• 보건행정학회지
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• 제22권1호
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• pp.65-84
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• 2012

Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.

• 보건행정학회지
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• 제7권1호
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• pp.125-154
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• 1997

The hospital, clinical department and the physician factor in explaining variations of hospital resource use in surgically admitted patients was compared. This analysis was based on 6, 361 discharges in 28 hospitals for three surgical conditions - lens procedures anal and stomal procedures, uterine and ovarian procedures using medical insurnce claim data. The results were as follows: 1. Regression analysis indicated that the hospital and clinical department characteristics, such as hospital ownership and size, were more significant predictors of the resource use indicators than the physician and patients' social characteristics. 2. Regarding to the physician factors, the hospital where the physician received the residency training and the medical shool where he/she graduated had less effect compared to the hospitals where he/she currently works. Between the residency trained hospital and medical school, the is more important than the latter. 3. When the hospital charges were divided into type of service provided i. e. room, drug, laboratory & radiologic, procedure & operation, and anesthesic charges, variance due to the hospital factor was larger than that due to the physician factor in each item. In summary, the hospital and clinical departmental factor played an important role than physician factor ; indicating to reduce the variation in hospital resource use, the policy that affects hospital behavior would be more effective than that targets individual physician behavior.

• Genomics & Informatics
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• 제17권2호
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• pp.16.1-16.4
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• 2019

Medical Subject Headings (MeSH), a medical thesaurus created by the National Library of Medicine (NLM), is a useful resource for natural language processing (NLP). In this article, the current status of the Japanese version of Medical Subject Headings (MeSH) is reviewed. Online investigation found that Japanese-English dictionaries, which assign MeSH information to applicable terms, but use them for NLP, were found to be difficult to access, due to license restrictions. Here, we investigate an open-source Japanese-English glossary as an alternative method for assigning MeSH IDs to Japanese terms, to obtain preliminary data for NLP proof-of-concept.

• 한국사회복지학
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• 제62권3호
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• pp.83-108
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• 2010

본 연구는 고령사회 준비를 위한 현황이해 차원에서 앤더슨 모형을 이용하여 노년기 외래의료 서비스 이용궤적 및 예측요인을 살펴보고, 초기노년기와 후기노년기 간에 궤적이나 예측요인이 차이가 있는지를 살펴보는 것을 목적으로 한다. 한국복지패널의 1, 2, 3차년도 자료를 사용하여, 궤적 및 예측 요인은 잠재성장모형을 이용해서 분석하였고 연령 차이는 다중집단분석을 이용하여 분석하였다. 60세 이상 노인들은 해가 지남에 따라서 외래이용 횟수를 증가시키는 경향을 보였는데, 75세 미만의 초기 노년기의 노인들이 75세 이상의 후기노년기의 노인들 보다가 이용 횟수를 상대적으로 빨리 증가시켰다. 예측요인에 있어서는 선행요인, 자원요인, 욕구요인들의 상당수가 궤적과 유의미한 관계가 있었는데, 자원요인 보다는 욕구요인들이 의료서비스 이용궤적에 크게 영향을 주는 것으로 나타났다. 하지만 예측요인에 있어서 초기 및 후기 노년기 사이에 큰 차이는 없었다. 결과를 토대로 연구의 의의 및 함의를 논의하였다.

• 보건행정학회지
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• 제12권1호
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• pp.21-53
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• 2002

The purpose of this study is to measure the resource use of the elderly in long-term care services and to examine the effects of patient and facility characteristics on their use of resources. The data were collected from 510 old people over sixty years of age, residing in five long-term care hospitals and two skilled nursing homes during the period between December 1, 2000 and February 28, 2001. For a full sample, when the first level of RUG(Resource Use Group)-III categories were employed as the proxy of patient severity, facility characteristics, such as location, size and ownership, have large effects on the resource use measured by service intensity, whereas patient characteristics such as severity have little or no effect. The resource use is significantly high if the facility: (1) is located in rural areas (gun): (2) has mare than 200 beds; (3) is a long-term care hospital; (4) is private; and (5) has a low percentage of medical aid patients. The analysis of the resource use in each RUG-III categories, for which ADL(Ability of Daily Living) were employed as the prosy of patient severity, shows a similar result. The loose relationship between the needs of residents and the resource use seems to be closely associated with the ineffective reimbursement system for providers. The current reimbursement system has no provision for quality improvement and reimburses facilities simply according to their types: fee-for-service for long-term care hospitals, and monthly-flat-rate or full-coverage-national-aid for skilled nursing facilities. It will be necessary to develop a more reasonable reimbursement system that takes patient's severity into account and gives incentives for long-term care providers to offer cost-effective services.

