• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.4
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• pp.340-350
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• 2016

The Medical Service Act of Korea describes a clinic as providing services primarily to outpatients, while a large general hospital provides specialized medical services requiring a high level of expertise for treating serious diseases. The portion of medical revenue for clinics has been decreasing gradually compared with large hospitals. This article proposes two fundamental medical policies to fix the distorted medical delivery system of Korea. Firstly, uniform additional medical remuneration rates based on the type of medial institution should be divided into outpatient additional rates and inpatient additional rates. Secondly, to normalize the function of clinics and large general hospitals, an outpatient medical target budget system should be introduced. Finally, to properly implement the proposal, it is important to establish healthcare policy-making governance. The success of policy implementation strongly depends on the participation and incentives of the government, suppliers, and patients. Healthcare policy-making governance must be designed to encompass this fact and improve quality of care.

• Health Policy and Management
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• v.21 no.1
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• pp.23-43
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• 2011

Access to health care is complicated to define. It is a multidimensional process. In addition to the matters of quality of care, geographical accessibility and availability of the right type of care, finance, and acceptability are all involved. The purposes of this paper are to measure the geographic distances between patient residency locations and health service organizations in which the patients hadvisited, and to investigate the association between geographical distance measures and variables involved in health service utilization. The study used the first and the second wave of the 2008 Korea Health Panel Survey. The samples of analyses were patients who had visited outpatient or used ambulatory health services, and the total observations (visit numbers) analyzed were 229,128. We divided the samples into a frequent-visit illness group (Group 1) and a non-frequent visit illness group (Group 2) based on over 5,000 total visit numbers. We exploited three level analyses using xtmixed of STATA${\Box}$ 11.1 command with/without interaction terms among age, sex, and occupation. Geographical distances were measured using the Haversine method. Group 1 was tended to older and lower equivalent income than those of Group 2, but the geographic difference were not observed in terms of area deprivation index and standard mortality ratios. Amongst group 1, diabetes mellitus patients travelled far to visit health care organizations, and arthritis patients were more deprived in terms of the personal and areal characteristics. The study revealed that residents in rural areas traveled about 10 times more long distances than those whom lived in larger cities after adjusting for various variables, which we used for analyses. This study contributed to the practical understanding of health service utilizations using empirical analyses, and found that the types of diseases and socioeconomic characteristics of patients tended to define the amount of travel distance to healthcare organizations.

• The Journal of Korean Medicine
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• v.36 no.3
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• pp.98-110
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• 2015

Objectives: The purpose of this study was to analyze the medical cost of facial paralysis in payer perspective and to estimate the practice pattern of patient using 2011 Health Insurance Review & Assessment Service-National Patients Sample(HIRA-NPS). Methods: Basic statistical system was used for descriptive analysis of NPS dataset. A table for general information (table20) was extracted by disease code, and social demographic characteristics, distribution of the use among inpatients and outpatients, utilization of each kind of medical care institutions, medical cost were analyzed. Subgroup analysis was conducted for assuming the practice pattern of korean medicine and western medicine. Results: A total of 8,219 people and 64,345 claims data were identified as having facial paralysis. Proportion of outpatient was 95.23%, inpatient 0.84% and patient using both services 3.93%. Mean patient charges was 44,229 won per outpatient, 178,886 won per inpatient and 523,542 won per patient using both services. Utilization of korean medical care institutions was 68.81%(claims), 40.46%(patients), utilization of western medical care institutions was 31.19%(claims), 59.54%(patients). The amount charged by korean medical care institutions was 52.61% and western medical care institutions was 47.39%. Cost per claim was higher than those of the korean treatment and cost per patient of western treatment was lower than those of the korean treatment. Conclusions: The research assessed the medical cost and practice pattern associated with facial paralysis. These findings could be used in health care policy and subsequent studies.

• Health Policy and Management
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• v.32 no.2
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• pp.205-215
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• 2022

Background: The purpose of this study is to identify the factors infecting the medical care utilization from a new perspective by newly classifying the categories of administrative districts using the urban decline index and medical vulnerability index as indicators. Methods: This study targeted 150,940 people who used medical services using the 2015 cohort database (DB), 2010-2015 urban regeneration analysis index DB, and 2014-2015 public health and medical statistics DB. The decline of the region was classified using the urban decline index typed using k-means clustering and the medical vulnerability index typed using the quantile score calculation. Regression analysis was performed 3 times with medical expenditure, length of stay, and the number of outpatient visits as dependent variables. Results: There were 37 stable region (47.4%), 29 health vulnerable region (37.2%), and 12 decline region (15.4%). The health vulnerable region had lower medical expenditure, fewer outpatient visits, and a higher length of stay than the stable region. The decline region was all higher than the stable region but had no significant effect. Conclusion: The factors that cause the health disparity between regions are not only factors related to individual health behavior but also environmental factors of the local community. Therefore, there is a need for a systematic alternative that properly considers the resources within the community and reflects the characteristics of the population.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.12
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• pp.8820-8829
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• 2015

While medical services are recognized to be crucial in a process of disease treatment, the research has been done with the service space and waiting time in a medical institution. This paper's objective is to evaluate the waiting areas of lobby, outpatient clinic, operating room in a general hospital and to draw factors of architecture design for further improvement, identifying strengths and weaknesses to be analyzed in terms of medical service. Research method is to define concepts of waiting time through literature review and advanced researches, analyze characteristics of architectural plan through drawing analysis and site survey. This research will contribute to the improvements of the planning methods which will reduce the waiting time and increase the quality of medical service.

