• Title/Summary/Keyword: policy measure

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Developing a Hospital-Wide All-Cause Risk-Standardized Readmission Measure Using Administrative Claims Data in Korea: Methodological Explorations and Implications (건강보험 청구자료를 이용한 일반 질 지표로서의 위험도 표준화 재입원율 산출: 방법론적 탐색과 시사점)

  • Kim, Myunghwa;Kim, Hongsoo;Hwang, Soo-Hee
    • Health Policy and Management
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    • v.25 no.3
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    • pp.197-206
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    • 2015
  • Background: The purpose of this study was to propose a method for developing a measure of hospital-wide all-cause risk-standardized readmissions using administrative claims data in Korea and to discuss further considerations in the refinement and implementation of the readmission measure. Methods: By adapting the methodology of the United States Center for Medicare & Medicaid Services for creating a 30-day readmission measure, we developed a 6-step approach for generating a comparable measure using Korean datasets. Using the 2010 Korean National Health Insurance (NHI) claims data as the development dataset, hierarchical regression models were fitted to calculate a hospital-wide all-cause risk-standardized readmission measure. Six regression models were fitted to calculate the readmission rates of six clinical condition groups, respectively and a single, weighted, overall readmission rate was calculated from the readmission rates of these subgroups. Lastly, the case mix differences among hospitals were risk-adjusted using patient-level comorbidity variables. The model was validated using the 2009 NHI claims data as the validation dataset. Results: The unadjusted, hospital-wide all-cause readmission rate was 13.37%, and the adjusted risk-standardized rate was 10.90%, varying by hospital type. The highest risk-standardized readmission rate was in hospitals (11.43%), followed by general hospitals (9.40%) and tertiary hospitals (7.04%). Conclusion: The newly developed, hospital-wide all-cause readmission measure can be used in quality and performance evaluations of hospitals in Korea. Needed are further methodological refinements of the readmission measures and also strategies to implement the measure as a hospital performance indicator.

An Evaluation Framework for Defense Informatization Policy

  • Jung, Hosang;Lee, Sangho
    • Journal of Multimedia Information System
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    • v.7 no.1
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    • pp.73-86
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    • 2020
  • The well-known sentence, "You can't manage what you don't measure" suggests the importance of measurement. The Ministry of National Defense (MND) in Korea is measuring the effort of informatization for various dimensions such as validity, adequacy, and effectiveness using the MND evaluation system to obtain positive and significant effects from informatization. MND views the defense informatization domain as divided into the defense informatization policy, the defense informatization project, and the defense informatization level, which can measure the informatization capability of the MND and the armed forces or organizations. Furthermore, it feels there is some limitation, such as those related to ambiguity and reliability, present in the system. To overcome the limitations in the existing system to evaluate the defense informatization policy, this study proposes a revised evaluation framework for the policy of defense informatization, its indicators, and measurement methods.

Development and Adjustment of Indicators for Underserved Area (분야별 의료 취약지 선정지표 개발 및 적용)

  • Kwak, Mi Young;Lee, Tae Ho;Hong, Hyeon Seok;Na, Baeg Ju;Kim, Yoon
    • Health Policy and Management
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    • v.26 no.4
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    • pp.315-324
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    • 2016
  • Underserved area is a region that has a lack of healthcare resources. In the context of Korea, however, there are not enough detailed criteria for underserved areas. In this study, we aimed to develop indicators for underserved area through Delphi technique. We systematically reviewed the existing measure of underserved area. Sixty indicators were extracted as candidates across four domains in secondary medical care. Four domains are demand, medical resource, quality of care, and health outcome. To develop indicator, two round Delphi survey was conducted among 15 professional experts such as professionals and public administrators. In conclusion, 2 final indicators (accessibility, medical utilization) was determined as an appropriate measure in order to designate underserved area for secondary medical services. Using our criteria from Delphi technique, 36 areas were found as underserved areas for the secondary medical care.

