• Health Policy and Management
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• v.20 no.2
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• pp.40-52
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• 2010

Health insurance fees are set by relative value scales and conversion factors. Since 2008 the conversion factor has been classified into 7 according to the provider type, and a separate contract has been made respectively. As such classification of the conversion factor reflects only the different characteristics of providers, however, further classification to reflect the different cost structures of providers is proposed. Cost varies according to the type of not only providers but also services each provider supply. In fact different cost structures of providers are the result of their different services. This study analyzed the cost structure of medical services to propose a new approach to the classification of the conversion factor. This study analyzed the cost structure of medical services using cost data constructed in the revision study of relative value scales. The cost data consist of doctor's fee, support staff's fee, cost of medical equipments, cost of medical supplies and indirect cost. The proportion of each cost component to the total cost was analyzed in terms of service department and service type. 72 service groups are defined in terms of the combination of service department and service type. Through cluster analysis, 72 service groups were reduced into 7 clusters each of which has a similar cost structure. Conversion factor is contracted annually to reflect the change in the cost of providing medical services. So the classification of conversion factor has to be based on the cost structures of medical services, not the characteristics of providers. Service clusters derived in this study can be used as a new classification for health insurance fee contract.

• Korea Journal of Hospital Management
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• v.13 no.2
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• pp.36-63
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• 2008

This study carried out a covariance-structural analysis to verify formed causations between general variables and the influences of Medical Social Work Service of officers and NCOs in Korean Community Military Hospitals. The subjects were 7 hospitals, 337 military hospital executives in rear area, and the results of the survey are as below. First, about empowerment level, culture in the organization turned out to be the primary direct influential factor, and personal, organizational, and functional character were influential factor. There was no indirect influential factor present. Second, in Medical Social Work Service, empowerment level was significant on direct effect. In case of personal character indirect effect was important. It showed that the significant influence factor that affects Medical Social Work Service in total effectiveness is personal character and empowerment level. It's productive to suggest the possibility of application of furnish the outcome as a basic data for Military Medical Social Work Service revitalization plan. On the basis of the result, we propose several suggestions for Military Medical Social Work Service as follow. First, to educate empowerment increase program of officers and NCOs in Military Hospital, specific system which allows entrust education to a certain civil education institution or KAMTSW(Korean Academy of Military Social Welfare) is required. Second, need to provide the medical social work service that matches with Military Hospital and distinct from usual hospital. Last, for specific study we expect various follow-up researches on the basis of this study, which can develop concrete empowerment model by inquiring research, would come out.

• The Journal of the Korea Contents Association
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• v.13 no.7
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• pp.333-338
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• 2013

The purpose of this study is to research how to effectively export the dental prosthetic restoration and the service to the overseas. The study showed the present status of dental prosthetic restoration service in South Korea and some suggested ways to improve the export of the dental prosthetic restoration service to the overseas. The size of the medical service market has been gradually increased because of the globalization and the development of the information-oriented tendency. The medical industry is being perceived as a highly valuable service industry that emphasizes the importance of quality. Through the efforts of the nations attempting to develop the market and create new employment, the medical field is becoming a prospective field of trade. In order to develop the medical industry, the strategies; firstly, medical institutions need to explore overseas markets and strengthen globalization; secondly, medical service should be upgraded through specialization; and finally, specialized management system has to be established and medical management system has to be innovated.

• Anxiety and mood
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• v.8 no.2
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• pp.113-119
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• 2012

Objective : The purpose of this study is to assess the utility of clinician administered posttraumatic stress disorder scale (CAPS) to diagnose combat related posttraumatic stress disorder (PTSD) in Korean veterans of the Vietnam War. Methods : Sixty-one Korean male veterans of the Vietnam war participated in this study. We compared the diagnostic values of CAPS, Korean version of mini international neuropsychiatric interview (MINI) against the Structured Clinical Interview for DSM-IV (SCID) in diagnosing PTSD. Results : The overall internal consistency of CAPS was 0.93. Compared to the SCID, total severity 45 (TSEV45) showed the best results among 5 CAPS scoring rules. In detail, sensitivity was 71.4%, specificity was 85.1, positive predictive value was 58.8%, negative predictive value was 90.9%, and accuracy was 82.0. Conclusion : CAPS was demonstrated as a reliable tool to diagnose combat related PTSD in the elderly. The optimum CAPS scoring was TSEV45.