• Health Policy and Management
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• v.19 no.3
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• pp.125-141
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• 2009

The purpose of this study was to examine the role of provider practice patterns in the difference in health expenditure between the two types of patients: Health Insurance and Medical Aid type 1. The study used the outpatient claim data for all Medicaid and health insurance patients of hypertension who received medical services from 8,454 primary care physicians during the first half of 2006. The data were stratified by patient's gender and age for the two groups of patients who received care from the same physician. The dependent variables were the differences in medical expenditure per case, patient days per case and medical expenditure per patient day between Medicaid patients and health insurance patients. Empirical results showed that physician characteristics, such as physicians under age 50, greater proportion of pediatric Medicaid patients, lower proportion of new Medicaid patients and the greater number of comorbidity of Medicaid patients are associated with the greater difference between the two types of patients (i.e., greater expenditure of Medicaid patients relative to health insurance patients). This study shows that factors associated with provider practice patterns need to be taken into account in Medicaid policy.

• The Korean Journal of Health Service Management
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• v.6 no.1
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• pp.77-86
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• 2012

Objective of the study represents experiences of medical utilization of Psychiatric Outpatients. This research draws on information obtained from the 2008 National-wide sampling study of the Korean Healthcare Panel(KHP) conducted. The results of our study suggest the significance of variables such as the gender(p<.001) in the social demographical characteristics, the medical security type(p<.016), medical institution utilization(p<.012) treatment type(p<.004) in the utilization factors. In the case of medical utilization cost, the financial support factor(p<.018) showed a significant relationship. Depending on the particularities of gender, medical security type, financial support, medical institution utilization, treatment type were determined through a multiple logistics regression analysis. Gender showed that, among Psychiatric outpatient age of 30-59 level was 5.358 times and 60 years and older, their the second medical examination level was 4.490 times higher than Psychiatric outpatients under the age of 29. Health insurance type showed for the others medical allowance was 6.712 times higher than job health insurance and the other treatment was 0.395 times lower than drug treatment. Psychiatric outpatients utilization are rooted in the thoughts and factor levels of the Psychiatric patients and must be understood from the Psychiatric outpatients's perspective. The point is not only to gauge the patients research during Psychiatric medical utilization. The important of social community mental healthcare services levels goes beyond the goal of enhancing healthcare.

• Korea Journal of Hospital Management
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• v.8 no.1
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• pp.81-94
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• 2003

This paper aims at developing a prediction model and analyzing a sensitivity for the outpatient's overall satisfaction on utilizing hospital services by using data mining techniques within the context of customer satisfaction. From a total of 900 outpatient cases, 80 percent were randomly selected as the training group and the other 20 percent as the validation group. Cases in the training group were used in the development of the CHAID and Neural Networks. The validation group was used to test the performance of these models. The major findings may be summarized as follows: the CHAID provided six useful predictors - satisfaction with treatment level, satisfaction with healthcare facilities and equipments, satisfaction with registration service, awareness of hospital reputation, satisfaction with staffs courtesy and responsiveness, and satisfaction with nurses kindness. The prediction accuracy rates based on MLP (77.90%) is superior to RBF (76.80%).

• Korea Journal of Hospital Management
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• v.10 no.2
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• pp.26-44
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• 2005

The purpose of this study was to investigate these major factors on patient satisfaction, and to examine the affecting level of major factors in. The subjects in this study was 70 hospitals that were surveyed the hospital evaluation program containing the survey of patient satisfaction by KHIDI(Korea Health Industry Development Institute) from 1997 to 1999. The collected data was analysed SPSS for Windows(Ver 10.0). On basically, frequency analysis, t-test, and ANOVA was performed and, for more analysis, correlation analysis, factor analysis, multiple regression analysis, logistic regression analysis was utilized. According to this study, the major factors of inpatient satisfaction are divided 3 types facility factor, manpower factor, and service factor. And the major factors of outpatient satisfaction are analyzed 5 types; facility factor related direct medical service, facility factor related indirect medical services, manpower factor, pharmacy factor, and facility factor related utilization convenience. The importance of this study lies in the identification of major factors on hospital patient satisfaction.

• Proceedings of the Korean Institute of Interior Design Conference
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• 2005.05a
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• pp.203-206
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• 2005

Recently, it is not to much to say that the world of hospital architecture in Korea is in a time of transition that undergo big changes. Each hospital pursues their transformation not only for patiences' changing demands on medical services but to cope with rapid environmental changes that pouring like boundless competition, opening tendency and to get an advantage of competition to attract patiences with other hospitals. It is because national expectations and standards on medical services have risen and they are not satisfied with hospitals that run for doctors and medical care that served technically any more. With rising interests in health, it is emphasized not the functions of hospitals to prevent diseases but the purpose of treatment and securing other facilities according to rising economical incomes except medical facilities.