Study on the ICU Nurses' Intention to Use Restraints and Related Factors (중환자실 간호사의 억제대 사용의도와 관련 요인에 관한 연구)

  • 박명화;이병숙
    • Health Policy and Management
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    • v.8 no.2
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    • pp.191-215
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    • 1998
  • This descriptive correlational study was done to identify ICU nurses' intention to use restraints and related factors using Ajzen and Madden(1986)'s Theory of Planned Behavior. Self-reported questionnaires were used to measure intention and related factors. The subjects of this study were 287 ICU nurses in 21 general hospitals with at least 200 beds at Taegu, Pusan and Kyungbuk area in Korea. The results of this study were : 1. There were significant differences in intention according to age and marnital status, attitude according to educastion(with indirect measure), subjective norm according to career in ICU(with both measures), perceived behavioral control according to age and career in ICU(with direct measure), and knowledge according to education and position. 2. There were significant correlations among intention and all factors. Intention was correlated with attitude(r=.2119), subjective norm(r=.1112), and perceived behavioral control(r=.3448) with direct measure. Attitude was correlated with subjective norm(r=.2530), perceived behavioral control(r=.3005), and knowledge(r=.1388) with direct measure. Subjective norm was correlated with perceived behavioral control(r=.1321) with direct measure. Intention was correlated with attitude(r=.1496) and perceived behavioral control(r=.2922) with indirect measure. Attitude was correlated with subjectivenorm(r=.2829) and knowledge(r=-.1390) with indirect measure. Also, subjective norm was correlated with perceived behavioral control(r=.2363) with indirect measure. 3. ICU nurses' intention to use restraints was explained 16.7% by perceived behavioral control, attitude with direct measure, control belief, and age. By this study, it was foundr that ICU nurses reported high level of intention to use restraints. The most important predictor of intention to use restraints was perceived behavioral control toward using restrains, which reflected the easiness and difficulty in the use of restraints.

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A Study on the Performance Measure for Recoverable Item Control (수리 가능한 부품통제를 위한 성능측정수단에 관한 연구)

  • 김지승;김병극
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.19 no.40
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    • pp.23-28
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    • 1996
  • This paper deals with performance measures for recoverable item control where the demand process is time-dependent. The performance measure is essential for modelling a multi-echelon inventory problem for repairable items. Most repairable items are expensive and have a great influence on the performance of equipments. Thus the information on these items is very useful to the decision maker. The purpose of this paper is to derive the system performance measure and the part(component) performance measure considering a cannibalization policy under the dynamic environment.

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The Cost Effectiveness Analysis of Health Promotion Policy: WHO-CHOICE Programme (WHO-CHOICE 프로그램: 건강증진정책의 비용효과분석 도구)

  • Oh, In-Hwan;Yoon, Seok-Jun
    • Korean Journal of Health Education and Promotion
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    • v.28 no.2
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    • pp.41-50
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    • 2011
  • Objectives: Objectives: The objective of this study is to describe the WHO-CHOICE(World Health Organization- CHOosing Interventions that are Cost-Effective) programme, and to consider the application of WHO-CHOICE programme in Korea, especially on the health promotion policy. Methods: Literature review was conducted on the contents of WHO-CHOICE programme in the previous studies, guidebook, and software. We also contacted WHO-CHOICE team at WHO to identify the contents not clearly presented in the documents. Results: The WHO-CHOICE programme is a standardized tool for analyzing and comparing the cost effectiveness of health promotion policies. It is composed of PopMod to measure the health effect of intervention and of CostIt to measure the cost. The cost of tobacco control policy in Korea was analyzed with the cooperation of WHO-CHOICE team preliminary, and the results were different with the results of tobacco control policy on western pacific region of WHO. Conclusions: The cost effectiveness study based on WHO-CHOICE programme could help decide a priority of health promotion policy for settings with limited resources. For the improvement of health, the future work on WHO-CHOICE programme need to be considered.