• 보건행정학회지
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• 제5권2호
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• pp.202-229
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• 1995

In Korea, Resource-Based Relative Value Scale(RBRVS) is suggesting to the alternative of Korean Medical Fee Schedule. This study developed to methodology of RBRVS applicable to Korean situation and applied to services of internal medicine and general surgery. Our methodology of RBRVS is basically same to Hsiao's. But there are some differences between our method and H냐매's because Korean medical situation differs to American. The first difference is method of measurement of work. The Unit of work in our study is total work including intra-servic work and pre-/post-service work. Secondly, in extrapolation, we use primary data gathered to small group of physician. Tertially, in measurement of practice cost, we directly survey to budget data of hosptials and analyse practice costs by service. Some results are presented in a companion article.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제16권9호
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• pp.3008-3028
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• 2022

In this paper, we investigate traffic scheduling for a delay-sensitive multi-hop relay network, and aim to minimize the priority-based end-to-end delay of different data packet via joint relay selection, subcarrier assignment, and power allocation. We first derive the priority-based end-to-end delay based on queueing theory, and then propose a two-step method to decompose the original optimization problem into two sub-problems. For the joint subcarrier assignment and power control problem, we utilize an efficient particle swarm optimization method to solve it. For the relay selection problem, we prove its convexity and use the standard Lagrange method to deal with it. The joint relay selection, subcarriers assignment and transmission power allocation problem for each hop can also be solved by an exhaustive search over a finite set defined by the relay sensor set and available subcarrier set. Simulation results show that both the proposed routing scheme and the resource allocation scheme can reduce the average end-to-end delay.

• 간호행정학회지
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• 제14권3호
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• pp.229-240
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• 2008

Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

• Journal of Preventive Medicine and Public Health
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• 제26권2호
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• pp.293-309
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• 1993

With expanded and extended coverage of the national medical insurance and fast growing health care expenditures, appropriateness of health service utilization and quality of care are concerns of both health care providers and insurers as well as patients. An accurate patient classification system is a basic tool for effective health care policies and efficient health services management. A classification system applicable to Korean medical information-Korean Diagnosis Related Groups (K-DRGs)-was developed based on the U.S. Refined DRGs, and the performance of the developed system was assessed in this study. In the process of the development, first the Korean coding systems for diagnoses and procedures were converted to the systems used in the definition of the U.S. Refined DRGs using the mapping tables formulated by physician panels. Then physician panels reviewed the group definition, and identified medical practice patterns different in two countries. The definition was modified for the differences in K-DRGs. The process resulted in 1,199 groups in the system. Several groups in Refined DRGs could not be differentiated in K-DRGs due to insufficient medical information, and several groups could not be defined due to procedures which were not practiced in Korea. However, the classification structure of Refined DRGs was retained in K-DRGs. The developed system was evaluated fur its performance in explaining variations in resource use as measured by charges and length of stay(LOS), for both all and non-extreme discharges. The data base used in this evaluation included 373,322 discharges which was a random sample of discharges reviewed and payed by the medical insurance during the five-month period from September 1990. The proportion of variance in resource use which was reduced by classifying patients into K-DRGs-r-square-was comparable to the performance of the U.S. Refined DRGs: .39 for charges and .25 for LOS for all discharges, and .53 for charges and .31 for LOS for non-extreme discharges. Another measure analyzed to assess the performance was the coefficient of variation of charges within individual K-DRGs. A total of 966 K-DRGs (87.7%) showed a coefficient below 100%, and the highest coefficient among K-DRGs with more than 30 discharges was 159%.

• 한국산학기술학회논문지
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• 제12권11호
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• pp.4968-4979
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• 2011

본 연구는 의료소비자들이 의료기관을 선택할 때 이용하는 의료정보원에 성별, 연령, 직업, 소득수준, 의료보장의 형태, 주거지역 등 사회경제적 요인이 어떤 영향을 미치는지 알아보기 위한 면접조사이다. 2008년 지역사회 건강조사의 일환으로 충북 지역 거주자들을 대상으로 표준화된 설문지를 이용한 면접을 통하여 의료정보원과 관련된 자료를 수집하였고, SPSS version 12.0을 이용하여 분석하였다. 의료기관 선택 시 가장 많이 이용한 정보원은 입원, 외래 모두 개인적 정보원(41.9%, 33.5%)이었으며 가정 적게 이용한 정보원은 경험적 정보원(3.0%, 4.3%)이었다. 개인적 정보원에는 입원, 외래 모두 성별의 차이가 존재하였으며, 외래이용에서 교육수준과 거주지역의 차이가 존재하였다(p<0.001). 공공적 정보원은 입원 시는 연령, 교육수준, 월 가구 소득 간의 차이를 보였고 외래이용 시는 거주지역만 차이를 보였다(p<0.001). 경험적 정보원은 거주지역의 차이만 보였으며, 전문가 정보원은 입원 시는 남자가 외래이용 시는 여자가 더 많이 이용하는 결과를 보였다. 결론적으로 의료기관 선택 시 사용한 정보원은 의료이용자의 사회 경제적 요인과 관련성을 가지고 있으며 이는 의료기관 이용형태(입원, 외래)에 따라 서로 다른 양상을 보였다.