• 한방재활의학과학회지
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• 제23권3호
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• pp.159-175
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• 2013

Objectives Herniated Intervertebral Disc of C-spine is one of the most common diseases that causes posterior neck pain. This study was designed to analyze the general distribution and hospital cost by day and case of Korean medical treatment for Cervical Herniated Intervertebral Disc (HIVD). Methods The 132 impatients for treatment of HIVD were analyzed according to the distribution of sex, age, the duration of HIVD, the contributory factors, the Clinical grade at admission, the clinical findings at admission, the duration of hospitalization, the clinical grade at admission and the hospital cost per day and case. Results 1) The total hospital cost per case averaged 1,985,600 Won, which was consisted of room charge 584,044 Won (29.41%), performance fee 511,463 Won (25.76%), herbal medication 381,517 Won (19.21%), Korean medical physiotherapy 296,310 Won (14.92%), food expenses 199,997 Won (10.07%) in order. 2) The total hospital cost per day averaged 137,285 Won, which was consisted of room charge 39,036 Won (28.43%), performance fee 33,594 Won (24.47%), herbal medication 30,642 Won (22.32%), food expenses 12,870 Won (9.37%), and the average duration of hospitalization was 15.1 days. 3) There was statistically significant difference in the consultation fee, room charge, and herbal medication on the part of sex. 4) There was statistically significant difference not only in the performance and consultation on the part of duration of hospitalization but also the in the duration of average duration of hospitalization. 5) There was statistically significant difference in the Korean medical physiotherapy and herbal medication on the part of clinical findings. 6) There was statistically significant difference in the Korean medical physiotherapy and herbal medication on the part of duration of HIVD. 7) There was statistically significant difference in the Korean medical physiotherapy and herbal medication on the part of clinical outcome. 8) There was not only statistically significant difference in the performance, but also in the herbal medication on the part of clinical grade at admission. Conclusions This study provides plenty of information to design out the specific terms of Korean medical expenses of Cervical HIVD inpatients hospitalized at Korean medicine hospital.

• 대한예방한의학회지
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• 제15권2호
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• pp.145-155
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• 2011

The purpose of this paper is to review the profitability of sixteen university hospitals of oriental medicine during 2007~2009. Data was collected from 16 hospitals that reveal financial statements to the public and the hospitals were classified into 7 groups. Net sales and COGS per 100 beds of the 7 groups were analyzed to measure profitability and as a percentage of net sales, the rates of personnel expenses, maintenance costs, and material costs were evaluated. The results showed that six groups had consecutively recorded net loss in medical services and differences in profitability among 7 groups were substantial. The analysis showed the profitability was significant for medium-sized hospitals. The rates of personnel expenses in net sales were above 50% in 6 groups with net loss and one group with net profit was 45%. This result indicate the rate of personnel expenses in net sales could be the main factor affecting profitability and further studies are recommended to analyze the determinants of profitability in oriental medical hospitals.

• 보건행정학회지
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• 제33권3호
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• pp.363-369
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• 2023

The term "catastrophic health expenditure" means assessing the extent to which medical costs cause financial hardship for households. The aim of this research is to analyze the percentage of households that faced severe financial strain due to medical expenses from 2006 to 2021. This was achieved by utilizing data obtained from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). A trend analysis was conducted to examine the percentage of households that experienced catastrophic healthcare expenses. The households that experienced the catastrophic health expenditure was 2.49% in 2021 using the NaSTaB data. The trend analysis yielded a statistically significant result, indicating a decreasing trend (annual percent change [APC], -4.79; p<0.0001) in the proportion of households facing catastrophic health expenditures. Also, the results of the 2019 KHP and the 2021 HIES showed 1.09% and 2.44% for the households that experienced catastrophic health expenditure. The trend was increased according to the KHP (APC, 0.55; p=0.0004) and the HIES (APC, 7.04; p<0.0001). As a result, this study proposes that sustained attention and further interventions are necessary to ease the economic pressure caused by catastrophic health expenses, particularly for low-income households.