• Anxiety and mood
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• v.8 no.2
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• pp.106-112
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• 2012

Objective : In posttraumatic stress disorder (PTSD), it is essential to evaluate the severity of trauma with a reliable instrument. The combat exposure scale (CES) is one of the most widely used measures for the combat-related trauma. The present study was conducted to test the reliability and validity of the Korean version of CES (CES-K). Methods : One hundred and forty-five male Korean veterans of the Vietnam War participated in this study. CES-K, the structured clinical interview for DSM-III-R (SCID), clinician administered PTSD scale (CAPS), and the Korean version life events checklist (LEC-K) were administered. Results : Cronbach's coefficient of CES-K was .85, and the test-retest reliability was .94. The mean [standard deviation (SD)] scores of CES-K were 20.4 (9.0) in the PTSD group and 12.0 (8.6) in the non-PTSD group (p<.001). CES-K showed a significant correlation with LEC-K (r=.31, p<.001) and CAPS (r=.52, p<.001). Only one factor was revealed by the factor analysis. Conclusion : CES-K showed good reliability and validity for assessing the severity of combat exposure. Further, it demonstrated comparable psychometric properties to the previous study. It is expected that CES-K will be a useful tool for evaluating the severity of combat exposure in Korea.

• Journal of Digital Convergence
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• v.13 no.5
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• pp.297-307
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• 2015

This study reviews equipped with enhanced capability of medical care, quality service, accessibility, and consumer awareness to be a competitive and representative local healthcare service provider with improved administrative efficiency. The method of analysis are ANOVA and Structural Equation Modeling. The results which revealed the significant difference among demographic factors in determining the preference or degree of satisfaction at medical service to select local healthcare institutions suggest that the close review on the needs of groups of major customers of local healthcare institutions are necessary when preparing the strategy of specialized medical service of local healthcare institutions. this suggests that both images would be important factors to secure the competitive advantage of local healthcare institution and therefore the strategy maximized the enhancement of medical service with embossed image of hospital to attract customers of medical service is needed.

• Korea Journal of Hospital Management
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• v.9 no.4
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• pp.45-69
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• 2004

The purpose of this study is to identify the nature of the inpatient service quality of national university hospital, and based on that, to examine the relationship of hospital inpatient's perceived quality, overall satisfaction, customer loyalty(intention of revisiting, intention of oral transmitting). To carry out these objectives, first we analyzed the dimensions of inpatient care service quality using SERVQUAL scale. The SERVQUAL scale is based on the gap theory, that is, the difference of patients' expectations and the actually received medical care service in hospital. On the basis of this theory, we measured the inpatient's perceived service quality, overall patient satisfaction and customer loyalty. Data were collected by self-administered questionnaires at a 809 bed national university hospital. These questionnaires measuring the service quality were distributed to 400 inpatients. The data samples are 347 cases in final. The response rate was 86.8%. Firstly, to categorize inpatient service quality in hospital, the factor analysis was performed on 48 items. The reliability and validity of these items was evaluated. Finally to explore the relationship of service quality, overall satisfaction, and customer loyalty, the multiple regression and logistic regression analysis are used. This study shows firstly, the dimension of inpatient service quality was categorized into 7 dimensions, that is, kindness, medical service, nurse caring, environment, facilities, appropriateness and access. Secondly, the reliability and validity of inpatient service quality items was satisfied. Thirdly, as a result of multiple regression analysis, the effect of inpatient's perceived service quality, especially, nurse caring(P<0.01), environment (P<0.01), facilities, appropriateness and access variables(P<0.05), on overall satisfaction was statistically significant. Lastly, in case of the effect on customer loyalty as a intension of oral transmitting, medical service(P<0.05), environment(P<0.01) and overall satisfaction(P<0.01) are statistically significant. Also, in case of intension of revisiting, medical service, environment, access, and overall satisfaction variables are significant factors. In conclusion, to maintain the satisfaction and customer loyalty on national university hospitals, the efforts to improve the inpatient service quality, especially, environment, medical service, and access factors might be needed.

