9%, injection; Lab, tests respectively: 10.5%, physical examination : 8.6% surgical intervention; 7.9% admission : 6.3%, X-ray and diagnosis: 1.5%, rehabilitation. 2) Treatment expenses per case of common diseases were quite different from not only type of medical care institutions, such as university hospital, general hospital, hospital and clinic, but also from level of symptom. 3) Treatment expenses per case for the aged were higher than that of the young. The treatment cases for over 60 years of age accounted for 19.4% of the total, however the proportion of treatment expenses accounted for 23.8% of the total. 4) Duration of treatment and visits for same diseases varied from type of medical cara institutions. Based on these study findings, the following further research should be conducted: (1) Establishment of health care delivery system. (2) Feasibility of the development of health care programme for the aged. (3) Strengthening for primary health care approach.

• Journal of Digital Convergence
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• v.13 no.7
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• pp.259-268
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• 2015

This research grasped the difference of between the daily medical expenses and the medical expenses reduction rate also the cause of change. In the centre, it was conducted in order to offer the necessary basic data to a recuperation pay management solution's establishment. This research surveyed across the country's urban region 50-general hospital's the infective enteritis disease for a year. Then it was conducted the average daily medical expenses and the average medical expenses reduction rate as a distinguishable survey that is a hospitalization and an outpatient the result is followed. The inpatient daily medical expenses correlated with the total number of medical institution personnel, and the outpatient daily medical expenses correlated with the number of beds.. Inpatient medical expense reduction rate was correlated with number of beds and the total number of medical institution personnel. The interaction between medical institution information and daily medical expenses was found to have a positive (+) effect on the total number of medical institution personnel, as well as the numbers of inpatients vs. outpatient. This research about the medical expense reduction rate and daily medical expense help medical institution's efficient, rational decision making and it will be an important basis of a priority recuperation pay's policy.

• Journal of Hospice and Palliative Care
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• v.2 no.2
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• pp.109-113
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• 1999

Purpose : Because we don't have inappropriate health care system for the terminal cancer patients, there were abnormal behavior patterns of health care utilization. So, There were needs to develop the comprehensive care for terminal cancer patients. Increased attention is being paid to the futility of life-sustaining treatment and high cost of management of terminal cancer patients Materials and Methods : This study was performed on cancer patients, registered in 1996 Central Cancer Registry, who were as insured person of Korea Medical Insurance and died from January 1997 to June 1998. We studied the day of medical care and medical expenses of 151 cancer patients evaluable. Results : The mean day of inpatient care was 39 days, and the mean days of outpatient care was 14 days in study subjects. Mean expenses per day of medical care, day of inpatient, and day of outpatients care were 85,392 won, 105,908 won, and 40,173 won. 95% of medical expenses is paid to the general hospital, and 85% of medical expenses was paid for inpatient care. About half of all medical expenses in th last 6 months were incurred in the last 60 days of life, and about 30 percent were incurred in the last 30 days. Expenses of outpatients care increased between 6 month and 3 months, after which they decreased. Expenses of inpatients care increased during all last 6months Conclusion : The distribution or medical expenses during the last 6 months in our study is similar to the distribution of American Medicare costs. We need to study medical expenses during the last year of life with large scale and details in order to develop the plan about the management of terminal cancer patient.