• 대한물리치료과학회지
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• 제9권3호
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• pp.129-140
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• 2002

This study intended to find out how the handicapped use medical aid, their satisfaction at using it and so on. First a preliminary survey(Apr. 20$\sim$24, 2002) was made for the handicapped who had been cured for rehabilitation by wearing medical aid at hospitals and welfare center in Jeonbuk region. Then total 120 subjects were asked to fill out a standardized questionnaire from May 15$\sim$22, 2002. Out of total 95 questionnaires collected, 84 questionnaires were analyzed except for 11 cases unsuitable for the intention of this study. The results can be outlined as follows: 1. In general characteristic, it was found that the causes of disability included disease(35 respondents; 41.7%), traffic accident(23 respondents, 27.4%) and so on. In addition, 1st handicap comprised the majority(32 respondents; 58.2%) in handicap grade and ankle foot orthosis(or b-k orthosis) was most often used as medical aid(28 respondents: 33.3%) 2. In particular, it was also shown that the 1st handicap mainly resulted from traffic accident(15 respondents, 27.3%) and post-disease disability (11 respondents, 20.0%). They wore medical aid for 1 year or less on the average, because they were hospitalized for cure, which showed statistically significant level(P<0.05). 3. It was found that total 69 respondents(82.1%) were more or less satisfied with their medical aids depending on the causes of disability, and total 46 respondents(83.6%) were satisfied with their aids according to their handicap grade, but there were no statistical significance. 4. Total 56(66.7%) respondents answered that they would purchase medical aid on their own expenses, when they became handicapped. And the price of medical aid ranged from $\300,000{\sim}400,000$(25 respondents: 29.8%) to \ 500,000 or more(24 respondents: 28.6%). It means that they purchased more or less expensive medical aid on their own expenses, which showed statistical significance(P<0.05). 5. If there was any failure of medical aid, 9 respondents(37.5%) answered that they would be serviced from medical companies, and 7 respondents(29.2%) would be serviced from medical aid manufacturers. Most respondents were serviced for their medical aids from related companies. For the question about the causes of dissatisfaction upon repair service, 11 respondents(45.8%) answered that existing service company provided unskilled repair services and other respondents answered that there was no spare part or higher service expenses than they thought. These answers had the statistical significance(P<0.05). However, 20 respondents(79.2%) answered that they were satisfied with the repair service, which means that most respondents are satisfied with the service. In view of the results as described above, it can be concluded that their handicap or disability results from disease or sequelae after traffic accident and most of the affected wear their own medical aid. In the future, it is required that the medical insurance should cover those medical aids, and the service for failed medical aids should be commissioned by technical serviceman to realize customized manufacture and repair service according to different causes so that the handicapped can enjoy more or less comfort and convenience in their daily lives without any extreme difficulty.

• 보건행정학회지
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• 제34권2호
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• pp.196-210
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• 2024