• Health Policy and Management
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• v.30 no.1
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• pp.72-81
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• 2020

Background: The out-of-pocket maximum is one of the distinctive healthcare systems which sets a ceiling on co-payment in order to reduce the burden of households from the unpredictable medical expenditure. However, this leads to an increase in the demand for healthcare services especially in long-term care hospitals (LTCHs) in Korea. Methods: This study analyzed the influence factor of medical service overuse of 165,592 inpatients in LTCHs which out-of-pocket maximum is applied, by utilizing data from the National Health Insurance Service (2016). Based on Anderson Model, the medical service overuse, as a dependent variable, was defined as long-stay admission more than 180 days at the LTCHs. Independent variable was comprised of predisposing factors (gender, age), enabling factors (income level, types of out-of-pocket maximum) and need factors (illness level, patient use of tertiary hospital). Results: The most powerful factor of medical service overuse in LTCHs was availability of pre-payment for the out-of-maximum (odds ratio [OR], 191.66; p<0.001). This tendency was found in high income level status (p<0.001). Furthermore, mild inpatients (OR, 1.50; p<0.001) which had no experience with the tertiary hospitals (OR, 2.06; p<0.001) were more relevant to the medical service overuse in LTCHs, compared to the severe inpatients. Conclusion: It is suggested that a separate standard of out-of pocket maximum with regards to LTCHs is required to secure the beneficial functions of long-term hospitals and prevent unnecessary financial leakage to achieve sustainable and financially sound National Health Insurance.

• Research in Community and Public Health Nursing
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• v.25 no.3
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• pp.159-169
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• 2014

Purpose: The purpose of this study was to evaluate the effectiveness of case management for patients with hypertension on their health status and medical service utilization. Methods: This study was a secondary analysis of data collected for a larger study of chronic disease management in 2008 using the National Health Insurance Corporation database. A total of 12,944 patients who received case management for hypertension were included in this analysis. The subjects of case management were classified into subgroups, namely, over-use, under-use, and non-use groups according to the amount of medical service utilization. To compare the medical service utilization, a control group was selected randomly. The data were analyzed through descriptive statistics, McNemar test, and ANOVA. Results: All the subgroups displayed significant differences in blood pressure, self-management, social support, and their characteristics of medical service utilization. The total medical expense of the under-use and non-use groups increased after case management. However, there was no decrease in the medical expense of the over-use group. Conclusion: This finding suggests that there is a need to re-examine why patients overuse medical services and to supplement specific strategies for encouraging appropriate medical service utilization, and enhancing case management efforts for the over-use group.

• Korean Journal of Clinical Pharmacy
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• v.20 no.1
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• pp.17-23
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• 2010

Aprepitant is a substance P/neurokinin-1 (NK1)-receptor antagonist that was approved in 2003 for prevention of CINV. In addition, updated anti-emetic guidelines that include the aprepitant regimen have been published by NCCN and ASCO. However there is scarce clinical data in Korea. The prospective study was performed to evaluate the prevention of high dose cisplatin induced nausea and vomiting in all patients who started high-dose cisplatin-based chemotherapy at our hospital. We checked the nausea severity and vomiting episodes by calling patients within 4 to 5 days after chemotherapy. The retrospective study was performed to compare the prevention of CINV in solid tumor patients who switched their anti-emesis regimen from the standard regimen to the aprepitant regimen. In aprepitant regimen, aprepitant was added to the same anti-emetic regimen used during previous cycles. We checked the nausea, vomiting grades and adverse events in electronic medical records (EMR). In prospective study, 195 patients were included in the analysis. 88.2% of patients achieved a complete response (no emesis and no rescue therapy). In retrospective study, 54 patients were reviewed. With aprepitant regimen, nausea and vomiting grades were improved in 22 patients (40.7%) and in 9 patients (16.7%), respectively. Compared with standard regimen, addition of aprepitant provided superior prevention against CINV in Korean patients receiving highly emetogenic cisplatin-based chemotherapy. Moreover, aprepitant significantly prevented CINV in patients who received the standard regimen to prevent CINV in previous chemotherapy cycles.