An International Comparison of R&D Efficiency: DEA Approach

  • Lee, Hak-Yeon;Park, Yong-Tae
    • Journal of Technology Innovation
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    • v.13 no.2
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    • pp.207-222
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    • 2005
  • A prerequisite for making R&D more productive is to able to measure its productivity. Most of the previous studies on this topic have attempted to measure R&D productivity at the firm or industry levels. In this study, however, R&D productivity is measured at the national level to provide R&D policy implications, particularly for Asian countries. Contrary to the previous studies where total factor productivity was adopted, this study employs the data envelopment analysis (DEA) approach to measure R&D productivity. DEA is a multi-factor productivity analysis model for measuring the relative efficiency of each Decision Making Unit (DMU). In addition to the basic DEA model that includes all inputs and outputs, five additional models are constructed by combining single input with all outputs and single output with all inputs in order to measure specialized R&D efficiency. In this study, the twenty-seven countries are classified into four clusters based on the output-specialized R&D efficiency: inventors, merchandisers, academicians, and duds. Then, the characteristics of the Asian countries with respect to R&D efficiency are identified. It is found that Singapore ranks high in total efficiency, and Japan in patent-oriented efficiency. Meanwhile, China, Korea, and Taiwan are found to be relatively inefficient in R&D. We expect that the findings from this study will be able to provide directions for R&D policy-making of the Asian countries.

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Measuring the Degree of Integration into the Global Production Network by the Decomposition of Gross Output and Imports: Korea 1970-2018

  • KIM, DONGSEOK
    • KDI Journal of Economic Policy
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    • v.43 no.3
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    • pp.33-53
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    • 2021
  • The import content of exports (ICE) is defined as the amount of foreign input embodied in one unit of export, and it has been used as a measure of the degree of integration into the global production network. In this paper, we suggest an alternative measure based on the decomposition of gross output and imports into the contributions of final demand terms. This measure considers the manner in which a country manages its domestic production base (gross output) and utilizes the foreign sector (imports) simultaneously and can thus be regarded as a more comprehensive measure than ICE. Korea's input-output tables in 1970-2018 are used in this paper. These tables were rearranged according to the same 26-industry classification so that these measures can be computed with time-series continuity and so that the results can be interpreted clearly. The results obtained in this paper are based on extended time-series data and are expected to be reliable and robust. The suggested indicators were applied to these tables, and, based on the results we conclude that the overall importance of the global economy in Korea's economic strategy has risen and that the degree of Korea's integration into the global production network increased over the entire period. This paper also shows that ICE incorrectly measures the movement of the degree of integration into the global production network in some periods.

Equity in urban households' out-of-pocket payments for health care (도시가계 의료비 지출의 형평성)

  • Lee Weon Young
    • Health Policy and Management
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    • v.15 no.1
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    • pp.30-56
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    • 2005
  • This paper used two threshold approaches to measure the equity in urban households' out-of-pocket payments for health care from 1997 to 2002, which developed by Wagstaff and van Doorslaer. One approach used catastrophic health expenditure, which means that payments exceed a 'pre-specified proportion' of total consumption expenditures or ability to pay and the other used impoverishment that they did not drive households into poverty. Indicies for 'catastrophic expenditure' captured intensity as well as its incidence and also the degree of which catastrophic payments occur disproportionately among poor households. Measure of poverty impact also captured both intensity and incidence. The methods applied with data on out-of-pocket payments from the Urban Household Expenditure Survey Incidence and intensity of catastrophic payments - both in terms of total household consumption as well as ability to pay - increased between 1997 and 2002, and that both incidence and intensity of 'catastrophic expenditure' became less concentrated among the poor, but more concentrated in 2001 than in 1997. The incidence and intensity of the poverty impact of out-of-pocket payments increased between 1997 and 2002. Health security system may not have provided financial protection against catastrophic health expenditure to low-income households, because of high user fee policy not considering income level. The policies alleviating catastrophic health payments among the poor need to be more developed, and two threshold approaches further evaluated on our policy context.