연구배경: 2018년 1월 의원급(의원, 치과의원, 한의원) 노인외래정액제 개선안이 시행되었다. 정액진료비 상한금액인 1만 5,000원 이하 진료를 받은 경우의 본인부담금은 기존과 동일하다. 개선안은 정액진료비 상한금액인 1만 5,000원 초과 진료를 받은 경우의 본인부담금을 차등적으로 인하하였는데, 1만 5,000원 초과 2만 원 이하 구간의 본인부담금은 진료비의 30%에서 10%로, 2만 원 초과 2만 5,000원 이하 구간의 본인부담금은 진료비의 30%에서 20%로 인하하였다. 우리나라는 급격한 인구 고령화로 고령인구와 노인진료비가 빠르게 증가하고 있고, 노인빈곤율이 경제협력개발기구 회원국 중 가장 높다. 연구는 건강보험 지속 가능성 유지와 노인복지 향상을 위하여 노인외래정액제 개선이 고령층의 의료이용에 미친 영향을 종합적으로 확인하려고 한다. 방법: 연구는 한국의료패널 자료를 사용하여 노인외래정액제 개선 이후 고령층의 의료이용 변화를 추정하였다. 연구는 단절적 시계열 연구 중 구간별 회귀분석을 분석에 이용하였고, 진료비 구간별 및 의원 종류별 외래진료 횟수, 입원횟수 및 일수 변화는 포아송 구간별 회귀분석을, 외래 및 입원진료비 변화는 구간별 회귀분석을 이용하여 추정하였다. 구간별 회귀분석은 개입으로 인한 효과와 시간의 흐름에 따른 효과를 구분할 수 있게 해주어, 개입이 없더라도 발생했을 변화와 개입으로 인한 변화를 명확하게 추정할 수 있도록 해준다. 의료이용에 영향을 미칠 것으로 예상되는 성별, 연령, 교육수준, 소득, 배우자 유무, 장애 정도, 지역, 주관적 건강인식, 질병 및 손상으로 인한 일상생활 제한 여부, 응급 및 입원 수술 여부, 응급실 이용횟수, 만성질환 개수, 계절은 통제변수로 포함하였다. 결과: 노인외래정액제 개선 직후 본인부담 변화가 없던 의원, 한의원 진료비 1만 5,000원 이하 구간의 외래진료 횟수가 감소하였다. 그러나 본인부담이 감소한 의원 1만 5,000원 초과 2만 원 이하 구간과 한의원 2만 원 초과 2만 5,000원 이하 구간의 외래진료 횟수는 증가하였다. 치과의원의 외래진료 횟수 변화는 통계적으로 유의하지 않았다. 입원율은 노인외래정액제 개선 직후 감소하였지만, 이후 다시 증가하였다. 외래진료비 중 본인부담금은 노인외래정액제 개선 직후 감소하였다. 입원진료비와 외래와 입원진료비를 합한 총진료비는 노인외래정액제 개선 직후 감소하였다가 이후 다시 증가하였다. 결론: 분석결과를 통해 노인외래정액제 개선 이후 일시적인 의료이용 증가와 본인부담금 감소를 확인할 수 있었다. 총진료비 중 입원이 차지하는 비중이 외래보다 크기 때문에, 노인외래정액제 개선이 고령 환자의 의료비 부담 완화에 미친 영향은 매우 제한적이었다. 장기적으로 고령 환자의 의료비 부담 완화와 건강보험 지속 가능성 유지를 위해서는 본인부담 완화 정책과 질병 악화로 인한 입원을 예방하기 위한 만성질환 관리정책이 함께 이루어져야 할 것으로 보인다. 연구의 결과는 정책을 수립할 때 본인부담 변화가 고령층의 의료이용 행태에 미치는 영향에 대한 기초정보를 제공할 수 있을 것으로 기대된다.

• 대한예방한의학회지
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• 제10권2호
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• pp.95-120
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• 2006

The purpose of this paper is to investigate the structure of cost-sharing for oriental medical services in the national health insurance. Out-of-pocket payment in ambulatory oriental medical care is a co-payment of KRW3,000 up to total expenses of KRW15,000, and co-insurance rate of 30% thereafetr. The empirical analysis based on medial claims data shows that the frequency of medical claims for outpatient care are mostly concentrated just below a total expenses of KRW15,000, and it decreases beyond a total expense of KRW15,000, while it rebounds between KRW17,000${\sim}$20,000. This means the current co-payment(KRW3,000) in oriental medical services should be applied up to a total payment of KRW17,000${\sim}$20,000, or the level of co-payment should be adjusted upward to KRW45,000 in order to be consistent in cost-sharing, between co-payment and co-insurance.

• 융합보안논문지
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• 제23권1호
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• pp.89-95
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• 2023

자동차보험 사고 환자의 진료비 감소를 위한 대책 마련에 도움을 주기 위해 본 연구에서는 자동차보험 사고 40대~50대 경상 환자들의 진료비에 가장 핵심 요소인 진료 기간을 예측하고 진료 기간에 영향을 미치는 요인을 분석하였다. 이를 위해 Decision Tree 등 5개 알고리즘을 활용한 머신러닝 모델을 생성하고 모델간에 그 성능을 비교·분석하였다. 진료 기간 예측에 정밀도, 재현율, FI 점수 등 3가지 평가 지표에서 좋은 성능을 나타낸 알고리즘은 Decision Tree, Gradient Boosting 및 XGBoost 등 3가지였다. 그리고 진료 기간 예측에 영향을 미치는 요인 분석 결과, 병원의 종류, 진료 지역, 나이, 성별 등으로 나타났다. 본 연구를 통해 AutoML을 활용한 손쉬운 연구 방법을 제시하였으며, 본 연구 결과가 자동차보험 사고 진료비 경감을 위한 정책에 도움이 되기를 기대한다.

• 대한통합의학회지
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• 제9권1호
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• pp.69-90
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• 2021

Purpose : This study explores unmet medical services within a region for patients admitted to a single medical institution in one region and was to analyze the importance and satisfaction of hospital selection attributes. Through this, we tried to solve the unmet medical needs of patients and provide useful basic data in terms of hospital management in the region. Methods : It were collected to a total of 250 questionnaires for patients admitted to the regional integrative medical hospital. However, 232 samples were used for the final analysis, excluding 18 copies not reported in good faith. For the analysis, first, demographic frequency analysis of inpatients and inpatients was performed, and second, characteristics of patients, including frequent disease receiving treatment, were analyzed. Next, descriptive statistics analysis was conducted on unmet medical service intentions. In terms of hospital selection attribute, the items of continuity maintenance (I quadrant), priority visibility (II quadrant), low priority (III quadrant), and excessive effort (IV quadrant) were derived using the IPA (importance-performance analysis) matrix technique. Results : The derived results were classified by item and area. In the priority administration area, it was the reputation and recognition of medical institutions and the service area of medical institutions. In the case of items, there were 6 items including the importance of surgery and medical expenses, and diet at hospitalization. 1) Conclusion : Thus a result of this study, resources are efficiently allocated to priority correction areas with high importance but low satisfaction and circulatory medical treatment is performed in the departments required by patients who use medical care and, various methods, such as preparing a policy to support medical expenses, should be sought.

• 한국병원경영학회지
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• 제25권4호
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• pp.13-28
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• 2020

Purposes: The purpose of this study is to analyze the institutional and personal factors that affect the medical utilization of patients transferred to tertiary medical institutions. Methodology: We retrospectively analyzed the 2 weeks electronic medical records of 1,556 patients, who were referred to the tertiary hospital, from June 15 to 26, 2015. The patient's personal characteristics, referral hospital, referral path, medical experiences and expenses were analyzed for 6 months after the patient's first visit. Findings: The largest proportion (848; 54.5%) of referrals was referred from primary clinic but the referrals of the same tertiary hospital level were one in seven (228; 14.7%) of the patients. Most patients (1,401; 90%) were referred from the clinics and hospitals directly and only one in ten (155; 10%) of the patients utilized the medical referral center. Patients who had been referred from tertiary care institutions had significantly higher medical costs than those referred to primary care (7,560,000 vs 2,333,000 won). The institutional factors including the numbers of visits to outpatient clinic, previous history of hospitalization and operation, consultation to other medical departments and hospitalization fee significantly influenced on medical utility pattern. Personal factors including patient's medical diagnosis and department of disease have a highly correlation with patient's referrals. Practical implications: The medical utilization of medical expenses and experiences is influenced by institutional and individual factors, and it is important to establish a referral system considering the institutional factors of the type of referral hospital.

• 한국콘텐츠학회논문지
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• 제17권5호
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• pp.366-375
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• 2017

본 연구는 의료급여환자와 가족 3인, 요양병원에 4년 이상 근무한 경험이 있는 종사자 5인에 대한 심층면접조사를 통하여 도덕적해이가 우려되고 있는 의료급여환자의 요양병원 이용과정과 입원, 의료서비스, 퇴원과 전원 등에 대하여 분석하였다. 주요 분석결과와 함의는 다음과 같다. 첫째, 요양병원 입원은 의료급여환자의 선택보다는 의료기관간의 연계와 유치를 위한 경쟁적 홍보에 의해서 이루어지고 있었다. 둘째, 의료급여환자의 요양병원 장기입원의 원인은 본인부담이 적어서 도덕적 해이를 유발할 수도 있었지만 거주지 부재, 간병인 부재 등 퇴원 후 사회적인 보호수단이 없는 것도 주요 원인이었다. 셋째, 대다수 의료급여환자들이 치료가 필요한 상태이지만, 건강보험환자에 비해 필요성이 높지 않음에도 입원을 유지하는 경우가 있었다. 넷째, 요양병원의 의료서비스는 재활서비스가 주를 이루고 있으며, 간호인력과 간병인의 역할이 중요하였다. 다섯째, 의료급여환자들은 요양병원 의료비를 수급비와 가족지원 등으로 부담하고 있지만, 일부 환자들은 병원에서 간병비나 본인부담을 면제 혹은 감면받고 있었다. 여섯째, 공공기관과 사회복지기관은 요양병원에 환자를 의뢰한 이후 지속적인 관리를 하지 않고 있으며, 퇴원 후 지역사회서비스 연계가 필요한 것으로 나타났다.